Systematic Training in Acute Illness Recognition and Treatment START

The START course is a one-day foundation training programme that equips FY1 doctors with a systematic approach to recognising and managing acutely unwell patients on the wards or high dependency unit (HDU). Developed collaboratively by surgeons, anaesthetists, physicians, an intensive care nurse, and a foundation trainee, the course extends assessment and management techniques beyond the standard ABCDE protocol, emphasising the critical role foundation doctors play within their clinical teams.

The course combines interactive lectures, group discussions, and practical simulation stations. Key activities include critiquing clinical cases, learning the START algorithm for managing potentially unwell patients, exploring human factors in clinical practice, participating in simulated patient scenarios to practise the START algorithm, and conducting virtual ward handovers to develop prioritisation and management-planning skills.

Participants receive a companion handbook with reflective activities and a certificate of attendance, which can be linked to the Horus e-portfolio. An increasing number of foundation training programmes have integrated START into their core training; check with your local Training Programme Director (TPD) to confirm whether it is included in your programme.

This course is suitable for Foundation Year 1 doctors, though final-year medical students and advanced care practitioners may also find it valuable. Surgical Care Practitioners (SCPs) can attend to meet curriculum requirements for Clinical Method in Surgical Practice, Perioperative Care, Critical Care & Core Clinical Capabilities.

By the end of the course, you will be able to:• Recognise an unwell patient• Perform a systematic patient assessment• Commence appropriate treatment• Escalate care to an appropriate senior• Recognise the importance of human factors in the workplace• Harness team resources available to you