This document discusses the career path of pre-hospital emergency medicine (PHEM). It defines PHEM as working in emergency medical systems to provide pre-hospital emergency care using equipment to support rescue, extrication, and safe patient transfer. The training curriculum involves phases from basic to consultant level practice over 6-12 months and includes national courses and region-specific training. Trainees gain experience through case loads working on ambulances, at events, and in trauma units. Those interested can start by taking courses, volunteering, or attending educational events while considering future jobs in fields like helicopter emergency medical services, retrieval, ambulance services, expedition medicine, and police work.

1. Why should I have a career in Pre-
Hospital Emergency Medicine?
Dr Zoë Smeed
ST6 Pre-Hospital and Emergency Medicine
Junior Doctors Conference
23/04/2016

2. Aims/Objectives
● What is PHEM?
● Where can I do it?
● Training Curriculum
● Case load
● What can I do now?
● Jobs for the future

3. What is PHEM?

6. Pre-hospital
Medical Practice
1. Working in
Emergency Medical
Systems
2. Providing pre-
hospital Emergency
Medical Care
3. Using pre-
hospital equipment
4. Supporting
rescue and
extrication
5. Supporting safe
patient transfer
6. Supporting
emergency
preparedness and
response
A. GOOD
MEDICAL
PRACTICE
B. CLINICAL
GOVERNANCE
C. TEAM
RESOURCE
MANAGEMENT
D.
OPERATIONAL
PRACTICE
What is PHEM?

7. Consultant practitioner level / Specialist (CCT/CESR)
Advanced practitioner level / Specialty trainee level (ST4-6)
Intermediate practitioner level / Core trainee level (CT1-3)
Assistant Practitioner level / Foundation level (FY1)
Basic Practitioner level / Foundation level (FY2)
4
5
6
7
8

8. Consultant level practice
● Complex decision making (scene, transportation)
● Skills – PHEA, sedation, analgesics, MUA
● Medication – critical care drugs, infusions
● Organ specific support
● Multi-cas/MI Mx
● Monitoring/near pt testing/US
● Advice

9. www.ibtphem.org.uk

10. • East of England
• NE &C London
• North
• South West Severn
• Wales
• West Midlands
• Yorkshire & Humber
Approved Training Programmes

11. Entry requirements - essential
• Emergency Medicine
• Anaesthetics
• Intensive Care Medicine
• Acute Medicine
NTN or post CCT in
● Successful ST4 ARCP
● 6 months EM in a training
post
● 6 months Anaesthetics in
a training post
● ATLS, ALS and APLS
provider status
● Ambulance service fitness
test
● National recruitment
(Oct)

12. 12 months WTE over 24
months
6 months 50% PHEM
phase 1 post, 50% core
CCT
6 months 50% PHEM
phase 1 post, 50% core
CCT
6 months 50% PHEM
phase 2 post, 50% core
CCT
6 months 50% PHEM
phase 2 post, 50% Core
CCT
6 months F/T PHEM
phase 1 post
6 months F/T Core CCT
6 months F/T PHEM
phase 2 post
6 months F/T Core CCT
12 months WTE
over 12 months
6 months F/T PHEM
phase 1 post
6 months F/T PHEM
phase 2 post
A
B
C
Schemes

13. Initial
1a
Development
1b
Consolidation
2
Training Programme

14. National
Summative
Assessment
2
National
Summative
Assessment
1
Continuous Formative Assessment within training programmes
Phase 1 Local
Formative
Assessment
Phase 1 Educational
Review and STR
Training
Assessment Panel
Initial
Educational
Review
PHASE 2
(six months WTE consolidation
training)
PHASE 1
(1 month WTE initial and 5 months WTE
development training)

15. National Training Course

16. Region Specific Training

17. National Training Days
● O & G and neonatal
● Cardiac Arrest
● Silver (Tactical) Command Course
● CBRN
● Paediatrics
● Ultrasound and analgesia
● Bariatrics and ballistics

18. Case Load

19. What can I do now?
● Courses
- BASICS Scotland
- PHTLS
● Educational events
- Cambridge University Pre-hospital Forum
● Volunteer
- St Johns Ambulance/Red Cross

20. Sporting events

21. Local events

22. Johannesburg Hospital Trauma Unit

23. Robin Mitchell Travel Fellowship - Norway

24. Jobs for the future?
● HEMS
● Retrieval
● Ambulance service
● Expedition medicine
● Remote and rural – oil rigs, expedition medicine,
airline
● Police medic

25. Any Questions?
www.ibtphem.org.uk