MEM-EM: Memorising Emergency Medicine: The Emergency Medicine Portfolio Pathway to Specialist Registration in the UK

A Strategic Roadmap to Specialist Registration: The Emergency Medicine Portfolio Pathway

1.0 Introduction: Understanding the Portfolio Pathway

The Portfolio Pathway, formerly known as the Certificate of Eligibility for Specialist Registration (CESR), represents a demanding yet flexible alternative to the conventional Certificate of Completion of Training (CCT) for achieving specialist registration in Emergency Medicine. This strategic plan serves as a comprehensive, multi-year professional roadmap. Embarking on this journey requires exceptional organization, unwavering commitment, and meticulous strategic planning from the outset. It is a significant undertaking, comparable to a marathon, not a sprint, and should be approached with the gravity it deserves.

A fundamental shift in assessment standards, effective from November 30, 2023, has reframed the core objective of the application. The requirement has moved from demonstrating "full equivalence" to a UK CCT training program to a more holistic approach: proving the applicant has attained the essential Knowledge, Skills, and Experience (KSE) required to practice as a consultant in the UK. This change, guided by the 2021 Royal College of Emergency Medicine (RCEM) curriculum, places greater emphasis on high-level outcomes rather than tick-box equivalence.

This pathway offers considerable benefits for the right candidate. It allows for geographical stability, enabling doctors to establish their personal and professional lives in one location without the need for rotational training posts. It also affords the flexibility to develop skills and competencies at one's own pace, fitting the demands of evidence collection around personal and work circumstances. Success, however, is contingent on a robust and well-executed plan. This begins with a thorough self-assessment and foundational preparation to build a strong base for the journey ahead.

2.0 Phase 1: Foundational Assessment and Strategic Preparation

The initial phase of this roadmap is strategically critical. A comprehensive self-assessment of your professional standing and personal readiness, combined with a clear understanding of the process's scope and demands, is the most important first step. This foundational work prevents wasted effort, minimizes frustration, and ensures you are fully prepared for the long-term commitment required. Approaching the Portfolio Pathway without this groundwork is a common cause of failure; taking the time to plan now will pay significant dividends over the coming years.

2.1 Personal and Professional Readiness

Before committing to this multi-year process, an honest appraisal of your personal and professional circumstances is essential. The following factors are critical predictors of success:

Motivation and Ambition: You must have a clear, compelling reason for pursuing specialist registration. Whether for career progression, personal ambition, or the opportunity to lead and enact change, this underlying motivation will be the fuel that sustains you through the arduous task of compiling evidence.
Organizational Prowess: The Portfolio Pathway is a test of organizational skill as much as it is of clinical competence. You must be highly organized to manage the extensive, long-term evidence collection process, which can span several years and amount to over 1,000 pages of documentation.
Support System: A robust support network is non-negotiable. This includes securing a designated Educational Supervisor who understands the pathway and can provide mentorship and structured reports. Equally important is the support of your clinical leadership and consultant colleagues, who will be instrumental in providing assessments, references, and verification of evidence.
Employment Stability: Attempting the pathway as a full-time locum is strongly discouraged. The logistical challenges of obtaining consistent, high-quality, and verifiable evidence—particularly for governance, leadership, and quality improvement activities—across multiple, temporary sites are immense and can jeopardize an application. A stable post at a single trust is the recommended foundation.

Mentor's Note: A stable post is not just about logistics. Assessors look for evidence of sustained engagement in a department's governance and quality improvement. This is nearly impossible to demonstrate as a locum and is a hallmark of a consultant's practice.

2.2 Key Timelines, Costs, and Process Overview

Understanding the logistical framework of the application is key to effective planning. The journey from starting an application to receiving a final decision is a structured process with defined stages and associated costs.

Stage	Timeline	Key Details
GMC Application Start	Up to 1 year before submission	The application is initiated via the GMC Online portal. An advisor is assigned to provide guidance. No payment is due until the portfolio is ready for formal submission.
GMC Initial Review	30 days post-submission	The GMC conducts a quantitative assessment to ensure the minimum evidence standards are met. If required, the applicant has a further 30 days to submit additional evidence.
RCEM Qualitative Review	3 months	The RCEM performs a detailed qualitative assessment of the evidence against the curriculum. This stage includes gathering referee reports and verifying the authenticity of selected documents.
Unsuccessful Application	Up to 1 year for review	An unsuccessful applicant has up to one year to request a formal review. This involves submitting additional evidence to address the specific deficiencies identified in the initial report.
Associated Costs	N/A	Initial Submission: £1781. Review Application: Approximately £750. (Note: These costs are subject to change by the GMC and should be verified at the time of application).

With a clear understanding of the personal commitment and the logistical road ahead, the first major evidence-gathering task involves building the clinical bedrock of your portfolio: the core specialty placements.

3.0 Phase 2: Core Specialty Placements - Building the Foundational KSE

The core specialty placements are a cornerstone of the Portfolio Pathway and a frequent stumbling block for unprepared applicants. These out-of-department experiences are non-negotiable for demonstrating the breadth of Knowledge, Skills, and Experience (KSE) required of an independent Emergency Medicine consultant. They provide critical competencies in managing patients beyond the initial emergency department phase, and evidence of proficiency in these areas must be robust, current, and signed off by specialists from those respective fields. Planning and securing these placements should be a primary objective early in your journey.

3.1 Mandatory and Recommended Placements

Each core specialty has specific time and assessment requirements that must be met to satisfy the evaluators.

Anaesthetics: The indicative time period for attaining the relevant evidence is between 3 to 6 months (full time equivalent (FTE)) in a dedicated post. While 3 months is the minimum, a longer placement may be necessary to gather sufficient high-quality evidence. The provision of the Initial Assessment of Competence (IAC) including Entrustable Professional Activities (EPA) 1 and 2 is mandatory.
Intensive Care Medicine (ICM): The indicative time period is between 3 to 6 months (FTE) in a dedicated post. The provision of the Holistic Assessment of Learning Outcomes (HALO) in ICM and the Anaesthetics HALO in Sedation is mandatory.
Acute Medicine: While a dedicated placement is preferable to demonstrate an understanding of the patient journey beyond the ED, these competencies can be achieved from within the Emergency Department. However, you must provide evidence of at least 20 reflective case histories of medical cases, demonstrating in-depth learning and insight, ideally with assessments signed off by acute medicine consultants.
Paediatric Emergency Medicine (PEM): A placement of at least 3 months (FTE) is recommended. This should be in a dedicated Paediatric ED or a General ED with a high volume of paediatric patients (over 16,000 attendances per year). A minimum of 20 reflective case histories in PEM must be provided.

3.2 Evidencing Competence from Placements

Simply completing the time in a placement is insufficient. You must actively and prospectively collect high-quality evidence during these secondments. This is your opportunity to build a rich repository of proof that demonstrates your competence as assessed by experts in other fields. Key evidence includes:

Workplace Based Assessments (WPBAs) such as CbDs, Mini-CEXs, and DOPS, which must be signed by consultants in that specialty.
Detailed logbooks of all cases encountered, capturing the breadth and complexity of your experience.
Reflective case histories that go beyond simple summaries to demonstrate deep learning and critical thinking.

Once these foundational specialty blocks are in place, the focus shifts to compiling the comprehensive portfolio that demonstrates your capabilities across the full spectrum of the Emergency Medicine curriculum.

4.0 Phase 3: The Evidence Portfolio - Demonstrating KSE Against the 2021 Curriculum

The evidence portfolio is the heart of your application. This phase involves the systematic collection, curation, and organization of a comprehensive body of evidence—typically running between 800 and 1,000 pages—that substantiates your claim to possessing the KSE of a UK consultant. The entire portfolio must be meticulously structured against the 12 Specialty Learning Outcomes (SLOs) of the 2021 RCEM curriculum. A key organizational principle is to place evidence in the most logical SLO section and cross-reference it elsewhere; for example, all general reflective case histories should be placed under SLO 1, your 10 in-depth case studies under SLO 7, all DOPS under SLO 6, and all ESLEs under SLO 8.

4.1 Background and Employment Evidence

Before detailing clinical competence, you must provide a solid foundation of professional and administrative documentation. This evidence provides the context for your entire career and must be complete and accurate.

Curriculum Vitae (CV): Your CV must be up-to-date and adhere strictly to the format specified by the GMC.
Qualifications: This includes your Primary Medical Qualification (PMQ) and any Specialist Qualifications. Achieving the Fellowship of the Royal College of Emergency Medicine (FRCEM) is highly recommended.

Strategic Insight: While not mandatory, approaching this pathway without FRCEM is like choosing to climb a mountain in trainers instead of hiking boots. It is the single most effective piece of evidence to benchmark your knowledge against the curriculum, underpinning every single SLO and significantly reducing the burden of proof you must provide elsewhere.

Employment Documentation: You must provide contracts, job descriptions, and job plans for all posts held within the last 6 years.
Appraisals: Formal appraisal or revalidation documentation from the last 3 years of your practice is required.
Workload Statistics: Include both departmental and individual workload statistics for the last 6 years. This data should demonstrate the size and type of hospitals you have worked in, as well as the volume and range of your personal clinical work (e.g., resus, majors, minors, adults, paediatrics).

4.2 Structuring Evidence Against the 12 Specialty Learning Outcomes (SLOs)

All clinical and non-clinical evidence must be organized to demonstrate that you have met the key capabilities for each of the 12 SLOs. This structure is the architecture of your application, and each piece of evidence should be purposefully placed to support a specific capability. The following table provides representative examples for four of the SLOs, with the remaining eight detailed below.

SLO # and Title	Key Capabilities Summary	Suggested Evidence Types
SLO 1: Care for physiologically stable adult patients	Demonstrate expert assessment and management of all adult patients in the ED, covering both physical and psychological ill health.	• FRCEM or equivalent<br>• CbDs, Mini-CEXs, ACATs<br>• Reflective Case Histories<br>• Multi-Source Feedback (MSF)<br>• Personal annual caseload statistics
SLO 6: Deliver key procedural skills	Show the clinical knowledge to identify when procedures are indicated, the psychomotor skills to perform them safely, and the ability to supervise colleagues.	• FRCEM or equivalent<br>• DOPS (all DOPS should be placed here)<br>• Procedural Logbook<br>• Assessment of simulated practice<br>• ESLE<br>• Initial Assessment of Competence (IAC)
SLO 8: Lead the ED shift	Demonstrate the ability to support all ED staff, liaise with the wider hospital team, maintain situational awareness, and lead clinical decision-making throughout a shift.	• ESLEs (all ESLEs should be placed here)<br>• Multi-Source Feedback (MSF)
SLO 11: Participate in and promote activity to improve the quality and safety of patient care	Show clinical leadership in Quality Improvement (QI) work and the ability to support and develop a culture of departmental safety and clinical governance.	• Quality Improvement Assessment Tool (QIAT)<br>• Audit reports (demonstrating a full cycle)<br>• Evidence of attendance at governance meetings<br>• Guidelines produced<br>• Reflective diaries on QI work<br>• MCR, MSF

SLO 2: Support the ED team by answering clinical questions and making safe decisions

Key Capabilities: Support the entire ED team in making safe decisions for discharge or further management; know when remote versus direct review is appropriate; apply clinical guidelines effectively; understand the use of diagnostic tests and be aware of human factors in decision-making.
Suggested Evidence: FRCEM, CbD, ESLE, Reflective work on governance and decision-making, ACAT, MCR (AM), Mini-CEX, MSF.

SLO 3: Identify sick adult patients, be able to resuscitate and stabilise and know when it is appropriate to stop

Key Capabilities: Provide advanced airway and ventilatory support; demonstrate expertise in fluid and circulatory support; manage all life-threatening conditions, including peri-arrest situations; lead resuscitation teams effectively; and manage end-of-life care discussions with patients and relatives.
Suggested Evidence: FRCEM, ICM-related Reflective Case Histories, CbD, ESLE, Mini-CEX, MCR (AM), MSF, Reflection.

SLO 4: Care for acutely injured patients across the full range of complexity

Key Capabilities: Provide expert assessment and initial management for all injured patients; lead the Major Trauma Team; perform pre-operative assessment and optimisation; safely provide procedural sedation.
Suggested Evidence: FRCEM, Anaesthetics-related Reflective Case Histories, CbD, ESLE, Mini-CEX, MSF, IAC (including EPA 1 and 2), all Anaesthetic WPBAs.

SLO 5: Care for children of all ages in the ED, at all stages of development and children with complex needs

Key Capabilities: Be an expert in assessing and managing all children and young adults attending the ED, including presentations that could be manifestations of abuse; lead multidisciplinary paediatric resuscitations, including trauma; manage children with complex medical and social needs.
Suggested Evidence: FRCEM, Paediatric-related Reflective Case Histories (~20), Paediatric-related WPBAs, assessment of simulated practice, CbD, ESLE, Mini-CEX, MSF.

SLO 7: Deal with complex and challenging situations in the workplace

Key Capabilities: Use expert communication skills to negotiate and manage complicated interactions; behave professionally with colleagues inside and outside the ED.
Suggested Evidence: FRCEM, 10 in-depth reflective case studies (medico-legal, coroner, family liaison), assessment of simulated practice, CbD, ESLE, Mini-CEX, MCR.

SLO 9: Support, supervise and educate

Key Capabilities: Undertake training and supervision of the ED team; prepare and deliver teaching sessions (simulation, small-group, didactic); provide effective constructive feedback and debriefs; mentor and appraise junior doctors.
Suggested Evidence: FRCEM, MCR, MSF, Teaching Observation (TO), relevant courses (e.g., Training the Trainers), Educational Supervisor reports, ALS Instructor status, teaching timetables, lecture slides, feedback from learners, redacted WPBAs as an assessor.

SLO 10: Participate in research and managing data appropriately

Key Capabilities: Appraise, synthesise, and use research evidence to develop care; actively participate in research projects.
Suggested Evidence: MCR, MSF, Good Clinical Practice (GCP) certificate, evidence of participation in trials (e.g., delegation log), critical appraisals, research papers, publications, presentations, all CPD certificates and reflective logs.

SLO 12: Manage, Administer and Lead

Key Capabilities: Handle a complaint, prepare a medico-legal report (e.g., for a coroner); investigate a critical incident; manage a staff rota; effectively represent the ED at inter-specialty meetings.
Suggested Evidence: FRCEM, MSF, Management portfolio (including complaint management, critical incident investigation, rota examples, business cases), Educational Supervisor reports, evidence of leadership and service improvement.

4.3 High-Volume Evidence Requirements

Beyond the qualitative alignment with SLOs, the portfolio must meet specific quantitative benchmarks for key evidence types. These minimums are non-negotiable and demonstrate the required volume and consistency of your experience and assessments.

Workplace Based Assessments (WPBAs): A minimum of 36 WPBAs (12 Case-Based Discussions, 12 Direct Observation of Practical Procedures, 12 Mini-Clinical Evaluation Exercises). Note that this number is exclusive of the WPBAs collected during your core specialty placements.
Extended Supervised Learning Events (ESLEs): A minimum of 6 ESLEs from the last 3 years of practice. Critically, 3 of these must be from the last 12 months prior to submission.
Reflective Case Histories: A total of 150 cases collected over the last 3 years (50 cases per year). These must contain highly developed reflective entries that demonstrate mature learning.
In-depth Case Studies: A minimum of 10 detailed case studies demonstrating your management of complex clinical or managerial problems, such as those involving medico-legal issues, the coroner, or challenging family liaison.
Continuous Professional Development (CPD): A minimum of 50 hours per year for the last 3 years, supported by reflective notes and covering the breadth of the EM curriculum.
Mandatory Courses: You must hold in-date certificates for Advanced Life Support (ALS), Advanced Trauma Life Support (ATLS), Advanced Paediatric Life Support (APLS) (or recognised equivalents), Level 3 Safeguarding (Children), and Level 1 Ultrasound sign-off.

Spotting the Sick Child (online course) is also highly regarded by the assessors.

Having gathered the extensive body of evidence, the final challenge is to prepare it meticulously for submission, ensuring every technical and procedural requirement is met.

5.0 Phase 4: Application Logistics and Submission Strategy

The final phase of preparing your application is as critical as the quality of the evidence itself. Meticulous organization, strict adherence to the GMC's technical requirements, and a clear submission strategy are paramount. Even the strongest portfolio can be delayed or have evidence rejected if it is poorly prepared or fails to meet the specified formatting and verification rules.

5.1 Essential Tools and Resources

Several key tools and resources are invaluable for streamlining the compilation and submission process, saving significant time and preventing common errors.

RCEM e-Portfolio (Kaizen): This is an extremely valuable tool for a prospective applicant. It allows you to collect assessments electronically, organize your evidence online, and directly map individual items to the RCEM curriculum SLOs. While not mandatory, managing the process without it is significantly more difficult.
Adobe Pro (or similar PDF software): This software is a necessity, not a luxury. It is essential for combining multiple documents into single, logically grouped PDF files for upload. Most critically, its redaction tool is invaluable for performing the mandatory and thorough anonymisation of all patient-identifiable data.
Prospective Planning: The most effective strategy is to collect, scan, and organize evidence concurrently as you progress, rather than attempting to do so retrospectively. Searching through years of old emails and files to find and validate documents is an inefficient and often fruitless task.

5.2 The Submission Checklist

Use the following checklist to ensure your final submission package meets all GMC portal requirements.

[ ] File Formats: Ensure all documents are in one of the accepted formats: .doc, .pdf, .ppt, or .xls. Note that any multi-sheet Excel files must be converted to a single PDF document before uploading.
[ ] Document Grouping: Group related evidence into logical, single PDF files (e.g., all appraisals from one hospital, all CPD certificates for one year). This is crucial for staying within the upload limit (maximum 150 uploads).
[ ] Naming Convention: Use clear, concise document titles that exactly match your evidence pro-forma (e.g., "Appraisals 2021-2023 - University Hospital"). This makes it easier for evaluators to navigate your portfolio.
[ ] Anonymisation: Confirm that ALL patient-identifiable data has been thoroughly redacted from every single document. This is an essential and non-negotiable requirement; failure to do so will result in evidence being discounted.
[ ] Verification: Nominate a verifier (typically a consultant or medical director) for each institution from which you are submitting evidence. They will be contacted by the GMC to confirm the authenticity of your documents.
[ ] Referees: Secure a minimum of four referees who have agreed to provide a structured report. At least two must be Emergency Medicine consultants. It is strongly advised that at least two of your referees have conducted an ESLE with you in the 12 months prior to submission.
[ ] Cross-Referencing: Do not upload duplicate evidence. If a single document is relevant to multiple SLOs, upload it once and cross-reference it in the description fields of the other relevant sections.

With the technical submission process understood, the focus now turns to managing the personal, multi-year timeline required to bring this entire plan to fruition.

6.0 Crafting Your Personal Timeline: A Multi-Year Roadmap

The monumental task of gathering years of comprehensive evidence can feel overwhelming. The most effective way to manage this is to create a structured, multi-year timeline that breaks the process down into manageable annual and quarterly goals. This strategic roadmap provides clarity, ensures consistent progress, and transforms an intimidating mountain of requirements into a series of achievable steps.

The following table provides a sample three-year strategic timeline. This should be adapted to your individual circumstances, but it illustrates how to logically sequence the key objectives and evidence targets.

Year	Primary Focus	Key Objectives & Evidence Targets
Year 1	Building Foundational KSE & Out-of-Department Competence	- Secure and complete 3-month Anaesthetics & 3-month ICM placements. <br> - Achieve mandatory IAC and HALO assessments. <br> - Complete all required WPBAs for these placements, signed by specialty consultants. <br> - Begin logging reflective cases (Target: 50). <br> - Complete 2 ESLEs.
Year 2	Consolidating EM-Specific Evidence & Demonstrating Leadership	- Secure and complete recommended PEM placement and gather associated evidence. <br> - Focus on accumulating WPBAs across all 12 SLOs (Target: 18+ this year). <br> - Continue logging reflective cases (Target: 50). <br> - Lead on one Quality Improvement Project (QIP) and ensure the full audit cycle is completed and documented. <br> - Complete 2 additional ESLEs.
Year 3	Mastering Advanced SLOs & Finalizing Application	- Complete final 3 ESLEs (must be within the last 12 months). <br> - Finalize all WPBAs to meet the minimum of 36 (excluding specialty placements). <br> - Complete final 50 reflective cases and all 10 in-depth case studies. <br> - Collate Management Portfolio evidence (complaint, critical incident report). <br> - Ensure all life support courses are in date for submission. <br> - Finalize, anonymise, verify, and submit the full portfolio.

Adhering to a structured plan like this is essential, but it is equally important to be aware of the common pitfalls that can derail even the most organized applicant.

7.0 Critical Success Factors and Mitigating Common Pitfalls

The Portfolio Pathway is a complex and exacting process, but it is a well-trodden one. Success is eminently achievable by proactively adopting the best practices of those who have completed the journey and by actively mitigating the common challenges and mistakes that lead to unsuccessful applications. The collective wisdom gained from previous applicants and assessors provides a clear blueprint for what works and what does not.

The following table contrasts key strategies for a successful application with the most frequent reasons for failure. Use this as a final guide to ensure your preparation is robust and your final submission is as strong as possible.

Strategies for Success	Common Reasons for Failure
- Achieving FRCEM to provide a clear, summative benchmark of knowledge across the curriculum.	- Not holding FRCEM without providing a substantial, robust, and comprehensive alternative portfolio of knowledge.
- Collecting evidence prospectively and concurrently, making it a routine part of your professional practice.	- Insufficient, out-of-date, or poor-quality evidence in core specialties (ICM, Anaesthetics, Acute Medicine).
- Using the RCEM e-portfolio (Kaizen) to organize evidence and systematically map it to the 12 SLOs.	- Life support certificates (ALS, ATLS, APLS) being out of date at the time of submission.
- Ensuring meticulous, page-by-page anonymisation (redaction) of all patient-identifiable data.	- Failure to complete and document a full audit cycle, including the crucial re-audit phase.
- Building a strong, supportive relationship with an Educational Supervisor for mentorship and guidance.	- Poor quality or insufficient volume of reflective practice, particularly in case histories and CPD logs.
- Attending an official RCEM Portfolio Pathway/CESR Applicant Training Day to gain direct insight from experts.	- A lack of consultant-supervised WPBAs, especially failing to meet the requirement for ESLEs within the final 12 months.

The Portfolio Pathway is more than an administrative hurdle; it is a profound professional development journey that formally recognizes your expertise and dedication to Emergency Medicine. Achieving entry to the GMC Specialist Register via this route is a testament to your resilience and commitment. By leveraging this strategic plan, you can navigate the process with confidence, demonstrate the full scope of your consultant-level knowledge, skills, and experience, and take your rightful place as a leader in Emergency Medicine in the United Kingdom.

Frequently Asked Questions (FAQs)

This section addresses specific, common questions from applicants to provide definitive clarity on key issues that often arise during the application process.

Do I need to use the RCEM e-portfolio? While not mandatory, using the RCEM (Kaizen) e-portfolio is highly recommended. It provides the correct WPBA forms, offers a structured way to map evidence directly against the curriculum, and serves as a central repository for your assessments and reflections, making the collation process significantly more manageable.

Can I rely on secondary evidence like letters of opinion alone to prove a competency? This is not advised. Primary evidence, especially structured Workplace-Based Assessments (WPBAs) signed by a consultant, provides a reliable and structured evaluation of your performance. This external review of your performance is a critical part of the assurance process and cannot be replaced by secondary evidence like letters of opinion alone.

My experience in a core specialty (e.g., Anaesthetics) was more than six years ago. Do I need to repeat the placement? While a full repeat of the placement may not be necessary, you must demonstrate current competence. The longer the time that has passed, the greater the need to demonstrate proficiency. This will likely require a period of refreshed experience, such as a secondment or day release, to gather new WPBAs, reflections, and a logbook demonstrating that you have maintained those competencies.

Does holding an MRCP qualification count as equivalent for the Acute Medicine competencies? No, it does not. The MRCP curriculum is not the same as the acute medicine curriculum required for Emergency Medicine training, and therefore it does not assess the specific competencies required for the Portfolio Pathway.

How many ESLEs are required under the 2021 curriculum? The requirement is a minimum of six Extended Supervised Learning Events (ESLEs) from the last three years of practice. Of these, three must have been completed in the last 12 months prior to your application submission.

To complete your preparation, the final section directs you to the definitive official resources.

8.0 Further Resources and Official Guidance

This final section provides direct links to the official documentation and key organizations that govern the Portfolio Pathway. Applicants are strongly encouraged to use these resources as their primary sources of truth throughout the application process.

• GMC Emergency Medicine Specialty Specific Guidance (SSG)

◦ https://www.gmc-uk.org/-/media/documents/sat---ssg--emergency-medicine-2021-curriculum---dc13727_pdf-87179601.pdf

• RCEM Emergency Medicine Curriculum 2021

◦ https://rcemcurriculum.co.uk/

• GMC Online Application Portal and User Guides

◦ https://www.gmc-uk.org/registration-and-licensing/join-our-registers/registration-applications/specialist-application-guides/specialist-registration-portfolio

◦ https://www.gmc-uk.org/-/media/documents/dc11550-post-brexit-sat---cesr-cegpr-online-application---user-guide_pdf-76194730.pdf

• RCEM Portfolio Pathway (CESR) Information Page

◦ https://rcem.ac.uk/certificate-of-eligibility-for-specialist-registration-cesr-and-combined-programme-cesr-cp/

• RCEMLearning Platform and CPD Diary

◦ https://www.rcemlearning.co.uk/

• RCEM Portfolio Pathway Applicant Training Days

◦ https://rcem.ac.uk/face-to-face-events/portfolio-pathway-applicants-training-day-cesr/

Glossary of Key Terms

· ACAT (Acute Care Assessment Tool): A Workplace Based Assessment (WPBA) designed to test a doctor's ability to manage a range of cases during a clinical shift, often adapted for the busy ED environment.

· ACCS (Acute Care Common Stem): A curriculum framework that covers the initial years of training in acute specialties, including Emergency Medicine, Acute Medicine, Intensive Care Medicine, and Anaesthetics.

· ALS (Advanced Life Support): A certification course focusing on advanced resuscitation skills for adults.

· APLS (Advanced Paediatric Life Support): A certification course focusing on advanced resuscitation skills for children.

· ARCP (Annual Review of Competence Progression): A formal annual review of a trainee's progress and competence within a UK training program.

· ATLS (Advanced Trauma Life Support): A certification course providing a systematic approach to the initial assessment and management of trauma patients.

· CbD (Case-Based Discussion): A Workplace Based Assessment (WPBA) where a candidate discusses a case they were directly involved in with a consultant, reflecting on their actions and decisions.

· CCT (Certificate of Completion of Training): The traditional route to specialist registration in the UK, awarded upon successful completion of a GMC-approved training program.

· CESR (Certificate of Eligibility for Specialist Registration): The previous name for the Portfolio Pathway, now used as an umbrella term for all alternative routes to specialist registration in the UK.

· CPD (Continuing Professional Development): Ongoing learning activities undertaken by doctors to maintain, improve, and broaden their knowledge and skills, required for appraisal and revalidation.

· DOPS (Direct Observation of Practical Procedures): A Workplace Based Assessment (WPBA) used to record and assess a doctor's skills in performing practical emergency medicine procedures.

· e-portfolio (Kaizen): An online tool, particularly the RCEM (Kaizen) e-portfolio, valuable for collecting, organizing, and mapping evidence against the curriculum for Portfolio Pathway applications.

· ED (Emergency Department): The department within a hospital that provides immediate treatment for acute illnesses and injuries.

· EPA (Entrustable Professional Activities): Units of professional practice that can be entrusted to a trainee once sufficient competence has been demonstrated, often used in conjunction with IAC for Anaesthetics.

· ESLE (Extended Supervised Learning Event): A Workplace Based Assessment (WPBA) involving a consultant observing and providing feedback on an applicant's clinical performance, teaching, and managerial style during an ED shift.

· FACEM (Fellowship of the Australasian College for Emergency Medicine): A specialist medical qualification in Emergency Medicine, recognized as comparable to FRCEM for the Portfolio Pathway.

· FRCEM (Fellowship of the Royal College of Emergency Medicine): The UK's specialist medical qualification in Emergency Medicine, considered the benchmark for knowledge and skills in the Portfolio Pathway.

· GCP (Good Clinical Practice): A standard for the design, conduct, performance, monitoring, auditing, recording, analyses, and reporting of clinical trials, also refers to general professional standards for doctors.

· GMC (General Medical Council): The regulatory body for doctors in the UK, responsible for maintaining the specialist register and overseeing the Portfolio Pathway application process.

· HALO (Holistic Assessment of Learning Outcomes): An assessment tool used to evaluate a candidate's achievement of learning outcomes, specifically mentioned for ICM and Anaesthetics (sedation).

· HST (Higher Specialty Training): The later stages of specialist medical training in the UK.

· IAC (Initial Assessment of Competence): A mandatory assessment in Anaesthesia, demonstrating basic competencies required for safe practice.

· ICM (Intensive Care Medicine): A core specialty placement required for the Portfolio Pathway, focusing on the management of critically ill patients.

· KSE (Knowledge, Skills and Experience): The new standard for assessment in the Portfolio Pathway, requiring applicants to demonstrate the KSE needed to practice as a Consultant in the UK.

· LTFT (Less Than Full Time): A working pattern where a doctor works fewer hours than a standard full-time position.

· MCR (Multiple Consultant Report): A report synthesizing feedback from several consultants regarding an applicant's performance.

· MIMMS (Major Incident Medical Management and Support): A course relevant to managing medical aspects of major incidents.

· Mini-CEX (Mini Clinical Evaluation Exercise): A Workplace Based Assessment (WPBA) designed to assess a doctor's skills, attitudes, and behaviors in a clinical setting, observed by a consultant.

· MSF (Multi-Source Feedback): A 360-degree assessment tool collecting feedback on a doctor's performance from various colleagues (peers, nurses, management) and patients.

· PA (Programmed Activity): A unit of time (typically 4 hours) used in job planning for doctors' duties, including Direct Clinical Care (DCC) and Supporting Professional Activities (SPA).

· PDP (Personal Development Plan): A plan outlining an individual's learning needs, objectives, and strategies for professional development, typically reviewed during appraisal.

· PED (Paediatric Emergency Department): A dedicated emergency department for children.

· PEM (Paediatric Emergency Medicine): A core specialty placement recommended for the Portfolio Pathway, focusing on emergency care for children.

· PMQ (Primary Medical Qualification): The initial medical degree obtained by a doctor.

· Portfolio Pathway: The current name for the alternative route to specialist registration in the UK, formerly known as CESR.

· QI (Quality Improvement): Systematic approaches to improve patient care and service delivery, evidence of which is required for the Portfolio Pathway.

· QIAT (Quality Improvement Assessment Tool): A specific assessment tool for Quality Improvement activities.

· QIP (Quality Improvement Project): A project undertaken to identify and implement changes to improve the quality and safety of patient care.

· RCEM (Royal College of Emergency Medicine): The professional body for Emergency Medicine in the UK, which assesses Portfolio Pathway applications for the GMC.

· Reflective Case Histories: Detailed accounts of patient cases, enhanced with highly developed reflective entries on learning points, required as evidence.

· Redaction: The process of obscuring or removing confidential or sensitive information (e.g., patient data) from documents.

· SAS (Staff and Associate Specialist): A grade of doctor in the UK NHS who are not in training but are not consultants, with nationally negotiated contracts.

· SLO (Specialty Learning Outcome): High-level learning outcomes within the RCEM Emergency Medicine Curriculum 2021, against which Portfolio Pathway evidence is structured.

· SPA (Supporting Professional Activities): Time allocated in a doctor's job plan for non-clinical duties such as CPD, teaching, research, audit, and management.

· SSG (Specialty Specific Guidance): Detailed guidance provided by the GMC and RCEM outlining the specific evidence requirements for the Portfolio Pathway in Emergency Medicine.

· STR (Structured Training Report): A report completed by an Educational Supervisor, providing a formal record of a candidate's progress.

· TO (Teaching Observation): An assessment where a candidate's teaching is observed and feedback is provided.

· Verification: The process of confirming the authenticity of evidence submitted, typically by a consultant or institution.

· WBA (Workplace Based Assessment): A general term for assessment tools used to evaluate performance in the clinical environment (e.g., CbD, Mini-CEX, DOPS, ESLE). Often used interchangeably with WPBA.

· WTE (Whole Time Equivalent): A measure of workload or experience expressed as if it were full-time, used to account for less than full-time work or breaks in practice.

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MEM-EM PODCAST

1.6 The Portfolio Pathway