Stage 3 training

This page provides an introduction to stage 3 of the curriculum, including the Special Interest Areas (SIAs), and then outlines the requirements for progressing through each year of training and completing stage 3.

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) and Training Programme Director.

    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.

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 anaesthetist in training should complete, with their Training Programme Director, a Notification of Completion of Training and send it to training@rcoa.ac.uk. This document outlines the training completed during higher and advanced training and can be sent to the College up to 4 months ahead of the 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 an anaesthetist in training 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 advisable to ensure that a copy of the Intermediate Level Training Certificate is available on LLp, in Milestones and Certificates.

It is helpful to inform the College if a start date for a substantive consultant post has been set.

2021 (current) curriculum

Anaesthetists in training who have transitioned to the 2021 curriculum in ST4 and above should complete, with their Training Programme Director, a Notification of Completion of Training and send it to training@rcoa.ac.uk. This document outlines the training completed on the 2010 and 2021 curriculum  and can be sent to the College up to 4 months ahead of the prospective CCT date. This form triggers the review processes at the College.

The Stage 3 Certificate should have been completed, with all 14 HALOs signed off, and the final ARCP outcome form have been accepted on the LLP. 

Depending on the year of transition and the transition plan, anaesthetists in training may have completed Stage 2 top up. If so, they will need to provide their EQ2 certificate.

If the anaesthetist in training transitioned directly into Stage 3 without completing a top up, they will need to have either the Higher ICM CUT form or the Stage 2 ICM HALO signed off on the LLP. 

The College also requires copies of all ARCP outcome forms from anaesthetic training, including those from core or ACCS training. ARCP outcome forms that were completed before the Lifelong Learning platform (LLP) was available should be uploaded to the LLP Document Store. If an anaesthetist in training 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 helpful to inform the College if a start date for a substantive consultant post has been set.

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

Please let us know what you think. If you feel the information on this page could be improved, please get in touch with us.

Last reviewed: 3 November 2022
Next review due: 2 November 2023