This paper will report on a documentary analysis of 26 ENB 199 Accident and Emergency (A&E) Nursing courses. This is part of a larger study commissioned by the English National Board for Nursing, Midwifery and Health Visiting to examine the national comparability of critical care programmes. The analysis revealed diversity in the courses in terms of the level at which they were set, the academic credits awarded, theoretical and practice assessment strategies, and the amount of student effort. The factors that influenced this variation are presented and the way in which A&E managers perceived this to influence the acquisition of comparable competences and skills outlined. The paper concludes that diversity has arisen in response to an increasingly heterogeneous student population, individual university requirements for the construction of curriculum, and a difference in perception about the purpose of the course: to prime the nurse for practice or to consolidate experience in the speciality. The authors suggest that national comparability of the course will remain an illusion until consensus over the purpose of the course is agreed.