Pick your parent college first — it determines everything.
Typical start years; people vary by a year or two. Diamonds are exams. Stage list and sources in the pathway tab.
Both parent programs (BPT and FACEM) are themselves contested; PEM is a scarce, desirable AT. Ratings are the encoder's 1–5 call from college numbers and r/ausjdocs; applicant-to-place ratios double-count people who apply in several states. Evidence rows are in getting selected.
The 36-month PEM program is 18 months PEM in accredited paediatric EDs (mixed EDs don't count), 12 months adult EM and 6 months PICU, plus research, developmental/psychosocial training and APLS. ACEM-stream trainees can fit 15-18 months inside core FACEM time if they plan well; the rest is extra time at registrar pay, which is why 'the amount of money PEM will cost you in lost wages should make you rethink' and why fewer trainees are finishing. The payoff is access to tertiary paediatric EDs and leadership roles. A Paediatric Emergency SRMO/CMO year is the best prevocational move and PICU is the scarce block.
This is good advice if you only want to see kids. Only caveat is that FRACP PEMs tend to be limited to work in dedicated Paediatric emergency departments rather than mixed EDs. So usually in metropolitan areas only.
Yes! Essentially you get all the Paeds ED related things for your department - working groups, policy lead, research lead, education lead. To more formal roles like - external incident case reviewer, DEMT, director, digital SMEs, acute paeds telehealth, APLS instructor etc.
Do PEM after exams if you really want to. The amount of money PEM will cost you in lost wages should make you rethink.
I'm doing PEM at the moment - I've done all my adult time and exams so just working on chipping away at the extra PEM requirements. I was a fairly late sign up (didn't commit to PEM until the last year of my training) but had done a 6 month rotation in gen paeds which I was able to get recognised towards my PEM…
All 26 curated quotes by topic, trajectories and threads.
policy.acem.org.au for the facts and summary, read 12 Sept 2026 · rating and pathway encoded by hand from the same sources · quotes are verbatim r/ausjdocs comments, community view not policy
Term advice: nothing encoded yet — not published.
Stages: racp.edu.au, health.nsw.gov.au, jobs.acem.org.au +1 · terms: r/ausjdocs term-strategy collection, counted by distinct author, community view not policy
"Mandatory" is the college's word. Amber "community" rows are what the sub says panels actually want.
Composition (18/12/6) is official (RACP/ACEM); the accredited-ED and NICU/NETS caps are a PEM trainee's account.
Perth Children's, Women's & Children's Adelaide, plus mixed EDs with high paediatric volume. Advertised via state JMO campaigns and the ACEM job board. NZ: only one accredited CED (Starship); a 2025 comment claimed 'no one can enroll at present' pending a PEM program review — verify.
Sydney Children's Hospitals Network (Westmead, Randwick): 'CHW is where it's at… their ED and PICU are incredible!'; RNSH Paediatric ED is also accredited for Paeds ED time. PICU is a true bottleneck in NSW. Paediatric SRMO network via the NSW paediatrics early round (22 May - 8 Jun, offers 29 Jun); registrar posts in the main round.
Queensland Children's Hospital: 'a great experience working at QCH in both the ED and the PICU'. Recruits via the RMO & Registrar campaign (1-29 June).
Royal Children's Melbourne, Monash Children's, Northern Health. Note: 'there is no fellow grade on the Victorian pay scale. You won't be paid as a FACEM, so it's just more years on the top of the reg scale.' RCH JRMO recruits directly (18 May - 7 Jun 2026).
RCH JRMO dates are from the recruitment-cycles report (RCH portal); the PMCV URL is the nearest captured source.
Dates drift a week or two each year; the calendar has confirmed vs expected windows.
No PEM-specific selection rubric; employer-recruited PEM posts; parent college selection applies (ACEM: standards-based, no interview, max 3 attempts; RACP BPT: network/jurisdiction rubrics).
Requirements and rubric: reddit.com, racp.edu.au, policy.acem.org.au · state mechanics: jobs.acem.org.au, reddit.com · community rows from r/ausjdocs
"Cost to get on" is a name-based pick of the one-off fees paid before or at selection. The college schedule is a lifetime-of-training list at each item's own year, not one bill; community amounts overlap it and are never summed. Courses, travel and repeat sittings are the part the sub complains about.
Exams and fees: policy.acem.org.au, racp.edu.au, acem.org.au +1 · claims, prep and costs quoted: r/ausjdocs exams-and-costs collection, community view not policy · paid prep products need three independent non-suspect authors and a free alternative to appear
Scored by the Paediatric emergency medicine rules — whether or not the title names the specialty — highest first, closing soonest next.
Faded bars are expected, not confirmed. Only 4 dated offer reports mention Paediatric emergency medicine, too few for a chart. Full detail on the calendar.
Jobs: last night's scrape, scored by hand-written rules (no AI) · units and offer reports: r/ausjdocs, counted by distinct author · campaign windows: canberrahealthservices.act.gov.au, health.nsw.gov.au, healthjobs.nt.gov.au +4
Verbatim, one caution beside one encouragement per topic where both exist, the rest folded. Every quote links to the comment.
Lots of utter horseshit in the comments. If you’re not interested in general paediatrics, do FACEM training. It’s a higher quality and tougher training program but you’ll be able to get a job in a non specialist children’s hospital. I’ve got friends who’ve got their PEM ticket, going back to do FACEM as an add on so…
I'm doing PEM at the moment - I've done all my adult time and exams so just working on chipping away at the extra PEM requirements. I was a fairly late sign up (didn't commit to PEM until the last year of my training) but had done a 6 month rotation in gen paeds which I was able to get recognised towards my PEM…
I think the best I’ve been able to do is to do my 15 months extra after finishing my FACEM qualification. I’ve tried to do as much as possible within my training, but I still have those extra 15 months after. I know some folks who have done their FACEM and have done all their 3 years extra at full time or part time…
I'm a recently fellowed FACEM and currently finishing off my training requirements for PEM. I've done most of my training in Queensland and have had a great experience working at QCH in both the ED and the PICU. I would recommend trying to get at least 6 months of gen paeds time out of the way before you do your…
The 18 months of Paediatric ED experience can only be done in accredited Paediatric EDs. It can’t be done in mixed EDs, that is part of your core ACEM time but not PEM time. I’ve done my 6 months of Paediatric ED as a Registrar in an accredited tertiary ED but the rest of my core ACEM time has been in mixed EDs. I…
My only advice is 6 months of NICU is pretty helpful to your stated goal whether a part of PEM or not. In many ways alot of paediatric patients are little adults. My token example is that ovarian torsion occurs in pre pubescent girls reasonably similarly to post pubescent. That is we can actually do a paediatric…
I would recommend through FRACP and considering doing General + ED. That way you have a better pathway out of Emergency Medicine when you want to move on. There's lots of FACEMs who get burnt out around their mid 40s who start to find the EM hours tiring. They often struggle to find a pathway out. Because their…
The lack of CED in NZ really does limit our training. But at least you can get Gen Peds and 12 month of Starship done in NZ. I wonder what will come of the review of the PEM programme - no one can enroll at present.
It’s not really a fellowship. It’s a pathway that RACP and ACEM have put together to subspecialise in Paediatric Emergency Medicine. On completion, it will be FACEM/PEM or FRACP/PEM not a FPEM. The fellowship is with the colleges, FACEM and FRACP.
PEM trainee here from NSW. I signed up as a PEM trainee as soon as I was post primary and eligible. I have 6 months of my training time left. I’m a TS4 trainee. In my long-ass journey, I have completed, 6 months of Paeds ED, 6 months of PICU and 9 months of Gen Paeds as part of my core ACEM training. After I’m…
I signed up for PEM when I entered early phase advanced training (TS2 equivalent) as my consultants told me that if you even had the tiniest inkling you might want to do PEM, just sign up so every rotation will count (the joint college committee has had issues in years past with recognising prior rotations even when…
If you want to work with kids only, ie paeds ED, better to go through RACP pathway. If you want some adult ED work as well, do the FACEM + PEM requirement route. To get the PEM certification from FACEM, you'll have to do a certain amount of dedicated time in PED/genmed/picu so you'll get the well-rounded paeds…
I think PICU counts specifically for the PEM time alone so it only shows up on my PEM portal. My critical care time was complete with Adult ICU/Anaesthetics before I did my PICU time. Critical care time only shows on my ACEM portal page not on the PEM portal. My guess is it won’t count, it will be interrupted training…
= FACEM (you can work in mixed EDs seeing kids) - There is an option to tac on PEM now which more people are doing, to do that you need to do PICU and some Paeds Reg time (though not BPT). More and more larger (and smaller) EDs are starting to prefer PEM trained bosses for even their mixed EDs because it makes a big…
For the reasons noted by others already, if you want to do Paediatric Emergency Medicine (PEM) it's probably best to properly dual train as both a General Paediatrician (FRACP) and Emergency Physician (FACEM). There is a dual training fellowship pathway established between the two colleges that attempts to streamline…
This is good advice if you only want to see kids. Only caveat is that FRACP PEMs tend to be limited to work in dedicated Paediatric emergency departments rather than mixed EDs. So usually in metropolitan areas only.
Employment wise it is one of the more recognised subspecialties in ED that offers specific training and more formal long term job opportunities. It's impossible to get into a tertiary PED without PEM, is highly preferred for mixed departments with separate PEDs and even in a pure mixed ED, it would definitely be seen…
That said PEM training is fairly easy to do and the market has become quite saturated - there aren't that many paediatric EDs around. However being a general FACEM you can work in any ED so it's not an issue this is more of an issue for those RACP.
Yes! Essentially you get all the Paeds ED related things for your department - working groups, policy lead, research lead, education lead. To more formal roles like - external incident case reviewer, DEMT, director, digital SMEs, acute paeds telehealth, APLS instructor etc.
So ACEM/PEMs are not Paediatricians. We only work in Paediatric EDs and some of them do some NETS/Retrieval as well. In the past, there was an option of also giving the Paeds exam and then they could qualify as Specialist Paediatricians but there was very little uptake and they scrapped that option.
If you are NSW based, the one place to do any of your PEM things, if you actually want to learn something and see a broad variety of pathology and amazing PICU experience, CHW is where it’s at. I know colleagues who have done PEM in Randwick PICU and they have their (somewhat limited) experiences, but if anything…
There is no monetary advantage to PEM Employment wise it will be easier to get a job at a tertiary paeds centre with PEM, and perhaps in a mixed ED. You can do the PEM time any time during facem training but most people will tell you to do it post facem. You get paid as a fellow rather than a reg if you already have…
Except there is no fellow grade on the Victorian pay scale. You won't be paid as a facem, so it's just more years on the top of the reg scale (which is better than the too of the reg scale in most other states). A lot of people doing time in pem post facem do paeds telehealth type gigs (especially in QLD) on the side…
Do PEM after exams if you really want to. The amount of money PEM will cost you in lost wages should make you rethink.
Paediatric Emergency Medicine via ACEM or RACP. As an ACEM/PEM dual trainee myself, it’s a loss of pay of Consultant money for 3 years at least, while you accrue your Paediatric experience and now (from 2027?) end up paying more money in fees to a college that does fuck all about it but monitors your time to get…
Money isn’t a driver for me. My biggest gripe with ACEM training is them thinking a logbook of 400 paeds cases is adequate exposure and training in paediatric emergencies. Like I said, my ultimate career goal isn’t to work in an adults only tertiary Ed, it’s to work in smaller mixed regional/rural EDs. Plus I’ll be…
1 people, counts not rates.
Almost TS4 trainee here, who is stupidly dual training PEM so the TS4 has been put off by tedious paediatric requirements.comment ↗
whiplashed super quick back to ED and signed up for FACEM. I did ED first and loved it but I was super keen on O&G.comment ↗
I was super keen on O&G. I lived in the US for a few years and I did my steps and applied to O&G residency programs and I wasn’t able to get in. It was very depressing but I also did not want to keep…comment ↗
I had signed up as ED AT as soon as I passed my primaries. I’ll be ACEM time complete in the next 6 months, within my core ACEM time, I’ve managed to do 9/12 months of Gen Paeds 6/6 months of PICU 6/…comment ↗
Reconstructed from what people said about themselves on a public forum. Self-report only; no verification against any register. Survivorship and self-selection are severe (people post when things go wrong and when they get on, rarely in between). Handles are public usernames; nothing here is combined with any off-platform data.
r/ausjdocs comments and posts, hand-curated from the paediatric-emergency collection; scores as at the dump · community view, not policy
Knowledge rows last loaded 13 Sept 2026, encoded by hand from the sources linked on each panel; no AI wrote any of it. Compare specialties · calendar · all guides.