Subspeciality training is available within the school in:


Intensive Care Medicine (ICM) 

Single CCT ICM Programme

For details of the single CCT ICM programme see the ICM programme page.

Dual programme in Anaesthetics and ICM

A dual programme in Anaesthetics and ICM enables trainees appointed separately to both programmes to ahcieve the dual CCTs in a much more timely manner than would be theoretically possible if they were sequential.  Where feasible modules of training count towards both CCTs.

ICM in the Anaesthesia programme

ICM is also an integral part of the Anaesthesia programme.  All anaesthetic trainees undertake three 3-month modules: basic (as part of core training), intermediate (at BRI or Frenchay) and higher (BRI, Frenchay or a DGH).  The Faculty of ICM has a number of membership categories open to anaesthetists - see the FICM membership page for more details.

ICU Teaching Programme

There is an ICM teaching programme for all trainees interested in ICM.  For more details see ICM Teaching Programme under the Events section.

New to ICU Course - For further information view the New-2-ICU website.

For any further information, please look at the Faculty of Intensive Care Medicine website or contact Dr Jeremy Bewley (ICM Regional Adviser) or Dr Anne Whaley (ICM Programme Director).

Cardiac Anaesthesia 

The cardiac unit in the newly built (2009) Bristol Heart Institute at the University Hospitals Bristol looks after about 1500 patients a year undergoing coronary artery bypass grafting, both on and off cardiopulmonary bypass, valve procedures, many of which are repairs, complex aortic operations and an increasing number of interventions performed in the cardiac catheter suite including stenting of the aorta and percutaneous insertion of aortic valves. There is a modern nineteen bedded intensive care/high dependency unit. New wards for cardiology and cardiac surgery patients are adjacent to coronary care, operating theatres and new catheter laboratories.

Cardiac intensive care is covered by a registrar anaesthetist with a consultant based in the unit all week and another dedicated to cardiac patients on call overnight and at weekends.  The rota is a shift pattern for eight junior doctors; six registrars in training and two cardiac fellows.

Anaesthetic trainees spend 3 months in the cardiothoracic module at the BRI usually during ST3-4 and they return for a shorter period of higher cardiothoracic training during ST6-7  Theatre time is spent on cardiac and thoracic lists with direct supervision by consultant anaesthetists.

Advanced training in cardiac anaesthesia is possible for 6 - 12 months during ST6-7 to gain further training and experience, including echocardiography.  Weekly teaching sessions are provided by consultants, project work and audit is encouraged and an academic evening is held for trainees and consultants during each module.

Cardiac Fellow posts are available for one year and can fom part of a training programme with appropriate prospective recognition. They are especially suitable for senior trainees or those with recent CCT, who would like to pursue a career in cardiothoracic anaesthesia and intensive care. For more information on the cardiac fellow posts please contact Dr Sally Tomkins via the Department of Anaesthesia, tel no 0117 342 2163 or email Dr Ian Ryder who is the lead clinician fo cardiac anaesthesia.

Obstetric Anaesthesia 

St Michael’s Hospital, Bristol

A three month obstetric module at St Michael’s Hospital, part of the University Hospitals Bristol NHS Foundation Trust (UHB), is available for senior trainees wishing to pursue an interest in obstetrics. The labour ward sees 5000 deliveries a year and has a 25% epidural rate. It is a tertiary referral centre for complex maternal and neonatal care. This includes complex cardiac disease.

As well as the potential to develop research/audit interests, there is the opportunity to attend management meetings including CDS working party and St Michael’s clinical governance meetings. There are also opportunities to develop an interest in teaching by becoming involved in the Emergency and HDU Study days, and midwifery, obstetric and medical student updates.

During daytime hours the senior obstetric trainee is part of the obstetric anaesthetic team, along with a junior trainee and consultant covering labour ward and the elective Caesarean sections. After 5pm, the junior obstetric trainee covers labour ward, and the senior obstetric trainee joins the 2nd on call rota which covers general theatres across the UHB precinct as well as obstetrics.

For more information or if you wish to express an interest in doing the module please speak to Dr Neil Muchatuta.

Obstetric Anaesthesia - Royal United Hospital, Bath

An advanced obstetric module has recently been set up at RUH, Bath. There are clinical as well as teaching, audit and research opportunities in obstetric anaesthesia. The unit sees 5000 deliveries per year and has a 19% epidural rate.

For more information or if you wish to express an interest in doing the module please speak to Dr Chris Marsh.

Paediatric Anaesthesia 

Within the school advanced paediatric training consists of either 6 or 12 month posts.  The 12 mont post is advertised internally more than a year in advance and consists of:

  • Paediatric Anaesthetics (9 months)
  • PICU (3 months)

The 6m posts typically consist:

  • two months general paediatric anaesthesia
  • two months paediatric cardiac with PICU on call
  • two months PICU

You should preferably be in ST6 or ST7 at the start of the module and you must have completed the module before your expected CCT date.  if interested contact Dr Judith Nolan. 

Please note that there is a limit on how much time you can spend training in any one subspecialty. Therefore, if you plan to do a paediatric year abroad these local slots may not be for you. Please discuss with the programme director.

The one year training at Great Ormond Street is also good and is advertised from time-to-time. That covers all areas of paediatric anaesthesia.


If you are interested in advanced training in neuroanaesthesia please discuss with the programme director and the college tutors at Southmead.

Regional Anaesthesia

If you have a particular interest in regional anaesthesia please discuss this with the programme director.

Pain Medicine 

Pain medicine incorporates acute, chronic and cancer pain. It is a core part of the anaesthesia curriculum at basic and intermediate levels. For those who wish to subspecialise in pain medicine there are optional higher and advanced modules available.

  • Core (CT1/2) – essential
  • Intermediate (ST3/4) – essential
  • Higher (ST5-7) – optional 1-3 months
  • Advanced (ST6-7) – optional 12 months (after completion of higher module)

For more information, please see the website for the Faculty of Pain Medicine of the Royal College of Anaesthetists.

Pain Medicine – Core and Intermediate

Local minimum standards

Core CT1-2

  • 4 acute pain rounds and 2 chronic pain teaching clinics each year
  • Start pain medicine logbook – keep throughout training (to download the logbook click the link below)

Intermediate ST3-4

  • Minimum of 20 pain sessions (including a balance of acute and chronic, with a minimum of 10 chronic)
  • At least one procedure list
  • Experience of acute pain, postoperative analgesia as well as regional anaesthetic and other analgesic techniques will be gained outside of the formal pain module

Pain Medicine – Higher and Advanced

Higher ST5-7

  • Optional 1-3 months
  • Essential for all trainees who wish to progress to advanced pain medicine training
  • Recommended for trainees considering a future consultant post with an interest in acute pain medicine

Advanced ST5-7

  • Advanced Pain Medicine training in ST5-7 is available within the Bristol School
  • Trainees spend six months at Frenchay and six months at either Cheltenham/Gloucester, Bath or BRI
  • All advanced pain medicine trainees become members of the Pain Faculty of the Royal College of Anaesthetists

For more information download the Advanced Pain Medicine training handbook and the Advanced Pain Medicine training logbook from the Faculty of Pain Medicine, Royal College of Anaesthetists website.


Pre-hospital Emergency Medicine (PHEM)

PHEM is a formally recognised subspecialty of both Anaesthetics and Emergency Medicine.  Severn have two trainees in PHEM.