CCP-AEM FRCEM PROGRAMME

• MBBS with Full MRCEM OR CCP-EM from LGEM
• Doctors with Full FRCEM may also apply if they wish to gain further clinical and practical exposure in Emergency Medicine

Duration: 2 Years

Programme Outline:

240 hours of advanced emergency medicine teaching delivered by NHS UK Consultants.

Programme Delivery:

• 60% Online
• 40% On-site, face-to-face

Online Sessions:

Delivered at weekends, consisting of 1-hour live lectures on Saturdays and Sundays.

Face-to-Face Sessions:

Delivered as full-day workshops over 6 days:

• 3 Days: 50 Advanced Emergency Medicine Procedures, including HALO (High Acuity Low Occurrence Procedures)
• 2 Days: FRCEM OSCE (Face-to-Face)
• 1 Day: Advanced EM Ultrasound

Successful candidates will be awarded a:

Certificate of Completion in Advanced Emergency Medicine

• Covering the entire RCEM curriculum delivered to UK trainees at ST4–ST7 levels
• Inclusive of 50 Advanced EM Procedures and Advanced EM Ultrasound Certification

Programme Outcomes:

• Mastery of consultant-level competencies in clinical and non-clinical domains
• Completion of a comprehensive, authenticated e-portfolio
• Preparation for FRCEM Final OSCE and SBA examinations
• Eligibility for senior and consultant-level emergency medicine roles in the NHS and globally
• Development of advanced leadership, education, and governance skills
• Recognition as an EM physician trained to international consultant standards

For Pakistani Trainees: £2,400 (£100/month for 24 months)

For International Trainees: £4,800 (£200/month for 24 months)

As an EM consultant, one must have a strong grasp of non-clinical and administrative responsibilities, including:

1. Leading the department
2. Managing staffing
3. Conducting interviews and recruitment
4. Responding to complaints
5. Investigating serious incidents
6. Responding to Datix reports
7. Implementing new pathways
8. Improving services
9. Conducting quality improvement projects
10. Performing audits, research, and developing departmental policies
11. Supervising and inducting juniors and new trainees
12. Managing rotas
13. Handling staff sickness and absences
14. Overseeing clinical governance
15. Supporting trainees or doctors in difficulty
16. Acting as educational and clinical supervisors
17. Completing “Train the Trainer” certification
18. Managing exit blocks and bed crises in the department
19. Prioritising effectively on busy clinical days
20. Applying the concept of an ED consultant tray on high-demand days
21. Addressing serious ethical, personal, or professional misconduct
22. Managing colleagues with alcohol or drug misuse issues
23. Liaising with police in the department
24. Managing prisoners or serious offenders in the department
25. Handling complex mental health patients who lack capacity and pose risks to staff
26. Managing children with suspected non-accidental injuries
27. Safeguarding adults and elderly patients, addressing neglect and abuse
28. Understanding the role of the ED physician when patients present with weapons
29. Managing frequent attenders (“frequent flyers”)
30. Organising teaching activities, including simulations
31. Serving as an interview panellist for ACCS and ST training programmes
32. Becoming involved in education and training with Royal Colleges, including stepping up as an OSCE examiner
33. Resolving conflicts with colleagues, patients, relatives, and carers
34. Managing major incidents within the department
35. Preparing the department to deal with city-wide major incidents (e.g., riots, terrorism)
36. Navigating appraisal, revalidation, and fitness-to-practise processes
37. Developing key pathways for service improvement
38. Having coaching conversations with juniors to support their development
39. Applying effective teaching methodologies
40. Conducting debriefs after challenging cases and critically ill patients
41. Chairing or conducting departmental meetings
42. Practising reflective learning
43. Understanding hospital structures and operations
44. Leading the department effectively during a declared major incident

This module will equip candidates with the ability to critically evaluate medical literature and apply evidence-based principles in practice. Key areas include:

1. How to appraise and summarise a paper
2. Understanding p-values
3. Identifying conflicts of interest and bias
4. Differentiating trial types: observational vs. interventional studies
5. Understanding study designs: RCTs, case-control, cohort, cross-sectional, systematic reviews, meta-analyses
6. Assessing validity, reliability, and applicability of research
7. Study methodology and ethical considerations
8. Evaluating outcomes and their clinical impact
9. Assessing consistency of results with existing evidence
10. Key statistics and interpretation:

• Types of data (categorical, continuous)
• Central tendency (mean, median, mode)
• Variability (standard deviation, range, IQR)
• Confidence intervals, p-values, statistical significance
• Sensitivity, specificity, PPV, NPV, likelihood ratios
• ARR, RRR, NNT

1. Bias and confounding:

• Types (selection, information, recall, etc.)
• Impact of confounding factors
• Strategies to minimise bias (randomisation, blinding, matching)

1. Diagnostic and screening tests:

• Sensitivity and specificity
• ROC curves and AUC
• Impact of screening on patient outcomes

1. Levels of evidence and hierarchies (e.g., GRADE system)
2. Clinical trial phases (I–IV), protocols, ethics, and regulations
3. Common statistical tests: t-tests, chi-square, ANOVA, regression, non-parametric (Mann–Whitney U, etc.)
4. Interpretation of graphs and tables: forest plots, funnel plots, Kaplan–Meier curves
5. Risk and odds ratios: relative risk, odds ratio, hazard ratio — when to apply each
6. Case reviews and case reports

1. FRCEM Final SBA Comprehensive Teaching
2. FRCEM Final OSCE Training – Online sessions plus face-to-face mock examinations.

50 Advance Emergency Medicine Procedures For EM Specialists & Consultants.

Difficult Airway Procedures:

1. Difficult Intubation/Failed Intubation 

2. Surgical Airway In Can’t Intubate Can’t Ventilate Situations

3. Video Assisted Endotracheal Intubation 

4. Rapid Sequence Induction & Intubation In Acutely Unwell Medical patient 

5. Rapid Sequence Induction & Intubation In Head injury patient .

6. Rapid Sequence Induction & Intubation In Suspected Cervical Spine Injury patients. 

7. Intubation Challenge Encountered During Advance Pregnancy. 

8. Paediatric Intubation 

9. Intubation In Neonate 

10. Endotracheal Intubation With Difficult colleague or incompetent team.

Advance EM Procedures For Breathing:

11. Noninvasive Ventilation BIPEP

12. Bilateral Thorocostomies

13. Securing A Chest Drain

14. Erector Spinae Block For Flial Chest & Multiple ribs fracture .

15. Serratus Anterior Nerve Block for chest drain insertion 

16. Setting Up Ventilator In ED 

17. Setting up Oxylog Portable Ventilator for critical transfer.

Advance EM Procedures For Circulation:

18. DC Cardioversion In Refractory or Unstable SVT & VT 

19. Safe Defibrillation In Shockable Rhythm

20. Ultrasound Guided vascular access 

21. Ultrasound guided Central line 

22. Echo In Life Support 

23. Pericardiocentesis

24. Resuscitative Thoracotomy

25.  Inotropic support in patient with septic shock 

26. Inotropic support in patient with heamorrhagic shock 

27. Active Rewarming In Hypothermic Cardiac Arrest & Peri Arrest Bladder and peritoneal lavage 

28. Leading A cardiac arrest and special and complex circumstances.

29. Insertion of Arterial line. ultrasound guided .

Opthalomogical Procedures:

30. Lateral Canthotomy For Retrobulbar Haematoma. 

Advance EM CNS Procedures:

31. Emergency Assessment Of Stroke Patient NIH Stroke Scoring In ED

32. Neuro Protective measures in patient with traumatic brain injury

33. Stroke Thrombolysis in ED 

34. Lumbar Puncture 

35. Assessment of Spinal Injuries 

36. Examination of back in patient with potential cord compression 

37. Neuro Examination of Upper limb

38. Neuro Examination of Lower Limb

39. Cervical Spine injuries and clearance of C Spine 

40. Intra Osseus Access at Tibia, Humerus & Femur 

Regional Nerve Blocks:

41. Ankle blocks 

42. Supra orbital Blocks 

43. Auricular Block 

44. Penile block

45. Median Nerve Block 

46. Scalene Nerve block .

Advance Gyane Obs Procedure In ED:

47. Spontaneous vaginal delivery & Placental separation Role Of EM Physician

48. Manual Manoeuvres to deal with Breech, face and shoulder dystocia 

49. Antenatal Examination in patient with minor injuries and advance pregnancy 

50. Peri Partum C Section In parri arrest and cardiac arrest situations.

The clinical component ensures candidates achieve proficiency in core consultant-level competencies, including:

• Recognition and management of critically ill patients
• Advanced decision-making in complex medical, surgical, trauma, and paediatric cases
• Senior-level leadership in multi-disciplinary teams
• Advanced risk management and patient safety practices
• Ethical and legal responsibilities in high-pressure clinical environments

This module focuses on advanced knowledge and leadership in resuscitation and critical care scenarios.

Topics include:

1. Leading a cardiac arrest in complex circumstances
2. Peri-arrest recognition and management
3. Post-cardiac arrest care, including targeted temperature management
4. Advanced airway management and decision-making
5. Management of cardiac arrhythmias and complex ECG interpretation
6. Advanced management of septic shock and refractory sepsis
7. Polytrauma resuscitation, including damage-control resuscitation principles
8. Major haemorrhage protocol leadership
9. Advanced management of burns and inhalational injuries
10. Management of toxicological emergencies and antidote use
11. Advanced ventilatory strategies in ED (e.g., ARDS management, non-invasive vs invasive ventilation)
12. Management of paediatric resuscitation in complex cases
13. Management of obstetric emergencies, including maternal collapse
14. Advanced simulation training in cardiac arrest, trauma, paediatric, and obstetric scenarios
15. Incorporating human factors and CRM (Crisis Resource Management) into resuscitation leadership

Candidates will undergo structured ultrasound training aligned with RCEM and international standards. This includes:

• FAST & E-FAST for trauma assessment
• Cardiac ultrasound (basic echocardiography in ED)
• Aortic scanning for AAA
• DVT ultrasound
• Thoracic ultrasound for pleural effusions, pneumothorax, pulmonary oedema
• Abdominal scanning for free fluid and organ pathology
• Vascular access ultrasound for line placements
• Ocular ultrasound
• Paediatric ultrasound applications

At the end of training, participants will receive an Advanced EM Ultrasound Certification, validated and signed by FRCEM-qualified consultants.