In anaesthesia they have been present for the last 10 years but have become more prevalent in the last four years. Many factors have led to this increase, but one of the biggest is the rise in the number of IMGs as new registrants on the GMC register. These totalled 40% of all new registrants in the last year.1 Other factors include training bottlenecks that have appeared as an unintended consequence of the changes from the 2010 curriculum.
This has led to increased competition for available posts, with significant numbers of doctors sitting in Locally Employed Doctor or Medical Training Initiative posts accumulating competencies that can count towards CESR. Understandably, trusts that can offer all the components of the curriculum in-house have recognised the potential to have a consistently high-quality, in-house workforce, with an ability to fill their own rotas when gaps appear. This is aided by the Lifelong Learning Platform being freely available to all members of the College, enabling training gaps to be easily identified and targeted with in-house training programmes.