Redeployment of Anaesthetists in Training
Many anaesthetists in training have once again been redeployed to support other services during the COVID surge, in particular in critical care but also in acute medicine in some Trusts and Health Boards. This has been an essential part of the UK-wide service response to the COVID pandemic. We are very grateful for the way in which anaesthetists in training have been willing to support patient care services despite the disruption that this has caused to their training.
As an update to our previous guidance issued in June, we would like to establish the following points,
- anaesthetists in training must be supervised by an identified and suitably qualified consultant at all times
- all anaesthetists in training must be able to undertake workplace-based assessments regardless of where they are working. Competencies gained, in particular during time spent supporting critical care services, will be recognised as part of a Completion of Unit of Training (CUT) form. Competencies gained may be in clinical areas such as:
- intensive care medicine
- perioperative medicine
- transfer medicine
- management of respiratory and cardiac arrest
- airway management.
- anaesthetists in training must have the opportunity to be assessed in demonstrating skills in many of the areas of professional practice as outlined in Annexe A of the CCT curriculum, including as part of a Multi-Source Feedback assessment if required
- an accurate record of experience and assessments completed during reallocation must be maintained. This must be reviewed and documented in the Educational Supervisors Structured Report at the end of the training year and assessments will be counted towards the appropriate Units of Training. The use of reflection to document learning should also be recognised by schools in situations where it has been difficult to conduct assessments
- anaesthetists in training in the ST3 and 4 years may count this experience towards their Higher Unit of Training in Intensive Care Medicine if they have already completed the Intermediate Unit
- Training Programme Directors, College Tutors and Educational Supervisors should take into account competencies gained during COVID related redeployments when setting educational objectives during future planned ITU attachments.
- there should be a flexible approach to allocating future training placements in ICM whilst maintaining a balance between training and service continuity. Initiatives may include:
- placements for less than three months duration
- allowing doctors working in ICM to undertake appropriate training lists in theatre during their ICM attachment whilst providing support for essential on call services.
Decisions regarding how this flexibility is enacted will be made by the School Board in liaison with ICM faculty tutors and service leads. The College is happy to provide additional advice and support to individual schools if requested. We must ensure that there will be continuity of service provision in ICM after the current surge subsides and, as outlined above, schools are encouraged to be flexible in the way in which anaesthetists in training provide essential support for this service, in particular for on-call services.
We must also note that a considerable amount of elective activity is not currently taking place. This may affect requirements for future training regardless of redeployment. As well as derogation at the end of Core Training the College supports combining Intermediate and Higher Units of Training flexibly during a single attachment, providing all learning outcomes are met.
Both the College and Faculty of Intensive Care Medicine would also like to offer thanks to all anaesthetists in training who have agreed to be redeployed to other areas during the COVID pandemic. We recognise the fundamental importance of the work that you are doing to provide care for patients during the hugely challenging situation that the NHS is facing.