2021 Curriculum frequently asked questions
No, both will be required in the new curriculum but in different ways.
The MTR differs from the MSF as it concerns an anaesthetist’s training progress with key capabilities and learning outcomes. MSFs seek feedback from the multidisciplinary team, including consultants, on overall professional behaviour and attitude.
An MTR will only be required once per year with some exceptional additions to cover specific areas of training, such as the Initial Assessment of Competence.
Following the Junior Doctors Industrial dispute, a review into training supported by patient groups, junior doctors, employers and postgraduate bodies was conducted. Existing training was seen to be rigid, slow to adapt and contained too many tick box exercises. The Shape of Training Review and the GMC’s Excellence by design: standards for postgraduate curricula provided an opportunity to reform postgraduate training to produce a workforce fit for the needs of patients, producing a doctor who is more patient focused, more general and has more flexibility in career structure as recommended by the GMC document Adapting for the future.
These documents have triggered all medical colleges to revise their curricula and incorporate interchangeable and consistent generic professional capabilities at the forefront.
The current CCT curriculum was introduced in 2010 and although there have been detail changes, such as the introduction of Units of Training in Perioperative Medicine, it remains largely unchanged over the last decade. A review of the 2010 curriculum was conducted by Aidan Devlin in 2014 and many of the recommendations have been incorporated into the 2021 curriculum.
The RCoA has used this opportunity to try and improve training for anaesthetists in training. Current data shows that more than 40% of CT2s do not complete core training and move into ST3 after two years. Pressure to pass the FRCA Primary exam and a desire to gain further anaesthetic experience (especially in obstetrics) were cited as particular stressors in the College’s Welfare and Morale Report published in 2017. These issues are addressed in the 2021 curriculum.
No. The 2010 curriculum is an indicative 7 year programme consisting of core training (2 years), intermediate training (2 years), and higher/advanced training (3 years). This totals at 7 years.
The 2021 curriculum is also an indicative 7 years, consisting of Stage 1 (3 years), Stage 2 (2 years), and Stage 3 (2 years).
CT3s will be completing their third year of Stage 1 and will be expected to be working to complete their Stage 1 training. No anaesthetist in training is expected to work beyond what they feel comfortable with or beyond their stage of training. With regards to rotations and rotas, design and implementation will be led by regional schools of anaesthesia and by local departments, respectively. They will aim to fairly balance training needs and local service commitments.
The College aims to ensure no trainee is disadvantaged by the curriculum changes and is pushing to ensure that the pay scale will be in-line with the 2016 junior doctor contract, where ST3 and CT3 pay points are identical across the UK.
There will be recruitment (including applications and interview process) into Stage 1 training – the equivalent of the current Core Training recruitment. A requirement for Stage 1 completion is to complete the FRCA Primary. There will be recruitment (including applications and interview process) at Stage 2 training. A requirement during Stage 2 completion is to complete the FRCA Final . There is no recruitment at Stage 3 but entry into Stage 3 requires a successful ARCP and completion of the FRCA Final in Stage 2.
This has been a long and complex project which has been ongoing for a number of years. The GMC is currently reviewing the College's curriculum plans and will formally comment on these in early 2021. The new curriculum is set to be rolled out from August 2021 for stage 1 (CT1) recruitment and August 2023 for stage 2 (ST4) recruitment. With regards to transition onto the new curriculum, there is a GMC requirement that all anaesthetists in training must be on the new curriculum within 2 years.
August 2021 / February 2022 will be the final intake for ST3 in Anaesthesia. From August 2022 there will no longer be any ST3 recruitment and competitive entry to Higher Specialist Training rotations will be at ST4 commencing August 2023. Trainees appointed to Core Anaesthesia from August 2020 and ACCS Anaesthesia from August 2019 will automatically include an additional year from August 2022. Trainees appointed to Core Anaesthesia prior to August 2020 and ACCS Anaesthesia prior to August 2019 will not be eligible for an additional year within their core training programme.
Trainees who have completed CT2 on the 2010 curriculum can use the recently published gap analyses to identify the additional areas of development required to complete Stage 1 of the new curriculum. These competences/capabilities can be gained in trust-grade posts (or similar non-training posts) and this time would be eligible to count towards a CCT. We are working on reflecting these gap analyses in the LLp, to support progress during this period.
We are working with stakeholders including HEE and its equivalents in the devolved nations, Postgraduate Deans, the GMC and the BMA to try to ensure that these posts offer fair terms and conditions (including pay) for those who need to access them.
The College believes that trainees who accept an ICM NTN starting in August 2021, and who wish to subsequently apply to dual train with anaesthetics, should have priority in accessing resources required to complete Stage 1 of the new curriculum, in order to be eligible to apply for ST4 (Stage 2) posts in anaesthetics.
The RCoA will continue to work with stakeholders including the Faculty of Intensive Care Medicine, HEE and its equivalents in the devolved nations, Postgraduate Deans, the GMC and the BMA to try to ensure that these posts offer fair terms and conditions (including pay) for those who need to access them.
It is also worth noting that dual training programmes can only be developed once all of the corresponding new curricula have received GMC approval.
A designated trainer of the local Assessment Faculty will be responsible for reviewing the evidence that has been collated to determine if the anaesthetist in training has met the requirements for the domain of training.
The Assessment Faculty includes Consultants who are Clinical Supervisors or Educational Supervisors. It is intended that this is an evolution of the previous role of Unit of Training supervisors and reflects the greater emphasis on the role of the expert trainer as part of the new Programme of Assessment.
SLEs can still be completed by all trainers and assessors and is not limited to members of the Assessment Faculty.