Acute Care Common Stem (ACCS)

**2021 ACCS curriculum now available...>

Welcome to the national training website for the Acute Care Common Stem (ACCS) specialty training programme.

This website is intended to provide information and resources for current trainees and those looking to apply for ACCS training and is endorsed by the Intercollegiate Committee for Acute Care Common Stem Training.

As a new and growing training programme, ACCS is continually developing - as are the pages of this website. Please be aware that local deanery requirements may be different to those specified here which are based on the ACCS curriculum and current guidance. If in doubt please check with your Educational Supervisor.

ACCS Introduction
ACCS is a three year training programme that normally follows Foundation Year 2. It is the only Core training programme for trainees wishing to enter Higher specialty training in Emergency Medicine and is an alternative Core training programme for trainees wishing to enter Higher specialty training in Anaesthesia and any of the Specialties listed on the JRCPTB website. The first two years are spent rotating through Emergency Medicine (EM), Acute Internal Medicine, Anaesthetics and Intensive Care Medicine (ICM). The third year is spent in training that will ensure the trainee meets the minimum requirements for entry into Higher specialty training in their parent specialty (EM, JRCPTB Specialty, Anaesthetics and also ICM). The components of training in ACCS are:

  • 1 year Emergency Medicine + Acute Internal Medicine (usually 6 months each)
  • 1 year Anaesthesia + Intensive Care Medicine (usually 6 months each)

Aims of ACCS
The aim of ACCS training is to produce multi-competent junior doctors able to recognise and manage the sick patient and who have the complementary specialty training required for Higher specialty training in Emergency Medicine, JRCPTB specialty, Anaesthesia and Intensive Care Medicine.

Within the overall aim, each parent specialty has a specific objective for their ACCS trainees:

  • Acute Internal Medicine: ACCS is one of the training options available for delivering the core competencies required for a CCT in GIM, AIM or one of the JRCPTB specialties in a pre-planned and structured manner. The first two years of ACCS training (AIM, EM, Anaesthetics and ICM) are followed by a further year in AIM. This three year training programme fulfils the requirements for progression to Higher training in GIM, AIM or any of the JRCPTB specialties.
  • Emergency Medicine: ACCS constitutes the first three years of the CCT in EM in a pre-planned and structured manner. The first two years of ACCS training (EM, AIM, Anaesthetics and ICM) are followed by a further year gaining additional competences in adult EM (including musculoskeletal emergencies) and Paediatric Emergency Medicine; thus fulfilling the requirements to progress to Higher training in EM.
  • Anaesthesia: Anaesthetics offers career opportunities in a wide range of subspecialty areas all of which can be achieved by direct entry to an Anaesthetic CCT programme. However, those Anaesthetic trainees with an interest in the ‘acute’ end of the Anaesthetic spectrum will find ACCS an ideal career starting point. It provides trainees with more widely based experience than is available via the Core Anaesthesia programme. The first two years of ACCS training (AIM, EM, Anaesthetics and ICM) are followed by a third year spent gaining additional competences in Anaesthetics, thus fulfilling the requirements for progression to higher ST3.
  • Intensive Care Medicine: ACCS allows trainees who wish to obtain the single CCT in ICM or dual CCT in Acute Internal Medicine & ICM, Anaesthetics & ICM or Emergency Medicine & ICM, to obtain the competencies of the complementary specialties in a pre-planned and structured manner.
  • ACCS and the academic trainee: Trainees joining the ACCS programme may wish to pursue an academic career and have the opportunity to compete for academic training posts. This gives the successful trainee the opportunity to undertake an additional year of training specifically to prepare them for research. This will enable them to submit a research proposal which, if successful, will provide the funding to support their research before they enter Higher specialty training. When this year is undertaken will be determined locally and will typically involve attendance at taught courses covering such areas as critical analysis of scientific literature, information management, study design, basic statistical analysis, fraud, ethics and plagiarism, presentation skills, scientific writing and publishing skills. Trainees may have the opportunity to complete a Masters programme in research. The three years of clinical training within the ACCS programme has to be completed by these trainees. The clinical component is demanding and experience has shown that trainees need all this time to gain the knowledge skills and attitudes required and to be successful in the summative assessments. The overall clinical training time for these trainees should not be shortened.

During the ACCS programme, you must complete a portfolio of evidence in support of your achievement of the curriculum. As well as work place based assessments this should include a clinical log book; a record of educational, management, audit and clinical governance activities; relevant continuing professional development activities; a written record of your supervisors meetings and personal development plan. Details of these can be found across the relevant webpages.