Guide to Anaesthetics Training (The Handbook)

Structure of the 2021 Curriculum for a CCT in Anaesthetics

The Anaesthetic training programme is delivered in 3 stages of training.

The 2021 Curriculum describes 14 domains of learning for each stage of training, these are divided into 7 specialty specific areas of clinical practice and 7 generic professional domains.

The 7 generic professional domains are:

• Professional Behaviours and Communication
• Management and Professional and Regulatory Requirements
• Team Working
• Safety and Quality Improvement
• Safeguarding
• Education and Training
• Research and Managing Data

The 7 speciality specific domains are:

• Perioperative Medicine and Health Promotion
• General Anaesthesia
• Regional Anaesthesia
• Resuscitation and Transfer
• Procedural Sedation
• Pain Medicine
• Intensive Care

Each domain has a high-level learning outcome that describes what must be achieved by the end of the training programme and learning outcome(s) for each stage.

Within each domain, a number of stage-specific key capabilities are described, which will guide the anaesthetists in training towards achieving the learning outcomes.

Evidence of attainment of key capabilities is described in the agreed assessment framework. The complexity of the key capabilities and the level of attainment expected increases as the anaesthetist progresses through the training programme.

Stage 1 Training

Stage 1 training takes the doctor from being a novice (someone new to anaesthesia) to a level where they can anaesthetise an ASA 1 or 2 patient for non-complex surgery with distant supervision.

This training is for an indicative 3 years. The Initial Assessment of Competence (IAC) must be completed during the first phase of the stage of training. This in unchanged from the previous curriculum, however, the mechanisms that underpin assessment have been revised and updated.

The Initial Assessment of Competence in Obstetric Anaesthesia (IACOA) must be obtained by all anaesthetists in training before being considered safe to work in an obstetric unit without direct supervision. Achieving the IACOA does not signal achievement of all the key capabilities in this area for stage 1.

Intensive care medicine training should be completed in a six-month block, although anaesthetists in training may do this in two three-month blocks.

In order to complete stage 1 training, anaesthetists in training will need to demonstrate evidence of completion of all 14 domains of the 2021 curriculum at this stage and must also pass the Primary FRCA examinations.

A Stage 1 Certificate will be achieved on completion of these components.

Stage 2 Training

Stage 2 training develops the skills of the anaesthetist in training and broadens experience in the complexity of cases. It is for an indicative 2 years and includes training in sub-speciality areas of anaesthetic practice such as neuro-anaesthesia and cardiothoracic anaesthesia. Intensive care medicine should be completed in a three-month block.

In order to complete Stage 2 training, anaesthetists in training will need to demonstrate evidence of completion of all 14 domains of the 2021 curriculum at this stage and must also pass the Final FRCA examinations.

A Stage 2 Certificate will be achieved on completion of these components.

Stage 3 Training

Anaesthetists in training who successfully complete stage 2 training will progress to stage 3 of the 2021 Curriculum. This period of training sees the anaesthetist progress to a level where they can practice independently. Stage 3 training also lasts for an indicative 2 years and includes the opportunity for anaesthetists in training to develop their knowledge and skills within one or more special interest areas (SIAs) of anaesthetic practice.

Stage 3, including the special interest areas (SIAs), is not the same as higher and advanced training in the 2010 curriculum. It should be thought of as a mosaic of training where the skills and experience gained in the SIAs also informs the capabilities for stage 3 and vice versa. Completion of stage 2 will equip the anaesthetist in training with the capability to complete any of the SIAs in stage 3. This is different to the 2010 curriculum where higher training in an area of practice was needed before commencing advanced training in that area.

Special Interest Areas (SIAs)

During stage 3 anaesthetists in training must undertake 12 months (whole time equivalent) of training in one or more areas of special interest. The time taken in each SIA depends on the type of SIA.

Upon completion of stage 3, anaesthetists in training will be awarded a Stage 3 Certificate. This process will also incorporate the previous process for the Notification of Completion of Training.

A more detailed description of the structure of the 2021 curriculum can be found here.

The programme of assessment associated with the 2021 curriculum can be found here.