The Training Programme in Anaesthesia is divided into 3 sections as follows:
Stage 1 (CT1, CT2, CT3)
As from August 2021 Core Training became a 3 year training programme. Stage 1 training now comprises three years in one or two District General Hospitals and a period of time in the Bristol tertiary hospitals. At the start of training there is a period of directly supervised work lasting about three months until achievement of the Initial Assessment of Competence which now comprises EPA 1 and 2. After this the trainee may join the on call rota working with close supervision. As well as gaining competencies in anaesthesia for general surgery, orthopaedics and gynaecology, three months of the first year will generally be spent in intensive care. The second year will continue with general cases and training in obstetric analgesia and anaesthesia. The third year will build on the experience of the first two years with the trainee gradually increasing the amount of indirect supervision they receive. They will have a further period of Intensive care to complete a total of 6 months during stage 1 training and a further 3 months of obstetrics training. In order to complete Stage 1 training trainees must complete assessments according to College guidelines and pass the Primary FRCA examination. They are then awarded the Core Level Training Certificate.
For those entering through the ACCS(Anaes) four year programme (CT1,2,3 and 4) the same rules apply to the anaesthesia and intensive care modules. One year in acute and emergency medicine will also have been completed. Successful completion of Core training is a requirement for application to Specialty training which will start at ST4 (for those from either entry route). (The final entry to ST3 will be by open competition for February 2022 start.) Further recruitment from February 2023 onwards will be at ST4 level.
Minimum standards for out of hours supervision. of core trainees.
Stage 2 (ST4 & ST5)
Stage 2 years are usually spent at University Hospitals Bristol (Bristol Royal Infirmary, Bristol Royal Hospital for Children and St Michael's Hospital) and North Bristol (Southmead Hospital). Training is modular and covers all sub-specialties of anaesthesia.
When the trainee has completed all units of training and passed the Final FRCA exam they are awarded the Intermediate Level Training Certificate.
Trainees will often not have completed all subspeciaty modules before sitting the exam; this is recognised by the Royal College of Anaesthetists and reflected in the expectations of the examiners. Study days to specialist units can be arranged before the exam.
Stage 3 (ST6 & ST7)
In general the programme is more flexible for more senior trainees to allow them to target their training towards their career aspirations. At least one year is spent in a DGH, during which time trainees further develop their clinical skills and will take on additional clinical responsibilities and supervision of more junior colleagues. In addition further experience will be offered in teaching, audit, research and management. Further experience is gained in anaesthetic sub-specialities at a senior level in the teaching hospitals. The organisation of modules is dependent on the trainees’ requirements and future career plans.
During stage 3 of the Anaesthetics Curriculum, 12 months (whole time equivalent) of training must be undertaken in one or more areas of special interest. This allows the anaesthetist in training to develop knowledge and skills to enable them to gain the capabilities required to be an independent practitioner. It also prepares them for specialised areas of anaesthetic practice that they may want to pursue as a consultant or in preparation for additional training opportunities that might be undertaken in a more specialised area of anaesthetics practice after gaining CCT.
Special Interest Area (SIA) training is not separate from that of stage 3. In fact the capabilities acquired during this training inform the capabilities of stage 3. This is particularly relevant for the generic professional domains of learning. Stage 3 domains and the special interest areas together lead to achievement of independent practice.
Intensive Care Medicine
The Anaesthesia programme contains three months ICM blocks at core, intermediate and higher levels for all trainees.
Trainees appointed in open competition to both Anaesthesia and ICM programmes are supported by maximising opportunities for relevant modules to count towards the CCT in both specialties. This dual programme leads to CCTs in both Anaesthesia & ICM. For up to date information on ICM training and recruitment see the Faculty of Intensive Care Medicine website.