Following completion of the training programme in Emergency Medicine in Ireland, the option exists to develop a subspecialty interest, either in a newer or more traditional area of Emergency Medicine practice.

While the majority of EM specialists train exclusively in (general) Emergency Medicine, some may wish to develop a subspecialty interest in Paediatric Emergency Medicine (PEM). The joint PEM training programme outlined in The Development of Paediatric Emergency Medicine in Ireland provides an opportunity for subspecialisation in PEM and allows access to the subspecialty for trainees who come either from an Emergency Medicine or a General Paediatric background. It allows a paediatric trainee who completes PEM subspecialty training to be eligible to be included in the Register of Medical Specialists under both Paediatrics and Paediatric Emergency Medicine (when the latter division is created) and be able to apply for a Consultant post in Paediatric Emergency Medicine. Equally, an Emergency Medicine trainee with PEM subspecialty training will be eligible to be included in the Register of Medical Specialists under both Emergency Medicine and Paediatric Emergency Medicine (again, when the latter division is created) and be able to apply for a Consultant post in Paediatric Emergency Medicine.

Although not mandatory for a substantive post in Emergency Medicine, many EM trainees consider a period of time spent working in another healthcare system as a complement to their training in Ireland. In recent years, an increasing number of trainees have gone to the United Kingdom, Australia, New Zealand, Canada, the United States to pursue further training opportunities in areas such as:

• Critical Care medicine
• Pre-hospital and Retrieval Medicine
• Simulation in Emergency Medicine
• Emergency Medicine Ultrasound
• Toxicology in Emergency Medicine
• Paediatric Emergency Medicine