Higher Specialist Training in Emergency Medicine, ST4+, gives opportunities to build on knowledge and skills, as well as developing management, critical appraisal, research and leadership skills. During this time it is expected that trainees will work towards achieving FCEM examination. 

Recruitment for Higher Specialist Training in Emergency Medicine is currently co-ordinated on a National basis. Selection centres hold interviews at one central site and from here, trainees can select to come to work in the West Midlands. The large variety of training sites, including 3 Trauma centres and a specialist children's hospital, along with the well developed programme of delivered teaching held on a weekly basis make the West Midlands a popular choice for EM training.