STAGe one training

Written by Dr Joanna Lau with input from Ramiro D’Abrantes and James Kirkland

Core: CT1-3

ACCS: ACCS CT1-4

Welcome to the Thames Valley Core Anaesthetic Training program. Over the next three to four years, we will take you from a novice to a capable anaesthetist who can confidently run your own lists. You will have the opportunity to learn from consultants across a wide variety of anaesthetic specialities. In addition to honing your technical abilities, we also help you build the resilience to handle stressful situations and tragic circumstances, and stay on top of the organisational side of things like your portfolio and ARCPs.

There is a useful guidance to your core training if you follow this link.

For your first few months your novice period will be supported by our RIACT course (Readiness for the Initial Assessment of Competency) which runs for 6 days in total, on Mondays. This is run largely by senior AiT and is a great opportunity to share your novice experiences as well as learn!

During your time with us, you’ll have access to regular teaching which runs both face to face and virtually, twice a month. This covers exam and clinical topics taught by local experts, as well as being a chance for you and your peers to discuss cases and support one another. We also run wellbeing days at least once a year. As you near the Primary FRCA, exam-focussed teaching sessions are an invaluable resource.

The requirement for completion of Stage 1 is that the primary FRCA exam, IAC and IACOA will be completed. Stage 1 level expectations of each of the key capabilities in all 14 domains should be met and all HALOs (Holistic Assessment of Learning Outcomes) will be complete.

In order to apply for Higher Speciality Training you must have the Primary FRCA by the time of interview. For this reason it is strongly encouraged to start the process of sitting the Primary FRCA in your CT2 year.

Detailed guidance can be found at https://www.rcoa.ac.uk/sites/default/files/documents/2024-02/FINAL%20Assessment%20Guidance%20V1.5.pdf

IAC

To be achieved within 3-6 months; 4 months is the recommended aim.

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:

Workbooks

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