DEMT Application

DEMT Application

Please fill out this form to apply
Before completing this application, please familiarise yourself with the DEMT Position Description.

If you do not meet or need clarity around the below eligibility criteria, please contact the training team on 61+3 9320 0444 or via demt@acem.org.au for assistance.
Do you meet each of the criteria below?*

Currently have an appointment of 0.5FTE or greater at the relevant ACEM-accredited ED, and work clinically at least 0.25FTE or a minimum of one (1) clinical shift per week within that ED.I am at least 3 years post-Fellowship* or will be working in a Co-DEMT model with another FACEM who is 3-years post-Fellowship. (*Fellows who obtained their FACEM qualification via the SIMG pathway and are not 3-years post-FACEM are eligible for consideration)I am in Good Standing with my College (i.e. financial and CPD compliant with ACEM or RACP)I am not the sole DEM, Local WBA Coordinator or Mentoring Coordinator at the relevant site.I am not currently completing Joint PEM training in either Stage 2 or 3 with ACEMI have completed the 3 ACEM Assessing Cultural Competency ModulesI have completed the ACEM Core Values Modules
Name*

First NameLast Name
ACEM ID*

Street Address

Street Address Line 2

City

Zip Code
Your Email*
As part of this process, your Regional Censor will make contact with you to talk about the DEMT roles, your experiences and determine if there is any other support you require. Please list a preferred contact number. *
Is there are any particular days or times you would like to be contacted that would make this easier. A DEMT appointment cannot be finalised until this process has taken place.
Hospital where DEMT Role to be undertaken*

Street Address

Street Address Line 2

City

Zip Code
I am applying for the following role*

DEMTPaediatric DEMTNetwork DEMT
Date DEMT appointment effective*

DayMonthYear
Date
Are you applying to cover an existing DEMTs temporary leave?*

YesNo
Name of DEMT going on temporary leave*

First NameLast Name
Are you applying to replace a resigning DEMT?*

YesNo
Name of resigning DEMT*

First NameLast Name
If you will be working in a Co-DEMT model, please list the name/s of other DEMTs at the site.
Current FTE Employment in the ED*

Street Address

Street Address Line 2

City

Zip Code
Qualification*

FACEMFRACP PEM Specialist
Please upload letter of Good Standing*

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Year Qualification attained (eg. year of Fellowship) *

Street Address

Street Address Line 2

City

Zip Code
If you have not held the DEMT role in the last 2 years, please upload a current CV

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DEMT Application

The following data will be used to tailor educational resources and orientation documents to your needs.