A career in prehsopital care is far different from the comfort and relative safety of wards, theatres and emergency departments. Not only is the environment stressful and challenging but the opportunity to develop interest in PHEC is sparse for many medics.  There are no formal pathways in training and funded jobs are rarer than hens teeth!  The only people who seem to have a half decent pathway in place are the PHEC team in Birmingham (West Midlands).  A well defined strategy and transition from recruitment, training, observer to professional is set out by our colleague in England.  However, as expected a large proportion of the clinical work load is non-paid and at the most unsocial hours. 

AS there is no specififc point of entry in to prehospital care from a medical point of view it is obvious that training could begin during undergradate triaining with multiple points of entry and seamless progession to postgraduate practice.  The Northern Ireland model of training doctors in prehospital care is identical to the westmidlands model but facillitates earlier development of training in prehospital care through the addition of a first aid for medics course for first to third year medical students.

First Aid for Medics

This course hopes to consolidate basic clinical knowledge and impart a safe approacg to dealing with a range of problems that are commonly encoutred as an undergraduate medic.  The aim is to emphasise the importance of basic examination skills coupled with a SAMPLE history and a low threshold for referral to definitive help to develop the confiedence to approach a problem systematically when it has been thrust upon oneself be expectant by standers or relatives!

The course runs over 40hours and content by section is out lined below.

1. Introduction
2. Emergency aid
3. Basic First Aid: Common medical / surgical problems in the community
4. Basic Trauma First Aid: Wounds, Fractures & Burns
5. Introductory patient handling and immobilisation
6. First Aid in Specialist Disciplines 1: Obs & Gynae
7. First Aid in Specialist Disciplines 2: Paeds

Prehospital Trauma Care: Undergraduates

This course is for fourth year medics and was developed by Professor porter in Birmingham University.  It is an excellent sequel to the first aid for medics and more than adequately prepares students who are keen to take the BASICS PHEC course.  The author personaly feels that the course should be more widely available

Final MB and Pre-registration Training

At this point the aim is to gain further training and practical experience as an observer.  There are a number of courses available from teh resuscitation council (ALS, EPLS), RCS Eng (ATLS) and other agenices such as the ALSG.  It is up to the indvisual how they persure this but obviously mandatory they are atteched to a local BASICs Scheme and are working towards the DIP IMC from the faculty of prehospital care.