Information for prospective trainees

---

There are two routes to be coming a PEM physician, ‘The ED route’ or ‘The Paediatric route’.
 
Both end at the same destination – becoming recognized as a PEM specialist – but each route offers different opportunities and unless you plan to do dual fellowship, it is worth considering where and how you want to spend your time when you become a specialist before you sign up.
 
For some this is fairly straightforward. For example, those choosing ‘The Paediatric route’ have the option to specialise in PEM and General Paediatrics. So, if you wish to spend some of your time seeing children in a ward or clinic setting then this would be the way to go.  Alternatively, if you wish to only work in an ED setting and also manage adult patients then ‘The ED route’ is the most efficient path.
 
For those wishing to work only in PEM it is a little more challenging.  As a general rule (although this does vary from hospital to hospital), if you want to work in a mixed emergency department then you need to go down ‘the ED route’ or obtain dual fellowship. 

The ED Route 

Parent college
​Australian College of Emergency Medicine (ACEM)

Qualification Obtained
​FACEM with letter from PEM joint training committee or if you choose to complete extra paediatric requirements, dual fellowship

Opportunities
​As a FACEM you are qualified in both adult and paediatric emergency medicine and can work in any emergency department

Entry Requirements
Must be an advanced trainee of ACEM which entails

• 24months basic training (i.e. intern/SHO years)
• 12months of provisional training in an adult/mixed ED
• Passing ACEM primary exams 

Time ​
​Minimum 4yrs full time equivalent

Assessments/Minimum requirements for training completion

• Work based assessments
• Fellowship examination
• Trainee Research Requirement

The Paediatric Route

Parent college
Royal Australasian College of Physicians​

Qualification Obtained
FRACP with letter from PEM joint training committee or if you choose to complete extra ED requirements, dual fellowship

Opportunities
As a FRACP PEM you are qualified in paediatric emergency medicine and as a general rule can work only in designated paediatric emergency departments (although this is hospital dependent). You have the option to complete additional training to also specialize in General Paediatrics.

Entry Requirements 
Must be an advanced trainee of RACP which entails:

• 36 months basic training in paediatrics
• FRACP part 1 exams 
  
• Current medical registration
  
• Appointment to an appropriate advanced training position

Time ​
Minimum 3yrs full time equivalent​

Assessments/Minimum requirements for training completion

• Work based assessments
• Research requirement
• Log book (Adult EM procedures)
• APLS course
• Development and psychosocial training

Dual Fellowship

Some PEM specialists choose to obtain fellowship of both ACEM and RACP. This may be in order to gain further experience or improve their job opportunities. 
 
The path to dual fellowship involves completing ‘Stage 2’ of training via one route (Fellowship of one college with a letter from the PEM training committee) before joining the second college and meeting further training requirements.​ More information about the requirements for dual fellowship can be found here.

Stories by the PEM Crew

“I chose the RACP pathway to pursue my PEM training, as I was convinced that I needed a solid grounding in general paediatrics. Perhaps this was because of my developmental background in speech pathology (my former career), and my awareness that understanding the child in health and illness was important to my becoming the best doctor I could be; perhaps because my early post graduate years were spent at the RCH Brisbane, which had embraced and encouraged me and helped me to develop in my junior years.
Despite my late start (commencing medical school at 36) and advancing age (hehehe!) I was a SLOW stream trainee as I graduated Med school with a 1 year old and a 9 year old. I was privileged to work in a job share capacity for the first 10 years of my training and secured a role at the then Royal Children’s Hospital, Brisbane, from my JHO year, remaining there for 10 years.  I am very grateful that I chose the pathway I did – I feel I had a well-established paediatric foundation on which to build my emergency skills. I fulfilled the RACP college’s requirements for PEM and found myself at the proverbial fork in the road. I had 12 months to complete my general paeds training or I could extend my Emergency skills and undertake a Fellowship through the Emergency college. The defining moment came when a trusted colleague asked me “So do you want to be a General Paediatrician?” I knew the answer to this was a resounding No (no disrespect intended!). The second challenge that I experienced was the potential for employment –I was 53 at this time and knew I needed to get myself sorted in order to secure a job that would be fulfilling and allow me to hone my skills before it was time for me to retire! I used to joke that I needed to complete my training before I died! Job opportunities at that time were limited for RACP PEM only physicians with most Emergency departments “FACEM lead” – I needed another string to my bow! That made my career plan easy –to pursue my FACEM.  This was no easy task in my 50s –I vividly remember working as a registrar in a very busy adult emergency department having not seen an adult for almost a decade – the learning curve was steep but not unachievable and I always felt supported by my colleagues. My training pathway was serendipitous – I was not strategic, I didn’t have a mentor, I really just wrote my own ending! So here I am, dually fellowshipped –RACP PEM and FACEM. My story continues and I look forward to where this amazing area of paediatric emergency will take me. Let the adventure continue!”

​Dr. Faye Jordan

FRACP PEM and FACEM

---

“Even as a medical student I knew that I wanted to specialise in Emergency Medicine – I loved the variety, the challenge of the undifferentiated patient and the adrenaline rush of resuscitation. I also knew that Paediatrics terrified me and that this was something I was going to have to combat if I wanted a career in Emergency. So I challenged myself and completed a rotation in Paediatrics as a JHO. It was a huge surprise to find that I actually really enjoyed it.
After moving to Australia and working in ED for 18months I signed up to start my ACEM training. I soon came to realise that seeing children was consistently the highlight of my working day. I looked for every opportunity to learn more about managing sick children and after completing my Provisional training I joined the joint training program for PEM.
My next rotation – 12months of Paediatric Emergency Medicine at the state Children’s Hospital – cemented this decision; I met my crew, discovered my passion and have never looked back."

Dr. Danielle Scarfe

FACEM PEM

RETURN

Information from ACEM (www.acem.org.au) and RACP (www.racp.edu.au) websites, September 2021
Whilst we will make every effort to ensure this information is accurate and up to date, please let us know if you discover any inaccuracies