ACCS: Induction

Right.  You are about to start CT1, either in acute medicine or EM.

You are undoubtedly going to have to fill out about 20 forms, and go to a hospital induction during which you’ll be told about diversity and fire procedures, but you won’t get access to the blood reporting system, PACs or a computer log on.  All that is going to do is p*ss you off, and it will not help you in any measurable way.  If you want to make progress do this…

Do these in week 1:

  1.  Find out the identity of your educational supervisor, and clinical supervisor.  Schedule a meeting with both of them.
  2. Gain access to eportfolio for EM.  This requires you to send £90 to Royal College of Emergency Medicine.  Yes it’s extortion.  No it’s not fair.  Just do it.
  3. Find out what heap of assessments you will need to provide at the end of the year, your deanery should publish a checklist of what they want.  If they don’t use the version from here, (I’ll be going into more detail soon).
  4. Start keeping a list/book of interesting cases.  In that book write down a list of all clinical problems you need to cover.
  5. Write a development plan, the following things should be in it, there is no reason why you can use the same development plan for your ES and CS.
    1. Courses
      1. Life support courses, do them, get instructor potential for them.
      2. USS level 1
      3. USS vascular access
    2. Vague stuff
      1. Improve management of emergencies
      2. Improve team working and communication skills
      3. Develop history taking and examination skills
      4. Develop bedside and formal teaching skills
    3. Stuff related to training in ED
      1. Sit MCEM part 1, or A, or whatever the hell its going to be called.  Aim to do the first bit.
      2. You need to do an audit.  Just because.

At the first meeting do the following.  This is your checklist.

  1.  Make sure you know what your ES/CS is expecting from you at work.
  2. Bring food/coffee to that meeting
  3. Get an assessment while you are there.  Bring a case.  Anything.
  4. Get your ES or CS to help you decide on a topic to audit
  5. Get any A/L and S/L forms signed for the next 6 months.
  6. Set the date for another meeting in 4 weeks time.
    1. This is so you can check progress, come with a tranche of further assessments AND discuss your audit.

The Rota.

You ideally need to meet your CS and ES after you’ve got a handle on the rota.  The rota will be horrible.  Every ED rota is horrible.  I am sorry.  So sorry.  It get’s better the more senior you become. I promise.

  1. Take EVERY second of annual leave you are entitled to.
    1. Yes, even odd days here and there where you have nothing planned.
  2. CHECK what you are entitled to in terms of bank holiday lieu days.  ED rotas often ignore them, but sometimes don’t give you days in lieu for working them.  So check.
  3. Book things to look forward to.  As complex as holidays, as simple as meeting someone for a coffee.  Make these a priority OVER audit, OVER portfolio, OVER revision.
  4. Your training is a marathon, it is not a sprint, it’s okay to stay late occasionally if stuff is going on that will benefit you, but make sure you leave on time, the majority of the time.  Giving the trust or the department an extra 2 or 3 hours a shift is not on.  This means being present at handover on time, and handing stuff over (my wife will roll her eyes at this point as I am very very bad at this, however I recognise it’s important).
  5. Giving handovers mean you have to have happy to receive handovers as well, so accept them with a (sometimes fake) smile.


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