Application for Enrolment (PEM) 2023

Application for Enrolment

ACEM Paediatric Emergency Medicine (PEM) Training Program
This form will allow you to submit an application to enrol into the ACEM Paediatric Emergency Medicine (PEM) Training Program.

To enrol in the program, you must be either:
- registered as a Training Stage Two (TS2), Three (TS3) or Four (TS4) trainee with ACEM, or
- a Fellow of ACEM (FACEM).
If you are a Fellow of RACP wishing to pursue dual Fellowship with ACEM, please contact the Training Services Unit by email at training@acem.org.au, or by phone on +61 (0)3 9320 0404.
Full Name*

First NameLast Name
ACEM membership number*
Date Training Stage Two (TS2) commenced:*

DayMonthYear
Additional files (if required):

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Declaration & Submission

Application for Enrolment
I declare that this information provided in this application is accurate and complete the best of my knowledge.*

I am a registered as a Training Stage Two, Three, or Four FACEM Training Program trainee, or Fellow of the Australasian College for Emergency Medicine (ACEM).I formally apply to register as a trainee in the ACEM Paediatric Emergency Medicine Training Program, administered by the Committee for Joint College Training in Paediatric Emergency Medicine of the Australasian College for Emergency Medicine (ACEM) and the Royal Australasian College of Physicians (RACP).I understand that ACEM provides governance of those components which determine the FACEM qualification and the RACP those components which determine the FRACP qualification.
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Application for Enrolment

Declaration & Submission