I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here.
While this may seem obvious to some of you, remember that I work in Ireland and we have a different document for our system yet I still have to learn the UK one too for the exam.
RCEM have a lovely summary document
- group one
- people like you and me I suspect – just cars
- group two
- lorries and passenger carrying vehicles (buses not taxis it seems)
First unprovoked fit
- Group 1: 6 months
- Group 2: 5 years
Depends a little on the type
Simple vasovagal
- Group 1: no restriction
- Group 2: no restriction
Likely simple vasovagal (see the guidance for more detail)
- Group 1: no restriction
- Group : 3 months
Loss of consciousness with high risk factors (I couldn’t find what they meant by that)
- Group 1: 6 months if no cause found, 4 weeks if cause found and fixed
- Group 2: 12 months if no cause found, 3 months if found and treated
Cough Syncope (this is of course fairly benign but it has huge implications for driving cause it may well happen again…)
- Group 1: 6 months
- Group 2: 5 Years
- Group 1: 1 month as long as recovery is adequate
- Group 2: 1 year
ACS
- Group 1: 1 week if PCI, 4 weeks if not
- Group 2: 6 weeks
A Fib/Flutter/Arrhythmia
- no restriction if unlikely to cause incapacity
- if likely to cause incapacity then group 2 folk lose their license
Hypertension (i didn’t even realise this was a thing…)
- group 2 lose their license if consistently over 180/100
- will not be for us to make that decision but important to know
I haven’t gone into the definitions of these terms here. both assume free from alcohol problems for the stated period.
persistent misuse
- Group 1: 6 months
- Group 2: 1 year
alcohol dependance
- Group 1: 1 year
- Group 2: 3 years
Hi Neil
I think the high risk factors include LOC with no prodrome, no provocation etc, LOC in seated or lying position, or LOC thought to be owing to a cardiac cause.
Great thanks.
Andy