Guidance on Dual CCT Programmes in ICM and Anaesthetics

As demonstrated by the * notations in the diagrams in the previous section, once doctors have completed Stage 1 training, the entirety of Stage 2 and Stage 3 ICM is dual-countable with Stage 2 and Stage 3 Anaesthetics.

Stage 1 ICM and Stage 1 Anaesthetics

At completion of CAT (including a pass in the FRCA Primary), doctors can apply for training posts leading to Dual CCTs in Anaesthetics and ICM.

Stage 1 includes the doctor’s Core Programme and the beginning of their Higher Specialty Training (HST). Stage 1 ICM is an indicative 4 years minimum in duration and for all Dual CCT doctors this will happen by default, 3 of these years must consist of indicative 12/12 month blocks each in ICM, Anaesthetics and Medicine (for ACCS doctors 6/12 each of Internal Medicine and Emergency Medicine may count toward the Medicine requirement). The final 12 months can be in any of the above specialties.

Dual CCT doctors entering from CAT will therefore need to complete any remaining specific ICM training placements to make up the 12 months required, and the necessary 12 months of Medicine to complete Stage 1 ICM. Dual CCT doctors entering from ACCS (Anaesthetics) will have completed the required 12 months of Medicine and 12 months of Anaesthetics as part of the ACCS (Anaesthetics) programme, along with 6 months of ICM. These doctors will therefore need to complete a further 6 months of ICM to complete Stage 1.

Stage 2 ICM and Stage 2 Anaesthetics

Stage 2 covers two indicative years of training, of which an indicative year will be spent in a variety of ‘special’ areas including paediatric, neurosurgical and cardiothoracic Intensive Care and Anaesthetics placements.

Paeds/Neuro/Cardio blocks:

Stage 2 in both Anaesthetics and ICM for doctors following a dual CCT programme, requires an indicative 3 month block in each of these areas. The purpose of these attachments for the respective curricula is not to produce specialists but to introduce doctors to these areas so that if and when they take up a consultant post in ICM/Anaesthetics they will be useful members of the team able to recognise, resuscitate, stabilise and transfer critically ill patients who require specialist care and treatment. Training in Stage 2 ICM/Anaesthetics specialist modules should be dual counted for both programmes. The requirements are flexible so that doctors following the dual CCT programme can pick up the capabilities of the respective curricula in either their Anaesthetics or ICM attachments. This is possible since many capabilities are common to both programmes and can be acquired while on placements in theatre or on the intensive care unit. The minimum time spent in either should be that which is required to achieve those capabilities unique to either theatre or ICU and the remaining time in the module may be spent in either location.

Doctors on a Dual CCT programme spend the remaining 3 months in General ICM or a suitable placement that will satisfy the respective Stage 2 curricula requirements of their Dual programme.

For a Dual CCT in ICM and Anaesthetics, the second year of Stage 2 comprises an indicative 12 months of Stage 2 Anaesthetics (this is referred to as the Special Skills Year in the ICM CCT curriculum).

This overall dual counting of capabilities allows dual Anaesthetics and ICM CCT doctors to undertake their respective Stage 2s concurrently without an extension to training, unless a doctor has joined the Dual programme later on in one of their specialty training programmes (though not later than the end of Stage 2).

Stage 3 ICM and Stage 3 Anaesthetics

Stage 3 of the Dual CCT Programme is an indicative two years of which an indicative 12 months is spent in Anaesthetics and an indicative 12 months in ICM. We recommend the specialty Stage 3 years are completed as full 12-month blocks; however, they can be completed in any order. A CCT is awarded in both specialties when all of the respective curricula’s outcomes and capabilities have been attained. There will be one overall CCT date for the dual programme on completion.