Anaesthetic Training Update January 2021

Published: 15/01/2021

Services across many parts of the country are currently experiencing enormous disruption, which is once again having a considerable impact on anaesthetic training.

We understand the stress and uncertainty that comes with balancing clinical responsibilities with applying for, studying and taking part in new proctored examinations and family life. It has contributed to a uniquely challenging time for trainees.

The Royal College of Anaesthetists has been working very hard to minimise disruption and has been communicating changes and guidance in as timely a fashion as possible.

This document provides a current overview of the situation and the steps that your College has taken to mitigate the burden and disruption caused by the COVID pandemic on anaesthetists in training.

Training progression and Annual Review of Competency Progression (ARCP)

We will continue to support anaesthetists in training to progress through the programme wherever possible. Derogation of clinical and exam milestones will continue until at least September 2021, reflected by ARCP outcomes 10.1 and 10.2. This includes the ability to carry over outstanding units of training from one level of the programme to the next.

Possession of the Primary FRCA MCQ will be required at the time of ST3 interview with the full Primary FRCA required by the end of ST3. Anaesthetists in training will have until the end of ST5 to complete the Final FRCA. We anticipate that these exam requirements will continue until the new anaesthetic curriculum is introduced, which will require completion of the Primary FRCA at the end of CT3 and the Final FRCA at the end of ST5.

We ask that particular consideration be given to those at critical progression points in the training programme and those with non-anaesthetic ACCS pathways.

Redeployment of anaesthetists in training

Many anaesthetists in training have once again found themselves being reallocated to support essential patient services such as Intensive Care Medicine and Acute Medicine. We have released updated guidance  for those members who are being asked to redeploy.  

We have received guidance from the four Nation Statutory Education Bodies that February rotations will go ahead where it is possible to do so.  However, regions will also have the opportunity to pause rotations where necessary. 

We note that, due to the surge in COVID cases in London, Health Education England has postponed rotations for all doctors across the city until 3 March.  We advise anaesthetists in training to seek guidance from their Training Programme Directors if there is any uncertainty.


All elements of the FRCA exam are now being delivered virtually and it is our intention to continue to run scheduled exams as planned. We are working to reduce the backlog of candidates following the cancellation of exams last year, but we will need to continue to prioritise candidates when the demand for a sitting outstrips capacity.

We understand the huge impact caused by delays in being able to take exams and we are working to catch up with the demand by the end of this academic year. While we will do everything possible to provide exams as planned, there remains the possibility of a risk to their provision if examiners become unavailable at short notice because of clinical commitments, illness or the need to self-isolate. This has been communicated to candidates with upcoming exam sittings.  

Further information regarding exams can be found on our website


Following the disruption to recruitment last year we have worked with Medical and Dental Recruitment and Selection to provide online interviews for both CT1 and ST3. This will depend on the availability of interview panellists, but we are working to deliver this as planned.


We have updated our guidance for anaesthetists in training who are themselves or by proxy in a clinically vulnerable group.

Morale and welfare

The challenge of working in the pandemic remains a serious threat to the morale and welfare of staff working in the NHS. The impact on anaesthetists in training is particularly significant given the challenges it causes for meeting the requirements of the training programme, and because the skills anaesthetists possess mean they are often the first group of doctors redeployed to support the care of patients with COVID.

We urge all anaesthetists in training to maintain close links with their peer group, clinical and educational supervisors and other colleagues for mutual support. Guidance from the Association of Anaesthetists on managing stress and additional support that is available may be found here and further support and wellness resources are available on the College website here.

There are also local mechanisms in place for providing support and deaneries provide a range of services across the four nations:

Finally, College Council, volunteers and staff would like to offer once again their heartfelt thanks to all members who are providing essential care for patients in such challenging circumstances. The tireless work of anaesthetists in training, SAS and locally employed doctors, and consultants across the whole of the UK is a great credit to our profession.