Training and regulation of pre-hospital clinicians: DipIMC practice questions
PHEM curriculum unit 1.3 · Theme 1: Working in Emergency Medical Systems
The DipIMC is blueprinted against phase 1 of the UK Pre-hospital Emergency Medicine (PHEM) curriculum. This page covers unit 1.3, Understand the training and regulation of pre-hospital healthcare personnel.
Below are 2 free practice questions from the DipIMC.Ninja bank, in the Part A single best answer format. Every answer names the textbook page, guideline or statute it was written from, so you can check it rather than take it on trust. The bank holds 11 questions on this unit.
Question 1 · Law, Ethics & Human Factors · Moderate
A doctor new to a helicopter emergency medical service (HEMS) is told that on this shift she is a medical passenger rather than a HEMS crew member. Under the aviation regulations governing HEMS flights, what does that mean?
AHer role is patient care; she needs only a pre-flight briefing and must fly with a HEMS crew member
BHer role is patient care, but she may not fly until she has completed the full HEMS crew member course
CHer role includes navigation and radio management, once she has completed HEMS crew training
DHer carriage means the mission no longer counts as a HEMS flight and loses its weather alleviation
EHer role is patient care, and after a pre-flight briefing she may fly alone with the pilot
Show answer
Answer: A
Her role is patient care; she needs only a pre-flight briefing and must fly with a HEMS crew member
The ABC sets out the JAR-OPS categories. A medical passenger is carried during a HEMS flight with a primary role of patient care; no specific training other than a pre-flight briefing is required, but a medical passenger must be accompanied by a HEMS crew member. A HEMS crew member is specifically trained and assigned to the flight and assists the pilot with roles such as navigation or radio management. So a full crew course is not a precondition for a medical passenger, the navigation and radio role belongs to the crew member, and flying without a HEMS crew member is not permitted. The HEMS designation carries alleviation from normal weather limits and exemption from certain rules of the air; missions that do not meet the JAR-OPS definition are air ambulance missions and cannot use those exemptions. The ABC lists the medical passenger as one of the two categories of medical personnel carried on HEMS flights, so carrying one does not remove the designation. The Oxford Handbook describes the same two categories.
Where this comes from
ABC of Prehospital Emergency Medicine
Ch. 2 Activation and Deployment · Deployment by helicopter: the HEMS flight definition · p. 5“The HEMS designation is important as it carries with it alleviation”
Ch. 2 Activation and Deployment · Deployment by helicopter: HEMS crew member · p. 6“assist the pilot during a mission with such roles as navigation or radio management”
Ch. 2 Activation and Deployment · Deployment by helicopter: medical passenger training · p. 6“No specific training other than a pre-flight briefing is required”
Ch. 2 Activation and Deployment · Deployment by helicopter: medical passenger accompanied · p. 6“must be accompanied by a HEMS crew member”
Ch. 2 Activation and Deployment · Deployment by helicopter: air ambulance missions · p. 6“classified as air ambulance missions and cannot employ the same exemptions”
Oxford Handbook of Pre-Hospital Carep. 720Ch. 13 Patient rescue and transportation · Helicopters: aircrew“No specific training is necessary other than pre-flight briefing.”
ABC of Prehospital Emergency Medicinep. 6Ch. 2 Activation and Deployment · Deployment by helicopter: medical personnel carried on HEMS flights“Medical personnel carried on HEMS flights fall into one of two categories”
law-054 · Law, Ethics & Human Factors · EMS Systems · Moderate · v3
Question 2 · Law, Ethics & Human Factors · Hard
A specialty registrar in emergency medicine who works shifts with a regional air ambulance asks you how sub-specialty training in pre-hospital emergency medicine (PHEM) is structured, so that she can plan her application. According to the Intercollegiate Board for Training in PHEM (IBTPHEM), which description is correct?
ASix months whole-time equivalent after ST3, with the DipIMC as the phase 2 national summative assessment
BTwelve months whole-time equivalent after ST4, with the DipIMC as the phase 2 national summative assessment
CTwelve months whole-time equivalent after CCT, with the FIMC as the phase 2 national summative assessment
DTwenty-four months whole-time equivalent after ST4, with the FIMC as the phase 2 national summative assessment
ETwelve months whole-time equivalent after ST4, with the FIMC as the phase 2 national summative assessment
Show answer
Answer: E
Twelve months whole-time equivalent after ST4, with the FIMC as the phase 2 national summative assessment
IBTPHEM, which runs PHEM training and assessment on behalf of its parent colleges, states that specialist trainees in emergency medicine, anaesthesia, intensive care medicine or acute medicine may apply, and that a programme consists of 12 months whole time equivalent training taken after the ST4 year; places are offered to specialist trainees through national recruitment, so it is not a post-CCT year. Because the Board favours blended training (scheme A), many programmes last two calendar years — one year of PHEM and one of the base specialty — which is where the 24-month figure comes from, but the PHEM component is still 12 months WTE. Training runs in three phases: 1a initial (1 month), 1b development (5 months) and 2 consolidation (6 months). The national summative assessments are the RCSEd Diploma in Immediate Medical Care for phase 1 (NSA1) and the Fellowship in Immediate Medical Care for phase 2 (NSA2); the Training and Assessment Panel then recommends accreditation to the parent college and the GMC. The Oxford Handbook agrees that the programme may not begin before completion of ST4 and that accreditation requires passing the FIMC.
Where this comes from
IBTPHEM — TrainingIntercollegiate Board for Training in Pre-Hospital Emergency Medicine·Programme“consist of 12 months whole time equivalent training taken after the ST4 year”Open at this section
IBTPHEM — AssessmentIntercollegiate Board for Training in Pre-Hospital Emergency Medicine·Formal assessments“Phase 2 National Summative Assessment (NSA2) - the Fellowship in Immediate Medical Care”Open at this section
Oxford Handbook of Pre-Hospital Carepp. 12–13Ch. 1 An approach to pre-hospital care · Subspecialty accreditation in PHEM“The programme may not begin before completion of the ST4 training year”
law-225 · Law, Ethics & Human Factors · EMS Systems · Hard · v1