Stage 1 equivalent training guidance

Published: 31/03/2021


This guidance was updated on 16 May 2022 to improve clarity and ease of understanding; there have been no changes made to the requirements for attaining stage 1 equivalence.

These pages will be reviewed and potentially updated no later than 15 May 2024.

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

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This guidance sets out the experience and evidence required for the transition year between completing core level training on the 2010 Anaesthetics curriculum and commencing stage 2 training on the 2021 Anaesthetics curriculum.

What is a CT3 Equivalent Year?

In the new 2021 Anaesthetics curriculum, stage 1 training is an indicative 3 years duration, from CT1 to CT3, with stage 2 commencing from ST4.

For a number of reasons, there will be a cohort of doctors who completed core level training on the 2010 Anaesthetics curriculum, or ACCS (Anaesthetics), but who did not commence a ST3 anaesthetics post by February 2022 - the final recruitment round to ST3.

These anaesthetists will need to gain the necessary experience and demonstrate the learning outcomes required for stage 1 of the 2021 Anaesthetics curriculum, in order to be eligible for recruitment to higher specialty training in Anaesthetics at the ST4 (stage 2) entry point. This will be done in a CT3 equivalent year. Doctors are eligible to apply to work on a less than full time basis, following the normal procedures.

A CT3 (stage 1 ‘top up’) equivalent post that is not in the training programme is the type of post that may have been called a clinical fellow post, occupied by anaesthetists in training who required time after core training to perhaps pass the full Primary FRCA exam, or those who wished to take time out before applying for a higher specialty training post. Any anaesthetist in such a post should ensure that they comply with trust appraisal and GMC revalidation requirements.

What if I am in an ST3 post?

This guidance should also be used by anaesthetists in training who commenced ST3 posts in either August 2021 or February 2022.

For this group, some rotations may already be planned in areas such as cardiothoracic and neuro-anaesthesia. Training in these blocks counts towards stage 2, so some flexibility has been allowed in the transition period so that training progression is not negatively impacted - anaesthetists in training will be able to collect evidence towards elements of stage 2 without having completed all the requirements for stage 1. However, stage 1 equivalence should be completed as soon practicable, although individuals are still be expected to complete 12 months WTE indicative training time in completing stage 1 capabilities.

Who should read this guidance?

Doctors who have completed core level training of the 2010 Anaesthetics curriculum but have not completed stage 1 training of the 2021 Anaesthetics Curriculum. These could be in either CT3 or ST3 posts.

Attainment of the following experience and evidence will allow individuals in CT3 posts to apply for ST4 as it is consistent with the completion of stage 1 as part of the new 2021 Anaesthetics curriculum.

This guidance may also be useful for Educational Supervisors to support doctors as part of their development during this time.

Separate but complementary guidance has been developed for Clinical Directors in this area.

What additional training will I need to undertake to be eligible for ST4 (stage 2) applications?

The additional experience required is detailed in the following pages, structured around the domains of learning that comprise the new curriculum.

Will I need to demonstrate evidence of attainment of Generic Professional Capabilities (GPC) as part of the CT3 equivalent year?

Yes. However, Structured Learning Events (SLEs) for the clinical domains can also be used to evidence capabilities in the GPC domains. In addition, individuals can use previous evidence from core level training of the 2010 Anaesthetics curriculum, from the non-clinical sections of the Lifelong Learning platform (LLp).

Will I be able to evidence attainment of stage 1 capabilities within the LLp?

Yes. The LLp has been updated to include a section that will enable anaesthetists with access to the LLp, to record and evidence attainment of stage 1 capabilities. This section is called 2021 Stage 1 'top-up' and can be found under the core curriculum in the 2010 version of LLp and the stage 1 curriculum in the 2021 LLp.

What evidence do I need to show attainment of stage 1 capabilities?

Examples of evidence for all the domains of learning at stage 1 of the 2021 Anaesthetics curriculum are detailed in the following pages, structured around the domains of learning that comprise the new curriculum.

What happens at the end of stage 1 equivalent training?

Your Educational Supervisor and College Tutor will review the evidence that you have accumulated and will assess this together with your logbook and consultant feedback.

They will then be able to issue a Stage 1 Equivalence Certificate, which will show equivalence for completion of stage 1 training of the 2021 Anaesthetics curriculum. This should be completed on the LLp; the equivalence certificates - also known as EQ1A and EQ1B - can be found on the Milestones and certificates section. NB all the evidence linked to stage 1 equivalence will be listed against each of the individual 2021 domains of learning in the certificate, you can view this at any time prior to getting the certificate signed off.

What can I do once I have completed CT3 equivalent training but do not yet have an ST4 post?

Capabilities attained in a locally employed post can count towards the award of a CCT in Anaesthetics provided a minimum of 3 years training occurs in a UK GMC approved training programme.

Once stage 1 equivalent training is completed, you can start using stage 2 of the 2021 Anaesthetics curriculum and collect evidence for these capabilities. This evidence can be presented to ARCP panels in the future once you have been appointed to a higher specialist training post in anaesthesia, where some of it may count towards your training.

It is likely that overseas experience may also count towards training. For guidance regarding counting time from outside the training programme towards a CCT, please see Training programme update - No. 01/2020: Completion of units of training outside the training programme.

You should discuss any experience of this sort with your Training Programme Director once you have commenced ST4 training.