Meet the Director of LGEM Programme:

Dr Ashfaque Sorathia (Dr Ash) is among the few leading EM consultants in the UK who has taught and trained over 1000 EM physicians in the UK, he is a very passionate EM physician with a vast academic and teaching background, he is actively involved in teaching MRCEM, FRCEM and EBEEM Courses. He is the director of London Clinical Courses and a Founder of Pakistan Emergency Medicine Association.

Dr Ash has worked at Leading NHS UK hospital trusts, including Barts London NHS, The Royal London Hospital, Guys and St Thomas Hospital London, Queen Hospital London, and Newham Hospital London.

He has conducted numerous teaching sessions in UAE, Dubai, Saudi Arabia, Egypt, and Brussels Belgium.

He is the pioneer of MRCEM /FRCEM courses In Dubai and Medina.

All he wants now is introduce Emergency Medicine to masses at grass root level specially targeting non trainee doctors who were left out the main stream training programmes.


INTRODUCTION:

This is a unique programme, it is one of its kind, never been offered before nor being taught , this programme is an intellectual asset of Dr Ashfaque Sorathia (Dr Ash) and it is innovative in so many ways, this programme is offering:

a) Academic and clinical education of RCPCH and RCEM Curriculums

b) Hands on practice sessions face to face

c) Comprehensive preparation of DCH & MRCPCH Exam.

d) FREE MRCPCH 1-2 and Clinical courses by London Clinical Courses.

e) 50 Paediatric Emergency Medicine procedures including clinical examinations for DCH and MRCPCH clinicals f) Complete portfolio and final signed off transcript by LGEM with certification of completion of programme.

g) More than 180 hours teaching in 2 years programme.

 Programme Duration And Target Clinicians:

1 year DCH (RCPCH) & 2 years MRCPCH Programme

This programme aims to target all Future Paediatricians of Pakistan and most importantly non trainee doctors who are working as MO, RMOs and SMO, it will also welcome post graduate trainees and qualified consultants who wish to get more exposure in Paediatric EM and improve their Emergency Medicine , trauma and resuscitation skills.

This programme will cover entire RCPCH General Paediatrics curriculum as well as RCEM Paeds EM curriculum. It is a first of its kind project where a doctor will master not only General Paediatric illnesses but will also learn core Paediatric Emergency Medicine as per RCEM curriculum from qualified NHS UK consultants, in short this programme will produce a Paediatrician who is not only able to deal with OPD and Ward illnesses but will also be able to deal with a wide range of paediatric emergencies including trauma and resuscitation.

How this programme will be delivered:

This programme will be 60% online and 40% on-site Face to Face.

Total 180 -200 hours of teaching will be done (For MRCPCH PROGRAMME) & 100-120 Hours teaching for 1 year DCH PROGRAMME.

 Online Teaching Programme:

* One hour live online lecture from UK twice a week.

* First 10 minutes Candidates will do case presentations as per RCEM /RCPCH published curriculum

then tutor will thoroughly teach each case, highlighting all relevant investigations and management plans as perUK guidelines. * There will be case-based regular discussions and logbooks will be maintained for each case.

* Tutor will also provide relevant references and resources used for further learning.

* All sessions will be recorded, this will allow candidates to watch missed lectures flexibly in their free time and

write reflective feedbacks.

* Every six months we will arrange a practical hands-on workshop to help candidates acquire necessary practical

skills outlined in RCPCH AND RCEM curriculum.

* There will be full long day conferences, seminars and workshops to help candidates boost their preparation for EM exams.

Note: This is not just the DCH/MRCPCH Exam Preparation programme, it’s much more than that, this programme will provide comprehensive teaching on General and Emergency paediatrics with adequate supervision, guidance and mentorship, it will enable candidates to map the entire PEM Royal College of EM and RCPCH curriculum into their clinical practice and make them an accomplished paediatrician who is not only competent in dealing with General Paediatrics but also Emergency Paediatrics.

Programme Outlines:

1 year DCH programme

2 Years MRCPCH Programme

A) 1 Year DCH Programme.

To get DCH from RCPCH candidate must

a) Have adequate clinical exposure to Paediatric patients and be working in Acute Paediatric Clinical setting. b) Pass Foundation Of Practice (FOP) & DCH OSCE exam. (Total 2 exams)

During one year London GEM DCH programme we will provide comprehensive teaching related to

both above exams, arranged practical clinical sessions and prepare candidate for DCH OSCE exams.

B) 2 Years MRCPCH programme:

To complete MRCPCH exam , RCPCH requires doctors to undergo more extended training and get exposure to wide range of Paediatric illnesses. In UK Candidates attempting final MRCPCH OSCE exams have at least 4 -7 years of Clinical Experience. We aim to expedite academic learning for this exam in 2 years’ time. To get MRCPCH from RCPCH candidates must

1) Must demonstrate adequate clinical exposure to wide variety of Paediatric illnesses in acute paediatric settings. 2) Must pass all components of MRCPCH exams which includes:

a) Foundation Of Practice (FOP)

b) Theory And Science (TAS)

c) 2 Papers of Applied Knowledge in Practice (AKP) d) Final MRCPCH OSCE exam

During 2 years of London GEM Paediatric EM programme candidates will get comprehensive teaching on all above components of Exam by leading NHS UK Consultants.

Teaching and assessment tools:

We will be using following learning tools to

assess the progress of trainee.

a) Case Base Discussions (CBDs)

b) Directly Observed Practical Skills ( DOPs) In Simulated Settings c)Self Reflective Learnings ( SRLs)

d) Constructive Feedbacks

e) MSF multi-source Feedbacks

f) Quarterly Supervisor Meetings

g) Annual ARCPs

h) Practical Workshops

I) OSCE Preparation face to face workshops

Note: There will be no final exam or assessment by LGEM, we will assess candidates on above mentioned learning tools and award certification of completion of programme.

Directly Observed Procedural Skills (DOPS)

This is to demonstrate your practical & procedural skill in paediatrics.

You need to complete one satisfactory DOPS for the specific mandatory procedures stated in RCPH curriculum.

We will arrange Paediatric procedures workshop in Pakistan which will cover all listed RCPCH procedures. Candidates will be taught how to perform these procedures on mannequins under senior supervision, this will give candidates enough confidence to be able to perform these procedures in real life under limited supervision.

Procedures for which DOPS are compulsory

* Bag / mask ventilation (can be covered by APLS or NLS or equivalent life support certification) * Peripheral venous cannulation

* Lumbar puncture

* Airway maintenance (Neonatal) to include airway opening manoeuvres and the use of airway

adjuncts to maintain an airway to the point of intubation. * Umbilical venous cannulation

* Collection of blood from central lines

* Suprapubic aspiration of urine

* Umbilical artery cannulation

* Umbilical vessel sampling

* Urethral catheterisation

* Percutaneous long-line insertion

* Intubation of preterm baby less than 28 weeks

* Administration of surfactant

* Peripheral arterial cannulation

* Intraosseous needle insertion

* Electrocardiogram (ECG)

* External cardiac massage

* Emergency needle thoracentesis

* Chest drain insertion

* Perform basic lung function tests

* Administer intradermal injections

* Administer subcutaneous injections

* Administer intramuscular injections

* Administer intravenous injections

* Collection of blood from central lines

* Suprapubic aspiration of urine

* Umbilical artery cannulation

* Umbilical vessel sampling

* Urethral catheterisation

* Percutaneous long-line insertion

* Intubation of preterm baby less than 28 weeks

* Administration of surfactant

* Peripheral arterial cannulation

* Intraosseous needle insertion

* Electrocardiogram (ECG)

* External cardiac massage

* Emergency needle thoracentesis

* Chest drain insertion

* Perform basic lung function tests

* Administer intradermal injections

* Administer subcutaneous injections

* Administer intramuscular injections

* Administer intravenous injections

RCPCH DOMAINS

This 2 years programme will cover all 11 domains outlined by RCPCH at core trainee level. During first 2-3 years RCPCH Expects all candidates to must achieve level 1 competencies outlined in RCPCH curriculum below.

LGEM 2 years programme will make sure all successful candidates achieve level 1 competencies in all 11 domains.

DOMAIN 1

Domain 1 - Professional values and behaviours and professional knowledge (GPC 1 and 3)

Level 1

* In addition to the professional values and behaviours required of all doctors (Good Medical Practice), a paediatric trainee maintains confidentiality but judges when disclosure may be required in relation to safeguarding, taking into account the differing legislation and health services between the four countries

Level 2

* Adheres to the specific legislation (including safeguarding) and healthcare systems between the four countries. which applies to children and families’ legislation

* Acts as a role model and guides junior colleagues in developing professional values and behaviours in relation to paediatrics

* Creates an open and supportive working environment

Level 3

* Adheres to current legislation related to children and families, e.g. adoption, safeguarding, etc.

* Adopts a self-regulatory approach to their own behaviour and demonstrates the professional qualities required by a paediatrician undertaking independent practice, across the four countries

Domain 2

Domain 2 - Professional skills: communication

Level 1

* Develops effective relationships with children and families and colleagues, demonstrating effective listening skills, cultural awareness and sensitivity

* Communicates effectively in the written form, by means of clear, legible, and accurate written and digital records Level 2

* Participates effectively in the MDT and engages with patients and families/carers, facilitating shared decision making * Recognises complex discussions and when to seek assistance

Level 3

* Leads MDTs and demonstrates effective communication skills in a range of environments and situations with children, young people and families in challenging circumstances

* Communicates effectively with external agencies, including authoring legal documents and child protection reports

Domain 3

Domain 3 - Professional skills: procedures

Level 1

* Adapts clinical examinations to meet the needs of the child and family/carers, undertaking basic paediatric clinical procedures

* Recognises an emergency situation, knowing when and how to escalate appropriately. Initiates basic life support and able to carry out advanced life support with guidance

Level 2

* Supervises and assesses junior staff when undertaking clinical procedures

* Responds to and manages emergency situations, and is able to perform advanced life support

Level 3

* Demonstrates competence in the full range of clinical skills relevant within paediatrics and either General Paediatrics or their chosen sub-specialty

* Utilises the skills of other health professionals when required

Domain 4

Domain 4 - Professional skills: patient management

Level 1

* Conducts a patient assessment and makes a differential diagnosis

* Plans appropriate investigations and initiates a treatment plan

Level 2

* Refines differential diagnosis and tailors management plans in response to the patient’s needs and/or response to initial treatment

Level 3

* Considers the full range of treatment and management options available, including new and innovative therapies, relevant within paediatrics and either General Paediatrics or their chosen sub-specialty

* Anticipates and determines the need for transition from paediatric services and plans accordingly

Domain 5

Domain 5 - Health promotion and illness prevention

Level 1

* Promotes healthy behaviour, including giving advice, from early years to adulthood

Level 2

* Takes into account the potential impact of cultural, social, religious and economic factors on child and family health Level 3

* Demonstrates leadership in the promotion of health and wellbeing practices in the wider community

Domain 6

Domain 6 - Leadership and team working

Level 1

Recognises why leadership and team working are important in the paediatric clinical environment. Works constructively within a team, valuing contributions of others. Develops personal leadership skills

Level 2

Demonstrates an awareness of own leadership qualities, adjusting their approach to improve outcomes

Participates effectively and constructively in multidisciplinary and inter-professional teams

Level 3

Leads in multi-disciplinary team working. Promotes an open culture of learning and accountability by challenging and influencing colleague’s behaviour

Supports the development of the team’s leadership qualities and critical decision-making skills

Domain 7

Domain 7 - Patient safety including safe prescribing (GPC 6)

Level 1

* Establishes the importance of safe prescribing, and is able to prescribe commonly-used medication in an appropriate manner

* Recognises when a patient has been exposed to risk and escalates in accordance with local procedures

Level 2

* Applies appropriate procedures to both prescribing and clinical care situations and manages risk effectively

* Demonstrates ability to mitigate against potential risks.

Level 3

* Participates in investigating, reporting and resolving risks to patients, including appropriate communication with patients and families/carers

* Evaluates safety mechanisms across a range of healthcare settings, applying a reflective approach to self and team performance

Domain 8

Domain 8 - Quality improvement (GPC 6)

Level 1

Applies quality improvement methods (eg audit and QI projects) under guidance

Level 2

* Independently applies knowledge of quality improvement processes to undertake projects and audits to improve clinical effectiveness, patient safety and patient experience

Level 3

* Identifies quality improvement opportunities

* Supervises healthcare professionals in relation to improvement projects

* Leads and facilitates reflective evaluation in relation to quality improvement interventions

Domain 9

Domain 9 - Safeguarding (GPC 7)

Level 1

* Promotes the professional responsibility of safeguarding children and young people, and able to document accurately and raise concerns in a professional manner to senior staff

Level 2

* Takes responsibility for raising concerns, getting advice and taking appropriate actions, with supervision

Level 3

* Independently leads the full process of safeguarding management for children, including assessment and reporting

Domain 10

Domain 10 - Education and training (GPC 8)

Level 1

* Performs planned teaching and learning events under guidance

Level 2

* Plans and delivers teaching and learning experiences to trainees and other professionals

* Provides appropriate and constructive feedback.

Level 3

* Demonstrates the required knowledge, skills and attitudes to provide appropriate teaching, learning opportunities, supervision, assessment and mentorship in the paediatric healthcare setting

Domain 11

Domain 11 - Research (GPC 9)

Level 1

* Adopts an evidence-based approach to paediatric health practice and the critical appraisal of existing published research

Level 2

* Implements an evidence-based approach to practice to inform decision-making and enhance patient care and patient outcomes

Level 3

* Demonstrates the independent development and revision of guidelines and procedures centred around current clinical research and evidence-based healthcare to improve service delivery.

Note: Level 1

This is the first level of training and usually lasts between 2-3 years. This level provides a basic level of knowledge about paediatrics and child health. The trainee usually learns this in the following settings: acute general, community and neonatal departments, by the end of 2 years programme all our LGEM trainees will have level 1 understanding in all above domains, along with RCPCH curriculum this programme will also cover RCEM Paeds EM curriculum which is outlined below.

Paeds Emergency Medicine Component of LGEM Programme.

During this 2 years programme London GEM trainees will learn most competencies outlined by RCEM with learning outcome 1.

RCEM Sub-specialty Learning Outcome 1 Includes following Key Capabilities

1. Manages the critically ill neonate, child and young person.

2. Assesses and manages the patient in respiratory failure.

3. Assesses and effectively manages the septic or shocked patient.

4. Assesses and manages the patient with a cardiac disorder.

5. Assesses and manages the patient presenting with a reduced level of consciousness.

6. Assesses, diagnoses and manages the patient presenting to the PED with major or minor trauma.

7. Identifies and manages acute mental health conditions in the PED.

8. Assesses and manages presentations that suggest physical or psychological abuse.

9. Manages the processes following an unexpected death in the PED.

10. Illustrations

11. Upper airway obstruction.

12. Allergic conditions and anaphylaxis.

13. Respiratory failure, in particular related to acute asthma, pneumonia and bronchiolitis. 14. Sepsis, the systemic inflammatory response and shock.

15. Hypotension and heart failure.

16. Congenital heart disease.

17. Cardiac arrhythmias. Myocarditis.

18. Recognises, assesses and manages the full range of paediatric emergency conditions. 19. Demonstrates knowledge of the PED management:

20. Hypertension.

21.Syncope.

22. Acute neurological emergencies, including status epilepticus.

23. Febrile and non-febrile seizures.

24. Raised intracranial pressure and reduced level of consciousness. Headaches.

25. The neurosurgical patient.

26. Diabetic ketoacidosis.

27. Hypoglycaemia.

28. Metabolic disease.

29. Endocrine abnormalities.

30. Common childhood illnesses.

31. Minor and severe infections.

32. Upper respiratory tract infection (URTI) and lower respiratory tract infection (LRTI), Gastroenteritis.

33. Non-blanching rash.

34. Kawasaki disease.

35. Upper and lower urinary tract infections.

36. Common and emergency nephro-urological presentations.

37. Abdominal pain, including surgical and non-surgical causes as well as functional abdominal pain.

38. Scrotal pain.

39. Bilious vomiting.

40. Gastrointestinal bleeding.

41. Inflammatory bowel disease.

42. Common and emergency gynaecological presentations.

43. Sexually transmitted diseases.

44. Patients seeking emergency contraception.

45. Life-threatening ENT emergencies, eg quinsy and post-tonsillectomy bleeding.

46. Common ear, nose and throat (ENT) disorders, eg otitis media, nasal injuries, epistaxis and removal of foreign bodies.

47. Common oral and dental injuries and emergencies

48. Management of the injured child and young person

49. Demonstrates knowledge of the PED management of:

50. The child or young person with polytrauma and potential major trauma

51. Bleeding disorders in trauma and recognises and manages massive haemorrhage

52. Chest trauma and performs and facilitates key chest procedures, eg chest drain insertion

53. Abdominal and pelvic trauma, including the application of pelvic binders

54. Acute head and spinal injury, including spinal cord injury

55. Acute drowning and immersion injury

56. Acute burn injuries (including electrical burns) and subsequent complications

57. All limb-threatening injuries, including open fractures and reduces injuries compromising nerve or vascular supply

58. All fractures and ligamentous injuries

59. A dislocated joint and reduces the joint and manages the onward referral

60. All lacerations and open wounds

61. Rhabdomyolysis and compartment syndrome

62. Common and emergency ophthalmological presentations. Common and emergency dermatological conditions.

63. Bites and infestations.

64. The limping child.

65. Rheumatological and non-traumatic musculoskeletal presentations. Acute and chronic pain. 66. Oncological conditions, including making an initial assessment and diagnosis as well as managing complications related to the disease process or its treatment.

67. Haematological disorders, e.g. sickle cell disease. Immunodeficient states.

68. Delirium and psychosis.

69. Self-harm.

70. Poisoning, accidental drug ingestion and overdose. Hypothermia and hyperthermia.

71. Electrolyte abnormalities.

72. Needlestick injuries.

73. Anticipates injury patterns in common trauma presentations in each age group.

74. Demonstrates knowledge of the PED management of:

75. The child or young person with polytrauma and potential major trauma

76. Bleeding disorders in trauma and recognises and manages massive haemorrhage

77. Chest trauma and performs and facilitates key chest procedures, eg chest drain insertion

78. Abdominal and pelvic trauma, including the application of pelvic binders

79. Acute head and spinal injury, including spinal cord injury

80. Acute drowning and immersion injury

81. Acute burn injuries (including electrical burns) and subsequent complications

82. All limb-threatening injuries, including open fractures and reduces injuries compromising nerve or vascular supply

83. All fractures and ligamentous injuries

84. A dislocated joint and reduces the joint and manages the onward referral

85. All lacerations and open wounds

86. Rhabdomyolysis and compartment syndrome

87. Safeguarding within the PED:

88. Recognises presentation patterns which suggest physical or psychological abuse, stratifies risk and engages with allied professionals in accordance with national and local policies and guidance. 89. Recognises how societal issues, such as sex trafficking, involvement with gang culture and female genital mutilation (FGM) may impact on children and young people presenting to the PED. 90. Mental health:

91. Manages children and young people sensitively where sexual assault and sexual abuse is suspected.

92. Performs a mental health assessment relevant to PED care.

93. Risk-stratifies children and young people attending the PED with acute mental health issues to identify those who require admission or urgent intervention

LGEM Programme Outcomes:

1 year DCH programme Outcomes.

A) Full preparation of DCH ( FOP & OSCE Exam)

B) Learn Key Procedures outlined by RCPCH in curriculum above

C) Learn 50 most commonly encountered General & Emergency Paediatric illnesses .

2 Years MRCPCH Programme Outcomes.

A) FULL MRCPCH Exam preparation. MRCPCH 1 (FOP+ TAS Exam) MRCPCH 2 (AKP Paper 1-2) MRCPCH (Final OSCE)

B) Learn all procedures outlined in RCPCH and RCEM curriculum.

C) Achieve level 1 competencies in all domains outlined by RCPCH & RCEM mentioned above.

D) Learn more than 100 General and Emergency Paediatric illnesses including trauma resuscitation, leadership in trauma and cardiac arrest.

Programme Fee:

MRCPCH programme:

Total fee for this programme is £2500 for 2 years.

£100 to be paid at the time of registration

Remaining £2400 can be paid in monthly instalments of £100/month over 2 years period.

DCH Programme:

DCH Programme Fee £1300 total.

£100 to be paid at the time of registration

Remaining £1200 to be paid as monthly instalment for 12 months.

Fee Reimbursement:

All trainees registered in GEM MRCPCH OR DCH Programme will get

1. LCC MRCPCH Foundation of Practice 2 Days short course (£499) for free 2. LCC MRCPCH Theory and Science 2 Days short course (£499) for free

3. LCC MRCPCH AKP 2 Days short course (£499) for free

4. LCC MRCPCH Clinical OSCE Course 3 days short course (£800) for free. 5. LCC 50 Paediatric EM procedures skills workshop (£499) for free.

In short, candidates registered in 2 years MRCPCH programme will get more than £2400 reimbursement in a form of short courses which will be conducted by London Clinical Courses.

Non LGEM registered trainees pay full fee to attend London Clinical Courses mentioned above.

Note: Candidate dropping out of this programme will have to pay entire course fee of £2500 before they can be released from this programme, failure to clear programme fee may result in black listing the candidate and reporting to credit control authorities in UK, so please be absolutely sure before you sign up for this programme.

Eligibility:

1. Must have MBBS or Equivalent Qualification

2. Must have Valid PMDC licence

3. Must be working in acute paediatric clinical setting

4. Ideally candidate must not be registered in any other training programme as this programme is very rigorous and will require a lot of commitments

5. No FCPS PLAB IELTs or OET required

Lecture Delivery, Duration and Days

Duration: 1 hour lecture

Days: Saturday & Sunday

Timings: 10-11 am UK Time

Lecture Delivery: All lectures will be delivered by NHS UK consultants live online.

All lectures will be recorded on our portal, personalised user ID and password will be given to each trainee which will allow them to re visit lectures in case they missed due to any reason.

FAQs

What is the worth of DCH?

DCH from RCPCH is a world recognised qualification in paediatrics, candidates holding DCH are eligible to work as specialist in many part of the worlds including UAE and Gulf countries.

With DCH doctor can work as a consultant / specialist in private setups in many countries and may be able to set up own safe private clinical practice.

What is the worth of MRCPCH?

MRCPCH is considered as one of the highest qualification in the field of Paediatrics, it is worldwide recognised and candidates holding full MRCPCH are eligible to get GMC UK registration and licence to

practice in the UK.

Candidates holding full MRCPCH with 5+ years clinical experience and having all competencies signed off can apply for CESR and start working as consultant in NHS UK.

With full MRCPCH Candidates can also apply for higher speciality training in paediatrics and get CCT after completing training programme.

MRCPCH is widely accepted as specialist qualification all across UAE, Gulf and KSA

In short MRCPCH can open the whole world of Paediatrics and candidate will be eligible to work as specialist/consultant paediatrician in many part of the world without undergoing further exams.

Who should apply?

All non-trainees, staff grades, MO/ RMO/SMOs who are not in any training programme should avail this opportunity as this is the only option which is best for them

LGEM Exam Timeline and Candidate Responsibilities:

a) Before applying for this programme candidate must have a financial plan in place, it must not be subject to job situation, they must also have sufficient funds to book and attempt MRCPCH exams as per LGEM timeline, we expect all trainees to pass both Theory exams latest by first 18 month of programme and clinical OSCE exam by end of 2 years or latest by 2.5 years.

b) Candidate must attend more than 80% lectures live and provide immediate reflective learning feedback on same day, they must complete all CBDs, SRLs and DOPs in time.

c) They must be honest and trustworthy.

d) Must participate actively in the group, help and appreciate others work, respond to all text messages when possible and play active role in promoting and spreading this knowledge which they learn through this project.

e) We treat every candidate as our Ambassador and also expect them to reciprocate the same.

LGEM Responsibilities:

a) To treat all trainees fairly irrespective of their Race, Religion, Academic or Family background

b) Deliver all lectures timely

c) Provide one to one guidance and design personalised professional development plans for every single trainee

d) Deliver all committed practical workshops and courses timely

e) Supervisor Dr Ash to stay connected with all trainees via WhatsApp group and make sure no trainee is left behind.