Supporting Information
Evidence (1 of 2)
1. Advance Life Support
Applicants must have up to date and demonstrable advanced life support skills at the time of application.
Current certification in ALS OR equivalent
OR
Supporting evidence as work based assessment/simulation/faculty statement (applicants must have all 3 types) at time of application
Failure to upload adequate evidence at the time of application submission will result in your application being removed from the process.
Do you have up to date and demonstrable advanced life support skills? (Yes | No)
These can be demonstrated by:
- A current certification in advanced life support or equivalent, at the time of application
OR
- Supporting evidence as work-based assessment/simulation/faculty statement (must have all 3 types at time of application)
2. ROUTE OF ENTRY
There are a number of different routes in to ST3 Emergency Medicine. For more information about the routes please read the 2025 Person Specification. The questions below will be used to identify which route you are applying for.
Any time periods specified refer to Full Time employment. For Less Than Full Time employment please use the Whole Time Equivalent.
Route of Entry – From an approved UK ACCS Training Programme
At the time of application, have you completed two years of ACCS training within an approved UK training programme? (Yes | No)
Please note: You should only be answering “yes” to this question if your experience is from a UK ACCS training programme.
ACCS training programmes outside of the UK are not recognised.
Route of Entry – From an approved UK Core Surgical Training programme
At the time of application, have you completed Core Surgical Training, or the first two years of run-through training in a surgical specialty, within an approved UK training programme? (Yes | No)
Route of Entry – From the Equivalent of a Core Surgical Training Programme
At the time of application, have you completed the equivalent of a Core Surgical Training programme? (Yes | No)
3. Career Progression, CCT / CESR or Specialist Register
Do you already hold, or are you eligible to hold a CCT/CESR in Emergency Medicine or are you currently eligible for the specialist register in this specialty? (Yes | No)
Self-assessment
1. Instructions for completing the Self Assessment Form
Listed below are the 12 Self-Assessment questions that appear on the application form along with the possible responses to each question and details of suitable evidence to substantiate your responses.
All supporting evidence will be uploaded to a secure server after submission of your application.
If the interviewers are unable to verify that your evidence matches the answers you provided on your application form you will not be awarded any marks for those criteria.
If it is subsequently discovered that any statement is false or misleading, evidence will be collected and you may be referred to a Probity Panel.
Question 1
Have you completed and been awarded any degrees in addition to your primary medical qualification? Please do not include teaching degrees (these can be included in Q6 below). Please select the highest scoring option that applies to you.
- Masters level or higher degree involving research thesis (stand alone and not related to primary medical qualification) : 3
- Additional degree with first class honours : 2
- Any other undergraduate or postgraduate degree/diploma not fulfilling criteria above : 1
- No additional degrees : 0
Evidence:
- Please provide a copy of your degree certificate
- For non-UK Masters / Higher degrees please also provide a written statement from the awarding body confirming equivalence to UK regulations for MSc or above, with a copy of Masters degree and topic of research.
Question 2
Have you been awarded any academic prizes / awards? Please select the highest scoring option that applies to you.
- National award for academic achievement as a postgraduate or undergraduate : 3
- Local postgraduate award for academic achievement : 2
- Local undergraduate award for academic achievement, e.g. merit, distinction : 1
- None of the above : 0
Evidence:
Please provide evidence of any academic prizes/awards i.e. certificate or letter confirming achievement.
Question 3
Please select the highest scoring option that describes your involvement in presentation / publications (excluding Letters to editor, abstracts and case reports).
- Oral presentation at national/international meeting : 3
- First author of article in peer reviewed journal : 3
- Oral presentation at regional meeting : 2
- Co-author of article in peer-reviewed journal : 2
- Poster presentation at regional or national/international meeting : 1
- None of the above : 0
Evidence:
- Please provide a copy of the presentation with meeting programme / publication which clearly shows your role
Question 4
Please select the highest scoring option that describes your involvement in audit / Quality Improvement projects.
- Designed and led a completed audit / Quality Improvement project with closure of loop (with confirmation of role by supervisor) : 3
- Designed and led an audit / Quality Improvement project (with confirmation of role by supervisor : 2
- Involvement as team member in an audit / Quality Improvement project (with confirmation of role by supervisor) : 1
- Involved in RCEM audit : 1
- None of the above : 0
Evidence:
Please provide a summary of the audit / project (including evidence of second cycle where applicable)
Please provide evidence of your role in the audit/project i.e. confirmation by supervisor
Question 5
Please select the highest scoring option that describes your involvement in teaching
- Principal organiser of relevant course : 3
- Participated as faculty member on relevant course : 2
- Formal planned teaching at least monthly (MUST submit teaching plan) : 1
- None of the above : 0
Evidence:
- Please provide evidence of your role as organiser/faculty of a course. i.e. letter confirming involvement.
- For formal teaching please provide timetable evidence of frequency and teaching plan.
Question 6
Do you have a formal teaching qualification? Please select the highest scoring option that applies to you.
- Masters degree in medical education : 3
- Postgraduate diploma in medical education : 2
- Postgraduate certificate in medical education : 1
- University accredited educational supervision course : 1
- ‘Train the Trainers’ education supervision course : 1
- No formal teaching qualifications : 0
Evidence:
- Please provide your qualification or course attendance certificate
Question 7
Please select the option that best describes your previous experience in ACCS training posts (Acute Medicine, Anaesthetics, Intensive Care Medicine, Paediatric Emergency Medicine) at the time of application (excluding Emergency Medicine experience scored in section 7)
- Post-Foundation training in three or more other ACCS specialty (at least 3 months’ continuous placement in each) : 3
- Post-Foundation training in two other ACCS specialty (at least 3 months’ continuous placement in each) : 2
- Post-Foundation training in one other ACCS specialty (at least 3 months’ continuous placement) : 1
- No substantive post in other ACCS Specialties : 0
Evidence:
- Please provide evidence of training posts i.e. ARCP documentation/completion of ACCS training certificate
- For non-training posts, please provide your contract of employment, or a letter from your supervisor / HR / Medical Staffing on hospital headed paper. Email evidence may be provided if it has been sent from a hospital email address.
Question 8
Please select the option that best describes your exam status
- Passed full MRCEM OR FRCEM intermediate (all parts) : 3
- Passed FRCEM primary AND one element of intermediate (could be MRCEM OSCE) : 2
- Passed FRCEM primary or full MRCS : 1
- No relevant postgraduate exams : 0
Evidence:
- Please provide evidence of your exam status. i.e. certificate or results letters
Question 9
Please select the option that best describes your demonstrable competences in the following skills:
- I have demonstrable competences in 3 or more life support courses or evidence of competence in dealing with and resuscitating sick adult, children and trauma patients : 3
- I have demonstrable competences in 2 life support courses or dealing with and resuscitating adult and child, or adult sick and trauma patients : 2
- I have demonstrable competences in adult life support only or evidence of demonstrable competences in dealing with and resuscitating only adult sick patients : 1
- I do not have demonstrable competence in any of these skills : 0
Evidence:
Competence can be demonstrated in the following ways:
- By providing an in-date course certificate
- By providing a statement from a supervisor confirming you have received local training and assessment in these skills
Question 10
Have you undertaken and completed any additional courses relevant to Emergency Medicine
- Three or more additional courses : 3
- Two additional courses : 2
- One additional course : 1
- No additional courses : 0
Evidence:
- Please provide evidence of completion of any additional courses i.e. certificates
Question 11
Please select the highest scoring option that describe your Achievement of competencies via work based assessments, supervisor reports and multi source/360 feedback
- WBAs AND MSF / 360 feedback AND supervisor reports all excellent (must have all 3 types of evidence) : 3
- WBAs AND MSF / 360 feedback AND supervisor reports generally good (must have all 3 types of evidence) : 2
- WBAs AND MSF / 360 feedback AND supervisor reports satisfactory (must have all 3 types of evidence) : 1
- None of the above : 0
Evidence:
- Please provide evidence of your achievement of competencies i.e. WBAs, MSF/360 feedback and supervisors reports (all three elements to score mark).
Question 12
Please select the highest scoring option that describes management / leadership roles you have undertaken.
- Leadership role at national level, e.g. BMA national committee member : 3
- Leadership role at postgraduate level, e.g. BMA rep, trainee rep, chair of junior doctors forum. Rota coordinator does not count. : 2
- Leadership role at undergraduate level, e.g. committee chairman, head of student union : 1
- None of the above : 0
Evidence:
- Please provide evidence of your management / leadership role i.e. letter confirming appointment to role / letter from supervisor confirming position
