Core Specialist Training (CSTEM)

Training pathway

During CSTEM, you will obtain a wide range of experience in a variety of specialities, structured as six-month posts.

Year 1

  • Emergency medicine
  • Acute medicine, trauma and orthopaedic surgery, or plastic surgery

Year 2

  • Paediatric emergency medicine or acute general paediatrics emergency medicine
  • Emergency medicine

Year 3

  • Anaesthesia/critical care
  • Emergency medicine

Throughout your training, you will work towards successfully completing the Intermediate Fellowship Exam of the Royal College of Emergency Medicine (FRCEM) of the Royal College of Emergency Medicine/MRCEM.


During CSTEM, formal trainee appraisal is carried out every six months in RCSI, Dublin. Prior to the meeting, both the trainer and trainee provide feedback. The appraisal process reviews this feedback and the trainee’s progress with examinations, mandatory courses and non-clinical training. Continuation on the programme is contingent on a satisfactory appraisal. Recommendations for targeted or extended training may be made after appraisal.

Progression to ASTEM

Once you have completed CSTEM and passed the Intermediate Fellowship Exam of the Royal College of Emergency Medicine (FRCEM), you will receive your Certificate of Completion of Core Training (CCCT) and be eligible to apply for the ASAT process (Assessment of Suitability for Advanced Training).

While the aim of the programme is that CSTEM trainees deemed suitable for advanced training will progress, the number of advanced training (SpR) posts available each year is determined in collaboration with HSE National Doctors Training and Planning (NDTP). Where the numbers seeking to progress from CSTEM to ASTEM exceeds the agreed number of SpR posts in any year, competition for the posts will apply.