Model Standards and Procedures for Training Site Accreditation

From August 2027

For the most part, the revised Accreditation Standards assess the same, or similar, accreditation requirements to what is currently assessed. However, the revised standards are phrased differently, and the ways in which these standards can be met are changing.

The College still has clear expectations around minimum requirements for some criteria. For example, sites will still need to ensure they nominate specific DEMT(s), DEM(s) and Local WBA Coordinator(s) in order to maintain accreditation.

Many of the existing processes remain, so sites should not experience significant increases in preparation time for accreditation inspections. For example, accreditation cycles and the application process will remain unchanged.

1. Domains of assessment

The domains that sites are assessed against will change:

2. Introduction of outcomes-based standards.

The revised standards are outcomes-based, focusing on the result, benefit or intention of a standard rather than the process used to get there. For example, a standard may focus on ensuring trainee wellbeing is supported at a site rather than requiring a specific policy or process to be in place related to trainee wellbeing. In practice, this means a site can demonstrate different processes for meeting a standard. Evidence expectations may be proportionate to the size and context of the site. Sites are still required to meet all standards.

3. Increased emphasis on trainee wellbeing, quality of supervision and training, and cultural safety and delivery of culturally safe care.  

The revised standards place greater focus on trainee wellbeing, reflected across Domain 1 in areas such as fatigue management, return-to-work processes, flexible work arrangements, and the identification and management of risks to trainee health and welfare.

The revised standards place greater focus on quality of supervision and structured learning, not just whether the relevant processes exist. This is supported by AMC guidance on supervision and structured learning. Together, this guidance provide information on how the College may assess supervision and training quality in practice.

The revised standards place greater focus on culturally safe supervision, support and care for Aboriginal and/or Torres Strait Islander and Māori trainees and patients. This is supported by AMC guidance on cultural safety. This guidance provides information on how the College may assess cultural safety and delivery of culturally safe care.

4. Removal of tiers and other classifications of accreditation.

Current site classifications, such as tiers, TS4 accreditation, Linked EDs and Emergency Medicine Training Networks, have been removed from the revised Accreditation Standards. Further information is provided on these changes in Section 2.

No. Sites that are currently accredited will not be re-accredited under the revised standards until their next scheduled re-accreditation inspection. Sites will be monitored in between inspection cycles by the College according to the revised standards from August 2027.

Before August 2027, all sites will be accredited under the current accreditation requirements. Click here for the current accreditation requirements.

From August 2027, all sites will be accredited under the revised accreditation standards. Click here for the revised accreditation standards.

ACEM’s standards apply to ED/PED accreditation only.

Non-ED placements accredited by other Specialist Medical Colleges may be affected by the revised standards as those Colleges implement the new standards. For more information about these placements, refer to the relevant College website.

Special Skills Placements (SSPs) are assessed under a different framework from the revised accreditation standards. The current framework and the associated processes will continue to apply to SSPs.

The College’s Paediatric and Private Emergency Departments site classifications and their associated training time restrictions will remain unchanged as per College Regulation G.

From August 2027, site classifications will no longer be used when accrediting sites:

• Tier 1, Tier 2 and Tier 3 
• TS4 
• Linked ED 
• Emergency Medicine Training Network

Trainees will continue to gain the breadth of experience by completing placement requirements in the following settings throughout training, as set out in Regulation G:

• Major Referral ED, 
• Non-Major Referral ED, 
• Regional, Rural and Remote ED (for trainees commencing in 2027), 
• Non-ED, and Critical Care.

Tiers (Tier 1, 2 and 3) are being removed as a site classification from August 2027. The characteristics they currently determine will instead be assessed across the relevant criteria in the revised standards.

Site characteristics currently determine a site's tier classification (Tier 1, 2 or 3), which limits how long a trainee can have certified towards training time at that site. These classifications will be removed from August 2027.

This means a trainee can choose how long they stay at a site.

Removing tiered accreditation will also mean:

1. Supervision – From August 2027, sites will be assessed on their ability to provide timely and effective supervision. This will be assessed based on data such as rosters, trainee feedback (including survey data), and other evidence gathered through site applications, inspections and interviews.
2. Casemix and patient exposure – From August 2027, sites will be assessed on their ability to offer a clinical caseload that supports trainees in achieving the required curriculum learning outcomes. This assessment will be tailored to each site's individual size and context.
3. Structured education – From August 2027, sites will be assessed on their ability to provide trainees with sufficient opportunities to engage in structured and unstructured learning to achieve training program outcomes.
4. Research support – From August 2027, sites will be assessed on their ability to coordinate and facilitate research activities for trainees to achieve their training program outcomes.

Sites should closely consider whether they would like to apply for a tier upgrade with introduction of revised standards occurring in less than a year. Tier upgrade requests will not be accepted after 1 December 2026.

Tier downgrade recommendations will continue to be managed under existing processes until August 2027.

TS4 is being removed as a site accreditation classification. The learning activities it currently covers will now be assessed in all sites across the relevant criteria in the revised standards.

Sites with a current TS4 accreditation status will remain the only sites eligible to provide TS4 training until August 2027.

From August 2027, all sites will be assessed under the revised accreditation standards to ensure they are adequate learning opportunities for trainees.

Before recruiting a TS4 trainee, sites should thoroughly consider their capacity to deliver appropriate education and training to TS4 trainees, including support for completion of assessment requirements. Sites’ capability will then be formally assessed as part of the site's standard accreditation criteria at their next scheduled reaccreditation inspection. Further information on this will be disseminated over coming months.

The removal of TS4 accreditation means that, from August 2027, TS4 trainees may train at any accredited site. Training time completed before this date at sites that do not hold TS4 accreditation but can train TS4 trainees after August 2027 will not be backdated to be recognised as meeting TS4 training time requirements – see Training time below for detail.

Linked ED and EMTN classifications will be removed from August 2027. Sites will still be able to network with each other via collaborative training arrangements. Collaborative training arrangements under the revised standards will mean sites have more flexibility in the standards in which they collaborate and how they collaborate. Each site still remains independently accountable for its own accreditation.

Until August 2027, current arrangements can continue to operate as they do now.

At the next application for reaccreditation, sites will need to complete a collaborative training declaration identifying their partner sites and describing how they are collaborating as part of their application.

An updated Accreditation Support Guide and Collaborative Training Guidelines will be released ahead of August 2027 and will include more information on collaborative training arrangements for sites.

Sites that are conditionally accredited before August 2027 will continue to work through their existing conditions under the current accreditation requirements as normal. These conditions remain and must be addressed within the timeframe specified in a site’s Quality Improvement Plan. Conditions will remain in place if they relate to a standard in the revised accreditation standards beyond August 2027.

Sites will be assessed against whichever standards are in effect at the time of their inspection:

• Before August 2027 – current accreditation requirements 
• After August 2027 – revised accreditation standards

Processes to becoming accredited still apply as outlined in G550 FACEM Training Program Site Accreditation Process Guide.

As outlined in current process, if a site does not meet a revised accreditation standard, the site will be required to engage in a Quality Improvement Plan to ensure they work toward meeting all standards.

Training time already accrued under a site's current maximum remains certified and continues to count towards a trainee's requirements. Upon implementation of the revised standards in August 2027 and subsequent removal of tiered site classification, trainees may choose to stay at a site, subject to it remaining accredited and the meeting of any other applicable Training Program requirements.

If a trainee meets a site's current tier maximum for training time before August 2027, they will be required to move to a different site to have more training time certified, or enter surplus training at that site as per TA822 Interruption to training in the FACEM Training Program.

The revised accreditation standards webpage provides information about the revised accreditation standards and processes that will be introduced in August 2027. Support resources for the revised standards and processes are in development and will be published in the coming months.

The College accreditation website provides information about current Accreditation Requirements and processes that are in place until August 2027.

For training sites – [email protected]

For trainees – Speak with your DEMT in the first instance, or contact [email protected]