FAQs - New POM Curriculum Units


Q) Where can I find more information on the new units?

The list of core learning outcomes, competences and associated workplace based assessments can be found in the annexes of version 1.7 of the CCT in Anaesthetics Curriculum. Please see the links below for the exact location in the relevant annexes.


https://www.rcoa.ac.uk/system/files/TRG-CCT-ANNEXB.pdf       - Page 58


https://www.rcoa.ac.uk/system/files/TRG-CCT-ANNEXC.pdf      - Page 35


https://www.rcoa.ac.uk/system/files/TRG-CCT-ANNEXD.pdf      - Page 25


https://www.rcoa.ac.uk/system/files/TRG-CCT-ANNEXE.pdf       - Page 63


Q) When do the new units come into effect?

The units came into effect at the start of the 2016 academic year (August 2016).

Q) Which levels of training need to complete these units?

All trainees who started a new level of the training programme in August 2016 are required to successfully complete the new units. These include CT1s, ST3s and ST5s who started in August 2016. All other trainees will commence their mandatory units when they progress to their next training level i.e. ST3/5 in 2017.

Q) How do these units fit into the training programme?

The Perioperative Medicine units of training are intended to run in parallel with other units of training. They are not designed to be undertaken as standalone dedicated modules. The learning outcomes are applicable to all patients and will be achievable during clinical practice whilst undertaking the other units of training.

Q) Where can I find more information about perioperative medicine?

There is a perioperative medicine microsite on the homepage of the Royal College’s website.


Q) Where are the best learning opportunities to complete these new units?

Each unit has a variety of areas where they can be completed, other than in the operating theatre. Most can be completed during a pre-operative assessment clinic, or during a multidisciplinary team meeting about complex surgical patients. As well as these, there will be a variety of other clinics, such as smoking cessation clinics, pulmonary rehabilitation and lifestyle clinics, which can also offer some alternative places to complete the workplace based assessments. These should provide a broader and more complete understanding of the hospital services.

Q) What is perioperative medicine?

The term Perioperative Medicine (POM) describes the medical care of patients from the time of contemplation of surgery through the operative period to full recovery. As the population ages and more patients live with chronic disease, the complexity of patients presenting for surgery is increasing. These patients require individualised care in order to minimise complications and use NHS resources efficiently, however the surgical patient pathway typically works best for the well patient, with management of more complex patients on an ad hoc basis. The Royal College of Anaesthetists (RCoA) is developing a POM strategy in conjunction with surgical specialties and allied health professionals in order to drive the provision of modern, individualised perioperative care.

Q) Why have these new units been implemented?

In January 2014, the RCoA unveiled its vision for the future of perioperative medicine, outlining the importance of developing a coordinated and collaborative approach to improve the care patients receive before, during and after surgery.

The drivers for developing the field of perioperative medicine are compelling. Of the 10 million or so patients undergoing surgery every year, around 250,000 run a high risk of complications. It is well established that outcomes in surgical patients vary widely, with significant implications for both patients and NHS finances. The RCoA is promoting the establishment of care pathways for patients that will improve the quality of care, putting individuals at the centre of their treatment. Developments in perioperative medicine will also support the wider ambitions of the NHS in developing a more effective, efficient and collaborative approach to healthcare.

The RCoA is committed to developing a collaborative programme for the delivery of perioperative care across the UK. This strategy has been widely publicised over the last couple of years through various events and meetings, supported by a vision document, animated film and dedicated micro-site (http://www.rcoa.ac.uk/perioperativemedicine).

The development of the perioperative medicine units of training will help ensure there is a universal standard of training to support the future delivery of perioperative medicine.

Q) Within higher and advanced training the learning outcomes specifically states that the trainee should be "Demonstrating the ability to lead a medical preoperative assessment clinic is a mandatory component of this unit of training". How can I achieve this when there is no room for me to work independently?

In practical terms, this is the same as a theatre list. Initially the consultant provides local direct supervision with the trainee seeing patients and making decisions (having discussed them with the consultant). Gradually the consultant removes them self from the consultation, only there to answer challenging questions.

The idea is that by the end of the unit a trainee should be able to demonstrate that they would be able to work in a consultant post within a pre-operative assessment clinic sessions.  Although the knowledge is core in all areas of clinical practice there are still elements of verbal and written communication and team-working that are specific to clinic-based practice which makes this a worthwhile exercise.

If there is only one clinic room then by the end of the unit the trainee should be competent in seeing patients with the consultant outside, although it is appreciated that the practical logistics of this may be difficult in some cases. Consultants should be directed to this FAQ if they have any further questions.

Q) Who will sign off these Units of Training?

It is strongly suggested that every department recruits a module lead to take responsibility for coordinating training and signing off the unit of training (UoT). Large departments may need more than one module lead.  They will be responsible for ensuring that the learning outcomes have been met and suitable assessments have been completed in the same way as for other Units of Training. This should be someone with the appropriate expertise and interest in perioperative medicine.  College Tutors should ensure that appropriate leadership and supervision is in place but it is not envisaged that they will normally have responsibility for completing the UoT signoff.  Signoffs and assessments will be reviewed at ARCP in line with other units of training.

If you have any further questions, please email training@rcoa.ac.uk