2021 Curriculum implementation and transition

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.

ARCP guidance for those transitioning from 2010 to 2021 curricula can be downloaded here.

2010 to 2021 LLP transition guide

Dr Ian Whitehead, co-Chair of the College's LLp Clinical Reference Group has recorded a walkthrough video showing the most effective way for anaesthetists in training who are transitioning between curricula to carry evidence on the LLp from the 2010 curriculum to the 2021 curriculum.

You can watch the video here [external link].

Year of training in August 2023

CT1 or ACCS2

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 ie some evidence in terms of SLEs, personal activities or reflections across a number of domains, both generic professional and clinical domains

ACCS1s and ACCS2s:

Please refer to the ACCS ARCP 2021-2 Decision Aid on the ACCS website.

CT2 or ACCS3

Transition plan:

Anaesthetists in training have moved to 2021 curriculum are continuing with Stage 1.

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

Initial Assessment of Competence in Obstetric Anaesthesia
progress with Stage 1 capabilities in both generic professional and clinical domains. There should be evidence in all domains with the exception of ICM if this has not been completed
generic professional HALOs should be kept open and approved towards end of Stage 1

CT3 or ACCS4

Transition plan:

Anaesthetists in training have moved to 2021 curriculum and are continuing with Stage 1

Guidance for ARCP requirements at end of CT3 year:

all Stage 1 HALOs completed
Primary FRCA pass
Stage 1 certificate can then be issued

ST4

Transition plan:

Anaesthetists in training have moved to 2021 curriculum and are doing Stage 1 'top up' or may be doing a hybrid of mostly Stage 1 'top up' but also some Stage 2

Guidance for ARCP requirements at end of ST4 year:

Stage 1 'top up' training should be completed, if not completed before
EQ1 certificate completed
Progress with Stage 2 capabilities

ST5

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 training who have not done specialty areas of practice such as cardiac, neuro, paeds in ST3.

Option B may be better for those anaesthetists in training who have done specialty areas of practice such as cardiac, neuro, paeds in ST3.

Anaesthetists in training should discuss this with their Training Programme Director.

Option A

Transition plan:

Anaesthetists in training who have moved to the 2021 curriculum and are doing a hybrid of mostly Stage 1 'top up' but also some Stage 2

Guidance for ARCP requirements at end of ST5 year:

Anaesthetists in training should have an EQ1 certificate on the LLP as Stage 1 'top up' should have been completed by the end of ST4 year
all Stage 2 HALOs completed
Final FRCA pass
Stage 2 certificate can then be issued

Option B

Transition plan:

Anaesthetists in training who have stayed on the 2010 curriculum to complete intermediate level training

Guidance for ARCP requirements at end of ST5 year:

ILTC completed
Final FRCA pass
Stage 2 'top up' HALO approved
eligible for EQ2 certificate

ST6 whose transition is in progress

Transition plan:

There are three options. The decision as to which option will depend on what training has been completed in ST5 and how much evidence needs to be transferred to the new curriculum.

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

Anaesthetists in training should discuss this with their Training Programme Director.

Option A

Transition plan:

Anaesthetists in training who have completed all of Stage 2 'top up' in year ST5

Guidance for ARCP requirements at end of ST6 year:

Generic professional domains
- There should be some evidence for the majority of generic professional domains (research may be an exception)
- SLEs such as ALMATs should be linked to the generic professional domains, eg Professional Behaviours and Team Working
- There should be at least engagement in quality improvement activities
Stage 3
- Evidence linked to key capabilities. SLEs should demonstrate progression
- Triple C forms should be completed for discrete areas of the curriculum if appropriate, such as paediatrics and obstetrics
- It is possible that some Stage 3 domains may sufficient evidence but the expectation would be that the majority of HALOs are completed towards the end of ST7
Special Interest Areas
- SIA evidence may also be linked to Stage 3 domains, eg General Anaesthesia - key capability E.
- Time spent whilst doing an SIA should be clearly recorded

Option B

Transition plan:

Anaesthetists in training who have completed all of Stage 2 'top up' with the exception of ICM

Guidance for ARCP requirements at end of ST6 year:

Stage 2
If ICM training is completed then Stage 2 'top up' HALO should be approved and EQ2 certificate completed
Generic professional domains
- There should be some evidence for the majority of generic professional domains (research may be an exception)
- SLEs such as ALMATs should be linked to the generic professional domains, eg Professional Behaviours and Team Working
- There should be at least engagement in quality improvement activities
Stage 3
- Evidence linked to key capabilities. SLEs should demonstrate progression
- Triple C forms should be completed for discrete areas of the curriculum if appropriate, such as paediatrics and obstetrics
- It is possible that some Stage 3 domains may sufficient evidence but the expectation would be that the majority of HALOs are completed towards the end of ST7
Special Interest Areas
- SIA evidence may also be linked to Stage 3 domains, eg General Anaesthesia - key capability E.
- Time spent whilst doing an SIA should be clearly recorded

Option C

Transition plan:

Anaesthetists in training's transition requiring more flexibility from higher 2010 to Stage 3 2021

Guidance for ARCP requirements at end of ST6 year:

Stage 2
If outstanding areas of training have been completed then Stage 2 'top up' HALO should be approved and EQ2 certificate completed
Generic professional domains
- There should be some evidence for the majority of generic professional domains (research may be an exception)
- SLEs such as ALMATs should be linked to the generic professional domains, eg Professional Behaviours and Team Working
- There should be at least engagement in quality improvement activities
Stage 3
- Evidence linked to key capabilities. SLEs should demonstrate progression
- Triple C forms should be completed for discrete areas of the curriculum if appropriate, such as paediatrics and obstetrics
- It is possible that some Stage 3 domains may sufficient evidence but the expectation would be that the majority of HALOs are completed towards the end of ST7
Special Interest Areas
- SIA evidence may also be linked to Stage 3 domains, eg General Anaesthesia - key capability E.
- Time spent whilst doing an SIA should be clearly recorded

ST6 and ST7

Transition plan:

Anaesthetists in training who have transitioned to the 2021 curriculum

Guidance for ARCP requirements at end of ST6 year:

Generic professional domains
- There should be some evidence for the majority of generic professional domains (research may be an exception)
- SLEs such as ALMATs should be linked to the generic professional domains, eg Professional Behaviours and Team Working
- There should be at least engagement in quality improvement activities

Stage 3:

Evidence linked to key capabilities. SLEs should demonstrate progression
Triple C forms should be completed for discrete areas of the curriculum if appropriate, such as paediatrics and obstetrics
It is possible that some Stage 3 domains may sufficient evidence but the expectation would be that the majority of HALOs are completed towards the end of ST7

Special Interest Areas

SIA evidence may also be linked to Stage 3 domains, eg General Anaesthesia - key capability E.
Time spent whilst doing an SIA should be clearly recorded

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.

Please note: if an anaesthetist in training has not completed higher ICM on the 2010 curriculum before transitioning to the 2021 curriculum, then they must complete stage 2 Intensive Care in the 2021 curriculum; this would be expected to comprise a 3 -month placement in ICM.

Staying on the 2010 curriculum

Transition plan:

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:

As per 2010 requirements

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.

If you would like to contact us, you can email the Anaesthetics Curriculum and Equivalence Team on training@rcoa.ac.uk or call on 020 7092 1550.

Please let us know what you think. If you feel the information on this page could be improved, please get in touch with us.

Last reviewed: 13 January 2023
Next review due: 31 January 2024

2021 Curriculum implementation and transition