Paediatric Emergency Medicine (PEM)

Paediatric Emergency Medicine

NB: the new Paediatric Emergency Medicine syllabus will come into effect from August 2018.  It replaces the PEM sub-specialty curriculum 2010 (revised 2012).  Syllabus FAQs available here.

Paediatric Emergency Medicine is a sub-specialty of both Emergency Medicine and Paediatrics.  EM Trainees in the UK have the opportunity to apply for and, if successful, train in a sub-specialty training programme while retaining their NTN.   When both parent specialty and sub-specialty training are completed successfully then the College will recommend to the GMC that the trainee be included on the specialist register with PEM as a sub-specialty.  

Six months Paeds/PEM training is part of the EM curriculum during the CT/ST3 year.  This six months training cannot count towards the twelve months training at sub-specialty level.  This section of the website will be concerned with sub-specialty level PEM.

Who is this information for?

This information is designed for use by anyone interested in Paediatric Emergency Medicine (PEM). This includes the following:

  • Medical students
  • Foundation doctors
  • Acute Care Common Stem trainees
  • Trainees in Emergency Medicine
  • Trainees in Paediatrics
  • Heads of School, and Training Program Directors for Emergency Medicine and Paediatrics
  • Educational supervisors of any of the above

How can I train to be a Consultant in PEM?

If you plan to train in the UK you will have to decide in your Foundation Programme whether you want to approach this from the Emergency Medicine (EM) route or the Paediatric route. In both cases this would extend training to be a consultant by about a year.

If you choose to take the EM route, this currently means applying during Foundation Year 2 to enter the 2-year Acute Care Common Stem (ACCS) training (CT1 and CT2). In the next CT3 year all EM trainees spend the year based in an Emergency Department with a large proportion of time dedicated to PEM. Once you enter Higher Specialist Training (ST4-6) trainees can spend an additional year acquiring the competencies required to have PEM registered as a Sub-Speciality on the UK Specialist Register as a consultant. The training consists of 6 months in a PEM training ED, and 6 months based on the wards, in clinics and in Paediatric Intensive Care.

If you choose to take the Paediatric route, at ST4-5 level Higher Specialist trainees in Paediatrics can opt to spend an additional 2 years in their senior training, acquiring the competences required to have PEM registered as a Sub-Speciality on the UK Specialist Register as a consultant. PEM training is usually undertaken as ST6 and ST7 training. There is an annual round of national applications to 'the Grid' which is a competitive matching system between applicants and posts available. This is run by the Royal College of Paediatrics and Child Health.  The 2 year training consists of 12 months in a PEM training ED, 6 months in the Paediatric Intensive Care Unit and 6 months in surgery / orthopaedics.

How do I train in PEM if I’m already on a Paediatric or Emergency Medicine training programme?

Paediatric Emergency Medicine (PEM) evolved as a sub-specialty of EM in 2002 and of paediatrics a few years later. In July 2010 a new GMC-approved curriculum for PEM training was launched by RCEM and the RCPCH.  It is a joint curriculum for trainees of either background.  This curriculum has been updated and is now the PEM SS syllabus.


Trainees from an EM background

Subspecialty training for PEM for EM usually requires extension of the predicted CCT date by an extra year. Training comprises one year, which will be spent gaining experience in a PED, and other areas such as PICU and General Paediatrics. This will lead to a CCT in Emergency Medicine, with subspecialty accreditation in PEM. The year's training can be completed in a block, or spread out through higher specialist training.

How do I find out more?

Speak to an EM(PEM) or a Paed(PEM) consultant in your area, or approach your Training Program Director or Head of School. 

Trainees from a Paediatric background

Trainees will undergo a two-year training programme, completed after "core training" and not usually requiring an extension of CCT date. This is called “grid” training and is a competitive entry process, usually undertaken in ST4-5. It comprises one year of which is spent training exclusively in a paediatric ED, with the second year requiring periods of training in paediatric intensive care medicine, anaesthesia, paediatric surgery and paediatric orthopaedics.

Which UK centres offer PEM training?

Click here for a list of PEM training centres and Lead PEM consultants and to see how many places there are for EM registrars, paediatric registrars and the department's profile – the number of paediatric cases seen and whether there is a dedicated Paediatric ED. 

RCEM trainers wishing to start a new rotation or become a trainer for Emergency Medicine trainees will find the documents below of use.

RCEM or RCPCH trainers wishing to start a new "grid" post or become a trainer for Paediatric trainees, please contact the RCPCH.

How do I find out more?

Speak to an EM(PEM) or a Paed(PEM) consultant in your area or approach your Training Program Director or Head of School or e-mail

You'll find more information about Paediatric Emergency Medicine training by using the tabs at the top of this page.

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