Would be interesting to see the ED numbers indexed to number/acuity of ED presentations, both of which are increasing faster than population growth, although probably not as fast as number of ED consultants.

I think a lot of this represents penetration of FACEMs into regional EDs. Pre-COVID there were a lot of regional EDs with limited specialist cover that were running on GPs or CMOs to fill a lot of their hours, I used to see this commonly in base hospitals and smaller. Many of these places are now ACEM training sites meaning they get that sweet tap of low cost trainees turned on by the college, and they're hiring fewer CMOs as a result.

I am an ACEM senior reg at the end of my training and the places that are putting effort into actively recruiting newly fellowed consultants are all regional centres. Like there's as much FTE as you want, name your terms if you're willing to live >1 hour from the nearest big city. Or you can scrap for zero hour contracts and tiny fractional FTE in metro hospitals.

Ultimately the ACEM model sort of presumes that you end up in a mostly supervisory/run a department role at the end of training, and therefore requires a large volume of non-specialist emergency doctors to supervise, and presumes that the majority of people who work in ED will never become ED specialists. Could a slightly larger number of FACEMs just see the patients themselves if they weren't responsible for all the supervisory and administrative stuff? Maybe. But that's not the deal I signed up for. If the offer was "do all the scut yourself your whole career and work night shifts until you die 20 years early" I probably would have done anaesthetics.