Pre-Hospital Opportunities in Royal Navy

Hello. I can answer this for you, and will be posting a detailed thread for MO applicants soon.

You must remember that PHEM is a sub-speciality associated with anaesthetics/EM, and it adds a year to your training. It isn't possible to be a consultant in PHEM alone: you must dual-qualify with either EM or anaesthetics. The day job will be EM or anaesthetics, with PHEM taking up a few clinical sessions. Even the guys at London HEMS aren't exclusively PHEM doctors - they are EM or anaesthetic doctors first, who do PHEM on the side.

After your 3 years as a general duties are up, you then specialise. Your speciality is decided with your careers manager, but the Service's needs come first - although a mutually beneficial agreement is normally sought. For EM and anaesthetics, you will be sent through the Acute Common Care Stem (ACCS) training pathway.

The specialities that are mainly being recruited for at the moment are GP, EM and anaesthetics. There may be chances to undertake training in Psychiatry, acute medicine, surgery, radiology, opthalmology, etc. - but this cannot be guaranteed.

The PONG specialities (paeds, obstetrics, neonatology and gynaecology) are not required by the service and thus unavailable. Most speciality care is now provided by RNR doctors, so cardiology/neurology/etc. are not routinely available.

In short: you will be able do train as an anaesthetist in the Royal Navy, and will almost certainly be able to add PHEM to your repertoire!

Best of luck.

Thank you very much for your detailed response and to everyone else who has previously posted.

That's absolutely perfect and was exactly what I was hoping to be able to.

The ACCS was what I would've wanted to do if I get rejected from the Navy and stay in the NHS so am glad to hear that it fits in well with what the Navy need and that there are opportunities.

I know it obviously depends on what the RN is involved in at the time, but what kind of PHEM opportunities would there be? (In terms of day-to-day work). Is it a case of you work within a team as an Anaesthetist/EM Doc on board a larger ship (my understanding is that the smaller ships normally only have a GDMO, and sometimes just LMA), and that when a PHEM 'situation' arises, you go with the team that deals with it?

This brings me onto another question I have: How does Medical Facilities vary from Ship to Ship? As part of the Portsmouth tour we visited HMS Richmond, where the sick-bay essentially seemed to me to have similar equipment levels as used in the back of an ambulance, with not much more diagnostic equipment. Is this pretty standard, or is there a lot of variance? I.e. What Medical facilities would I be working within if posted aboard a larger ship?

I appreciate I am jumping the gun, so to speak, but the more info the better so I know what I'm getting myself in the for!

When you post the thread to the MO applicants, please link me to it so I can read that too!

Thanks again.
 

MSBravo

Midshipman
"I know it obviously depends on what the RN is involved in at the time, but what kind of PHEM opportunities would there be? (In terms of day-to-day work). Is it a case of you work within a team as an Anaesthetist/EM Doc on board a larger ship (my understanding is that the smaller ships normally only have a GDMO, and sometimes just LMA), and that when a PHEM 'situation' arises, you go with the team that deals with it?"

You receive your PHEM training, including Battlefield Advanced Trauma Life Support (BATLS), in the NEMO Course.

As a GDMO, your PHEM exposure will be very limited in terms of attending road traffic accidents, cardiac arrests, stabbings etc. if that's what you mean?

On a ship, your job is to provide primary care. Anything requiring more will require a helicopter and MEDEVAC: remember as a GDMO you're "only" working to the standard of an FY2 doctor. Even something like cellulitis or a severe infection would probably require MEDEVAC.

If you want to do proper PHEM, that won't come until you are at least an ST4+ emergency medicine/anaesthetic trainee, which is the only time that you can do PHEM in the NHS.


"This brings me onto another question I have: How does Medical Facilities vary from Ship to Ship? As part of the Portsmouth tour we visited HMS Richmond, where the sick-bay essentially seemed to me to have similar equipment levels as used in the back of an ambulance, with not much more diagnostic equipment. Is this pretty standard, or is there a lot of variance? I.e. What Medical facilities would I be working within if posted aboard a larger ship?"

Naturally these capabilities are going to vary and even if I knew the answer in detail, I assume they should not be posted on a public forum. You have, however, probably already answered your own question with what you've written (!), and this indicates the standard of care you'll be providing when at sea. There is a reason the RN medicals are so thorough: they don't like or expect people to get too ill at sea!

Now, the hospital ship RFA Argus is a whole different ball game. Have a Google and you'll see that it is essentially a floating hospital complete with operating theatre and ITU!
 
You receive your PHEM training, including Battlefield Advanced Trauma Life Support (BATLS), in the NEMO Course.

As a GDMO, your PHEM exposure will be very limited in terms of attending road traffic accidents, cardiac arrests, stabbings etc. if that's what you mean?

On a ship, your job is to provide primary care. Anything requiring more will require a helicopter and MEDEVAC: remember as a GDMO you're "only" working to the standard of an FY2 doctor. Even something like cellulitis or a severe infection would probably require MEDEVAC.

If you want to do proper PHEM, that won't come until you are at least an ST4+ emergency medicine/anaesthetic trainee, which is the only time that you can do PHEM in the NHS.

Thanks for your response. What I meant is, after the ST4+, what would I be doing PHEM-wise in the RN? What kind of work/jobs/opportunities? Obviously I understand as a GDMO it will be very limited in terms of PHEM work.
 

MSBravo

Midshipman
Thanks for your response. What I meant is, after the ST4+, what would I be doing PHEM-wise in the RN? What kind of work/jobs/opportunities? Obviously I understand as a GDMO it will be very limited in terms of PHEM work.

You'd be working full time in the NHS as a speciality registrar, and deployed to fulfil that role if there's a war going on which requires PHEM input.
 

MSBravo

Midshipman
Because I have a weird and savant like ability to navigate DII, I've found the latest Recruitment Guide to Specialty Training, 2016.

It lists PHEM (which I what I think you are referring to) as a specialty for ST3+, but at the moment the RN has 0 (zero) openings. I would note, however, many of my Medical Officer friends have not necessarily been limited by what the "book" says. However, against that, you will be trained for the needs of the RN first, and your preferences second. If they align, great, if they don't, tough. I know a MO who was awarded an MBE for their efforts on Op HERRICK, and then denied their choice of specialty training.

In short, yes, you probably could do PHEM, but don't join the Armed Forces as your only option for it.

If you are able to or allowed to, could you please post the full list of available specialities for the RN this year? Thanks!
 
Like I said, it's a changing feast, and unless you are in (and if you were, I'd be worried if you were asking for this via RR vice your CO/CM), it won't be able to help you much. Off the top of my head, it's all the specialties you'd expect - emergency medicine, surgery, general practice, etc etc.
 

barny006

War Hero
Commander Adamson on/in Invincible, had the record for most circumcisions in the RN and had quite a unique way of doing it, he did with his teeth and that seals off all the blood vessels, and the sailors got quite a kick out of it too .he also had a baseball bat complete with officers sword knot and a brass sleeve, he stated at least when you tapped someone on the head with it they stayed out
 
Commander Adamson on/in Invincible, had the record for most circumcisions in the RN and had quite a unique way of doing it, he did with his teeth and that seals off all the blood vessels, and the sailors got quite a kick out of it too .he also had a baseball bat complete with officers sword knot and a brass sleeve, he stated at least when you tapped someone on the head with it they stayed out

send key setting k.........
 

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