Anaesthetists in Training Webinar - Recruitment

In face-to-face interviews the portfolio station accounted for 50 per cent of the overall interview score. In virtual interviews the weighting is 38 per cent. More interview stations would be preferable in providing a more balanced weighting. The RAG is proposing that two, or three stations with six independent assessors are used for 2022 recruitment. This is currently a proposal and will be dependent on MDRS approval following testing of software platforms which are able to run multiple stations virtually.   

For clarity, this is the RAG proposal for the 2022 recruitment. Those preparing for round three applications in the 2021 recruitment timetable, which is for posts starting in February 2022, will have the same interview station format as in previous rounds this year.

We are awaiting approval from MDRS, for a ST4 recruitment round for a February 2023 intake. This is six months earlier than the original planned first intake for ST4 in August 2023.

Doctors in this situation should discuss with their trainers why their self-score is not translating to interview offers. Review each domain in turn and consider where scores can be increased and the evidence to support this. In addition, feedback around interview practice and technique can be useful.

The College continues to lobby for an increase in anaesthetic training post numbers, and recently the anaesthetic shortages were mentioned in parliament during the second reading of the Health and Social Care Bill.

Clinical Fellow posts are an essential part of the NHS workforce and offer opportunities to gain additional experience, which can be used to boost portfolio self-scores. Collect as much evidence of your educational activities and clinical experience as you can. Using the Lifelong Learning Platform will ensure it can be considered by trainers at a later stage with a view of potentially counting this experience towards training.

There is clear guidance for doctors who will not commence a ST3 anaesthetics post by February 2022. This guidance  sets out the experience and learning outcomes required for stage 1 of the 2021 Anaesthetics curriculum and will require sign off of a Stage 1 equivalence certificate in order to be eligible for recruitment to higher specialty training at the ST4 (Stage 2) entry point. 

Once CT3 equivalent training is completed, it is possible to start collecting evidence towards the capabilities for Stage 2 of the 2021 Anaesthetics Curriculum. This evidence can be presented to an ARCP panel in the future once appointed to a higher specialist training post in anaesthesia, where it will be ratified, and a decision made whether or not it can be counted towards training.

An alternative to training as a route to the GMC Specialist Register is the Certificate of Eligibility for Specialist Registration (CESR) process.  

The Recruitment Advisory Group has raised this with the Faculty of Intensive Care Medicine. FICM is looking at how this can be managed, with a view to obtaining agreement from the four national statutory education bodies and the GMC to extend the application/appointment window by an additional year.

Understandably we are unable to guarantee that there will be CT3 equivalent posts next year, however this has been raised with the Lead Dean for Anaesthesia who has fed this back to the four nation statutory education bodies. The College Tutor Network is actively sharing where posts are available that would meet the requirements for CT3 equivalent training, and doctors in training are encouraged to approach local departments. Please contact Training Programme Directors, College Tutors and clinical leads/directors in the area you wish to work to explore what opportunities may be available for you.

Providing the experience gained meets the requirements of Stage 1 as described in the CT3 equivalence guidance.

Flexibility for doctors in training has improved recently following changes to GMC requirements, guidance from the Academy of Medical Royal Colleges, and the new out of programme options from HEE; all of which present opportunities to recognise experience from outside of a NTN training post.

The actual process of how this is done is in development with members of the College’s Training Committee. We will publish this guidance as soon as it is complete, but in essence, any experience accrued after the completion of core training could be counted; this will be a year in most cases but could be longer. Potentially up to 12 months of experience towards stage 2 of the curriculum could be recognised.

In the meantime, the advice is to record all experience, preferably on the Lifelong Learning Platform which will make it easier for trainers to review.

Doctors are eligible to apply to work on a less than full time basis, following the normal procedures. This is also an equality and diversity matter covered by legislative regulation.

Offers are issued via Oriel and applicants have the option to ‘accept’, ‘hold with upgrades’ or ‘decline’, and must make a decision within 48 hours.

The offers process means that where an offer is held with upgrades, if a higher ranked post becomes available it is offered to the applicant. However, the same higher ranked post would not be offered to an applicant who had already accepted their original offer: it may be offered to another applicant who scored less in the interview process because the original applicant it was offered to, rejected it.

This is the way that offers are recycled in the system and the process is determined by how offers are accepted or declined.

Some additional posts were made available in Scotland at the end of the window for accepting offers. This was done in good faith to improve the availability of jobs and opportunities for all trainees but the exact timing of the release of these posts had an impact on trainees’ ability to upgrade offers if they had already accepted posts. It is important that all regions are aware of the implications related to the timing of making additional posts available at the end of an offers window.   

The impact and associated uncertainty of the pandemic meant that it was impossible to predict whether there would be capacity to accommodate everyone who wished to sit the Primary FRCA, and so it was deemed fairer to assume that there may not be the opportunity for all to do so.

The curriculum derogation agreed with the GMC allowed completion of core level training without the full complement of core level competences and/or the full Primary FRCA, in order to facilitate applications for ST3 recruitment for February and August starts in 2021 and 2022. In this instance, the Primary MCQ is a prerequisite for eligibility.

The February 2022 intake for recruitment sits within the round and process that was agreed for 2021 national recruitment. Therefore, the principles and ST3 Person Specification that were agreed with MDRS at the end of 2020, continue for this round.

In addition, the curriculum derogation agreed with the GMC remains in place until September 2021 which encompasses the autumn recruitment round.

The full Primary FRCA will be a requirement for ST4 applications in the next recruitment round, which we are planning for a February 2023 start.

The February 2022 intake for recruitment sits within the round and process that was agreed for 2021 national recruitment. Therefore, the principles and ST3 Person Specification that were agreed with MDRS at the end of 2020, continue for this round.

It was agreed with the four nation statutory education bodies that appointments to Core Anaesthesia from August 2020 and ACCS Anaesthesia from August 2019 would automatically include an additional year from August 2022.

It is not the remit of the College to mandate this. Doctors are eligible to apply to work on a less-than-full-time basis, following the normal procedures. This is also an equality and diversity matter covered by legislative regulation.

Higher competition ratios inevitably lead to a higher cut-off score for interview. However, offers are based on portfolio and interview scores combined. The portfolio self-assessment criteria are well publicised and doctors work towards this goal years in advance, this is why it remains fairly consistent and can result in higher portfolio scores.

The RAG is proposing that two or three stations with six independent assessors are used for the 2022 recruitment year. This still requires MDRS approval but would decrease the weighting of the portfolio score.

ACCS trainees complete an indicative eight years in total, compared to straight anaesthetics which is an indicative seven years.

The range of specialties that can be used in the portfolio self-assessment criteria has been widened for ST4, recognising that many transferable skills are useful to anaesthesia.

This is something that the RAG could consider, however, it would need to be approved by the four nation statutory education bodies and MDRS.

The RAG feel there is no requirement to recruit to grades higher than ST4.

We currently run national recruitment to CT1 and ST3 (ST4 from 2023). If a trainee can demonstrate evidence of capability at a higher level within the curriculum, then it is possible to be accelerated through the training programme if this can be accommodated locally; this is in discussion with the Training Programme Director, Head of School and the RCoA Training Committee who make a review of the evidence and accelerate the trainee if appropriate.

If a trainee can demonstrate evidence of Stage 2 capabilities, then it is possible to be accelerated through the training programme if this can be accommodated locally. It will also be possible to recognise experience from outside of a National Training Number training post. The actual process of how this is done is in development with members of the College’s Training Committee and will be published as soon as defined. In the meantime, the advice is to record all experience, preferably on the Lifelong Learning Platform which will make it easier for trainers to review.

We do appreciate that some doctors felt that requirements for CT3 top up years were published late. However, this was due to the tight timescales we were required to work to including agreement from the four nation statutory education bodies and GMC before we could confirm that the 2021 curriculum had been approved. Only with this approval could we publicise requirements for top-up posts.

The cut-off score for interview changes in each recruitment round. Many applicants will have been impacted by COVID-19 disruption and so their respective portfolio scores may be lower, resulting in a lower threshold for interview. Many organisations have facilitated ways for trainees to present posters, or partake in conferences and applicants are encouraged to speak to their local trainers for advice on how to increase portfolio scores in the coming months.

Doctors are eligible to apply to work on a less than full time basis, following the normal procedures. This is also an equality and diversity matter covered by legislative regulation. We have escalated this matter to the COPMeD Lead Dean for Less than Full Time Training.