How to Prepare for ATLS or the European Trauma Course as an IMG Doctor
If you are applying for emergency medicine, surgical, orthopaedic or anaesthetic posts in the NHS, you will often see an accredited trauma course such as ATLS listed in the person specification. Both ATLS and the European Trauma Course (ETC) are demanding, assessed courses, and IMGs who prepare well get far more out of them. This guide explains what each course is, how it is assessed, and the UK guidance you should know before you go.
Quick answer
ATLS is a two-day hybrid course developed by the American College of Surgeons and run in the UK by the Royal College of Surgeons of England, with mandatory pre-course e-learning, an MCQ and a practical initial-assessment scenario. ETC is a team-based, scenario-heavy course. Prepare by mastering the <C>ABCDE primary survey, key NICE major trauma guidance and clear team communication.
What you will learn in our free Trauma Life Support — UK Guidelines course
Show you can approach a major trauma call systematically using UK guidance — and prepare for your ATLS® course. Our free online Trauma Life Support — UK Guidelines course is written for NHS doctors and international medical graduates. You study at your own pace in 6 short modules, with worked examples, interactive exercises and a short quiz at the end. There is no sign-up, and your progress is saved so you can stop and come back.
The 6 modules
Foundations: trauma in the UK and getting ready: Major trauma in the UK, What is expected of you on a UK trauma call, Mechanism of injury — read the story, The pre-alert and preparing the team, The trauma team and its leader
The primary survey: <C>ABCDE: The primary survey — <C>ABCDE, <C> — catastrophic haemorrhage, A — airway with cervical spine control, B — breathing: the immediate chest killers, Chest decompression and drains
Injuries by body region: Head injury — the Glasgow Coma Scale, Head injury — NICE CT rules (adults), Head injury — when to call neurosurgery, Spinal injury and C-spine imaging, Abdomen and pelvis
Imaging and the secondary survey: Imaging in major trauma, The secondary survey, Tertiary survey and missed injuries
Special groups: burns, children, older people and pregnancy: Burns — first hour, Children, Older people, Pregnancy
Transfer, communication and records: Transfer to definitive care, Handover and documentation, Patients, families and the team
By the end of the course you will be able to
Describe how major trauma care is organised in the UK and how to prepare a trauma team
Carry out a structured <C>ABCDE primary survey and treat life threats as you find them
Control catastrophic and major haemorrhage using UK guidance (pressure, tourniquets, pelvic binder, TXA, blood products)
Recognise and treat the immediately life-threatening chest injuries
Apply the NICE CT rules for head and cervical spine injury
Use imaging appropriately and complete a secondary survey
Adapt care for burns, children, older people and pregnant patients
Arrange safe transfer, give a structured handover and communicate well with families
Why it helps your NHS application
The <C>ABCDE primary survey, step by step, with a full worked case
NICE rules for head and C-spine CT, major haemorrhage, burns and special groups
Strong preparation for emergency, surgical and acute medicine posts
How to write it on your NHS application
In your CV and on NHS Jobs or Trac: list it under "Courses and CPD" (or in the training and courses section of the form), for example:
Trauma Life Support — UK Guidelines, online CPD course, CareerPro UK. Certificate of completion, [month and year]; verifiable online, ID CP-XXXXXXXX.
In your supporting statement: show what you learned and how you use it. For example (adapt it so it is true for you):
"I have strengthened my approach to the injured patient, including the <C>ABCDE primary survey and NICE major trauma guidance, through an online trauma course ahead of attending ATLS."
At interview: the course also prepares you for questions such as "You are first on scene at a trauma call. Talk us through your approach."
Your certificate of completion
When you pass the quiz, you can download a certificate pack:
A verifiable PDF certificate of completion with your name, the course, your CPD time and a QR code that shortlisters and appraisers can scan
An appraisal-ready reflective note, pre-filled with the course learning outcomes
A ready-to-paste line for your NHS Jobs or Trac application and CV, and a one-click "Add to LinkedIn" button
Studying is free. The certificate pack is a one-off £5, and you pay only after you pass
Online course — not an ATLS® provider certificate and not evidence of competence in trauma care.
What ATLS and ETC are
Advanced Trauma Life Support (ATLS) teaches a systematic, priority-based approach to the first hour of trauma care: find and treat what will kill the patient first, then look for everything else. The course and its methodology were developed by the American College of Surgeons and it is taught in many countries. In the UK, RCS England says it is the only UK provider of the ATLS provider course, which is now in its 11th edition.
The European Trauma Course (ETC) is a joint initiative of the European Resuscitation Council, the European Society for Trauma and Emergency Surgery, the European Society for Emergency Medicine and the European Society of Anaesthesiology. It is a 2.5-day course in which candidates spend most of their time in scenario-based workshops, working in small multi-specialty teams that mirror a real trauma team. It places strong emphasis on teamwork, leadership and non-technical skills, and it is aimed at clinicians who already have experience of treating major trauma. In the UK it is delivered at approved centres, often through NHS trust education or resuscitation departments.
Which should you choose? Check the person specifications for the posts you want. ATLS is the trauma course most often named in UK surgical and emergency medicine person specifications. ETC suits doctors who already work on trauma teams and want to develop team leadership. Some employers accept either, so ask if you are unsure.
What the ATLS course involves in the UK
RCS England's course page sets out the current structure. In summary:
Eligibility: doctors at FY2 level and above, equivalent staff grades, and some eligible advanced clinical practitioners and hospital-based dentists.
Pre-course e-learning: mandatory and substantial, with modules, videos and pre-course MCQs. It must be completed in full by the deadline before the face-to-face days. If you do not finish it, you cannot attend.
Manual: you are expected to read the participant manual in full. RCS England describes this as the best preparation for the MCQ.
Face-to-face: two days of interactive sessions and skills and scenario stations.
Written assessment: an MCQ test on the final day, with a set pass mark and limited resit opportunities.
Practical assessment: you are assessed throughout, and on the last day you manage a simulated initial-assessment scenario scored against objective criteria.
Validity: provider status lasts four years, with a one-day reverification course available.
Because the e-learning has a firm deadline and failure to complete it means losing your place, plan it around your rota as soon as you book. Fees, resit rules and timings can change, so always read the current RCS England page.
ETC centres typically describe continuous assessment through the scenarios, with a summative assessment at the end focused on technical skills and team leadership. Check the details with the centre you book with.
The <C>ABCDE primary survey
Both courses are built on a structured primary survey. In UK practice this is written <C>ABCDE: catastrophic haemorrhage first, then airway, breathing, circulation, disability and exposure. You treat each life threat as you find it, before moving on.
<C> Catastrophic haemorrhage: stop obvious life-threatening external bleeding first. NICE advises direct pressure with simple dressings, and a tourniquet in major limb trauma if direct pressure has failed.
A Airway with cervical spine protection: assess and secure the airway, protecting the cervical spine where injury is possible.
B Breathing: look for immediately life-threatening chest injuries such as tension pneumothorax, open pneumothorax, massive haemothorax and flail chest. Do not wait for an X-ray to decompress a tension pneumothorax in a shocked patient.
C Circulation: recognise shock and look for bleeding in the chest, abdomen, pelvis and long bones. Activate your major haemorrhage protocol early.
D Disability: conscious level (GCS), pupils, blood glucose and gross neurology.
E Exposure: examine the whole body while preventing hypothermia, and log-roll or use a scoop according to local practice.
On a course scenario, say each step aloud and state what you are doing about it: "C: heart rate 130, BP 85 systolic, pelvis not sprung, binder on. Activate the major haemorrhage protocol, two units through a warmer." Assessors want to hear the priorities and see you reassess after every intervention.
The NICE trauma guidance worth knowing
ATLS and ETC teach international principles. In NHS practice you also need UK guidance, mainly NICE NG39 on major trauma. Key points include:
Tranexamic acid: give IV tranexamic acid as soon as possible to patients with major trauma and active or suspected active bleeding. Do not use it more than 3 hours after injury unless there is evidence of hyperfibrinolysis. This is why the time of injury in the pre-alert matters.
Pelvic binder: if active bleeding from a pelvic fracture is suspected after blunt high-energy trauma, use a purpose-made binder. An improvised binder is only for when a purpose-made one does not fit.
Volume resuscitation: use a restrictive approach for active bleeding until bleeding is controlled. In adults, use a 1:1 ratio of plasma to red blood cells.
Anticoagulation: rapidly reverse anticoagulation in major trauma with haemorrhage. Use prothrombin complex concentrate for warfarin and other vitamin K antagonists, and get haematology advice for other anticoagulants.
Imaging: a negative FAST does not exclude intra-abdominal or retroperitoneal bleeding, and a negative chest eFAST does not exclude pneumothorax. NICE recommends whole-body CT for adults with blunt major trauma and suspected multiple injuries.
Families: be honest, explain what is happening and why, give the family a clear point of contact, and document key conversations.
You should also know the NICE head injury guideline (NG232) rules for CT head scanning and the NICE spinal injury guideline (NG41) for cervical spine imaging. Your emergency department's head injury proforma usually follows these.
Our free Trauma Life Support — UK Guidelines course brings these together in one place, with worked resus-room examples, the NICE CT rules, burns, children, older people, pregnancy and transfer. It is revision only and does not replace ATLS, ETC or any accredited, hands-on trauma course.
A practical preparation plan
Check what your target posts ask for, then book early and plan study leave.
Start the pre-course work the day you get access, and read the manual properly. For ATLS, the e-learning deadline is strict.
Practise the primary survey out loud on colleagues or a manikin until it sounds automatic.
Learn your local systems: your trauma network, trauma call criteria, ATMIST pre-alerts and the major haemorrhage protocol.
Rehearse team communication. Use closed-loop instructions and short summaries: "Summary so far: airway patent, right tension pneumothorax decompressed, still shocked, pelvis bound, blood running."
Join trauma calls in your current post where you can, and reflect on each one afterwards.
How ATLS or ETC helps your NHS application
On an application form, list the course, the date passed and the expiry date in your qualifications or training section. If you are booked but not yet done, give the date. Never describe online revision as an ATLS or ETC certificate.
At interview, trauma usually appears as a clinical scenario: "A motorcyclist arrives in resus with a heart rate of 140 and a low blood pressure. Talk us through your management." Answer with the <C>ABCDE structure, name specific interventions, mention the major haemorrhage protocol and tranexamic acid timing, and finish with handover, documentation and communication with the family. If you are applying for surgical roles, our guide to surgical career routes in the NHS for IMGs explains where courses like ATLS fit into a wider application. Trauma calls you have attended can also become strong examples of teamwork and leadership in your NHS supporting statement.
Start the free course
The free Trauma Life Support — UK Guidelines course is split into short modules covering UK trauma systems, the <C>ABCDE primary survey, injuries by body region, imaging and the secondary survey, special patient groups, and transfer and handover. It is free to study, ends with a quiz, and offers an optional verifiable certificate and a reflective note for your appraisal. If you would like your NHS application reviewed and rewritten (£35), email cvreviewexperts@gmail.com.
Frequently asked questions
Who runs the ATLS course in the UK?
In the UK, the ATLS provider course is run by the Royal College of Surgeons of England. The course and its methodology were developed by the American College of Surgeons.
How long does ATLS provider status last?
RCS England states that ATLS provider status lasts four years. A one-day reverification course is available to renew it.
What is the difference between ATLS and the European Trauma Course?
ATLS teaches a systematic individual approach to initial trauma assessment, with an MCQ and a practical scenario assessment. ETC is a team-based course that spends most of its time on realistic scenarios in multi-specialty teams, with a strong focus on leadership and non-technical skills.
What does <C>ABCDE stand for?
It stands for catastrophic haemorrhage, airway with cervical spine protection, breathing, circulation, disability and exposure. Life-threatening problems are treated as they are found, in that order.
Can an online trauma course replace ATLS or ETC?
No. ATLS and ETC are accredited, hands-on, assessed courses. Online revision can help you prepare, but it cannot certify your competence in trauma care.
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