2021 Curriculum for a CCT in Anaesthetics

Generic Professional Capabilities and Good Medical Practice

Figure 3 – the GMC’s Generic Professional Capability Framework

The GMC has developed the GPC framework [external link] with the Academy of Medical Royal Colleges (AoMRC) to describe the fundamental, career-long, generic capabilities required of every doctor. The framework describes the requirement to develop and maintain key professional values and behaviours, knowledge, and skills, using a common language. GPCs also represent a system-wide, regulatory response to the most common contemporary concerns about patient safety and fitness to practise within the medical profession. The framework will be relevant at all stages of medical education, training and practice.

Good Medical Practice (GMP) [external link] is embedded at the heart of the GPC framework. In describing the principles, duties and responsibilities of doctors the GPC framework articulates GMP as a series of achievable educational outcomes to enable curriculum design and assessment. The GPC framework describes nine domains with associated descriptors outlining the ‘minimum common regulatory requirement’ of performance and professional behaviour for those completing a CCT or its equivalent. These attributes are common, minimum and generic standards expected of all medical practitioners achieving a CCT or its equivalent.

The 9 domains of the GPC framework are directly identifiable in the anaesthetics curriculum. They are mapped to each of the generic and specialty specific domains, which are in turn mapped to the assessment blueprints. This is to emphasise those core professional capabilities that are essential to safe clinical practice and that they must be demonstrated at every stage of training as part of the holistic development of responsible professionals. This approach will allow early detection of issues most likely to be associated with fitness to practise and to minimise the possibility that any deficit is identified during the final phases of training.

Domains of learning

The anaesthetics curriculum contains 14 domains that describe the standard that anaesthetists must demonstrate as they progress through training and ultimately attain a CCT. Anaesthetists in training are required to demonstrate achievement of both the generic professional and specialtyspecific domains throughout their training period.

Each domain has a High-level Learning Outcome (HLO) that sets the scene for what constitutes an anaesthetist.

Below that is a stage learning outcome that provides a description of attainment to be achieved at the end of that stage in order to progress to the next.

Next follows a set of key capabilities that are mandatory capabilities that must be evidenced by anaesthetists in training to meet the stage learning outcome. These are also therefore mapped to the GPC framework.

Every HLO at each stage of training includes a selection of examples of evidence that give the range of clinical contexts that anaesthetists in training may use to support their achievement of the key capabilities, as well as suggested assessment methods. These are intended to provide a prompt to the anaesthetist in training and their trainers as to how the overall outcomes may be achieved. They are not intended to be exhaustive and there are many more examples that would provide equally valid evidence of performance. In addition, excellent anaesthetists in training may produce a broader portfolio of evidence that demonstrates deeper learning. It is not expected that anaesthetists in training provide a set quota of evidence; the aim of assessment is to provide adequate, robust evidence against every key capability to demonstrate acquisition of the HLOs at each stage.

Satisfactory achievement for each stage of training requires demonstration that, for each of the HLOs, the anaesthetist in training’s performance meets or exceeds the minimum requirements as described. This will require educational supervisors to make a global judgement indicating whether satisfactory progress for the defined stage of training has been made. More detail is provided in the programme of assessment section of the curriculum.

Practical procedures

There are a number of procedural skills in which an anaesthetist in training must become proficient to the level expected by the end of training. They must be able to outline the indications for these procedures and recognise the importance of valid informed consent, and of requesting help when appropriate. For all practical procedures the anaesthetist in training must be able to recognise complications and respond appropriately if they arise, including calling for help from colleagues in other specialties when necessary.

Anaesthetists in training should ideally receive training in all procedural skills in a simulated setting before performing these procedures clinically. When the anaesthetist in training has been signed off as being able to perform a procedure independently, they are not required to have any further assessment (eg DOPS) of that procedure, unless they or their educational supervisor thinks that this is required (in line with standard professional conduct).

The procedural skills are an essential component to meet some key capabilities in the respective stage of the relevant domains. A list of practical procedures to be covered by stage 1 to 3 (in brackets) by all anaesthetists-in–training, but not including any related to the special interest areas, is included in Annex F.