RCEM curriculum SLO codes mapped to topics

TL;DR: The RCEM 2021 curriculum (last updated v1.5, August 2025) is built around 12 Specialty Learning Outcomes (SLOs) — 8 Clinical and 4 Supporting — that together define what an Emergency Medicine consultant must be entrusted to deliver independently. Core trainees evidence the 11 ACCS Learning Outcomes; from intermediate training onwards you evidence the 12 RCEM SLOs against Key Capabilities, with a Faculty Educational Governance (FEG) statement, three ESLEs per year and an MSF feeding each ARCP.

What is an SLO and why does the RCEM curriculum use them?

A Specialty Learning Outcome (SLO) is an entrustable unit of consultant work — an activity the training faculty must be willing to entrust you to deliver independently. The RCEM 2021 curriculum, written to satisfy the GMC’s 2017 Excellence by Design framework, abandons the old tick-box presentation list and groups everything an EM consultant does into 12 SLOs.

Eight of these are Clinical SLOs (patient-facing activity on the shop floor). Four are Supporting SLOs (teaching, research, quality improvement, and lead-and-manage activity off the shop floor). Each SLO is underpinned by Generic Professional Capabilities (GPCs) from the GMC framework, broken down into Key Capabilities (the bits you must evidence) and Descriptors (illustrative examples — not a checklist).

The point of the SLO model: ARCP panels make a holistic, professional judgement that you can do consultant-level work, not that you have accrued a magic number of WPBAs.

Are there really 12 SLOs — and have any changed recently?

Yes — 12, since launch in August 2021. The most recent meaningful change landed in the August 2025 v1.5 update:

• SLO 12 was retitled from “Manage, Administer and Lead” to “Lead & Manage”, with extra Key Capabilities on leadership theory, cultural impact and emotional intelligence.
• SLO 5 (children) gained additional descriptors on paediatric resuscitation, complex needs, safeguarding and transition to adult care.
• SLO 6 (procedures) now explicitly includes adult sedation in the progression standards table.
• SLO 8 (lead the ED shift) had its Intermediate and Higher descriptors revised around situational awareness and staff wellbeing.
• SLO 11 (QI) now uses the revised QIAT, aligned with current AOMRC guidance.

If you trained pre-2021 you may still hear consultants reference the old 2015 curriculum’s CiPs (Capabilities in Practice). The 2021 curriculum doesn’t use “CiP” as the headline unit — SLOs are the unit — but the GPCs and Key Capabilities serve the same purpose.

The 12 RCEM SLOs — full code map

This is the table to bookmark when you’re tagging evidence in the ePortfolio. Eight Clinical SLOs (1–8) and four Supporting SLOs (9–12):

How do the 11 ACCS Learning Outcomes map onto the 12 RCEM SLOs?

This is the bit that trips up trainees moving from ST2 into ST3. Core (ACCS) training uses 11 ACCS LOs common to all four parent specialties (EM, AM, ICM, anaesthetics). Once you finish ACCS, three things happen:

• ACCS LO 5 (“safe basic anaesthetic care including sedation”) and ACCS LO 8 (“organ dysfunction and failure”) fold into RCEM SLO 3 and SLO 6. They don’t disappear — they become subsumed under resus and procedural skills at a more sophisticated level.
• Two new SLOs appear that don’t exist in ACCS: SLO 5 (paediatrics) and SLO 8 (lead the ED shift). Both become formal requirements from intermediate training.
• A twelfth SLO — SLO 12 (Lead & Manage) — kicks in from intermediate training onwards. There is no ACCS equivalent.

The numbering also reshuffles. ACCS LO 5 is anaesthesia; RCEM SLO 5 is paediatrics. Don’t tag a paediatric resus case as “SLO 5” in your ACCS year — there is no SLO 5 yet, and the equivalent paediatric experience in core sits under SLO 1, 3 or 6 depending on what you actually did.

What’s the difference between SLO, CiP, GPC and Key Capability?

These terms get used loosely. The RCEM 2021 curriculum is precise about each:

• SLO (Specialty Learning Outcome): the unit of consultant work. There are 12. This is what your ePortfolio tags evidence against.
• GPC (Generic Professional Capability): the GMC’s 9 domains every doctor must demonstrate. Each SLO is mapped to several GPCs (SLO 1 maps to GPCs 1, 2, 3, 4, 6, 7 — for example).
• Key Capability: the mandatory specific capabilities within an SLO that you must evidence. These are what the FEG statement signs off.
• Descriptor: illustrative examples of skills/behaviours that demonstrate a Key Capability. You don’t need to evidence every descriptor — they are guidance, not a checklist.
• CiP (Capability in Practice): language from the old 2015 curriculum and other Royal Colleges’ curricula. RCEM 2021 uses SLO + Key Capability; if a supervisor says “CiP” in an RCEM context they almost always mean “Key Capability under an SLO”.

Which SLOs are Clinical vs Supporting?

Plain-text key facts:

• Clinical SLOs: 1, 2, 3, 4, 5, 6, 7, 8 — eight in total, all patient-facing.
• Supporting SLOs: 9, 10, 11, 12 — four in total, all off the shop floor.
• Only the Clinical SLOs carry an explicit entrustment decision against each Key Capability.
• Supporting SLOs are assessed by professional judgement of the ES and ARCP panel against the “not yet achieved / good / excellent” grid in the curriculum.

What evidence do I need per SLO at ARCP?

The headline rule from the curriculum: there are no absolute numbers of WPBAs beyond the mandatory ones below. Quality and triangulation matter more than volume.

Mandatory minimums for intermediate and higher training:

• At least 3 ESLEs (Extended Supervised Learning Events) per training year.
• 1 MSF per year, completed in the first six months so concerns can be addressed in-year.
• Evidence of interaction with the training faculty in every Clinical SLO relevant to your stage of training, reviewed at the 3-month meeting.
• An FEG (Faculty Educational Governance) statement — the summative judgement that you’ve met the standard for each SLO.
• Specific WPBA mix per SLO (see table below).

Recommended WPBA per Clinical SLO (intermediate and higher):

The curriculum suggests aiming for roughly one observed episode per week across the Clinical SLOs (you can also align this revision with the top 10 high-yield FRCEM SBA topics), with the App episodes deliberately kept short (a few minutes plus a focused reflection).

Which SLO covers paediatrics?

SLO 5 covers paediatrics from intermediate training onwards — “Care for children of all ages in the ED, at all stages of development and children with complex needs.” Within SLO 5 you must evidence paediatric resuscitation (which also touches SLO 3), procedural skills in children (touches SLO 6) and safeguarding. The August 2025 update added explicit descriptors on transition to adult care and children with complex needs.

In ACCS you can accrue paediatric experience but it isn’t a formal SLO requirement until ST3.

Which SLO covers procedural skills and sedation?

SLO 6 — “Deliver key procedural skills.” Since the v1.5 update (August 2025), adult sedation is formally listed in the SLO 6 progression standards table, having previously sat awkwardly between SLO 3 and SLO 6 after ACCS LO 5 was retired. The procedural skills syllabus inside SLO 6 lists every technical skill you need to be signed off on, from ultrasound-guided cannulation to suprapubic catheterisation, with progression standards by training year.

Which SLO covers research, QI and teaching?

• SLO 9 — Support, supervise and educate: evidenced via Teaching Observations (TO), educational supervision activity, simulation faculty roles.
• SLO 10 — Research and data: evidenced via ACAF (Applied Critical Appraisal Form) and JCF (Journal Club Form); a published abstract or formal critical appraisal counts strongly.
• SLO 11 — Quality improvement: evidenced via QIAT (Quality Improvement Assessment Tool — revised in v1.5). A completed QI cycle with measurable change is the gold standard.

How do SLOs progress from core to intermediate to higher training?

The RCEM curriculum sets out three stages with different entrustment thresholds:

• Core (ACCS, indicative 2 years): evidence the 11 ACCS LOs. Entrustment decision at end of core: can you identify sick adults and resuscitate to a level where you can be on the floor as part of the team.
• Intermediate (indicative 1 year, typically ST4): evidence the 12 RCEM SLOs at intermediate level. End-point entrustment: can you safely function as the most senior clinician overnight, with a consultant available from home.
• Higher (3 years, ST5–ST6 in current numbering, with ST6/ST7 used in some deaneries): evidence the 12 SLOs at higher level. End-point entrustment: ready for independent consultant practice — “take on the most difficult and complex cases, supervise and evaluate others, do the above whilst maintaining departmental oversight.”

Generic SLO waypoints in the curriculum are set at end of ST2, end of ST3, and end of ST6.

How many SLOs do I need to evidence per year?

All of them, every year, at your current stage. The curriculum is explicit: you should be showing progress across every relevant Clinical SLO from the start of each training attachment, reviewed at the 3-month meeting with your Clinical/Educational Supervisor. You don’t bank an SLO and stop touching it.

What changes year-on-year is the level at which you’re expected to operate within each SLO — descriptors at intermediate are deliberately more demanding than at ACCS, and higher more demanding again.

Common mapping mistakes trainees make

From conversations on the registrar shop floor and supervisor feedback:

• Tagging a resus case under SLO 1 because the patient was “medical.” If you led airway, fluid resus or peri-arrest decision-making, it’s SLO 3 (and possibly SLO 8 if you were leading the shift around it).
• Confusing SLO 4 (injured adults) with SLO 5 (children). A paediatric trauma case from intermediate training onwards generally tags to SLO 5 first, SLO 4 secondary, plus SLO 3 if it’s polytrauma resus.
• Forgetting SLO 8 exists. Many trainees under-evidence shift leadership because the episodes feel diffuse. The fix: a short reflective entry after each shift you led, tagged to SLO 8, with one ESLE per attachment focused explicitly on flow and team leadership.
• Treating descriptors as a tick list. They’re illustrative. Your ES and the ARCP panel want evidence against Key Capabilities, not 40 disconnected reflections matching individual descriptors.
• Leaving SLO 10/11 evidence until the last six months. Critical appraisal forms and QI tools take time and feedback cycles. Start them in the first quarter of the training year.

How do I actually tag evidence in the ePortfolio against an SLO?

The RCEM ePortfolio (via the LaSE / RCEM Hub) lets you tag every WPBA, reflection and uploaded document against one or more SLOs and their Key Capabilities. The practical workflow:

1. After a clinical episode, open the RCEM App and pick the SLO most central to the encounter. Add the secondary SLOs as additional tags — the system supports multi-tagging.
2. Pick the specific Key Capability within the SLO. This is what your ES and the ARCP panel will look at, not the SLO header.
3. Write a short focused reflection (200–400 words). One learning point per reflection beats a sprawling essay covering five SLOs.
4. Trigger an ESLE every 4–6 weeks across the year so you hit the three-per-year minimum without bunching them in March.
5. At each Educational Supervisor meeting, run the ePortfolio’s SLO heatmap and look for gaps. Plan the next 6–8 weeks of evidence to close them.

FAQ

How many RCEM SLOs are there?

There are 12 RCEM SLOs from intermediate training onwards — 8 Clinical (SLO 1–8) and 4 Supporting (SLO 9–12). In core training you instead evidence the 11 ACCS Learning Outcomes shared with the other ACCS specialties.

What is the difference between an SLO and a CiP?

In RCEM 2021 the unit is the SLO. “CiP” (Capability in Practice) is language from the old 2015 RCEM curriculum and from other Royal Colleges. When supervisors say “CiP” in an RCEM context today they almost always mean a Key Capability sitting inside an SLO.

Which SLO covers paediatric emergency medicine?

SLO 5 — “Care for children of all ages in the ED, at all stages of development and children with complex needs.” It becomes a formal requirement from intermediate training. Paediatric resus also evidences SLO 3, and paediatric procedures evidence SLO 6.

Which SLO covers leading the ED shift?

SLO 8 — Lead the ED shift. It’s required from intermediate training onwards and is one of the most narrative-heavy SLOs to evidence; reflective entries after shifts you led, plus one ESLE per attachment focused on flow and leadership, is the standard pattern.

How many ESLEs and MSFs do I need per ARCP?

At intermediate and higher training: at least 3 ESLEs per training year and 1 MSF per year (completed in the first six months so concerns can be addressed in-year). Beyond those minimums there are no absolute WPBA numbers — quality and triangulation matter more.

What is the FEG statement?

The Faculty Educational Governance statement is the summative judgement by the local training faculty that you have met the required standard for each relevant SLO at your stage. It was renamed from “Faculty Entrustment Group statement” in v1.3 of the curriculum (December 2020). The FEG sits alongside your ePortfolio evidence and your ES report at the ARCP.

Did the RCEM curriculum change in 2025?

Yes — version 1.5 was issued in August 2025. The biggest change is SLO 12 being retitled from “Manage, Administer and Lead” to “Lead & Manage”, with extra descriptors on leadership theory and emotional intelligence. SLO 5 (paediatrics), SLO 6 (procedures and sedation), SLO 8 (shift leadership) and SLO 11 (QI — revised QIAT) also gained material descriptor changes. The 12 SLO numbering and titles otherwise remain as launched in August 2021.

How do I evidence research (SLO 10) if I’m not doing a formal project?

You don’t need a published paper. Two completed ACAFs (Applied Critical Appraisal Forms) per year, plus journal club participation evidenced via JCF (Journal Club Form), will usually satisfy SLO 10 at intermediate level. At higher level, ARCP panels expect more — a service evaluation, audit-linked appraisal, or contribution to a published study is the standard expectation.

How do I evidence quality improvement (SLO 11)?

The QIAT (Quality Improvement Assessment Tool) — revised in v1.5 of the curriculum — is the primary vehicle. A full QI cycle with measurement, intervention, re-measurement and reflection scores strongest. Start in Q1 of your training year — feedback cycles take months.

Do SLOs apply to ACCS trainees?

No — in ACCS you evidence the 11 ACCS Learning Outcomes, common to EM, AM, ICM and anaesthetics. You can accrue experience and feedback that will later count towards RCEM SLOs (especially SLO 5 paediatrics), but tagging in your ePortfolio during ACCS is against the ACCS LOs.

What happens at ARCP if I’ve missed an SLO?

An ARCP panel can issue Outcome 1 (satisfactory progress), 2 (development of targeted objectives), 3 (additional training time required), 4, or 5 (incomplete evidence). Missing evidence in a single SLO usually triggers Outcome 5 (more evidence requested) or Outcome 2 (targeted objectives) rather than 3. Talk to your ES before the panel — preventable gaps are easier to fix at the 6-month meeting than at the ARCP itself.

Where can I see the full current SLO descriptors?

The authoritative source is the RCEM 2021 Emergency Medicine Training Curriculum (v1.5, August 2025) hosted on the RCEM website, plus the rcemcurriculum.co.uk syllabus mapper. The intermediate and higher ARCP requirement guides on the same site set out year-by-year expectations.

Your next step

If you’re preparing your ARCP submission and want a structured way to revise the curriculum content underpinning each SLO — and to keep your MRCEM and FRCEM exam knowledge aligned with the same Key Capabilities — head to emfinalexams.com. The question banks and revision tracks are mapped to the RCEM 2021 SLO framework so you can drill exactly the capabilities your ePortfolio needs evidence against.

Facts last verified 30 May 2026 against the RCEM 2021 Emergency Medicine Training Curriculum v1.5 (August 2025 update) and the RCEM ARCP requirement guides.

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