2021 Curriculum implementation and transition

Moving to the new curriculum

Who could and should move when, and how to evidence progression into the new curriculum.

2021 Curriculum implementation

The 2021 CCT Anaesthetics Curriculum provides a programme of learning which can be flexed to deliver the necessary skill mix to suit the demands and aspirations of the NHS, and develop all trainees without compromising patient safety. The new curriculum has the same content and scope as the existing anaesthetic 2010 Curriculum, thereby ensuring a consistent output to meet the current and future demands of patients.

The 2021 CCT Anaesthetics Curriculum has been approved by the GMC for implementation on 4 August 2021. The College would like to transfer the majority of trainees from the 2010 Curriculum to the 2021 Curriculum at this time to allow them to enjoy the benefits the new curriculum provides, but also recognises the need to allow flexibility for schools of anaesthesia to transition trainees in a way that supports and manages the delivery of programmes locally. The following implementation plan is proposed:

  • the 2010 curriculum will remain in use until 31 January 2024
  • all August 2021 new CT1 Anaesthesia or ACCS (Anaesthesia) trainees commence on the new Anaesthetics (or ACCS) 2021 curriculum
  • CT1 Anaesthesia or ACCS (Anaesthesia) trainees who commenced in February 2021 are transferred to the new Anaesthetics (or ACCS) 2021 curriculum in either August 2021 or February 2022
  • CT2 trainees or ACCS (Anaesthesia) CT3 trainees who expect to have completed 18 months anaesthesia by August 2021 and intend to apply for ST3 Anaesthesia starting in February 2022 should complete competences for core level training on the 2010 curriculum to allow application for ST3
  • CT2 to ST5 trainees are transferred to the new curriculum in either August 2021 or February 2022, however;
  • any trainee who is expected to achieve their CCT by 31 January 2024 may remain on the 2010 curriculum. This should be discussed with the local Training Programme Director. Those who anticipate a CCT date beyond this date, for any reason, should transition to the new Anaesthetics 2021 curriculum at the earliest opportunity
  • the year of transfer will be a School of Anaesthesia decision based on local circumstances 
  • Anaesthetists in training are strongly advised to discuss their transition plan with their local trainers.

Below is a presentation from 25 March discussing the move from core training in the 2010 Curriculum to the new curriculum

Guidance for Transition from 2010 to 2021 Anaesthetics Curriculum

The boxes below gives detailed guidance on the transition of anaesthetists in training from the 2010 to the 2021 curriculum. It is intended to allow as much flexibility as possible and different options are set out to try and cover most of the variables.

There will be some anaesthetists in training who require more bespoke transition plans and this should be agreed between the anaesthetist in training and their Training Programme Director (TPD).

This guidance should be read in conjunction with the guidance on CT3/Stage 1 ‘top up’ training and the guidance on ST5/Stage 2 ‘top up’ training, which give details on the experience and evidence required for these top up years.

The Lifelong Learning platform (LLp) will only allow one curriculum at a time and this guidance sets out which curriculum the anaesthetist in training should use on the LLp.

NB this guidance was published on 13 May 2021 and replaces the bulleted list that was previously found under in the 'General principles to support transition' 'Anaesthetists within a recognised training programme' section.

Transition plan:

CT1s starts on 2021 Anaesthetics curriculum.

ACCS2s move to the 2021 ACCS curriculum. Some guidance is available in the ACCS Curriculum implementation toolkit, available on the ACCS website; further information will be published in due course.

NB: ACCS1s  should start the 2021 ACCS curriculum.  Please refer to the ACCS website for information.

Guidance for ARCP requirements at end of year:

CT1s:

  • Initial Assessment of Competence
  • progress with stage 1 capabilities.

ACCS1s and ACCS2s:

Transition plan:

CT1s move to the 2021 curriculum. Transfer evidence to new curriculum using CUT forms and WBAs to evidence key capabilities. Continue with stage 1 HALOs.

ACCS2s move to the 2021 ACCS curriculum. Some guidance is available in the ACCS Curriculum implementation toolkit, available on the ACCS website; further information will be published in due course.

Guidance for ARCP requirements at end of year:

CT1s:

  • Initial Assessment of Competence
  • progress with stage 1 capabilities.

ACCS2s:

Transition plan:

Move to 2021 Anaesthetics curriculum.

Transfer evidence to new curriculum using CUT forms and WBAs to evidence key capabilities. Continue with Stage 1 HALOs.

Guidance for ARCP requirements at end of CT2 or ACCS3 year:

  • Initial Assessment of Competence in Obstetric Anaesthesia
  • progress with stage 1 capabilities.

Subsequent end of CT3 or ACCS4 year:

  • stage 1 HALOs completed
  • Primary FRCA pass.
Transition plan:

Continue on 2010 Anaesthetics curriculum to gain the Core Level Training Certificate and apply for specialty training in February 22. If unsuccessful, complete CT3 equivalent year (EQ1a certificate) on 2010 LLp.

Guidance for ARCP requirements at end of CT2 or ACCS3 year:

  • Core training units completed.
  • Primary FRCA pass.
Transition plan:

Move to 2021 curriculum.

Use EQ1b (stage 1 ‘top up’ training) and stage 2 on 2021 LLp to provide evidence of completion of stages 1 and 2. For example, cardiac and neuro should be evidenced under the stage 2 General Anaesthesia HALO, ICM will be evidenced in the EQ1b certificate.

Transfer evidence from 2010 such as CUT forms to evidence key capabilities. Aim to sign off EQ1b as soon as possible once ST3 is completed, then progress with stage 2 HALOs.

Primary FRCA must be completed in full by the end of ST3.

Guidance for ARCP requirements at end of ST3 year:

  • completion of, or progress with, EQ1b
  • Primary FRCA pass

Subsequent end of ST4 year:

  • completion of EQ1b if not previously completed
  • progress with stage 2 capabilities.
Transition plan:

Move to 2021 curriculum.

Use EQ1b (stage 1 ‘top up’ training) and stage 2 on 2021 LLp to provide evidence of completion of stages 1 and 2. For example, cardiac and neuro should be evidenced under the stage 2 General Anaesthesia HALO, ICM will be evidenced in the EQ1b certificate.

Transfer evidence from 2010 such as CUT forms to evidence key capabilities. Aim to sign of EQ1b as soon as possible once ST3 competed then progress with stage 2 HALOs.

Primary FRCA must be completed in full by the end of ST3.

Guidance for ARCP requirements at end of ST3 year:

  • completion of, or progress with, EQ1b
  • Primary FRCA pass.

Subsequent end of ST4 year:

  • completion of EQ1b if not previously completed
  • progress with stage 2 capabilities.

There are two options. The decision as to which option will depend on what training has been completed in ST3 and how much evidence needs to be transferred to the new curriculum.

Option A may be better for anaesthetists in the midst of ST3 who have not done specialty areas of training such as cardiac/neuro/paeds.

Option B may be better for those trainees who are doing specialty areas of training such as cardiac/neuro/paeds during ST3

Trainees should discuss this with their Training Programme Director.

Option A

Transition plan:

Move to 2021 curriculum.

Use EQ1b and stage 2 on 2021 LLp for evidence of completion of Stages 1 and 2. Use CUT forms from 2010 to evidence key capabilities in stages 1 and 2 where appropriate. Aim to sign off EQ1b 2021 as soon as possible then progress with Stage 2 HALOs.

Guidance for ARCP requirements...

...if completing ST3 in February 2022:

  • EQ1b completed (ideally)
...if completing ST4 in August 2022:
  • EQ1b completed
  • progress with stage 2 capabilities.

Subsequent end of ST5 year:

  • all stage 2 HALOs completed
  • Final FRCA pass
  • Stage 2 Certificate awarded.

Option B

Transition plan:

Stay on 2010 curriculum, complete intermediate level training and get Intermediate Level Training Certificate (ILTC) or Intermediate Level Progress Report (ILPR). Then do Stage 2 ‘top up’ training (EQ2a) on 2010 LLp. Stage 2 (ie 'higher') ICM should be done in the ‘top up’ year ST5.

Move to 2021 curriculum stage 3 once ST5 completed.

Guidance for ARCP requirements...
....at end of ST3 year:
  • progress with 2010 intermediate training units.
....at end of ST4 year:
  • 2010 intermediate units of training completed. ILTC or ILPR awarded.

Subsequent end of ST5 year:

  • EQ2a completed
  • Final FRCA pass.
Transition plan:

Complete intermediate level training and get Intermediate Level Training Certificate (ILTC) or Intermediate Level Progress Report (ILPR). . Then do stage 2 ‘top up’ training (EQ2a) on 2010 LLp. Stage 2 (ie 'higher') ICM should be done in the ‘top up’ year ST5.

Move to 2021 curriculum stage 3 once ST5 completed.

Guidance for ARCP requirements at end of ST4 year:

  • 2010 intermediate level units of training completed. ILTC or ILPR awarded.

Subsequent end of ST5 year:

  • EQ2a completed
  • Final FRCA pass.

There are different options to consider. The decision as to which option to follow will depend on training already planned. Anaesthetists in training should discuss this with their Training Programme Director.

When it is published, refer to the ST5/Stage 2 ‘top up’ training document for guidance as to content of Stage 2 ‘top up’ training.

 

Option A (preferred)

If stage 2 (ie 'higher') ICM is available in the Stage 2 ‘top up’ year (ST5):

Transition plan:

Stage 2 ‘top up’ training (EQ2a) on 2010 LLp. Move to 2021 curriculum stage 3 once ST5 is completed.

Guidance for ARCP requirements at end of ST5 year:

  • EQ2a completed
  • Final FRCA pass.

 

Option B

If Stage 2 ICM can’t be scheduled until ST6 or ST7 then complete Stage 2 ‘top up’ (EQ2b) on 2021 LLp, with the exception of ICM.

Transition plan:

Start stage 3 capabilities in the last 3 months of ST5. In ST6 or ST7 complete stage 2 Intensive Care. Complete EQ2b once ICM is complete.

During this period of ICM training consider acquiring evidence for stage 3 Resuscitation and Transfer and stage 3 Intensive Care.

Guidance for ARCP requirements at end of ST5 year:

  • EQ2b completed with exception of Intensive Care
  • Final FRCA pass
  • some evidence for stage 3 capabilities.

Subsequent end of ST6 or ST7 year:

  • stage 2 Intensive Care HALO completed
  • EQ2b completed
  • progress with stage 3 capabilities potentially including Special Interest Areas (SIAs)
  • all stage 3 HALOs, including SIAs, to be completed by end of ST7 year.

 

Option C

If more flexibility (other than just ICM placement) is required in the stage 2 to stage 3 transition.

Transition plan:

Use EQ2b on 2021 curriculum on LLp to evidence stage 2 ‘top up‘ requirements. At the same time use stage 3 tab on 2021 LLp to evidence stage 3 capabilities. Aim to complete EQ2b as soon as feasible after the end of ST5 but this can be completed up to the end of ST7 if necessary.

Guidance for ARCP requirements at end of ST5 year:

  • EQ2b partially completed including all stage 2 generic professional domains of learning.
  • some evidence for stage 3 capabilities
  • Final FRCA pass.

Subsequent EOY ST6 or ST7:

  • EQ2b completed
  • progress with stage 3 capabilities potentially including Special Interest Areas (SIAs)
  • all stage 3 HALOs, including SIAs, to be completed by end of ST7 year.
Transition plan:

If CCT predicted to be before 31 January 2024 then continue on 2010 curriculum.

If CCT after 31 January 2024 then transition to 2021 curriculum.

Guidance for ARCP requirements at end of ST5 year:
  • if CCT predicted to be before 31 January 2024 then as per 2010 curriculum requirements.
Transition plan:

If CCT date predicted to be after 31 January 2024 due to reasons such as maternity leave, LTFT training, or OOPE then transition to the 2021 curriculum. This will need to be planned with the Training programme Director.

If CCT predicted to be before 31 January 2024 then stay on the 2010 curriculum and attain CCT.

Guidance for ARCP requirements at end of ST6 or ST7 year:

  • if CCT predicted to be before 31 January 2024 then as per 2010 curriculum requirements.

ST 6 and 7 who move to the 2021 curriculum do not need to complete the equivalence training for Stage 2 and do not need a Stage 2 equivalence certificate.

General principles to support transition

Anaesthetists within a recognised training programme

Any anaesthetist in training who is expected to achieve their CCT by 31 January 2024 may remain on the 2010 curriculum. This should be discussed with the local Training Programme Director. Those who anticipate a CCT date beyond this date, for any reason, should transition to the new Anaesthetics 2021 curriculum at the earliest opportunity.

Less than full time training (LTFT)

Those in LTFT in general should transition as soon as possible to the 2021 Curriculum with other trainees of the same grade, but this may require individualised training plans. This should be clarified and discussed with the local Training Programme Director at the next ARCP.

The 2010 Curriculum will remain in use until 31 January 2024. This may allow those in LTFT in ST6 and ST7 sufficient time to complete their training programmes on the 2010 Curriculum.

Flexibility of delivery of training between Stages 2 and 3

The College recognises that schools of anaesthesia deliver elements of the curriculum in different ways depending on local circumstances and the range of hospitals within a programme. This is particularly relevant to the delivery of the cardiac, neuro and intensive care medicine units of training of the 2010 Curriculum.

To enable rotations and individuals training programmes that have already been planned for August 2021 to proceed accordingly, whilst also facilitating any transition to the 2021 Curriculum, the College will allow a degree of flexibility in the delivery of training between Stages 2 and 3 of the 2021 Curriculum for the first 12-18 months of its implementation.

Anaesthetists outside of recognised training post

Utilise Structured Learning Events (WBAs), e-portfolio evidence from 2010 Curriculum CT1-2 training years, and evidence from Locally Employed post to evidence 2021 Curriculum Stage 1 key capabilities.

If unsuccessful in August 2021 and February 2022 ST3 recruitment rounds, work to achieve Stage 1 Equivalent Training Certificate to allow recruitment application for 2021 Curriculum Stage 2 (ST4) start in August 2023.

Frequently asked questions

August 2021 / February 2022 will be the final intake for ST3 in Anaesthesia.  From August 2022 there will no longer be any ST3 recruitment and competitive entry to Higher Specialist Training rotations will be at ST4 commencing August 2023. Anaesthetists in training appointed to Core Anaesthesia from August 2020 and ACCS Anaesthesia from August 2019 will automatically include an additional year from August 2022.  Anaesthetists in training appointed to Core Anaesthesia prior to August 2020 and ACCS Anaesthesia prior to August 2019 will not be eligible for an additional year within their core training programme.

Access your LLp profile page (click on your LLp ID - top right of the LLp dashboard page) and then scroll down to the Portfolio section to Generate and Download a zip archive of your Portfolio. Please note that the portfolio download will NOT include your Logbook, Document store, and entries you have approved. We are working to resolve these issues and will notify you when they are fixed. In the meantime, you can download the rest of your portfolio.

No. These anaesthetists in training will still need to complete ICM at ‘higher’ level for stage 2 equivalence.

Yes. The GMC rules have recently changed; if you have completed a minimum of three years within a training programme then you will be awarded a CCT.

This is covered in an anaesthetic training update from 20 May 2020.

Yes, but they will need to compile the evidence for CT3 equivalence onto LLp and be issued with the Stage 1 Equivalence Certificate before moving on to stage 2.

It is possible that some of this time in redeployment may count towards training, if it has occurred contemporaneously to the level of training being signed off.  However, in most cases we would not expect that the competencies achieved will be sufficient to complete units of training in ICM due to the specific nature of care provided during the COVID pandemic.

Please see our existing guidance for further details

No, your training to date, including your IAC, will be recognised in the collection of evidence that will contribute towards your CCT.

All anaesthetists in training, including LTFT, must be transitioned to the new curriculum no later than January 2024.  A CCT for the 2010 curriculum cannot be awarded after this time.

Fundamentally, the onus will be on the individual to organise these posts, in a similar way to applying for clinical fellow posts now. However, some Schools have already started to collate clinical fellow posts appropriate as CT3’equivalent’ posts. Securing one of these posts may require a move to a different region but the College is confident that there will be enough posts available for everyone; this process gives flexibility to anaesthetists in training to determine their own future.

Anaesthetists who have completed 2 years of training will be very appealing to clinical directors; there is research that indicates the benefits of employing anaesthetists in training. Anaesthetists in training looking at these top-up posts should familiarise themselves with the requirements of completing stage 1 and look for roles that will support this eg there is 3 months of ICM available, there is suitable provision of study leave.

Some individuals will effectively be out of the training programme for 2 years. 1 year could be spent accruing stage 1 equivalence and the other year could be spent undertaking complementary interests, and it is possible that some of the experience could also count towards stage 2 of the new curriculum (in a similar process to now).

The College recommends that anaesthetists in training should transition to the new curriculum as soon as is reasonably possible. LTFT anaesthetists whose points of progression don’t align with the transition guidance should liaise with their TPD about the best point to change curriculum and what evidence would be required to support the change.

31 January 2024 is an agreed date with the GMC. Anybody expecting to complete training after this date should transition to the new curriculum.

This is a viable proposition. If a trainee has completed stage 1 training and has been awarded the equivalence certificate then they are essentially eligible for ST4 (all other requirements, notwithstanding). It may be worth noting that August 2023 is the first ST recruitment to the new curriculum and this may have an impact on competition for posts.

Yes. These anaesthetists in training should move to the 2021 curriculum and complete EQ1b to map any remaining stage 1 capabilities once they have completed stage 2 cardiothoracics and neuro. More information can be found in the Guidance for Transition from 2010 to 2021 Anaesthetics Curriculum above.

Yes. Please see the Guidance for Transition from 2010 to 2021 Anaesthetics Curriculum above for further details.

Depending on local training arrangements it may be best to wait until ST4. Decisions around this should be made using the Guidance for Transition from 2010 to 2021 Anaesthetics Curriculum above.

It would be advisable to transition to stage 1 of the 2021 Anaesthetics Curriculum and avoid any potential confusion regarding requirements of the 2021 ACCS Curriculum. Relevant summative assessments should be transferred and mapped to stage 1. Please refer to the Guidance for Transition from 2010 to 2021 Anaesthetics Curriculum above.

Yes, that’s right. If they are in their ST3 year and are doing standard things like ICM, obstetrics, and general duties they will stay on the 2010 curriculum on the LLp and complete the equivalence certificate called EQ1a.

But an ST3 who is doing cardiothoracics, neuro, and paediatrics would go onto the 2021 curriculum and complete equivalence certificate EQ1b. This is the equivalence certificate for stage 1 but is available in the 2021 curriculum on the LLp. This allows them to also do some stage two capabilities. If they’re doing cardiothoracics in ST3, they can evidence it in the appropriate section of stage 2 and if they're doing ICM in ST4 they can evidence it back to stage 1.