Since the following article was written, the future of ACCS
as a three-year acute medicine program has become the subject of debate. At the
time of writing (May 2011) the debate is ongoing. Until this is resolved,
trainees who turn to ACCS to perform acute medicine cannot be guaranteed 18
months of medicine in addition to intensive care, ED and anesthetic posts. When
deciding between ACCS and CMT, you need to carefully consider whether you are
willing to accept the possibility that the training program may be put at
further risk.
You can apply to become an acute physician in ST3 from a CMT
or ACCS (acute medicine flow) background. When deciding which flow to follow
from the foundation a pragmatic view would be to apply both flows and wait to
see what work you receive. Where you have freedom of choice, the pros and cons
of each flow are shown below.
ACCS (AM) is a three year program. This gives you more time
to reach PACES and develop your CV for interviews with the medical registrar,
as well as giving you an additional one year clinical experience to use as a
first year registrar. If used wisely, you should be more competitive in an ST3
interview after ACCS. ACCS also offers the opportunity to examine intensive
care (ICM). It is currently possible to request a double CCT program to certify
both acute medicine and ICM at any stage, from ST3 onwards. In the future,
however, those considering dual certification will have to make this decision
explicit at the beginning of ST3 and will not be able to add an ICT CCT later.