Stage 3 training

Stage 3 is the final 2 years of the anaesthetic training programme, years ST6 and ST7. Stage 3 is commenced on successful completion of stage 2.

Your training during this period will be designed in order that you will be able to demonstrate meeting the learning outcomes for all domains  for stage 3 and the learning outcomes for your chosen Special Interest Areas (SIAs).

For more detailed reading you can review the full curriculum here.

The anaesthetists must receive an appropriate outcome at their ARCP at the end of ST6. Please note that this is determined by the local ARCP panel.

To do this an anaesthetist should have:

1. made progress progress with stage 3 curriculum key capabilities across a number of both generic professional and specialty specific domains.
   Click here to review the stage 3 learning syllabus
   Click here to review the SIA learning syllabus
   
   IE some evidence in terms of:
   1. supervised learning events (ACEX, ALMAT, A-QIPAT, CBD, DOPs) to the suggested level of supervision
   2. personal activities
   3. personal reflections
2. completed a multiple trainer report
3. completed a satisfactory multi-source feedback
4. completed an Educational Supervisors Structured Report; this should be submitted to an Educational Supervisor 2 weeks in advance of the ARCP.

The anaesthetists must receive an appropriate outcome at their ARCP at the end of ST7. Please note that this is determined by the local ARCP panel.

To do this an anaesthetist should have:

1. completed a stage 3 training certificate and had it signed by their Regional Advisor (Anaesthesia), or Deputy Regional Adviser (Anaesthesia), and one other designated trainer. 
   
   To get the stage 3 certificate signed off anaesthetists will need to:
   1. demonstrate meeting the stage 3 learning outcomes for all 14 domains in the curriculum by getting approval for all stage 3 HALOs. Click here to review the stage 3 learning syllabus
   2. Completed training in 1 or more Special Interest Areas (SIAs). Click here to review the SIA learning syllabus
      
      Completion of a HALO requires the following evidence:
      1. supervised learning events (ACEX, ALMAT, A-QIPAT, CBD, DOPs) to the suggested level of supervision
      2. personal activities
      3. personal reflections
      4. evidence to demonstrate completion of discrete areas of practice including cardiothoracic, neuro-, paediatric, and obstetric anaesthesia; this can be collated using a Completion of Capability Cluster (‘Triple C’) Form
      5. multiple trainer report(s) that provide some feedback against all 14 domains of learning between them ie you do not need to complete a separate MTR for each HALO; however, also consider MTRs specifically for paediatric, and obstetric anaesthesia placements. MTRs should also be submitted against each SIA
2. completed a satisfactory multi-source feedback
3. completed an Educational Supervisors Structured Report; this should be submitted to an Educational Supervisor 2 weeks in advance of the ARCP.

Timing of Stage 3 certificate signoff

The Stage 3 certificate can be signed off at any point before the trainee’s CCT date, this will not affect the CCT recommendation processes initiated by the Training team at the College. Key things to note:

• The certificate should only be signed off once all 14 HALOs have been approved. This can be done 3 months in advance or close to the completion date, depending on the school’s preference.
• The trainee should post-date the certificate to match their CCT date. In the field “Choose date” they should enter their CCT date. If there is any confusion about the date, please contact the Training team for clarification.

Final ARCP outcome 6

The completion date on the final ARCP outcome 6 should be post-dated to match the trainee’s CCT date and the date on the Stage 3 certificate. ARCPs are usually conducted up to 4 months in advance of their CCT date.

Guidance has been developed by the Faculty of Intensive Care Medicine (FICM) and the College for the benefit of doctors undertaking Dual CCTs in Anaesthetics and ICM, as well as those Deaneries, Training Programme Directors, and Regional Advisors responsible for creating and delivering such programmes.

This guidance deals specifically with those areas in which the two curricula overlap to allow dual counting of capabilities and describes the layout and indicative timeframes of a Dual CCT programme.

The guidance for dual training can be found here.

Pre-Hospital Emergency Medicine (PHEM) is the only official subspecialty for Anaesthetics.

Click here to find out more about PHEM training.

On completion of training, the College reviews an individual's training file to ensure that we have all the relevant information to make a recommendation to the GMC.

NB the process is different for those completing on the 2010 (legacy) curriculum to those completing on the 2021 (current) curriculum. Both processes will be covered here for completeness.

Please note that an anaesthetist must be on the Specialist Register before commencing a consultant post on a substantive basis.

2010 (legacy) curriculum

The trainee should complete, with their Training Programme Director, a Notification of Completion of Training and send it to training@rcoa.ac.uk. This document summarises their higher and advanced training and can be sent to the College up to 4 months before their prospective CCT date. This form triggers the review processes at the College.

The College also requires copies of all ARCP outcome forms from anaesthetic training, including those from core or ACCS training. ARCP outcome forms from that were completed before the Lifelong Learning platform (LLp) was available should be uploaded to the LLp Document Store. If a trainee is missing an ARCP outcome form they should contact their School or Deanery administrator, in the first instance, who should be able to supply a copy.

It is also important to ensure that a copy of the Intermediate Level Training Certificate is available on LLp, in Milestones and Certificates.

Please inform the College if a start date for a substantive consultant post has been set.

2021 (current) curriculum

The Stage 3 certificate in the 2021 curriculum replaces the previous Notification of Completion of Training form. Trainees should complete the Stage 3 certificate, detailing the time spent in each SIA (rotations can be combined). Please ensure that these posts total 12 months whole time equivalent (WTE) and are accurately recorded on the Stage 3 certificate. The date on this certificate and the final ARCP outcome 6 should match the prospective completion date

Training team processes

• 4 months ahead of CCT date
  The Training team contacts trainee to confirm their details, including CCT date and curriculum. Trainees have one month to let us know of any changes.
  • If they respond, we update our records accordingly
  • In the event that no response is received by the Training Team, we will assume that they are on track to complete as per our records.
• 3 months ahead of CCT date
  The Training team begins processing recommendations for all those who are on track to complete. We review their LLP for:
  • CT1 – ST7 outcome forms
  • All certificates
  • Details of any College-approved OOPT/Rs
• Up to 2 months ahead of CCT date
  Once the final ARCP outcome and the Stage 3 certificate are completed, the Training team completes the recommendation and informs the GMC

Requirements for trainees who have transitioned

• Trainees completing on the 2010 curriculum: NoCoT form
• Trainees who transitioned to the 2021 curriculum with a ‘top up’ certificate (EQ1 or EQ2): Stage 3 certificate
• Trainees who transitioned to the 2021 curriculum without a ‘top up’ certificate: NoCoT and Stage 3 certificate. These trainees will also need their ILTC and evidence of higher/stage 2 ICM.

Please make sure that there are two signatures on all certificates and that the relevant units are signed off. 

All trainees can still submit a NoCoT form. This may be useful for those with complex transitions or who completed the Stage 3 certificate before the SIA fields were added. This will also trigger the review process at the College. 

If there are any queries about a CCT date, the team contacts the TPD and trainee to reach a consensus. For paperwork queries (ARCPs, certificates, etc), the team contacts the trainee or school admins directly.

For doctors on a Dual Anaes and ICM CCT programme
For your ICM CCT you will need to complete the FICM CCT Notification form and submit it to contact@ficm.ac.uk. Please click here for further details and the form. FICM are currently reviewing their processes, but for now they still require you to complete this form.