Skip to main content

Acute Care Common Stem (ACCS)

Doctor with laptop

Acute care common stem (ACCS) is a three year multi-disciplinary training programme. It is the most common route of entry into emergency medicine and is an alternative core training programme for trainees wishing to enter higher specialty training in general/acute internal medicine, anaesthesia or intensive care medicine.

If you have a hankering to work in a dynamic acute speciality, this is the ideal start to your training. Ideally suited to those who plan a career in an acute hospital, it provides a solid base of experience and skills that will be developed further in whichever speciality you choose.

You will gain structured experience in the skills needed to rapidly assess and appropriately treat sick and injured patients, and take these skills forward through your training.

This three year training scheme comprises six month attachments in emergency medicine (EM), acute medicine (AM), anaesthesia and intensive care medicine leading to a career in one of these specialities. In the third year, a post is provided according to the chosen parent specialty.

The hospitals providing ACCS schemes are:

  • Morriston Hospital Swansea ACCS EM and anaesthetics
  • Nevill Hall Hospital, Abergavenny ACCS EM and anaesthetics
  • Prince Charles Hospital, Merthyr Tydfil ACCS EM
  • Princess of Wales Hospital Bridgend ACCS EM
  • Royal Gwent Hospital, Newport ACCS AM, EM and anaesthetics
  • University Hospital of Wales, Cardiff ACCS EM and anaesthetics
  • Wrexham Maelor Hospital ACCS AM, EM and anaesthetics
  • Ysbyty Gwynedd Hospital, Bangor ACCS EM and anaesthetics

You will remain in the same hospital for the first two years and therefore will be able to use this to develop your understanding of how care of the sick patient is organised and dealt with throughout the hospital. This will enable you to communicate and understand the difficulties encountered by different areas in dealing with an acutely ill patient.

ACCS anaesthetics trainees complete the three years in the same site.

For ACCS AM there is a south Wales rotation which involves three years in Newport and a north Wales rotation which rotates between Wrexham for CT1-2 and Bangor for CT3.

ACCS EM rotate to a different site for their ST3 year. This is usually to a department with a consultant with sub-specialty paediatrc emergency medicine accreditation. In north Wales this involves a six week secondment to Alderhey.

Application to ACCS is through your chosen parent speciality via national recruitment - you cannot apply for ACCS on its own. The specialities offering ACCS as an option in their training programme are anaesthesia, medicine and emergency medicine (accident and emergency medicine).

What next?

Following completion of ACCS training, trainees can apply for higher specialist training:

Anaesthesia - If your parent specialty is anaesthesia, you will be eligible to apply for an ST3 anaesthesia post at the end of your three years in ACCS. You will need to have passed the primary FRCA exam.

Emergency medicine - If your parent specialty is emergency medicine, you may have chosen run- through training. If you choose core training only you will be eligible to apply for an ST4 emergency medicine post at the end of your three years in ACCS. You will need to have passed the Primary and Intermediate exams.

Acute medicine - If your parent specialty is AM, you will be eligible to apply for an ST3 Medicine (specialist) post at the end of your three years in ACCS. You will need to have passed the MRCP exam.

Intensive care medicine - Following completion of the ACCS scheme, you will be eligible to apply for an ST3 intensive care medicine post. You will need to have passed either MRCP, primary and intermediate FRCEM or primary FRCA exam.