Application Form – RPL into Emergency Medicine Certificate & Associateship Training Programs

Application Form - RPL into Emergency Medicine Certificate & Associateship Training Programs

Please apply in the form below.
The below form is to be used by current/former trainees of the FACEM Training Program to apply for Recognition of Prior Learning (RPL) assessment in the ACEM Emergency Medicine Certificate and Emergency Medicine Associateship Training Programs.

Applications can only be submitted via the online form including the uploading of supporting documentation.

All documents of evidence must be original or certified copies of the original.

Prior to enrolling, please read the relevant policy based on when you enrolled in the FACEM Training Program.
- Enrolled prior to 2022: Policy for Transition from the FACEM Training Program to the ACEM Emergency Medicine Certificate and Emergency Medicine Associateship Training Programs
- Enrolled from 2022: Policy for Transition from the 2022 FACEM Training Program to the ACEM Emergency Medicine Certificate and Emergency Medicine Associateship Training Programs
Please also review the relevant program page on our website to see what each program encompasses.

For assistance and enquiries, please contact:
Training Services: EMCD@acem.org.au or +61 3 8679 8872; or
Trainee Support unit:  trainee.support@acem.org.au or +61 3 8679 8874.
Name*

First NameLast Name
Email*
example@example.com
Preferred Contact Number*
Medical Board Registration Number*
Current or former ACEM ID*
Which program you would like to enrol in?

ACEM Emergency Medicine CertificateACEM Intermediate Emergency Medicine Training ProgramACEM Advanced Emergency Medicine Training Program

Documentation

The FACEM Training Program record will be used to verify components completed to determine RPL. The following additional documentation is to be submitted by an applicant for verification purposes and must be included with this application form.
Please upload applicable checklists for the program you are seeking to transition to be signed off by an ACEM Director of Emergency Training that confirms your ability to perform specific procedures outlined on the checklist.

If enrolled in the FACEM Training program prior to 2022, please upload applicable checklists:
- Emergency Medicine Certificate Procedural Checklist
- Intermediate Emergency Medicine (Formerly EMD) Procedural Checklist
- Advanced Emergency Medicine (Formerly EMAD) Procedural Checklist
If enrolled in the FACEM Training program from 2022, please upload applicable procedural checklist:
Please upload your signed off Procedural Checklist.

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Do you have a current and valid certificate of competency for the Advanced Paediatric Life Support (APLS) workshop.*

YesNo
Do you have a current and valid certificate of competency for the Advanced Life Support 2 (ALS 2).*

YesNo
Please upload your APLS and/or ALS2 workshop certificate of competency.*

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Do you have a current and valid certificate of competency for the Early Management of Severe Trauma (EMST) or Emergency Trauma Management (ETM) workshops?*

YesNo
Please upload your EMST or ETM workshop certificate of competency.*

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Have you completed a suitably credentialed Ultrasound workshop? (see training handbook below for further information)*

YesNo
Training Handbook
Please upload a confirmation letter from your DEMT/Supervisor of the course*

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Declaration

By submitting this application I acknowledge the following terms:
I understand that my ACEM Trainee Record will be the official record used to verify completion of FACEM Training Program requirements*
I understand that should I wish to enrol into the ACEM Emergency Medicine Certificate, ACEM Intermediate Emergency Medicine Training Program, or ACEM Advanced Emergency Medicine Training Program I am unable to remain a trainee in the FACEM Training Program and will be required to withdraw prior to commencement.*
I understand that if any further documentation is required for an assessment that it must be supplied within one month of the request. *
I understand that should I complete additional FACEM Training Program requirements after this application is assessed, I will be required to submit a new application for assessment.*
I understand that I will be required to pay an enrolment fee as outlined on the fee structure to start the ACEM Emergency Medicine Certificate, ACEM Intermediate Emergency Medicine Training Program, or ACEM Advanced Emergency Medicine Training Program*
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