title: Where did the acute medical trainees go? A review of the career pathways of acute care common stem acute medical trainees in London.
abstract: Acute care common stem acute medicine (ACCS AM) training was designed to develop competent multi-skilled acute physicians to manage patients with multimorbidity from 'door to discharge' in an era of increasing acute hospital admissions. Recent surveys by the Royal College of Physicians have suggested that acute medical specialties are proving less attractive to trainees. However, data on the career pathways taken by trainees completing core acute medical training has been lacking. Using London as a region with a 100% fill rate for its ACCS AM training programme, this study showed only 14% of trainees go on to higher specialty training in acute internal medicine and a further 10% to pursue higher medical specialty training with dual accreditation with internal medicine. 16% of trainees switched from ACCS AM to emergency medicine or anaesthetics during core ACCS training, and intensive care medicine proved to be the most popular career choice for ACCS AM trainees (21%). The ACCS AM training programme therefore does not appear to be providing what it was set out to do and this paper discusses the potential causes and effects.
authors.affiliation: School of Medicine, Health Education England, London, UK emily.gowland@nwl.hee.nhs.uk.
authors.forename: Emily
authors.initials: E
authors.lastname: Gowland
authors.affiliation: School of Medicine, Health Education England, London, UK.
authors.forename: Karen Le
authors.initials: KL
authors.lastname: Ball
authors.affiliation: School of Medicine, Health Education England, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bryant
authors.affiliation: School of Medicine, Health Education England, London, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Birns
mesh_terms: D002321:Career Choice; D004503:Education, Medical, Graduate; D004635:Emergency Medicine / Q000193:education / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D010820:Physicians / Q000706:statistics & numerical data*; D000078329:Workforce
keywords: Acute care common stem; acute internal medicine; acute medicine; core medical training; training pathway