2010 Curriculum

For most trainees the ARCP will confirm that they are on course to complete training without difficulty. For those not progressing as expected, additional help and support must be given to enable them to fulfil the requirements of the programme. The College strongly encourages all supervised training sessions to be assessed formatively so that trainees who are experiencing difficulties come to the attention of trainers early. This should give the trainee time to try and overcome the deficiencies identified, and allow trainers to target training and support. If the problems identified are related to attitudes and behaviours, the use of non-technical skills assessment and targeted training may be required [see also human factors Section 2.1.6].

Any difficulties should feed into the appraisal process, via the educational supervisor’s structured training report and MSF and consultant feedback. If local trainers are unable to remedy the situation, the ARCP panel must be made aware via the educational supervisor’s structured report so that directed learning objectives can then be set. Help might involve a combination of extra supervision, counselling or focused training. Those involved in the review should take account of any relevant external factors which may have affected progress in training. Trainees should be aware that the outcome of meetings with their clinical and educational supervisors will, with their knowledge, help inform the assessment process and therefore the ARCP panel; such discussions should be recorded.

Where progress is not judged satisfactory at the ARCP there are courses of action that may follow; more information can be found in the ‘Gold Guide’.

6.1       Guidelines for trainees who have not passed the FRCA examinations

6.1.1       Primary FRCA Examination

The Primary FRCA Examination assesses the knowledge and understanding required for progression from Core to Intermediate level training. Trainees who have not passed the Primary FRCA examination cannot progress to Intermediate level training.  The number of examination attempts is limited [see the examinations webpage], and the following action is advised when managing trainees who have not passed the Primary FRCA by the end of CT2:

• Providing there are no outstanding concerns in the other GMP domains the ARCP panel may recommend an ARCP “Outcome 3” allowing extra time. Any additional time is at the discretion of the Postgraduate Dean and subject to the conditions defined in the Gold Guide. 
• Reasons for the examination failure should be explored carefully with the trainee who should receive appropriate help, support and guidance to pass the examination. This could include guidance sessions organised by the RCoA.²¹ If there is a health issue underlying the examination failure, advice from an Occupational Health Physician should be sought regarding both training and the timing of future examination attempts.
• Failure to pass the assessment of knowledge at the end of an extension in training time will normally result in withdrawal from the training programme and loss of the training number.²²
• If the trainee subsequently passes the Primary FRCA Examination after losing their training number, the trainee may be eligible to apply for ST3 posts in open competition provided they have their trainers written support [see respective National Recruitment Person Specification and ‘Support for Reapplication to a Specialty Training Programme’ form].
• If, in addition to having failed the Primary FRCA examination, there are outstanding concerns about the trainee’s performance in other GMP domains, it is for the Dean to decide if the trainee should be allowed to continue training in anaesthesia, following advice from the trainee’s TPD, RA and other appropriate trainers.

6.1.2 Final FRCA Examination

The Final FRCA Examination assesses the knowledge and understanding required for progression from Intermediate to Higher level training. Trainees who have not passed the Final FRCA Examination by the end of the first 6 months of ST5 cannot progress to the remainder of Higher level training. The number of examination attempts is limited [see the examinations webpage], and the following action is advised when managing trainees who have not passed the Final FRCA by the middle of ST5:

• Providing there are no outstanding concerns in the other GMP domains the ARCP panel may recommend an ARCP “Outcome 3” allowing extra time. Any additional time is at the discretion of the Postgraduate Dean and subject to the conditions defined in the Gold Guide.
• Reasons for the examination failure should be explored carefully with the trainee who should receive appropriate help, support and guidance to pass the examination. This could include guidance sessions organised by the RCoA.²³ If there is a health issue underlying the examination failure, advice from an Occupational Health Physician should be sought regarding both training and the timing of future examination attempts.
• Failure to pass the assessment of knowledge at the end of an extension in training time will normally result in withdrawal from the training programme and loss of the training number. If the trainee subsequently passes the Final FRCA examination after having lost their training number, they may be eligible to apply in open competition to return to a training programme [see respective National Recruitment Person Specification and ‘Support for Reapplication to a Specialty Training Programme’ form].

If, in addition to having failed the Final FRCA examination, there are outstanding concerns about the trainee’s performance in other GMP domains, it is for the Dean to decide if the trainee should be allowed to continue training in anaesthesia, following advice from the trainee’s TPD, RA and other appropriate trainers.