Has your email address or phone number changed?

The contact details on the website are used by the Administrator, Trainee Progamme Directors and other members of the school to contact trainees so it is most important that this information is kept up to date. Please could you all check your email addresses and update them as necessary. If your phone or address has changed please also contact the administrator who will update your paper files

ARCP Information

We have added a new page to the site with information about ARCPs. You can find it here

New Study leave form for ST3+ Trainees

We have been sent a new Study Leave claim form to be used by ST3+ Trainees.
It can be downloaded from http://www.schoolofanaesthesia.co.uk/downloads/ST3+%20Study%20Leave%20Claim%20Form%20revised%20December%202009.zip.

Your study leave budget is Currently £750 per year from August - July. To make a claim you will need to send the fully completed form, together with your College TUtor signature, original receipts and your bank details to Anne Ramlal at St Thomas Hospital.

Good news

Congratulations to Dr Richard Marks who has been elected to the College Council!
This is fantastic for Richard and for our School!
Thanks to all those who supported him.

Intermediate Level Training Certificate - ST4/5 should read

It has come to my attention that the Intermediate Level Training Certificate has not been claimed by many trainees.

This is the piece of paper which certifies that you have satisfactorily completed the Key Units of Training and passed the Final FRCA. It can be filled in by your College Tutor. The College requires this to calculate your final CCT date.  Please note that until then your date is only provisional.

For further information see the entry on page 12 in the “CCT in Anaesthetics III - Specialty Training Years 3 and 4” document from the College

http://www.rcoa.ac.uk/docs/cctptiii.pdf

Alan McGlennan
Co-TPD StRs 3-7

Recruitment 2010 for CT1 and ST3

Please see our Recruitment Page

Queen’s Hospital Airway Courses

QUEEN’S AIRWAY MANAGEMENT COURSE
This study day consists of practical skills stations, video demonstrations and power point
presentations in advanced airway management. It is aimed at all grades of anaesthetists,
doctors interested in acquiring airway management skills, ODPs, anaesthetic nurses and
paramedics.
Booking:
Internal applicants: Please complete the relevant application form and return to the
education department at Queen’s Hospital at the above address
External applicants: Please complete the relevant application form and return to Dr
Youcef Sennoun, anaesthetic department at Queen’s Hospital at the above address or
email on
Venue: Education Centre,
Queen’s Hospital, Rom Valley Way Romford Essex RM7 0AG
Dates: 3rd November 2009, 6th May 2010 & 4th November 2010
Times: Start: 9.00am . Finish 4.30 pm
Hands-on practice on:
Fibreoptic intubation - Intubating LMA - Proseal LMA - C.trach - Intubation through LMA -
Airway exchange techniques - Glidescope - Cricothyrodotomy - Paediatric airway -
Currently the meeting on 3rd November is full, but there are spaces on the meetings next year.

For further information please e-mail Dr Sennoun on the above e-mail.

Safeguarding Children - message from the President of the RCoA

September 2009

Dear Regional Adviser and College Tutor

In July 2009 the Care Quality Commission’s (CQC) review of arrangements within NHS Trusts for safeguarding children and young people revealed significant gaps in the uptake and monitoring of training. Their current recommendation is that all anaesthetists should complete Level 1 and 2 training in Child Protection.

Safeguarding Children and Young People is the new e-learning program developed by the Royal College of Paediatrics and Child Health (RCPCH). The programme is designed to help health professionals meet the statutory training requirements of Section 11 of the Children Act and ensuring people are up to date with the issues surrounding Child Protection. The programme is closely aligned to current best practice as set out in the Intercollegiate Document 2006.

Level 1 - Introduction to Safeguarding Children and Young People:

• A single session that covers the knowledge and competences required for Level 1 Safeguarding

Level 2 – Recognition, Response and Record:

• Three sessions that cover the knowledge and competences required for Level 2 Safeguarding

These sessions are now available on e-Learning Anaesthesia (e-LA) to ALL anaesthetists.

• If you are already using e-LA you can log on with your existing username and password

• If you haven’t yet registered for access to e-LA please visit http://www.e-LA.org.uk and follow the link to the registration page. You will be sent your username and password within few days

Level 1 and 2 training can be found on the Learning Management System by clicking the menu item ‘Mandatory’ on the left of the screen as shown in the image overleaf. A short PowerPoint presentation with details of how to access this is also available on the College website.

The College recommends that all anaesthetists complete the National Level 2 e-Learning package to support local implementation of the current guidance from the CQC.

I would be grateful if you could disseminate this information to all members of your department.

Yours sincerely

Peter Nightingale

PRESIDENT

Information for new trainees in the School

We have prepared an information sheet for new members of the School which outlines the key responsibilities, the key members of the School Executive and some important practical information. It can be reached via the downloads page or directly accessed here

Swine flu information from the College

The College has posted some detailed information on swine flu, which will be of help to intensivists and anaesthetists. The information will be uodated from time to time. It can be accessed at http://www.rcoa.ac.uk/index.asp?PageID=64&NewsID=705

Fixed leave at UCH

We have been asked to notify members of the School that UCH have now changed to a fixed leave rota at UCH - 1 in 9 on call with two concurrent weeks off in a nine week block - in order to be 48 hour compliant. The information about UCH in the prospectus has been updated to reflect this. 

New guidance on Anaphylaxis

The Association of Anaesthetists has published new guidance on anaphylaxis. The document can be downloaded here.

(1) The AAGBI has published guidance on management of anaphylaxis during anaesthesia in 1990, 1995 and 2003. This 2008 update was necessary to disseminate new information.

(2) Death or permanent disability from anaphylaxis in anaesthesia may be avoidable if the reaction is recognised early and managed optimally.

(3) Recognition of anaphylaxis during anaesthesia is usually delayed because key features such as hypotension and bronchospasm more commonly have a different cause.

(4) Initial management of anaphylaxis should follow the ABC approach. Adrenaline (epinephrine) is the most effective drug in anaphylaxis and should be given as early as possible.

(5) If anaphylaxis is suspected during anaesthesia, it is the anaesthetist’s responsibility to ensure the patient is referred for investigation.

(6) Serum mast cell tryptase levels may help the retrospective diagnosis of anaphylaxis: appropriate blood samples should be sent for analysis.

(7) Specialist (allergist) knowledge is needed to interpret investigations for anaesthetic anaphylaxis, including sensitivity and specificity of each test used. Specialist (anaesthetist) knowledge is needed to recognise possible non-allergic causes for the ‘reaction’. Optimal investigation of suspected reactions is therefore more likely with the collaboration of both specialties.

(8) Details of specialist centres for the investigation of suspected anaphylaxis during anaesthesia may be found on the AAGBI website http://www.aagbi.org.

(9) Cases of anaphylaxis occurring during anaesthesia should be reported to the Medicines Control Agency and the AAGBI National Anaesthetic Anaphylaxis Database. Reports are more valuable if the diagnosis is recorded following specialist investigation of the reaction.

(10) This guidance recommends that all Departments of Anaesthesia should identify a Consultant Anaesthetist who is Clinical Lead for anaesthetic anaphylaxis.

Research and Audit - RAFT Prize

Congratulations to Annie Hunningher & Kate Adams who won the 1st RAFT prize (£500) announced at the North Thames SpR 345 study day last week for their audit regarding pregnancy and anaesthesia which was kindly sponsored by Professor Mythen and the Centre for Anaesthesia.  If you are interested in applying for the 2010 prize then now is the time to act.

All you have to do is
- Attend 2 RAFT meetings
- Sucessfully submit a poster or oral presentation to ANY national or international conference in Anaesthesia, Critical Care or Pain
Good Luck!!

Further information is on the RAFT website

Changing from ACCS to Anaesthesia

The following guidance was received from PMETB this week, which will be of interest to anyone considering changing careers.

The present position re ACCS is that we have four specialty specific core ACCS groupings: emergency medicine (EM), Intensive care medicine (ICM), Anaesthetics (AN) and several physicianly specialties for brevity here referred to as ACCS – GIM. These specialty specific core were sought by the Colleges involved and approved by PMETB in 2007.

Programmes in deaneries have been approved by PMETB in the above four ways and for some deaneries as a broad overall ACCS programme approval.

We have trainees, from 2007, 2008 and soon 2009 intakes following the approved curricula and programmes, that wish to transfer from one acute specialty to another. If PMETB held to a rigid interpretation of the Order we would expect that such trainees would have to revert to ST1 day1 of an ACCS programme and start again in that specialty. However the range of experiences are the same in all ACCS core; it is the proportion of the experiences in EM, AN, ICM, and ‘acute medicine’ that varies in the approved curricula.

In order to facilitate an appropriate transfer for these trainees, PMETB will consider the present ACCS programme approval as ‘generic’ and therefore each trainee wishing to transfer to a different specialty to which ACCS is core i.e. AN, EM, and the relevant physicianly specialties will be able to transfer recognising the experience that can be accredited against the new and different specialty. This means that trainees who wish to change parent specialty will enter core training at the appropriate level. PMETB expects that deaneries and Colleges will work together to ensure that the recognition is agreed at ARCP for each trainee. This opportunity for transfer is ONLY for those presently in ACCS 2007 onwards, including 2008 and 2009 cohorts.  From 2010 the Royal Colleges will have sought approval from PMETB for revised ACCS structures.

PMETB will continue to protect patients and trainees but not put unnecessary barriers to recognising relevant PMETB approved specialty training to CCT.

New TPD

I am pleased to welcome Dr Alan McGlennan as new TPD to the Central School. Alan will be working closely with Lila Dinner looking after mainly the ST3 - 7 years of training.(SpRs)
Alan’s appointment has come about following Jane Lockie standing down as TPD. So along with congratulating Alan on his appointment, I would like to thank Jane very much for all her hard work over the years. The School Executive will miss her.
There will be an ‘orderly handover’ occurring, but could all queries from ST3 - 7s about their rotations etc now be addressed either to Lila or to Alan.
Regina Milaszkiewicz
RA North Central Thames

ITU Training and ACCS

The following guidelines were recently issued by the College, with immediate effect.

Trainees, whether ACCS (anaes) or solely anaesthesia commencing CT 1 from August 2008 in uncoupled programmes, cannot progress to ST3 (anaesthesia) until they have obtained the Basic Level Training Certificate i.e. have achieved all the basic competences for anaesthesia and ICM.

· Training programmes may allow anaesthesia and ACCS trainees to complete 6/12 in ICM in the first 2 years but TPDs should be aware of the implications of point 1 , i.e. that all anaesthetic competencies will have to be achieved in, potentially, a shorter time.

· In the case of trainees completing more than 3/12 of ICM in the basic years, the additional time will not contribute to intermediate levels of competency because trainees will not have the wider experience that underpins intermediate level assessment standards. In other words a trainee who has done 6/12 ICM at basic level should only be assessed against the basic competences and will still have to
do 6/12 ICM training at the intermediate level.

· The intermediate level training should be completed in two 3/12 blocks, one in ST3/4 and the other in ST5/6/7. (For those programmes who complete 3/12 in ST3 and 3/12 in ST4, this requirement will take effect in August 2010)

Judith Hulf CBE

We are very pleased to hear that Dr Judith Hulf, Consultant at UCLH and President of the Royal College of Anaesthetists, who was awarded a CBE in the Queens Birthday Honours. Judith was formerly Regional Advisor to our School. She had made great contributions to our School and to the national stature of anaesthesia. Congratulations.

Fellows Posts August 2010

There are 2 posts available in Aug 2010, one for 6 months and one for a year. Interest in the following posts which are part clinical, part research should be forwarded to the supervisor of the post and the ST3-7 programme director,Lila Dinner. Candidates should expect to be post FRCA by commencement of the post.

Royal Free Hospital

Clinical Research Fellow in Hepatobiliary and Transplant Anaesthesia (6 months) Dr Susan Mallett

Research Fellow Hepatobiliary and Transplant Anaesthesia (12 months) Dr Susan Mallett

Please contact the relevant people ASAP with your CV and a short letter to explain why you should get the training opportunity. Closing date for this process will be 29th Nov 2009.

Advanced Pain Trainee post UCLH and RNOH

Advanced Pain Trainee post
The Pain Management Centre of UCL Hospitals
And
Royal National Orthopaedic Hospital, Stanmore

Consultants
Dr Andrew Baranowski UCLH Dr John Lee UCLH
Dr Jonathan Berman RNOH Dr Paul Nandi UCLH
Dr Brigitta Brandner UCLH Dr James Smart UCLH
Dr Joseph Cowan RNOH Dr Roxaneh Zarnegar RNOH
Dr Barbara Duncan UCLH

This rotating post starting at the beginning of August 2009 is for one year, with six months spent at each site. The post is open to post-fellowship anaesthetic STs with an interest in a career in chronic pain medicine. 
The successful applicant will gain experience to RCA Advanced level in the clinical management of acute and chronic pain. They will work closely with consultants in pain medicine and other members of the different multidisciplinary teams. Time may also be spent with palliative care teams. The development of good communication skills is essential within this speciality. There will be opportunities available within each trust to attend clinical sessions in other specialities relevant to pain medicine.
The post holder will be paid their basic salary according to the appropriate NHS pay scale. There is no on call and no commitment to anaesthetic services. A regular assessment system is in place.
The Advanced Pain Trainee would be encouraged to attend and present his or her work at local and national meetings.
In summary, this post will allow the successful applicant to gain valuable experience and develop their clinical skills in Pain Medicine with a view to applying for consultant posts in this field.
Dr Paul Nandi and Dr John Lee (0845 155 5000 ext 723066) are available to discuss the UCLH post and Dr Roxaneh Zarnegar (020 8954 2300) for the RNOH post
Please forward one application form and 10 copies of your CV in hard copy format only to: Medical Staffing, 6th Floor Central, 250 Euston Road, London NW1 2PG. Job reference: M956
Closing date for applications4th April 2009. Interviews April 2009.

Educational Fellow in Simulation and Anaesthesia- Lister and the university of Herts

This is an exciting post combining clinical duties and teaching using high-fidelity simulation and offering the opportunity to obtain a postgraduate qualification in medical education.Advert on BMJ(17th Jan). Contact Indu Sockalingam for more datails on 01438-781086.

Another School Trainee on the Royal College Council

Congratulations to Sanjiv Patel who was appointed onto the Royal College Council, replacing Alan McGlennan, as the trainee representative. We are sure that Sanj will be an approachable and positive influence and we wish him well.

New Regional Advisor for Intensive Care Medicine

Congratulations to Nick Harper, Consultant Anaesthetist at the Whittington, who was recently appointed as the Regional Advisor in Intensive Care Medicine. Nick was College Tutor for 6 years and has been very active in teaching. He will be the new point of contact for trainees looking for careers advice in Intensive Care.

Basic level training in Anaesthesia and ICM

The September Training Committee of the Royal College of Anaesthetists and subsequent Council meeting have agreed changes to the published curriculum guidance on the ratio of anaesthesia training to intensive care training at the basic level for both ACCS and anaesthesia trainees; and the progression rules from CT2 to ST3 for all trainees.

The current curriculum rules for the basic level are that trainees on the anaesthesia programme will normally complete 3/12 in ICM and 21/12 in anaesthesia. For ACCS trainees, training normally consists of 6/12 ICM and 18/12 anaesthesia. It is also possible for ACCS trainees to carry forward those basic level anaesthesia competences not achieved into ST3. These rules were introduced in the context of run through training and are in effect a legacy of time based training. The change to a competency based programme and uncoupling of CT2 from ST3, ironically has imposed a new time based rigidity on trainee progression.

For ACCS, emergency medicine and acute medicine are delivered in 6/12 modules. For rotation planning, in most Schools, it was decided that ICM and anaesthesia could also be 6/12 modules. This leaves 12/12 in the final year of the 3 year programme to be dedicated to anaesthesia. Some hospitals/Trusts, as a consequence of the ACCS structure, wish their anaesthesia trainees to complete 6/12 in ICM in their 2 year programme.

The new College policy is as follows:

• Trainees, whether ACCS (anaes) or solely anaesthesia, cannot progress to ST3 (anaesthesia) until they have obtained the Basic Level Training Certificate i.e. have achieved all the basic competences for anaesthesia and ICM.
• Training programmes may allow anaesthesia trainees (non-ACCS trainees) to complete 6/12 in ICM in the first 2 years but TPDs should be aware of the implications of point 1.
• The second 3/12 of ICM in the basic years does not contribute to intermediate levels of competency because trainees will not have the wider experience that underpins intermediate level assessment standards. In other words a trainee who has done 6/12 ICM at basic level will still have to do 6/12 ICM training at intermediate level. Normally trainees complete 3/12 in ST3-4 and 3/12 in ST5-6. Trainees must complete 3/12 of their intermediate level ICM training in the last 3 years of the programme.

Commencement Date: 1 August 2008. These changes have been submitted to PMETB for incorporation in the CCT in Anaesthetics and retrospective approval.

Simulator Information Update

The information about the Simulator on the website has been updated - please see the Simulator Page. There is also some new information about becoming a facilitator or teacher.

School Inspection by the Royal College of Anaesthetists

This summer the School was inspected by the Royal College. We are pleased to report that the inspectors were very complimentary about much that they saw.
As part of their inspection they took soundings from trainees - 110 responses were received. These were as follows:-

Overall Assessment of School:	No view	Poor	Less then adequate	Adequate	Good	Excellent
	12	1	2	18	59	18
Overall Assessment of Training:	No view	Poor	Less then Adequate	Adequate	Good	Excellent
	8	5	8	18	45	26

In their conclusion the inspectors wrote that the trainers should be congratulated on their efforts.  The trainees fully appreciate their hard work and commitment towards providing an exceptionally good, comprehensive, bespoke training programme.

The school labours under the four problems common to all anaesthetic training schemes within the UK: - the chaos and knock on of the MMC / MTAS process, annual recruitment and gaps in rotas, the effects of the WTD and the uncertainties around the new ARCP process.

Members wellbeing and supporting members welfare

The AAGB I(Association of Anaesthetists of Great Britain and Ireland) recognises the importance of supporting members’ welfare. Contact is welcomed from members with regard to any welfare issue.

The AAGBI supports the Doctors for Doctors scheme, an enhancement of the BMA Counselling Service which provides 24 hour access to help (http://www.bma.org.uk/doctorsfordoctors).

The Welfare Resource Pack is now available to download from the AAGBI website.  The pack is designed to provide members with a wide spectrum of relevant information which may be of help in times of need both in their career and domestic life.  It is part of the continuing work of the AAGBI Welfare Committee.  To download the pack, please visit the AAGBI Members’ Wellbeing main page http://www.aagbi.org/memberswellbeing.htm

ELearning Update

The College is now running an eLearning system. e-Learning Anaesthesia opened its doors to ST1/2 trainees in August. The first batch of sessions for block 1 are on the Learning Management System and more sessions will be available shortly. Trainees are continuing to register and activity on the Learning Management System has increased 10 fold over the last 2 months. Registration is now open for ST 3,4 and 5 trainees.

For more details and to log in go to www.e-lfh.org.uk/MoreInformation.aspx

UCLH Pain Documentation

The documentation used at UCLH for trainees doing Pain has recently been updated, and can be downloaded from here. The pack also contains some general information and protocols which may be of interest to people working in other departments and hospitals.

New Training Programme Directors

Congratulations to Dr Lila Dinner who will be taking over from Dr Richard Marks as ST 3/4 TPD and Dr Roger Cordery who is taking over from Dr Wynne Davies with a slightly different remit as ACCS and CT1/2 TPD with Dr Warwick Marchant.

Both Programme Directors will be getting a handover and introduction to their new roles over the next few weeks, so please continue to contact the existing TPDs while an orderly handover takes place. August 2nd is official changeover between Lila and Richard. A vacancy for the Less than Full Time (flexible trainees) TPD will result, although until a new person is appointed Lila will continue to deal with all issues relating to the LTFT trainees.

Thank you to Richard and to Wynne for their efforts over the years; and also to Lila for all her work with the LTFT trainees.

Richard, as a Deputy Regional Advisor, will still be actively involved in the running of the School.

Changes to the format of the Primary FRCA Exam

The following changes have been made to the rules governing the Promary FRCA.
.
11 Removal of the Initial Assessment of Competency as a requirement to sit the Primary MCQ Examination
12 Insertion of Initial Assessment of Competency as a requirement to sit the Primary OSCE/SOE
14(c)(ii) Temporary re-instatement of 30 months training granting eligibility to sit the Final FRCA Examination
16(a) Removal of a pass in Part 2 of the Fellowship of the Royal College of Anaesthetists as an exemption from the Primary FRCA Examination.

Full details are available on the College website http://www.rcoa.ac.uk

SpR 345 (postfellowship) Study Days

The 2008 dates for the SpR 345 Study days are

14.3.08 Barts
23.5.08 Royal College of Anaesthetists
12.9.08 Royal College of Anaesthetists
7.11.08 Royal College of Anaesthetists

They are open to all post-fellowship trainees. Further details to follow.

Fellowships in Medical Education

Applications are invited for appointment to five Fellowships in Medical Education. These unique posts offer an exciting opportunity for Specialty Registrars to develop their experience and skills as medical educators. The Fellowships scheme will commence in May 2008 and will consist of an out of programme experience for a period of 6 months attached to an ‘education unit’ within a London NHS Trust.

As part of the 6 month attachment successful applicants can expect to take part in regular Trust-based teaching activities, attend monthly seminars at the London Deanery, attend/teach on London Deanery faculty development courses, receive financial support to undertake the MA in Clinical Education at the Institute of Education and have a designated educational mentor. The posts will also include one day per week clinical training in the specialty of the applicant’s choice.

Employment will be through the Trust wherein the Fellowship resides and payment will be at the relevant point of the specialty training scale. There is no out of hours requirement. As the posts are ‘out of programme’ they carry no prospective approval for training and study leave is integral to the post.

Starting in May 2008, the following Fellowships will be available*:
· St Bartholomew’s and the London NHS Trust
· Imperial College Healthcare NHS Trust
· North Middlesex University Hospital Trust
· North West London Hospitals Trust
· Tavistock and Portman NHS Foundation Trust

The posts are open to Specialist Registrars in run-through training. Short-listed applicants will need to be eligible for Out of Programme Experience (OOPE) and will need to have obtained approval for OOPE prior to attending interview. Non UK/EEA applicants should ensure that they are aware of recent changes to the immigration rules for Postgraduate Doctors and Dentists. For further information on how this may affect your application, please visit http://www.homeoffice.gov.uk or contact the Home Office’s Immigration and Nationality Enquiry Bureau or telephone: 0870 606 7766 or by e-mail:

For an application pack please contact:
Samantha Hobbs at: or tel: 020 7866 3155
(please note that this number and account will not be checked between 21 December 2007–1 January 2008)
Application packs are also available to download at the London Deanery Faculty Development website in the ‘what’s new’ section at: http://www.londondeanery.ac.uk/facultydevelopment
The closing date for receipt of applications is Monday 7 January 2008, 17.00hrs.  Interviews will be held on Wednesday 30 January 2008.

Applications for Training Posts in 2008

The applications process for 2008 is due to commence shortly. Full details are on the applications page. 

School Xmas Party

For those of you that were there, you’ll remember the epic night that was the School Party at The Canal Bar last Xmas. For those of you that
couldn’t make it, you can stop sobbing now because…

It’s back.

And not just anywhere.

We have secured the opulent ballroom at Sin, a luxurious venue next to Tottenham Court Road station. So come and join for champagne, canapes, cocktails and dancing.
Date: 20th December
Time: 830pm-300am

Limited tickets will be available through agents at all hospitals.

This rotation is famous for it’s social life and nights like this
remind us why. So get involved.

We’ll be in touch to update you of our progress.

Planning to go abroad?

OOPEs - Out of program Experiences - are designed for trainees who wish to take a period of time away from the rotation. Usually this is to work abroad. If you are considering this, you will need to complete the necessary OOPE paperwork, which is now available for the downloads page.

SHO and ACCS Rotations now on the website

We have now added the SHO (or ST12) and ACCS Rotations to the website. They will be updated frequently. Individual rotations are also available.

If you cannot access your individual rotations, the most likely reason is that your user name on the website is not the same as your name on the rotational spreadsheet. You can change your user name by clicking on ALTER MY ACCOUNT. If your name is misspelt on the rotational spreadsheet then please notify your Program Director.

We hope to have the Flexible Trainee rotations added before the end of the year.

Study leave and travel expenses update

Study leave claim forms for ST3 and above are now available on the website. As most of you will already know, study leave claims for ST3 and above are now organised by the Postgraduate Centre at St Thomas' Hospital. The new form is available to download in the download section of this website here
The contact person for study leave administration is

ST1 and ST2 claims will be processed locally by the trusts. The Deanery is no longer involved in study leave.

Relocation / travel expenses are now dealt with locally by the Trust and are given at their discretion. Again, the Deanery is no longer involved.

Appointments in 2008

Although there is still a great degree of uncertainty about this, the MMC Board has published some general guidelines. They look quite promising. They can be downloaded from here

Rotation dates changing to 1st Wednesday of the month

Our current best information is that changeover dates will be on the 1st Wednesday of the month for the foreseeable future. This means that dates will be:-

Wednesday 01-Aug-07

Wednesday 07-Nov-07

Wednesday 06-Feb-08

Wednesday 07-May-08

Wednesday 06-Aug-08

Wednesday 05-Nov-08

Wednesday 04-Feb-09

Service gaps in the rotation

With the switch to MMC, we are presently recruiting only once a year for NTN posts. However trainees leave the rotation more frequently than this. Unfortunately we have no way of appointing SpRs into training posts between now and the summer, and will miss out on our previous quarterly rounds of recruitment. This will inevitably create gaps in the rotation, which will need to be filled locally (ie by local locum appointments).

OOPEs and other off-rotation training.

Out Of Program Training (OOPT) is the new name for OOPEs.

It has come to our attention that PMETB have granted approval for three OOPT posts which the Training Department at the College were not aware of. It is imperative that all trainees undertaking OOPT ensure that the College is sent the paperwork as outlined in the Prospective Approval of Out of Programme Training/Research document

There is now a new Form and new procedure to be followed when applying. The new form can be downloaded from the website on the Downloads page, or by clicking here
Please note that approval has to be obtained PROSPECTIVELY.

Registration with the Royal College

The College has been asked if trainees who have previously registered with the College as an SHO need to re-register after taking up an StR1/2, FTST or StR3 post? The answer is yes for the following reasons:

* StR posts are new contracts guaranteeing run-through training up to and including the award of a CCT. In this respect the requirement to re-register is no different to the previous situation where SHOs were appointed to SpR posts.
* Many trainees who started as SHOs in August 2006 never registered with the College, probably because of the uncertainty created by MTAS. The College therefore has to start from scratch so that it can remove from its database SHOs who have become Trust/SAS grades or have emigrated.

Of those StRs who have already submitted registration forms many have omitted their NTNs. The College cannot register a StR without knowing the NTN

Existing SpRs do not have to re-register, although it would be appreciated if those who have not already registered did so as soon as possible!

New post at the Royal Marsden

We have arranged a second StR slot in our program at the Royal Marsden, commencing March 2007. If you are interested in it then please let us know. This is a fairly senior post, and Final FRCA is required. It offers experience in major cancer surgery, postoperative care and pain management.

Requests to complete training as a locum consultant

We have received the following advice from the College:-

Time spent in a Locum Consultant appointment does not count toward the CCT: only time spent in a Deanery approved training post counts toward the CCT. Training time is under the control of the Postgraduate Dean and is normally delegated by him/her to the local Training Committee. The RCoA Training Committee recognises that some trainees towards the end of their training would benefit from being allowed to ‘act up’ in a consultant capacity and undertake duties similar to those encountered in consultant practice. If the period of acting up as a consultant is deemed by the Deanery/College to be a normal part of the anaesthetic CCT training programme and is intended to count towards the trainee’s CCT then PMETB approval will not need to be sought as in effect this is an already approved element of the training programme.

This however, should be allowed only within the trainee’s own scheme with the agreement of the local Training Committee, the Programme Director and the Clinical Director of the hospital concerned. The trainee will retain their NTN and continue to be supervised by and be responsible to the local Training Committee. It is essential that at all times the trainee has immediate access to consultant advice and understands that he or she is still in training until completion of the CCT. Such a post can only occur within the last 3 months of training with the proviso that the trainee must have satisfactorily completed all other aspects of the training programme. Trainees wishing to take up this option should apply directly to the College with the support of their Programme Director. If, however, the period of acting up as a locum consultant is not deemed to be a normal part of the anaesthetic CCT training programme, and the trainee still wishes this to count towards their CCT, then prospective approval must be sought from PMETB in the same way as other out of programme training.

Academic Posts in the School

The Academic National Training Numbers are to be Advertised soon on 12 October 2007!

Ever wondered how to get into research? Would you consider a career combining clinical time and academic time? The new Walport system of Academic Clinical Fellowships in Clinical Medicine is intended to make this possible, and the Central School of Anaesthesia is one of only two Schools in the UK to have funding for two Academic Clinical Fellows in Anaesthesia. You don’t have to have a research project already prepared, but you do need to have an interest in making this part of your career.
If you are interested in finding out more then contact Steve Harris or Roman Cregg.

New SHO/ST12 Program Director

We are delighted to announce that Dr Warwick Marchant has been elected to the post of Program Director for SHos and ST1/2s. Warwick is a consultant at the Royal Free. He will be joining Wynne Davies, who remains as SHO/ST12 program director based at UCH. They will also be looking after the Anaesthetic Trainees within ACCS.

Dr Marchant was a trainee within our School, and won the Gold Medal in the FRCA.

Resignation from MTAS Appointments Panel

A meeting was held of the School Executive of the North Central London School of Anaesthesia on 9/3/07 to discuss the problems of the first MTAS round. We were very concerned at the many irregularities of procedure and process that took place during shortlisting. We were divided on the correct course of action. This has always been a finely balanced decision. We reviewed this in the light of this morning’s letter from GAT (The Group of Anaesthetists in Training). This letter asks that we ‘do what we can to stop the process’. We are therefore decided that we should no longer continue with the present round of interviewing for anaesthetics.

We deeply regret taking this decision. We are very aware of the huge efforts that the candidates have undertaken, and the large amount of work that has gone into the process thus far. The Consultants involved in shortlisting have all worked long hours, often at weekends or during half term holidays, and have done their utmost to cooperate.

It is our professional duty as shortlisters to make sure that the appointment process is carried out correctly and that all candidates are considered equally and fairly. There have been a series of serious procedural errors during the process.

90 applications were ‘lost’ from the original boxes, due either to a Deanery error or an MTAS ‘black-hole’. These were ‘horizontally scored’ but by different scorers. We were given varying amounts of the application form for different candidates; with some we were given their entire application form (with name and email address). At the shortlisting meeting we had no discussion around any of the candidates after the scores were collected. The divergence on individual scores range from 2 to 12 points.

Most of us had 48 hours in which to carry out shortlisting of up to 650 applications. Some of our shortlisters were on annual leave, and their scoring was not done. Some of the (horizontally-marked) questions were scored by 2 people, some by only one. The “marking schedule” did not tally with the wording of some questions. Some of the scorers strictly followed the marking schedule for the ‘creative writing’ sections, others did not.

We believe that there may have been other procedural errors with regard to the composition of the panel. We have not been able to confirm this, since the regulations governing this entire process – the “Golden Guide” – are still in draft and are still unpublished. We were not sure whether the lay chairman had had sight of these regulations.

We would hope that many of these issues be addressed in Round 2.

There are some areas of this appointments process that are especially unfair. One is that candidates who are offered their second, third or fourth choice are ineligible to apply for round 2, even if their circumstances have changed (eg by passing exams or satisfying specific eligibility criteria). We also feel that London has been unfairly treated, since our ‘Unit of Application’ extends from Brighton to Southend to Stevenage to Ealing. The huge population of this area, which also includes KSS and parts of the Eastern Deanery, has meant that the burden on the appointments panel has been too high. It would be easier if it could be divided.

There has been a general recognition that round 1 of MTAS has been unfair and ineffective. Candidates appointed at round 1 may therefore fall foul of PMETBs generic requirements governing approval of run-through training programs.

Colin Beard – Deputy Regional Advisor
Wynne Davies – Program Director
Lila Dinner – Program Director
Ernie Grundy – Regional Advisor, Head of School
Jane Lockie – Program Director
Richard Marks – Program Director
Regina Milaszkiewicz – Deputy Regional Advisor
Sue Mallett – College Tutor
Jane Robinson – Program Director

Online logbook

One of our trainees has developed an on-line logbook program. Users can log operations, ITU, pain sessions, and courses,meetings etc. It creates an instant statistical report useful for RITAs, job applications etc. And its free to use! It can also import entries from some other database formats. We understand that there are about 100 users at present.

There is a dummy account set up to give an idea of how it works:-
username: Testing
password: password

Further information is at http://www.frca-primary.com

DISCLAIMER:- This logbook program is not officially sanctioned by the School, and the School takes no responsibility for anything that may happen if you use it.

More FRCA Passes

Once again, the Examiners have been defeated! Congratulations to our recent FRCA passers - Ed Burdett, Adnam Mustafa, Nicola Jones, Jamuna Navaratnarajah, Kate Cheeseman, Rob Broomhead and Sandra Reynolds.

Changes to the FRCA Exams

We have now received further details of the changes to the Primary and Final FRCA. In brief, these changes are:-
- Eligibility to sit the exam will be competency-based and not time-based.
- In order to sit the exam, candidates will need to be in a Deanery and PMETB-approved post.
- In order to be eligible for sitting Final FRCA, candidates will need to hold a ‘Completion of SHO Training’ certificate.

Fuller details of this, and other changes, are available here

Specialist Registrars and Pay Protection

The following letter was sent to the STC and TPD’s by Elisabeth Paice, Dean Director.

NHS Trusts and the Deanery are committed to improving working lives and ensuring that the 48 hour target is met by August 2009. One consequence of reducing the hours of Specialists Registrars is that the banding of posts will change. However, because of the pay protection afforded by the Terms and Conditions of Service, some trainees feel enabled to claim pay protection at a higher banding, even though the hours of the post have been reduced. This also affects that Trust’s ability to fund new posts to assist in reducing hours to meet the 2007 target.

When discussing possible rotational moves with trainees, it is important to stress that arrangements are provisional and cannot be regarded as final until the Trust has written formally to offer the position to the Specialist Registrar. Trusts have the right to refuse to accept trainees, and may exercise this right if they feel that they have been asked to accept a trainee who has grounds for claiming pay protection. It is the legal view that pay protection comes into effect once a post has been offered and accepted in writing. Therefore I should be grateful if any rotational schedules could be headed as ‘Draft - awaiting confirmation from employing Trust’.

If you require clarification of how this will affect you on an individual basis, you should discuss this with the Hospital or Trust, and it may be advisable to discuss your contract with them before the commencement of the post.

Appraisals at the start of a rotation

The majority of trainees now have some sort of appraisal with their new College Tutor within the first few days of starting at a new hospital. Probably these are best conducted informally. These appraisals are an essential opportunity to plan and consider the “training objectives” for the rotation. These objectives may include exams, audit, research and subspecialty training.

The trainees portfolio should be inspected at this appraisal. The portfolio should contain recent assessments from previous hospitals and records of studly leave and courses attended. In particular, we would ask College Tutors to ensure that the assessment from the most recently visited hospital is looked at. If this assessment is not available, it should be obtained as a matter of urgency.

Airway SpR Posts at UCH / RNTNEH

There are two Airway SpR posts available in the School. One of these is a one year post, 6 months at the Royal National Throat Nose and Ear Hospital and 6 months at UCH. The second is a 6 month post at UCH. These posts offer the opportunity to become proficient in advanced airway management techniques, to participate in teaching for anaesthetists and other health care groups, and to carry out airway related audits and research. They are suitable for post fellowship registrars with an interest in airway management.

If you would be interested in incorporating one of these slots into your rotation, please send your a copy of your CV to Dr Viki Mitchell at UCH.

Training in Intensive Care Medicine

We have received the following information from the College of Anaesthetists.



Following the meeting of the Royal College of Anaesthetists’ Training Committee on 7 July 2006, the decision has been taken that in future training in Intensive Care Medicine within the anaesthetic training programme must be delivered in 3 month blocks.

This change has been initiated in order to bring Intensive Care training within anaesthesia in line with the CCT in Intensive Care Medicine which is currently being drafted for PMETB.

This change is to be brought into effect by 1st August 2007

Any comments should be sent to James Goodwin, Secretary to the Training Committee at the Royal College of Anaesthetists.

MMC - A New Era in Medical Training

A detailed document with some up-to-date information is now available from the MMC website.

http://www.mmc.nhs.uk/download_files/NHSE-briefing-19-FINAL.pdf

More exam passes

Congratulations to all the others who got past the Examiners—Akane Iguchi, Claire Moloney, David Brealey, Jasmeet Kaur, Kate Bradshaw, Nick Pratap, Simon Mattison, Oliver Rose, Raj Saha, Sreerupa Majumdara and Vivian Ip.

First School GoKarting Rally

The First School Go-Karting rally was held in Kings Cross this week. Many thanks to Av Gobindrum for arranging it. The winner was Jim Roberts, with Rory Bell and Ben O’Brien runners up.
Photos will be posted here shortly.
We would greatly appreciate your other Summer Photos from departmental barbecues and other social events.

Working in Rwanda

We have had a request for an anaesthetist from Betty Khienza, a consultant anaesthetist at the King Faisal hospital, Rwanda. This is 145 bed hospital, to be upgraded to 350 bed. It is going to be the referral centre and post graduate training and research centre in Rwanda, funded by the Government and Saudi. Help is needed from an SpR or consultant to develop the department of anaesthesia and ICU, ideally for a period of up to 2 years. Duties include ICU 1-2 weeks a month, anaesthesia for elective cases and emergencies, supervising and teaching Anaesthetic assistants and post graduates, help in promotion of regional anaesthesia and epidural analgesia. He/she should be able to work in a team and if on call cover nights and weekends from home. The salary will be US $ 4500 per month; one can survive on this amount comfortably in Rwanda even with family but may not be able to save much. The experience gained will be invaluable!

If anyone is interested, could they contact Isabeau Walker at GOSH

Fibreoptic Intubation course at Colchester

We are running an awake fibreoptic training course at Colchester hospital. The delegates are the subjects , and to ensure 1:1 training, numbers are limited to 4 participants and two observers only. The course is running every two months and there are places available in June, October and December. The cost is £175 for participants and £150 for observers. All grades of staff are welcome-SHOs, SpRs , staff grades and Consultants. There is a website with full details of the course at http://www.fibreopticintubation.co.uk.
Please contact Marion Brown on 01206 742149 for further information and an application form. There are more details on the Meetings Page

Permit free training and overseas trainees

There have been some important changes in the legislation regarding overseas trainees, and there is some uncertainty as to how individuals may be affected. Christine Korin, advisor in the Overseas Doctors Division at the London Deanery, will be coordinating enquiries. She can be contacted at the Deanery, or emailed at

We have also been advised that it is the Employer, rather than the Employee, who applies for the permit. When calculating the duration for the work permit, there may be a six-month extension post-CCST available within the School.

There is some information on the COPMED website at http://www.copmed.org.uk/page.php?id=25
We have also posted a summary of the rules (provided by the Department of Health) onto the downloads page.

Judith Hulf elected President

On Tuesday 14 March Dr Judith Hulf was elected president of the Royal College of Anaesthetists. Dr Hulf is a consultant at UCLH and was previously the Regional Advisor for our School. Congratulations!!!

Clinical Research Fellows in Pain

Supervisors: Dr Brigitta Brandner, Consultant Anaesthetist, UCLH Hospitals Trust

Dr Lesley Bromley, Senior Lecturer and Honorary Consultant Anaesthetist,

Dr Sarah Chieveley-Williams, Consultant Anaesthetist, UCLH Hospitals Trust

Professor Monty Mythen, Portex Professor, Inst. of Child Health, UCLH Hospitals Trust

There are three post-fellowship posts open for anaesthetic SpRs with an interest in anaesthetic, pain and educational research. The successful applicants will gain experience in research methodology and data analysis. Areas of expertise within the group include vascular anaesthesia, major surgery, acute and non-acute pain management, optimisation and medical education. Experience with information technology is useful but not essential, as this again can be learned during the course of the year. The research fellow will work closely with members of the research team whilst conducting his/her study, and so good communication skills are beneficial.

The post holder will be paid his or her basic salary according to the current NHS payscale and provide anaesthetic services to the department of anaesthesia at UCH including on call on a 1 in 8 rota for which they will be paid Band 2B.

As well as recruiting patients for ongoing research, and so helping to conduct current studies, the Research Fellow will be involved in writing ethics applications and protocols for future projects. He or she will thus also gain valuable experience in setting up studies, as well as completing their own research project. A full range of computer facilities is available within the Centre for Anaesthesia including on line access to several current international anaesthesia journals, Medicine and statistical and bibliographic database software.

The Fellow would be encouraged to attend and present his or her work at local, national and international anaesthetic meetings. The fellows also are encouraged to organise the FRCA courses and participate in teaching.

UCH is a tertiary referral centre for complex urology, hepatobiliary and maxillofacial surgery as well as providing a service for a variety of other specialities including orthopaedics, general and vascular surgery. There is therefore a large high risk surgical population.

All posts will be starting in September 2006. Interviews to be held in March 2006.

Please submit your CV to Alison Lambert

Additional Paediatric rotations

We have managed to arrange two additional paediatric posts onto the rotation - one at the Evelina (part of St Thomas’ Hospital) and one at the London Hospital Whitechapel. Further details will be added to the website shortly.

Barnet and Chase Farm

Barnet and Chase Farm are a joint NHS Trust, and there is some degree of ‘rationalisation of services’ between the two sites. In view of this, we are hoping to set up cross-Trust rotations between the two sites. Initially this may be done on an informal basis.

Head injury Guidelines

The National Hospital for Neurology and Neurosurgery have some guidelines on the management of severe traumatic brain injury. These guidelines are now available for downloading from the Downloads page on this website.

The download consists of a PDF file describing the protocols in full, together with the evidence-base and references, and three posters summarising the algorithms. We would suggest that these posters could be printed out and posted in A/E where appropriate.

Clinical Fellows in Neuroanaesthesia

There are some Fellowship posts in Neuroanaesthesia available at The National Hospital for Neurology and Neurosurgery. These posts are available at various start times from March to November 2006. The posts would be ideally suited to a senior SpR with an interest in neuroanaesthesia. They are for a minimum period of 6 months, renewable to one year. The Clinical Fellow Post in Neuroanaesthesia will involve training in all aspects of anaesthesia for neurosurgery, neuroradiology and neuro-critical care.

There will be significant opportunities for clinical research and audit. There is an established research programme in the Surgical Intensive Care Unit affiliated with the Centre for Anaesthesia at the University of London. There is also collaboration with researchers in neurosurgery, neurology, neuroradiology and neurochemistry.

For further information please contact Dr Jeremy Radcliffe, College Tutor or Dr Sally Wilson, Consultant Neuroanaesthetist on 020 7829 8711. For information on research opportunities please contact Dr M Smith, Director of Surgical Intensive Care on 020 7829 8711

Top of page

Royal Free Obstetric Protocols

The Obstetric Anaesthesia Guidelines from the Royal Free have been revised, and are now available on the downloads page.

Paperwork at the end of your rotation

The final Certificate of Completion of Training (formerly known as CCST) form has been revised by the College.

If you are within 4 months of completing your training, this form needs to be completed (by you) and countersigned by one of the Training Program DIrectors or Regional Advisors. It then needs to be sent to the College.

The College will then review your training and issue your final CCT date. If this process does not take place, your Final RITA may be delayed.

The form has been revised, and is now available from this website in the Downloads page.

More exam passes

Congratulations to those of you who were succesful in the FRCA Exam:- Sunita Setty, Marcus Peck, Jeremy Dawson, Maya Nagaratnam, Simon Lappin, Helen Hume Smith, SS Bandi, Katy King, Clare Hayes Bradley, Kathy Satkurunath and Adam Woo.

Xmas Party

The School Xmas party is being held in Soho House on Thursday 22nd December. This is the first time that the party will be subsided by the UCH Consultants. All trainees past and present and Consultants are expected to attend, but tickets are strictly limited and only 100 are available. They are priced at £20 each and are selling fast! We have a bar extension until 3am. Tickets are available directly from Damon Kamming and will also be on sale at the Royal Free. This promises to be the event of the season! Further details will be posted here shortly. Dress glamorously!

New Offices for the School and the Deanery

The School of Anaesthesia and the London Deanery have both moved into new offices.

The school of anaesthesia office is now at the new UCH. The address is

School of Anaesthesia Office
Level 3 link corridor
University College London Hospitals
235 Euston Road
London
NW1 2BU
Telephone 0845 155 5000 ext 73378
Direct Line:- 020-7387-7487

The Deanery has also moved to:-
Stewart House
32 Russell Sq
London
WC1B 5DN
Telephone 0207 866 3100
The Specialty Manager for Anaesthesia is Paul Botha.

Leaving the Rotation

We now have over 170 people on the database. There have been some misunderstandings recently about how and when pepole can leave the rotation. Generally, the Training Program Directors need THREE MONTHS NOTICE before people can leave early. If this period of notice is not given, there will be empty posts, which we would like to avoid whenever possible since it messes up the rota for everyone else.

When you reach the end of the rotation, you are entitled to a 3-6 month period of grace before you are forced to leave. It is essential that you communicate your plans so that we know how many posts we will have unfilled.

Finally, you are permitted to spend the last 3 months of your rotations as a locum consultant, provided that this is in a hospital within our school and is approved in advance.

Research Posts

A research post can take many forms - teaching, a clinical study, writing a review, laboratory work, or developing computer, presentational, problem solving and statistics skills. We are actively looking for Anaesthetists who might want some time out from the grind of clinical training- even if it’s just for 6 months to start.

If you are interested in taking time out from weekends on call and doing something different please feel free to get in touch and find out more!

Robert Stephens

07946742344

Fellowships in Medical Simulation and Anaesthesia

Barts and The London Medical Simulation Centre is a flagship project for both the Trust and London Region. The Centre uses a range of simulators as tools for teaching and training a variety of healthcare professionals. Applications are now invited for 3 positions, which will place the successful applicants at the forefront of development of medical simulation training in the UK. The post holders will participate fully in the development, organisation and delivery of training programmes, including Anaesthesia Crisis Resource Management, Difficult Airway Management and Obstetric Anaesthesia. They will be expected to assist in development and delivery of new courses for non-anaesthetic healthcare workers in line with the Centre’s goal to promote inter-professional training. They will be expected to undertake research projects primarily in the field of simulation applied to medicine.

Applicants should be year 4-5 post-FRCA anaesthetic SpRs, and have an interest in medical education and research. The posts are ideally for one year (negotiable). Three positions are available:

1. An advanced anaesthesia post linked to the anaesthetic department at Barts and The London NHS Trust. This post is available from December 2005.

2. An ITU post linked to the Harley Street Intensive Care Fellows scheme at HCA Hospitals in central London. The contract is with Barts and The London NHS Trust. This post is available immediately.

3. An ITU post linked to the Harley Street Intensive Care Fellows scheme at HCA Hospitals in central London. The contract is with Barts and The London NHS Trust. This post is available from 1st March 2006.

For informal discussion please contact Dr Chris Sadler, Consultant Anaesthetist and Director, Medical Simulation Centre on 020 7480 4855.

FRCA Passes in July 2005

Congratulations to the SpRs in the School who succesfully defeated the Examiners and achieved their FRCA:- Ash Suxena, Ben O’Brien, Breda ONeill, Deborah Braham, Emma Chan, Helen Pryke, Huw Thomas, Javid Khan, Johann Emmanuel, Kat James, Kevin Fong, Lucy Bostle, Madhurie Chakravarti-Chattopadhyay, Mano Doraiswami, Mark Hearn, Nick Lees, Phil Bearfield, Rachel Pegg, Sarah Stirling, Susan Jain and Tanya Jones.

School of Anaesthesia Summer Party

Its the end of the exams. Its also a good excuse for a Summer Party. All trainees who have sat exams (now or at any other time) and any Consultants who have helped them are invited for what should be an excellent night out.
We will take over Jamies Bar in Charlotte Street (very close to the Middlesex Hospital).There is a late licence, and its Friday, and its near work and its summer! Tickets are available on the door.

Removal and Relocation Expenses

Since April 2005, there have been changes in the way that relocation and removal expenses are administered, which will affect trainees in North London and the Eastern Deanery.

New guidelines have been agreed by the DOH, BMA and London Deanery. These new guidelines make it clear that removal and associated expenses are the responsibility of the employer. New claims for removal expenses should therefore be dealt with by each your employing trust. Trainees in receipt of continuing commitments, excess rent or additional
travel costs will need to claim these from their employer. The trusts have been notified by the Deanery of this change. For a limited period, Hammersmith Hospital will provide historical information about the amount paid to trainees, but this will only include payments made up to 31 March 2005.

Expenses for Study Leave will continue to be handled by the Deanery.

Consultant Appointments and Exam Passes

In the last six months, a largeish number of trainees have been appointed to Consultant posts. Congratulations to:-

Mira Tewari - UCLH (paeds)
Stuart McCorkell St Thomas -
Madhu Rao - St Thomas (cardiac)
Nicky Zimbler - Royal London (cardiac)
David Celaschi - Moorfields
Farah Ahmed - Leicester
Sue Pearson - Colchester
Lajos Zsisku - Colchester
Jim Blackburn - St Georges (pain)
Jim Down - UCLH (ICM)
George Thomas - Scunthorpe
Yaqub Latoo - Bedford
Youcef Sennoun - King George
Nicola Curry - Luton & Dunstable
Sanjay Gulati - St Thomas
Mike Grocott - Whittington (ICM)

Also congratulations are due to our recent succesful FRCA candidates:-

Sara McNeillis, Andreas Goebel, Martyn Wildman, George Hallward, John Orr, Av Gobindrum, Ramani Moonasinghe and Dr Sidarshi.

UCLH Pain Protocols availalble for Download

The common protocols and guidelines that are used by the Pain Medicine Team at UCLH are now available on the website for downloading. These documents are used at UCLH to guide some therapies, and will also be of interest to people in other hospitals. The download also includes the current timetable for all trainees that are allocated to pain medicine: please note that sessions usually start promptly at 08.30

Rebanding of SpR posts

In line with the requirements of the New Deal and the European Working Time Directive the School of Anaesthesia will be implementing a Band 2B or Band 1A rota in all of its hospitals from September 2005. Anaesthetic trainees accepting a post after December 2004 will do so on the understanding that any posts currently banded as 2A and paid at 1.8 times basic salary will be rebanded to 2B or 1A and will be paid at 1.5 times their basic salary from September 2005. Any new trainees finding themselves working outside the Band 2B or Band 1A limits will have the right to appeal.

Working Time Directive

The introduction of the Working Time Directive has led to a number of comments from all involved in training and service delivery. Many people feel that training has been impaired and clinical standards have dropped. There have even been suggestions that trainees should “opt out”. We would welcome any thoughts.

School Meeting in Tignes

The 7th North Thames Anaesthetic Meeting is being held in the Hotel Village Montana, Tignes, France from Sunday 30th January - 5th February 2005.

The conference price includes scheduled flights, airport taxes, transfers, half-board Accommodation, wine with meal (conference nights), en-suite rooms, 5-day ski-pass and conference fee. Single rooms are £1475 and double/twin rooms are £1325. Arrangements can be made for anyone able to travel a day early. A £200 discount is availalble for anyone paying in full before 25th August. Special arrangements can also be made for anyone travelling independently - the basic conference fee is £300.

Provisional topics for the conference include history of anaesthesia, monitoring vs over-monitoring and vascular surgery. There will also be a number of problem-based learning discussions and controversies, and a prize for the best presentation by a trainee. In total, there will be approximately 22 hours of talks. Past years have attracted 15 CEPD points.

More details about the hotel can be found at http://www.vmontana.com. The hotel is set in the Espace Killy, which has 300 km of slopes, and runs right up to the Grande Motte Glacier (3656m). It provides skiing for people of all abilities.

To apply, please contact Natasha Curran, or download an application form from www.ntam.org.uk

Assessments and Competencies - which do you need?

There has been a bit of confusion about this, particularly when it comes to RITA’s. The bottom line is that you probably need both, particulary if you will still be in year 1 or 2 in February 2005.

Assessments are carried out on a per-hospital basis, and are normally carried out when your rotation at that hospital ends. Your assessments will be inspected at a RITA. Normally, you will not have been assessed at the hospital where you are presently working, unless your departure is imminent.
SpR 1/2 Competencies are subspecialty-based (eg ENT, Paediatrics, Pain). You can get them signed in any order, and at any hospital. In order to enter year 3 of training you will need to have obtained signatures in the 7 “key” modules (although there is a 6 month period of grace under certain circumstances).

East-West ITU Rotation

We have set up a rotation with the Eastern School for ITU Training. In effect, this means that we can send people for three months to the Royal London or Barts to do 3 months ITU. These posts were intended for Step I ITU training but may be suitable for anyone who lives in the Eastern side of London.

Royal Free Fellow in Liver Transplant Anaesthesia

Applications are invited for this post in Hepatobiliary and Liver Transplant Anaesthesia. This is a one year post based at the Royal Free Hospital which offers a unique opportunity to gain clinical experience in anaesthesia for complex major surgery and transplantation and also to become involved in ongoing research projects and initiate new studies.

Send a copy of your CV to Dr Sue Mallett, Department of Anaesthesia, Royal Free Hospital by July 5th.

Fellowship in Paediatric Anaesthesia in Toronto

The Hospital for Sick Children, or Sick Kids, is one of the largest paediatric academic health science centres in the world, with an international reputation for excellence in health care, research, and teaching.

Our program is a one year program consisting of 4 days per week of clinical anaesthesia (exposure to all of the subspecialty areas including pain management, cardiac, craniofacial, neuro, transplantation and neonatal anaesthesia).

Fellows are allocated one day per week of non clinical (academic) time. Additional protected time is available and dependant on the needs, goals and performances of individual fellows.

A structured educational program for fellows consists of seminars in cardiac anaesthesia, statistics and pain management. Fellows also attend weekly research rounds and Monday morning trouble rounds.

10 posts are available each year, with start dates in either January or July. For further details, contact please contact the Fellowship Program Administrator at

Awake Fibreoptic Intubation Course

There is now a monthly one-day course, held at UCLH.

The aim of the course is for registrars to learn how to anaesthetise the airway and pass a fibreoptic scope in an awake patient (each other!!). Basic training on cleaning & handling the scope will be included.

Candidates can get dates, further information & application form by emailing Viki Mitchell. The course fee will be £100. More details are on the Meetings Page.

Induction Days and weekends on-call

All Trusts now offer Induction Days for new staff. They are usually held in the mornings. It is a Training Requirement of the Deanery that these are attended. Please bear this in mind when planning Sunday Night rotas just before a changeover day, and try to avoid having staff on-call when they are due on another hospital on Mondays mornings.

School under New Management

Following the resignation of Ernie Grundy as Training Program Director and Colin Beard as his deputy, the School is happy to announce that Jane Lockie and Richard Marks have taken over as TPD’s from the beginning of March 2004.

Richard Marks will be responsible for trainees in years 1 and 2. He will liase with the DGH and ITU college tutors and manage the website.

Jane Lockie is responsible for trainees in years 3 4 and 5. She will liase with college tutors in the specialist hospitals. She is also responsible for OOPEs (out-of-program training) and Fellowships.

Ernie Grundy will continue in his role as Regional Advisor, and the two deputy regional advisors are Colin Beard and Regina Milaszciewicz.

‘Taster’ Pain slot at the Royal Free

The Royal Free offers a three-month “taster” slot in Pain, working with Dr Ordman. The post covers acute and chronic pain and gives a broad experience. It covers the obstetrics rota at night, and is open to all grades of SpR.

It would be useful for anyone interested in doing some pain or gaining the pain Competency.

Requests for Unpaid Leave

The School is happy to support applications from trainees who wish to take Out of Program Experience (OOPEs) to gain particular specialised experience, either in this country or abroad.

Unpaid leave for holidays requires the agreement of the hospital(s) which you will be working at and also requires formal permission from the Dean. The Deanery are normally reluctant to approve periods of unpaid leave, as this prolongs training. Requests are often turned down.

School Inspection June 2003

The School was inspected by the College in June, and we passed!

The written comments we received were:-

Currently the training at the Royal Free/UCLH School is working well and producing good results. Many of the problems faced by this School are common to all regions of the UK and are outside the control of the trainers. There are problems recruiting to the SpR grade in London that are currently worse than in other regions in the UK. It is important that the good work that has been started for implementation of competency based training is completed rapidly. The quality of the training and the trainers’ commitment are to be commended.

For anyone interested, I have posted the results of the Trainee Questionnare as an excel spreadsheet. They can be downloaded from the Downloads Page.

SpR 1/2 Competencies

The school is currently working on improving the delivery of some modules of training to help deliver competency training and provide the opportunity for assessment.

All SpR 1 AND 2’s are reminded of the importance of acquiring their competency assessments. Do not let a day with a consultant go by without getting some competencies ticked off! Further information and a list of the competencies required can be found at the Royal College of Anaesthetists website.

Changes to the FRCA Exam

We have received the following information from the College President.



I am writing to inform you of changes to the structure and detail of the Primary and Final FRCA examinations that will be introduced with effect from 1 June 2007. These are part of a strategy to restructure the examinations to meet the needs of seamless training and the introduction of the Acute Care Common Stem programme. The changes build on those introduced in September 2005 when the MCQ became a pass/fail examination with unlimited attempts. In summary the changes are:

• The Primary MCQ will become a stand-alone pass/fail examination.

• The Primary MCQ may be taken in the first year of training provided that the candidate has first passed the Initial Assessment of Competence.

• A trainee must have spent a minimum of one year in Deanery approved training posts on a PMETB approved training programme and have passed MCQ examination before being allowed to sit the OSCE/Oral component of the Primary FRCA Examination.

• A pass in the Primary MCQ will be valid for three years after which time, if the OSCE/Oral examination has not been passed, the MCQ must be re-taken.

• For trainees in Less the Full-Time appointments the Primary MCQ will be valid for the equivalent of 3 years full-time training.

• A trainee who passed the Primary MCQ examination before 1 June 2007 but who subsequently failed the OSCE/Oral examination will be allowed to carry forward their MCQ pass subject to the 3 year limitation.

• A pass in the Irish MCQ examination will not give exemption from the FRCA Primary MCQ examination.

• The concession whereby “trainees” in non-approved training posts can sit the FRCA Examinations at the discretion of the Examinations Committee will cease on 31 May 2007.

There will be no change to the following areas:

• A pass in the whole FCARCSI Primary Examination will continue to give exemption from the FRCA Primary Examination.

• College guidance interviews will not be provided for candidates who fail the MCQ. It is expected that this guidance will be arranged locally by tutors and supervisors.

• Candidates who fail the OSCE/structured orals twice cannot apply to sit the Primary examination again until they have attended a guidance interview with an examiner.

Cardiac Anaesthesia posts at Harefield

This post would be ideally suited to an NTN holder in year four or five of their anaesthetic training wishing to pursue a career in cardiothoracic anaesthesia. There are several posts available from January 2004 for one year depending upon satisfactory performance and the training needs of the individual applicant. Consideration will however also be given to other suitable candidates including those already in possession of their CCST. Appropriately qualified overseas applicants would be welcome.

The successful candidate will participate in the provision of all aspects of anaesthesia and intensive care for adults undergoing cardiac and thoracic procedures. There is an established consultant delivered teaching programme and excellent research and audit opportunities. This post includes a 11 weeks rolling rota with ITU sessions and
on-calls.

This post has college approval or can be taken as an O.O.P.E. It is 2A compliant.

Applicants may obtain further information from Dr D Royston, Chairman, via Harefield Hospital Switchboard on 01895 823737, Direct line 01895 828946.

To apply please send a copy of your Curriculum vitae including the names and addresses of two referees and a daytime telephone number to Dr D Royston, Harefield Hospital, Hill End Road, Harefield, Middlesex, UB9 6RL

Your photo on this website

The facility to upload your photo has now been added to the website. It is very helpful to see who people are, so please make use of the facility to post your mugshot.

Consultant Appointments and Exam Passes

Congratulations to the following who have made it to the exalted rank of Consultant:-

Richard Semenov - Royal Adelaide
Kate Thornton - Bristol (paeds)
John Lee - National Hospital for Neurology and Neurosurgery
Parulkar Dadarkar - Wexham Park
Warwick Marchant - Royal Free (livers)
Sally Harrison - Royal Free (livers)
Pippa Pemberton - Royal Free
Nick Levy - Bury St Edmonds

Also, congratulations to all who impressed the Court of Examiners:-

Primary FRCA passes - E Fernandez Garcia, J Rugen, Helen Twydell, Barry Lambert, John Orr, Matthew Outram and Rajesh Mehta.

Final FRCA passes - Kevin Hamilton, David Whitelock, Alan McGlennan, Richard Schoub, Andrew Badasconyi, Mike Shaw and Ranjika Seneviratne.

SpR 345 Powerpoint Presentations

Some of the Powerpoint presentations from the SpR 345 Training Days are now available for download, both for people who made it and for people who didn’t. They are held on the Imperial School website www.imperial-anaesthesia.org.uk/news.html

Research Posts in the School

A number of developements have happened over the last few months that have resulted in opportunites for SpR 3/4/5 training.

Obstetric at the RFH : starting in september 2003 there will be a 6 month module available, contact Roshan Fernando at the Royal Free.

The 6 month hepatobiliary posts at the RFH continue (liver transplant that was). If interested contact Tim Peachey (also at the Royal Free).

The airway fellowship is about to start. It will consist of 12 months split bewtween the UCLH site and RNTNE site. If interested contact Anil Patel at the RNTNE or Viki Mitchell at UCLH.

The GOSH rotations have been rejigged (thanks to the help of our Dean.In future we will only have 2 12 month rotations but we will now have four 6-month rotations. I expect these to be very popular.

The Heart Hospital continues to offer 6 and 12 month Fellowships. Andrew Smith has full details.

The National Hospital for Neurosurgery and Neurology (Queen Square) also has two posts. One is in neuroanaesthesia and there are two on the Surgical Intensive Care Unit. Both are for 6 months and up to a year. Contact Sally Wilson (College Tutor) for more info.

Reearch Fellowships are all coordinated by Roshan Fernando, so please contact him in the first instance and he can tell you what is available.

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