Information for Stage 1 Trainees

STAGe one training

Core training is no longer just a 2 year program; for the vast majority of trainees it will now consist of a 3 year program CT1-3. The expectation will be that the primary FRCA exam, IAC and IACOA will be completed by the end of CT3. Stage 1 level expectations of each of the key capabilities in all 14 domains should be met.

The vast majority of CTs will now be on the 2021 curriculum.

IAC

There is now an excellent podcast teaching resource for novice anaesthetists available from the RCOA website, co-developed by a Thames Valley trainee, Dr Eoin Dore.

Please click here to reach this highly recommended resource.

The IAC will now be achieved through achievement of a certain standard within two ‘Entrustable Professional Activities’ or EPAs.

IAC consists of EPA 1 and 2, these are peri operative assessment and anaesthesia for ASA I/II patients. In order to gain IAC the trainee must be at ‘entrustment level 2b’ which translates to needing their ‘supervisor in hospital for queries, able to provide prompt direction/assistance.’

The sign off for IAC is based on the collective opinion of training faculty, supported by evidence on the lifelong learning platform (LLP). Evidence should include SLEs (some of which are specific), logbook of cases, reflective practice, personal activities (including SIM) and at least one multiple trainer report completed. This MTR is intended to collate the opinion of multiple (at least 3) appropriate trainers before sign off, it is initiated by a member of the training faculty.

https://www.rcoa.ac.uk/training-careers/training-anaesthesia/2021-anaesthetics-curriculum/2021-curriculum-assessment-0

IACOA

Much like the IAC the IACOA will now be achieved through gaining a certain standard within two EPAs. These are EPA 3 and 4, which is administration of pain relief in labour and anaesthesia for obstetric operative procedures including category 1-3 LSCS. There is also a requirement to have completed simulation training in obstetric anaesthesia and assessment of general anaesthesia for caesarian section.

In order to gain the IACOA the required standard for EPA 3 and 4 is entrustment level 3, which is a requirement for ‘supervisor on call from home for queries, able to provide directions via phone or non immediate attendance’. A multiple trainer report must be completed towards the end of the training period to support the award of the IACOA, this is initiated by a trainer and collates at least 3 trainer views.

Evidence from the LLP (SLEs, personal activities, reflections and logbook) should support the award of the IACOA. Further information on this and on the specific SLE/SIM requirements can be found here:

https://www.rcoa.ac.uk/training-careers/training-anaesthesia/2021-anaesthetics-curriculum/2021-curriculum-assessment-0

Workbooks

There are now workbooks available to guide trainees through this and videos explaining the process: please see the link here.

Evidence needed

You will be expected to work your way through demonstration of the key capabilities under each HALO, to the appropriate supervision level for Stage 1. Importantly the LLP will reset when a trainee transitions, so you need to download your evidence before this happens if you are transitioning. Please see the LLP section for more information as well as information about the new assessments.

ct3 year

Some CTs have had a CT3 year added to the original core training, others are now completing a standalone CT3 year in order to allow application to ST4. The timing of transition will depend on individual circumstances.

If you complete CT3 equivalence on the lifelong learning platform prior to transition, there is a CUT form entitled CT3 equivalence, which will need to be completed. Notably this does not contain the standards you will need to achieve to gain equivalence; these can be found through the gap analysis document on the RCOA website and the HALO form for stage 1 training.