Acute Care Common Stem (ACCS)

The New ACCS website can be found here


Acute Care Common Stem is a two-year programme which covers the acute specialties of anaesthesia, acute medicine (general internal), emergency medicine and intensive care medicine. The ACCS programme is an alternative route into anaesthesia and acute medicine instead of core anaesthesia or core medicine training. ACCS is the only route to enter training in emergency medicine.

The two-year training programme is broken down into four component parts. Trainees complete six months in emergency medicine, acute medicine, anaesthesia and intensive care medicine. The anaesthesia training in ACCS is identical to the first six months of training core anaesthesia trainees receive. All trainees must pass the initial assessment of competence in their anaesthesia placement.  On completion of the two years ACCS programme, trainees return to their parent specialty.

The ACCS programme is designed to reflect acute care clinical practice and the focus for 18 of the 24 months is on:

  • Major presentations of patients with a core symptom who will need resuscitation;
  • Acute presentations of patients with a core general symptom who are seen in either the Emergency Department, the Intensive Care Unit, the Acute Medical Ward and those areas where anaesthetics are given;
  • Management of the airway safely (training completed in the anaesthesia component of the programme).

During the anaesthesia component of ACCS, trainees complete the 'basis of anaesthetic practice' and achieve the Initial Assessment of Competency.

Major presentations

  • Anaphylaxis
  • Cardio-respiratory arrest
  • Major trauma
  • Septic patient
  • Shocked patient
  • Unconscious patient

Acute presentations

  • Abdominal pain including loin pain
  • Abdominal swelling, mass and constipation
  • Acute back pain
  • Aggressive/disturbed behaviour
  • Blackout/collapse
  • Breathlessness
  • Chest pain
  • Confusion, acute/delirium
  • Cough
  • Cyanosis
  • Diarrhoea
  • Dizziness and vertigo
  • Falls
  • Fever
  • Fits/seizures
  • Haematemesis and melaena
  • Headache
  • Head injury
  • Jaundice
  • Limb pain and swelling – atraumatic
  • Neck pain
  • Oliguric patient
  • Pain management
  • Painful ear
  • Palpitations
  • Pelvic pain
  • Poisoning
  • Rash
  • Red eye
  • Suicidal ideation
  • Sore throat
  • Syncope and pre-syncope
  • Traumatic limb and joint injuries
  • Vaginal bleeding
  • Ventilatory support
  • Vomiting and nausea
  • Weakness and paralysis
  • Wound assessment and management