Moving from in-hospital to Pre-Hospital Emergency Medicine – Q&As with Dr Nicky

Are you a doctor in training looking to expand your skills and take your career to the next level? If you’re considering a career in Pre-Hospital Emergency Medicine (PHEM) but not sure if it’s for you, whether you’d fit in, or how to even go about it, Great Western Air Ambulance Charity’s (GWAAC) Doctor Nicky Moore dispels some common myths and explains how GWAAC can help.

PHEM is for everyone

In 2023, Medical Director Andy Lockyer came up with an idea for a GWAAC-led programme to help improve accessibility into PHEM. PHEM Trainee, Dr Nicky ran the first series of ‘Introduction to PHEM’ sessions at GWAAC’s airbase to encourage people to consider a career in PHEM and to breakdown perceived barriers to this career pathway. The sessions were met with success which led to the official roll-out of GWAAC’s Access to PHEM programme in 2024.

Dr Nicky, now a qualified Critical Care Doctor, continues to lead the programme alongside the newest PHEM Trainees at GWAAC.

Dr Nicky said, “We wanted to throw our arms out and throw the doors open and invite people along. PHEM isn’t for a select group of people. GWAAC’s Access to PHEM programme has been set up to widen access and support our local applicants for a career in PHEM. We want to make sure that GWAAC’s patients can benefit equitably from our expertise and that’s why we strive to provide clinical and operational excellence with a specialist and diverse team.”

Q&As with Doctor Nicky Moore

We sat down with Dr Nicky and asked him some common questions about the perceived barriers to working in PHEM:

Do I need to know someone inside a PHEM setting to stand a chance of being accepted as a PHEM Trainee?

Absolutely not. You do not have to have an inside contact to work in PHEM. PHEM training is a subspeciality of emergency medicine, anaesthetics or intensive care medicine so I’d encourage everyone training in those specialities to at least consider it as an option. If you want to know more, we’d love to hear from you!

I’m not sure I’d fit in!

We want to break down the barrier of unfamiliarity which might exist because we work in small teams and are often in and out of hospital. Say hello when you see us in hospital. Those early conversations will help you understand that we all come from the same place; you’ll get to know us and see how you could be part of the team.

We actively encourage people from different genders, social and cultural backgrounds to consider finding out more about being a PHEM Trainee at GWAAC. Having diversity of thought in the unit is really valuable to us; there’s something about how people from different genders and backgrounds approach problems that would benefit our organisation, and our patients.

How will being a PHEM Trainee and/or Critical Care Doctor work with my personal life?

People have different home-life situations and priorities outside of work. Typically, the time someone starts to think about a career in PHEM is when they’ve been working as a doctor for some years and this can coincide with having a young family.

Many of GWAAC’s Critical Care Doctors, male and female, have been through this process and found a balance with managing their shift patterns and time off for family. For anyone thinking about a career in PHEM, start having those conversations about what you would need to support your career plan and what you think the barriers could be. We can help with ideas of how it could work.

Can I attend GWAAC’s Access to PHEM introductory sessions if I hope to work for another air ambulance?

Yes. Doctors come from across the region to attend GWAAC’s open days and Access to PHEM training sessions. Often, they are attending because they have an interest in working with GWAAC in the future. We’d like to have an open door here, so people can get familiar with us and when a position comes up, they can apply. However, applicants may opt to apply for a Trainee PHEM position at another air ambulance.

What can I expect from GWAAC’s Access to PHEM programme?

We are currently running four sessions a year, all designed to improve the diversity of practitioners in PHEM. We’ll answer questions and support people with their applications. We want to remove the barriers that people from various groups face when starting out in pre-hospital practice from in-hospital practice.

Session one takes place in March and provides an introduction to PHEM. It is aimed at doctors near the start of their in-hospital specialist training to get them thinking about whether a career in PHEM could be for them. Typically, attendees can expect:

• talks from GWAAC Doctors and Specialist Paramedics in Critical Care
• a tour of the airbase, helicopter, cars and equipment
• a Q&A session
• an offer of ongoing, informal mentorship from a group of local doctors including those who have recently been through PHEM training at GWAAC

Session two takes place in August and is aimed at those who are hoping to apply for a PHEM Training role in the next year or two.

Session three happens in September when applications open for PHEM Trainee roles. It is for those who have submitted their applications. Group numbers are typically smaller and we help individuals with presenting their CV and considering how their unique experiences demonstrate that they would be a good candidate for the job.

Session four is in November because this is when the interviews happen for national PHEM Training positions. We’ll do a round-robin style practice interview so interviewees can get feedback from different people in GWAAC’s clinical team. We then provide ongoing support for the PHEM Trainee applicants by creating a community to share the experiences of successful and unsuccessful applicants.

To wrap up the Q&As, Dr Nicky said, “We’re all part of the same system and hopefully anyone who works in hospital or in the ambulance service and who engages with us will start to understand where GWAAC fits in, and how GWAAC could be a place for them.”

To learn more about GWAAC’s Access to PHEM programme, the successes that have come out of it and future plans for embedding diversity in GWAAC, read our blog post . And to stay informed of our clinical training and engagement opportunities, join our Clinical Engagement Mailing List or email inquiries to: clinical.engagement@gwaac.com