North Western Deanery

ACCS provides trainees with an interest in acute specialties with initial training in acute medicine, anaesthesia, emergency medicine and intensive care medicine. The North Western Deanery ACCS training programme is a programme of two years' duration (CT1 and CT2), and will provide six months' training in each of the aforementioned specialties.

General internal medicine (acute medicine)

The specialty of general internal medicine (GIM) has one six-month post per rotation. GIM training will be based upon the curriculum of the Federation of the Royal Colleges of Physicians, 'the physician of tomorrow: curriculum for general internal medicine (acute medicine)'. The aim of the GIM component of the rotation is to deliver training that allows the trainee to achieve the Level 1 competences defined in the curriculum.

Anaesthetics

The anaesthetic component of the acute common stem is provided at a number of hospitals in the North West, which have been chosen at trusts where anaesthetic and intensive care training has been of a consistently high standard. The posts will be for a period of six months.

Emergency medicine comprises of 16 CT1 posts of the ACCS rotation. During their time in this post, trainees will be exposed to all aspects of emergency medical practice, and will be given a basic grounding in the knowledge and skills necessary for safe practice. The syllabus will be that leading to the membership of the college of emergency medicine.

Intensive care medicine

The objective of the intensive care medicine component of ACCS is to provide experience in the management of the critically ill patient, in a closely supervised environment. Successful candidates will be expected to complete the ICM core competences (as outlined by the intercollegiate board for training in intensive care medicine) during their attachment. Further details of these competences can be found on ICBTICM page of the Royal College of Anaesthetists' website.

Hospital training

ACCS training is offered in many of the hospitals within the Greater Manchester, Cumbria and Lancashire areas of the North Western Deanery. In most cases training in each of the four component specialties will be offered within the same trust, but where this is not possible, training will be in two trusts with geographical co-locations.

The three programme zones, while providing the same high standards, each offer differing flavours of training. There are four trusts with seven sites in Cumbria and Lancashire; four trusts and seven sites in Greater Manchester North & West; and six trusts and sites in Central Manchester South & East.

Successful applicants are asked to express a preference between the different training tracks, to suit individual interests and career plans. Allocation to tracks is on the basis of expressed preference and interview score.

Each zone has 24 training paths, involving six four-month placements. These placements will involve at least one year in the main medical sub-specialties (geriatric medicine [care of the elderly], chest medicine, endocrinology/diabetes, gastroenterology, and cardiology).

Each path will provide 16-20 months of acute medical experience, with at least eight months of unselected acute medical 'take'. The majority of trainees will be based in one site for each year of the programme.

Each training path will allow a sub-specialist training focus for at least one four-month placement. This will be either cardiology, haematology, intensive care, liver unit, neurology, oncology, renal medicine, rheumatology, specialist chest medicine, infectious diseases, or palliative medicine.

Zonal general (acute) medicine curriculum-based protected teaching programmes are in place for CT1 and CT2 trainees, building on the mature individual trust and multi-trust teaching programmes already in place.

There is an active and successful NW regional Royal College of Physicians programme of education, including teach-ins and training days; the NW Physicians MRCP Part I course, now in its seventh year, and also a successful NW PACES teaching course.

The Manchester medical school has recently undergone significant expansion, incorporating the use of problem-based learning. Junior hospital doctors, particularly in medicine, form an important group of the trainers at undergraduate level.

The University runs a regular programme of teaching the teachers, which CMT trainees are encouraged to attend. All trusts have an actively supported programme of audit; CMT trainees are expected to undertake audit and are actively supported to do so.

Research is also supported, with presentation of research at national and international meetings and publications of research achieved regularly by trainees in the trusts in the regional programme.

Further information is available here: http://www.nwpgmd.nhs.uk/node/559