ACEM Curriculum Revision Project – Time to revise your exam plans

CRP: Not just a useless blood test!
Many of you would now know that ACEM is redesigning the training program, which will change the way your progress through ED training is monitored and assessed.  Perhaps most notably will be changes to the Fellowship Exam structure.  In a statement released just over a week ago, (which you can access here) the College gave a clear update on the planned changes, which (apart from containing the seemingly mandatory photos of the very good looking Registrars and Consultants at Southern Health in the pdf’s!) has all of the documents you should read if you are starting your ED training, or are planning on sitting the Fellowship Exam in the next 2-3 years.

Some of the proposed changes over the next few years include:

  • Changes to the Primary Exam – aready implemented
  • Changes to the Fellowship Exam, including:
    • Improved MCQ’s: increased clinical relevance and possible replacement with other formats like EMQ’s
    • Removal of VAQ and SAQ sections and replacement with other “more feasible and clinically applied forms of assessment” (not defined)
    • Long and Short cases removed and replaced with improved/expanded SCE’s
    • SCE’s may include elements such as:
      • Simulation
      • Standardised patients
      • Assessment of non-technical skills
    • SCE’s may focus on asessment of:
      • Teaching skills
      • Health Advocacy skills
      • Critical Research Literature Appraisal & Application of EBM
  • Implementation of:
    • Online learning portfolio
    • the dreaded WBA’s – Workplace Based Assessments

Like any big change in any organisation, there will no doubt be hiccups, a few people who get upset and (hopefully) fewer still who are screwed over by the process.  Having said that I believe that on the whole these changes are for the better, and reflect the current extremely pro-active stance of the College.

Some of the benefits will be:

  • A clearer set of standards/objectives for your training – which will force your hospitals to provide you with the required training/skill acquisition. This may sound silly, but I and many of my Consultant colleagues got through without ever doing or being taught certain procedures or skills, which is a big deficiency of the current system.
  • A more standardised and therefore (theoretically) fairer exit exam
  • A focus on teaching FACEMs actual teaching skills.  One of my main gripes with medical specialty training is that we are taught by people with no teaching qualifications.  ACEM is trying to rectify this, which should hopefully make your Consultants better clinical teachers.

Some of the downsides are:

  • WBA’s: these will create even more forms to fill out, and if I could quote an eminent British Emergency Physician who spoke at the ACEM Conference in Syndey last year about WBA’s: “we just glanced at them, and as long as they weren’t filled out in crayon, or didn’t look like thier mum had filled them out, we just passed them”.  This refers to the extreme volume of paperwork created for Consultants by implementaiton of WBA’s, and the lack of scrutiny they may undergo, so hopefully ACEM will bear this in mind.
  • Those caught up in the transition phase may find it hard to have clear exam study goals a year or so in advance, which is the time required to prepare for the Fellowship Exam.

Of course I’ll try and keep you up to speed with the changes as they are implemented.  There will now be new exam preparation techniques, new study methods, and I predict some new exam preparation courses that you can attend, but I encourage you to sit down with your DEMT’s soon and talk about your exam plans, even if it’s 2-3 years away, keep a close eye on the CRP section of the ACEM website for updates, and be strategic about when you sit the exam.

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