Clinical Fellow posts & occupational health


There is some stuff you need to know before applying for our posts.... forgive us if we give you it straight, rather than being all PC about it....

Are there any occupational health requirements to be aware of?

Obviously, the whole point of a job incorporating PHEM is to experience front-line PHEM activity. This will include hazardous environments and a degree of physical risk.  Also, when it comes to you flying with Helimed, then total crew weight becomes a factor.

The politically correct answer is, therefore, that “occupational health requirements for these posts are more rigorous than for a standard EM middle grade job” - in order to undertake front-line PHEM duties, you need to be able to pass an front-line ambulance personnel occupational health assessment, not just a hospital one.  We haven’t yet made our Clinical fellows do the full Welsh Ambulance pre-employment fitness test (which entails a few weeks of effort at the gym for anyone starting off as a couch potato!) but we do reserve the right to, and if you want to do Helimed shifts, you must take and pass the EMRTS Fitness test (see below).

The bullshit-free answer, therefore, is that whilst you don’t need to be an Olympic athlete, you definitely do need to be generally fit and healthy. There are also certain conditions that preclude occupational health clearance for front-line PHEM work, including pregnancy (see below).

You should also be aware that a poor sick leave record without good reason in any one-year fixed-term post is a potential problem: not only would it call into question your fitness for front-line PHEM duties (access to which would be withdrawn if there were any possibility they were contributing to the post-holder’s ill-health) but sick leave records are specifically enquired about in most structured references for training posts.

Finally, if your BMI is scarily on the high side and you have any ambitions to take up the opportunity to fly with Helimed, then you’ll probably want to think about signing up for Weightwatchers sooner rather than late, because you may be too fat to fly. It’s less of an issue on EMRT’s larger new aircraft than it used to be, but if you are heading for, or over, 100kg you may find yourself with restricted access to flying shifts (as total crew weight must be calculated) and it is not impossible you may occasionally be dumped at the side of the road on a job if the aircraft is picking up a particularly heavy patient.

There is no way round this apart from losing weight - it’s nothing to do with discrimination, we’re not being size-ist.... it is simply to do with the laws of gravity, fuel bills and aircraft performance!

The EMRTS Fitness test

Since August 2017, the Helimed 61 (Caernarfon) Welsh Air Ambulance transferred from being a Welsh Ambulance asset to being an EMRTS one. This has been an exciting time for our Clinical Fellows, who for the first time are able to work with an RSI+ve crew and see the full breadth of UK PHEM practice. However it does mean our Fellows must pass the EMRTS fitness test to be able to book onto Helimed shifts! This consists of carrying a 20kg backpack for a mile in a set time-limit followed by a cognitive challenge, usually running an ALS scenario, folllowed by a 2-person 70kg stretcher lift.

Er..... babies. Pregnancy seriously limits pre-hospital playtime

What we should probably do for this section is make some oblique reference that all applicants must be medically fit to undertake PHEM duties “and that amongst the conditions that may render someone unfit for PHEM duties would be pregnancy”.

The mere existence of this section on our website is likely to make Medical Staffing colleagues keel over in horror, as discussions about pregnancy and babies are generally a complete no-no in anything to do with medical personnel/recruitment...


The main attraction for Fellows coming to the PHEM posts is the pre-hospital playtime. If you happen to be a female doctor wondering about coming to work with us and wondering when is the best time to start a family, it is only fair to make you aware from the outset that participation in pre-hospital activities would be comprehensibly decimated if you were to announce a pregnancy during your time as a Clinical Fellow.

Welsh Ambulance - like other UK ambulance trusts - do not allow pregnant women to undertake any front-line duties.  Helicopter work would also be out. And a variety of the other more adventurous PHEM-related activities would also be deemed unsuitable... a baby on board would make whoever’s doing the health and safety risk assessment have a nervous breakdown: some of this stuff involves chucking you into a river/off a cliff/ down a hole in the ground, and other activities that are unlikely to feature in a manual of recommended activities for pregnant women.

So, if babies are on the horizon, you need to be aware that in the event of pregnancy during your Clinical Fellow year, your PHEM related activities would be basically limited to teaching or time spent within ambulance control. If you are most interested in systems and processes, this might not bother you (we could certainly think of some worthwhile research and learning projects covering the processes of unscheduled care) - but if your chief motivation for coming to Bangor were the PHEM opportunities, you might be a bit gutted to miss out.

There would be a saving grace, however, if any Clinical Fellows were to become pregnant.....  there’s scope for serious fun freaking out trainee winchmen and paramedics, facing them with a real pregnant lady for moulage purposes - even if it would have to be indoors rather than hanging off a cliff!

And on a serious note.... if you are a female EM or anaesthetic trainee interested in sub-speciality training and figuring out when is the best time to start a family, you do need to bear this in mind, as being pregnant would decimate any timetable for formal sub-speciality PHEM training, too.

Female applicants for our new Global EM programme should also be mindful about the risks of travelling to LMI countries during pregnancy, where healthcare access and standards may fall well short of those expected in the UK. Such travel is entirely at your own risk anyway, but do consider it when contemplating timing a pregnancy.