ICM CCT training is entered at ST3 level following completion of one of four designated core programmes: Acute Care Common Stem (ACCS), Core Anaesthetic Training (CAT), Core Medical Training (CMT) or Defined Route of Entry into Emergency Medicine (DRE-EM). Trainees must have completed one of these core programmes, including its associated specialty examination: FRCA (Primary), MRCP (UK), or MCEM (Full).

The indicative minimum duration for ICM CCT training is 7 years, including both core and HST (Higher Specialist Training).

The ICM CCT programme is broken down into 3 overarching stages. Stage 1 consists of the first 4 years of training and must contain a minimum 12 months each of ICM, anaesthesia and medicine. Because trainees enter the ICM CCT from different core backgrounds, the first two years (at least – it may be more if the trainee is in ACCS) of Stage 1 will be Core training. The remaining 2 years will take place in HST, during which time trainees make up those elements of the programme in which they are deficient (so a CAT trainee will undertake medicine; a CMT trainee will undertake anaesthesia). Stage 2 is the following 2 years of training, during which time trainees undertake specialist ICM modules (Paediatric, Neuro and Cardiac ICM) and a ‘Special Skills’ year. During Stage 2 trainees must pass the FFICM exam. Stage 3 is a final 12 month block of advanced level ICM during which time trainees develop senior management skills).

No. Under the previous Joint CCT system, it was technically possible for surgical trainees to enter the Joint ICM CCT. However in practice, no surgical trainee ever did so. When the standalone ICM CCT was being developed, it was found that there was insufficient competency crossover between core surgery and the other core programmes to allow trainees to enter ICM CCT training and still achieve the required standards in medicine, anaesthesia and ICM by the end of Stage 1 training. Whilst it is technically possible for a trainee to Dual train in ICM and Surgery (technically a trainee can Dual CCT in any two specialties, if a deanery is willing to pay for it) the lack of cross-mappable competencies would mean that the programme would be almost purely additive and the doctor would be in training for many years.

Yes. The ICM CCT programme has been specifically crafted, with its multiple entry core programmes, to facilitate dual accreditation. Trainees would enter the first specialty (either ICM or partner) in one recruitment episode and compete for entry to the second specialty the following year.

Yes. Up to 6 months of the 12 month Stage 1 medicine requirement can be undertaken in Emergency Medicine.

During Stage 2 trainees will be expected to develop and consolidate expertise in a special skill directly relevant to ICM practice. Areas of particular benefit to the future development of critical care and its work force are recommended including ultrasound expertise, education or research. The choice of special skill should be guided by the Programme Director to reflect the career intentions of the trainee, though the possibility of undertaking some Special Skills modules will by necessity be dictated by local availability. For example a trainee intending to practice in a more remote area may wish to develop greater paediatric expertise as these skills may be required more regularly in such an environment than in a large central hospital. Acquisition of this expertise must be as part of an FICM-approved, competency-based training programme. The Faculty is currently working on the development of specific Special Skills modules. Trainees undertaking Dual CCTs should expect to spend their Special Skills year training in their partner specialty.

No, it may not. The regulations laid down by the GMC stipulate that no overseas training can be retrospectively counted toward a UK CCT. Both the Faculty and the GMC must prospectively approve any overseas training. It would be possible for overseas time to be counted were you to apply for a CESR/CESR-CP in ICM; once a CESR/CESR-CP has been obtained, the candidate can gain entry onto the GMC Specialist Register for that specialty.

Since the formation of PMETB and its subsequent merger with the GMC, the FICM no longer directly approves training posts. The GMC approves training programmes, such as that for the ICM CCT. It does this with "specialty input". The GMC will not approve a trust to run a training programme without agreement from the specialty in question, usually obtained via the respective College. For the FICM, this begins with the gaining support and approval from the ICM Regional Advisor.  The Deanery should then complete the required GMC forms and submit these to the FICM for review.  Once approved, the FICM will issue a support letter to accompany the form submission to the GMC.  Your RA will not rotate you through a post that he/she does not believe will provide the required training standard for the programme. Simply put, if your ICM RA has rotated you to a certain post, it is approved by the FICM, via the RA as the Faculty's agent. The GMC now have a list of all approved sites on their website, please click here.