Pre-Hospital Emergency Medicine (PHEM)

Pre-hospital Emergency Medicine (PHEM)

Health Education East of England Programme preference form

Please fill out this form & hand in at your interview.

At this stage we now require the following information to help us if you are successful to match your training requirements and geographical preferences with suitable available vacancies. Please refer to the area information prior to completing this form.

Please indicate your Programme preferences below.

Please number (1 – 18) the Programmes you would consider (1 being your most preferred and 18 your least). If there is a Programme that you will not consider please tick the “Will not consider” box if you have no preference of any Programme please mark “no preference”. Successful candidates are ranked according to their scores and offers are based on this. The information given may be used in the offer process but is not a guarantee of being offered your first choice Programme. The information given is confidential and will not be disclosed to third parties. Name: App number: Scheme / Will not consider Employer / base LETB Operating Locations Duration/Start Specialty Limitation Preference Programme hospital date

Base 1 - Midlands Air Royal Stoke University A (C for LTFT Ambulance / MERIT Hospital rotating to only) West Midlands Anaesthetics or EM or ICM (Cosford/Oldbury) University Hospital 2 years Base 2 - The Air Ambulance Coventry Feb 2017 Service (Coventry/ East Midlands)

Base 1 - The Air Ambulance A (C for LTFT University Hospital Service (Coventry/ East Midlands) only West Midlands Coventry rotating to Royal Anaesthetics or EM or ICM Base 2 – Midlands Air 2 years Stoke University Hospital Ambulance/ MERIT Feb 2017 (Cosford/Oldbury)

Base 1 - Great North Air Ambulance, Durham Tees Valley A Sunderland Royal North East Airport 2 years Emergency Medicine Hospital Base 2 – North East Ambulance August 2016 Service, Newburn Riverside, Newcastle A Base 1 – Wyton (MAGPAS) Cambridge University East of England 2 years Emergency Medicine Base 2 – Cambridge (East Hospital August 2016 Anglian Air Ambulance) A Base 1 – Wyton (MAGPAS) Cambridge University East of England 2 years Emergency Medicine Base 2 – Cambridge (East Hospital August 2016 Anglian Air Ambulance)

Base 1 – Wyton (MAGPAS) Cambridge University C ALL East of England Base 2 – Norwich (East Anglian Hospital 1 year Air Ambulance) August 2016

East of England C Base 1 – Norwich (East Anglian Cambridge University 1 year ALL Air Ambulance) Hospital August 2016 Base 2 – Wyton (Magpas)

East of England Base 1 – Wyton (MAGPAS) C Cambridge University Base 2 – Cambridge (East 1 year ALL Hospital Anglian Air Ambulance) August 2016

East of England Base 1 – Cambridge (East C Cambridge University Anglian Air Ambulance) 1 year ALL Hospital Base 2 – Wyton (Magpas) August 2016

North Central East C London’s Air Ambulance Royal London (HEMS) EM, ICM, Anaesthesia London 1 year

** Scheme A = blended working between base specialty and Pre-hospital Emergency Medicine over 2 years (e.g. rotating 2 weeks Emergency Medicine and 2 weeks PHEM) Scheme B = working 6 months base specialty, 6 months Pre-hospital Emergency Medicine over 2 years Scheme C = working one year Pre-hospital Emergency Medicine full time

Please note you may be offered your least preferred Programme.

These posts are correct at the time of printing; however they may be subject to change. The organisation reserves the right to withdraw posts if necessary.