2021 Curriculum for a CCT in Anaesthetics

Doctors will enter anaesthetics training via a national recruitment process at either CT1 or ST4 level.

An alternative route into anaesthetic training at ST4 level is through completion of the ACCS curriculum. The ACCS curriculum sets out the learning requirements of a four-year programme of training in anaesthesia, internal medicine, emergency medicine and ICM. As such it covers some areas of the specialty curricula for the four specialty CCT programmes. Entry to ACCS training will be by competitive application under nationally agreed arrangements.

Anaesthetics is a craft specialty and much of the education and learning is acquired through experiential means and reflective practice with trainers. Learning is undertaken through a variety of formats including lectures, tutorials, seminars, simulation, e-learning and personal study.

Anaesthetic training is outcome-based rather than time-based. However, the indicative length of training is seven years from appointment to completion. There will be options for those anaesthetists in training who demonstrate exceptionally rapid development and acquisition of capabilities to complete training more rapidly than the current indicative time, although it is recognised that clinical experience is a fundamental aspect of development. There may also be a small number of anaesthetists in training who develop more slowly and will require an extension of training in line with the Reference Guide for Postgraduate Specialty Training in the UK (the Gold Guide) [external link].Those who choose less than full-time training (LTFT) will have their indicative training time extended prorata in accordance with the Gold Guide. LTFT anaesthetists in training should, pro-rata, undertake the same out-of-hours duties, including weekend duties, as full-time colleagues in the same programme and at the equivalent stage.

The anaesthetics curriculum, and thus training programme, is divided into three stages. Click here to download and open figure 2 [image].

Stage 1 (indicative three years – CT1-CT3): anaesthetists in training will be exposed to a comprehensive introduction to elective and emergency anaesthetic practice and perioperative care in areas that reflect ‘generalist’ anaesthetic practice. The initial novice period will be directly supervised until the Initial Assessment of Competence progression point has been attained. Time is spent gaining clinical experience primarily in a low to moderate risk patient population although there will be some supervised exposure to more complex cases. Time will also be spent developing relevant skills in ICM. Anaesthetists in training will complete the Primary FRCA examination during this stage of training.

Stage 2 (indicative two years – ST4-ST5): Having gained knowledge of the principles underlying clinical anaesthetic practice at Stage 1, anaesthetists are introduced to wider areas of practice during Stage 2. The focus of this part of the training programme is twofold: an introduction to specialist areas of anaesthetic practice and consolidation of the skills gained in Stage 1 in ‘generalist’ practice with greater autonomy whilst developing skills in managing a higher risk patient population. Anaesthetists in training will complete the Final FRCA examination during this stage of training.

Stage 3 (indicative two years – ST6-ST7): the final stage of training will prepare anaesthetists in training for the transition to consultant practice. This final level of training allows them to mature the clinical skills required for safe independent practice. The final stage of training also allows development of the generic professional capabilities to a level appropriate for the award of a CCT in areas which include medical leadership, management responsibilities, and the ability to teach, train and supervise others. This final stage equips anaesthetists with the expertise to treat patients with complex clinical needs and manage organisational issues. The generic nature (to anaesthetic practice) of the clinical learning outcomes will allow opportunities for service providers to provide training in clinical areas in a manner that is flexible to meet service requirements and developments. Completion of stage 3 training will ensure that anaesthetists in training are fully prepared for consultant roles in generalist and specialist practice and will lead to the award of the CCT. During Stage 3 trainees will develop advanced skills that are transferable between generic and specialist areas of practice; all day-1 Anaesthetics CCT holders will be appointable to any Anaesthetics post advertised.

There are a number of specialties that may continue to accept two years of anaesthetics training as an entry route to higher speciality training in that specialty. To facilitate this, those anaesthetists in training who may wish to move to train in one of these alternative specialties once they have completed CT2, are advised that if they subsequently wish to return to anaesthetics higher training at a later date, they will be required to meet all of the domains of learning required for completion of Stage 1 in this curriculum