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Are there any prerequisites for applicants? You can apply for PHEM training during your third year of specialty training, but the earliest you can start the training is after your fourth year (ST4). The training programme is currently only open to trainees with a national training number in emergency medicine or anaesthesia, and applicants must have passed the membership examination of the College of Emergency Medicine or the primary examination of the fellowship of the British Royal College of Anaesthetists, or their equivalent. Entry is also conditional on a successful ST4 annual review of competence progression. A useful guide to subspecialty training in pre hospital emergency medicine is available from the resources section of the IBTPHEM website. What qualities should a PHEM physician bring to the job? The role is challenging. The tempo of decision making, the hazards faced at incident scenes, the relatively unsupported and isolated working conditions, fake oakley mlb flak jacket xlj sunglasses the environmental challenges, the resource limitations, and the case mix all make this very different from in hospital emergency medicine and anaesthetic practice. That why the curriculum is so detailed and the training programme is so rigorous. In addition to the usual curriculum content, team resource management and operational aspects fake oakley polarized half jacket sunglasses of clinical practice play a big role. One of the most important qualities is the ability to reflect on your conduct and actions in stressful situations and to have the confidence and insight to learn and grow as a result. There is no other area in which the environment around you and your ability to work in a team are so important. The challenge of providing specialist medical care in the dark, cold, and wet with limited kit and only a single team mate are fake oakley probation sunglasses what makes the fake oakley felon oakley fake christian louboutin barbie shoes sunglass outlet online sunglasses job so rewarding. Making the first meaningful intervention to a patient in extremis and delivering the patient to a waiting resuscitation department is about as much job satisfaction as you can get (box). Coach factory sale michael kors factory outlet