CRP & Fellowship Exam Update from ACEM2012 in Hobart

I was lucky enough to get down to Hobart last week for the annual ACEM Annual Scientific Meeting.  Overall it was an excellent conference, with a great range of speakers and topics, and a fantastic social program culminating in a night at MONA.  Michelle Johnston (@Eleytherius) has written an excellent synopsis of the coference at Life In The Fast Lane, which you can read here.

Of relevance to EDExam readers however were two sessions that I attended. Firstly the session on the Curriculum Revision Project, and secondly was a presentation by Simon Craig, who presented the results of a survey of factors associated with Fellowship Exam success, which yielded some surprising results (which I’ll cover in a separate post).

Curriculum Revision Project Session

Presented by CRP project leads, and attended by ACEM President Sally McCarthy, this was a packed “standing-room only” session, reflecting the keen interest of conference attendees in this important subject, and the session actually ran about 40 minutes into the lunch break, due to some passionate discussion and debate in the question time.

Apart from the already published exam format changes, other important aspects of the CRP were presented, including:

  • ACEM has conducted analysis of the impact of the CRP on all affected groups, from medical students, through all ranks of junior doctors/Registrars, Consultants, DEMT’s and ED Directors so as to ensure that all views are taken into consideration.
  • Regarding implementation of changes: 18 months notice will be given with general information for major changes, and 9 months notice with specific/detailed information prior to implementation.
  • Workplace Based Assessments are a very controversial subject.  In the question time, serious concerns were raised about WBA’s, with possible negative implications including:
    • ED Consultants don’t have time to manage their current clinical workload, especially in the face of the 4-hour rule, so adding new supervision/feedback duties, with specific, high-stakes assessment requirements is not feasible for those working on the floor.
    • There is overwhelming pressure to provide pass marks for all WBA’s for all registrars, as the fallout from failing someone in a WBA is massive, and can include complaints, dispute resolution/mediation processes and even legal action. This “pressure to pass” is seen by many as a major downfall of WBA’s.
    • A counter argument was raised that each WBA should be of lower stakes, (possibly achieved by increasing the numbers of WBA’s… groan) so that failing one or two is not only acceptable, but expected, and that one or two fails won’t adversely affect one’s progress through training.
    • A recurrent theme was that many FACEMs aren’t interested in teaching or assessment. Many just want to come to work, do their clinical shifts and go home.  From what I understood, the College’s argument was that teaching and assesment are actually core skills of being a FACEM, and that it will actually be part of your future job requirements.  Personally I have grave concerns about forcing people to do things they lack interest or formal training in, and have no skills in (analagous to the 4.10 issue, and the clear fact that most people aren’t interested in doing research, as evidenced by the small numbers actually doing formal research for their 4.10 since the introduction of the alternative pathways).  ACEM is providing teacher/assessor training for FACEMs, but the utility of this will be hard to quantify, and while we all know that being taught by people with no teaching skills, (how nearly everyone of the current medical generation has been taught), is bad, we won’t know how good the new system will be until it’s trialled.

Despite the many criticisims of the CRP, (and there were many!), one thing that stood out was the enormous amount of work and thought that’s being put into this process, so while various aspects of it  may seem flawed in may people’s opinions, rest assured that no change will be made without serious analysis.

As mentioned in my previous post, those planning on sitting the Fellowship exam in the next year or two need to pay close attention to the CRP changes, bookmark the ACEM website and monitor CRP updates closely, liaise frequntly with your DEMT and any ACEM Examiners you know, and make sure that everyone in your study group is up to speed with the changes.  I’ll endeavour to keep you updated as well, as the new exam formats will require new study and preparation techniques.

 

Coming soon… Simon Craig’s Presentation at ACEM 2012 on a survey which looked at specific factors associated with Fellowship Exam success.

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