About the Training Program
The Central London School of Anaesthesia is based around two London Teaching Hospitals - The Royal Free and University College Hospitals and a number of general and specialist hospitals largely based in and around the north and central London area, who have joined together to provide training in all aspects of anaesthesia. Our school prospectus describes each hospital. This page describes the organisation of our Training Program. We provide a full range of subspecialties and research opportunities. For details regarding Applications, click here.
The School is part of Health Education England North East/North Central and there are close links with the North East School of Anaesthesia based around St Bartholomew's Hospital and the Royal London Hospitals Trusts. The Schools have close links but are run separately.
The Central School is overseen and administered by a group of consultants who form the School Executive. Close links exist with the College Tutor in each of the hospitals in the school.
Our training program is divided into three sections. Novices and junior anaesthetists can expect to be closely supervised and will attend a day-release ‘Introduction to Anaesthesia’ course. In the middle years we provide all the core specialties needed to achieve competencies and pass the necessary exams. More senior trainees are given the opportunity to customise their training programs as much as possible, and we aim for flexibility and individual planning.
Details of the applications process can be accessed via the Royal College of Anaesthetists
- ACCS (Anaes) - Acute Care Common Stem (Anaesthetics)
- Core Training - CT1 and CT2
- Intermediate level - up to Final FRCA
- Higher Training - the Senior Years
- Joint and Dual CCT in ITU
- Less than Full Time (LTFT) Training
- Entry Points and Start Dates
- Visiting Attachments and Clinical Observers
Hospitals in our School
ACCS (Anaes) - Acute Care Common Stem (Anaesthetics)The Anaesthetic Acute Care Common Stem programme is an alternative to core training in anaesthesia and was designed to be particularly attractive to those who are considering a career in Intensive Care Medicine (ICM) but is not essential for application to ICM specialist training. It is a three year programme: the first year (CT1) is spent doing 6 months acute medicine and 6 months emergency medicine; the second year (CT2a) is spent doing anaesthesia and ICM either as six month blocks or sometimes as a 9 month/3 month anaesthesia/ICM split, depending on how the specific rotations are designed. In the third year (CT2b) the trainees essentially merge with the core trainees at CT2 level to complete a second year of anaesthesia.
Requirements and expectations for trainees in the ACCS programme are identical to those for anaesthetic core training, although the ACCS programme has its own syllabus for the first two years with specific extra requirements relating to acute and emergency care. Once the CT2a year is commenced trainees are essentially embarking on core anaesthetic training but are still labelled as ACCS trainees until the CT2b year for training and assessment purposes.
The rotations are currently undergoing some restructuring but the first two years are usually spent either between Barnet Hospital and University College London Hospitals (UCLH) or between the North Middlesex Hospital and UCLH. The third years are variably spent at one of the following DGH's (usually for the entire year): King George's Ilford, the North Middlesex Hospital, Barnet Hospital or Chase Farm. The exact locations for the CT2b year are usually decided around 6 months in advance of the roation date in August, but are currently subject to change because of merger of Barnet and Chase Farm Hospitals.
Core Training - CT1 and CT2We anticipate that the majority of CT1 entrants will have no previous experience in anaesthesia when they start Core Training. During the first three months, trainees will be very closely supervised and will be expected to obtain their Certificate of Basic Competencies in their first 3-6 months. CT2 Entry is intended for trainees with at least 12 months of anaesthetic experience. We will attempt to match your choice of hospital with geographical and other specific requirements.
During the 2 years of core anaesthesia training, trainees will go to two different hospitals, each for 12 months. Most trainees will spend their novice year in one of our two Teaching Hospitals. We expect trainees to attend a course for Primary FRCA and to pass the Primary in their first two years.
Intermediate level - up to Final FRCASpecialist Trainee Years 3 and 4 are spent in Intermediate training. During this time, trainees will spend about a year at a Teaching Hospital and about a year at a DGH. They may spend three months at a specialist centre. Trainees must try to gain the key competencies as per the curriculum. Cardiac and neuro can be carried through to ST5 but MUST be done within the first 6 months of year 5. The other competencies cannot. ITU must be done as a 3 month block and this will usually be offered in a teaching hospital as DGH and teaching hospital ITU are often quite different. You should also try and gain as many other competencies as is practicable. It is your responsibility to make the College Tutors aware of your needs and you will be required to take part in workplace based assessments which will be reviewed at your Annual Review of Competencies' Progression (ARCP). Your other main job in the first 2 years is to acquire your Final FRCA exam.
With the exam and competencies achieved you need to get your Intermediate Level training certificate (ILTC signed by the College Tutor and the Regional Advisor). This can be done without cardiac and neuro modules achieved, but must state when these will be achieved.
Higher Training - the Senior YearsDuring the final three years, we try to provide as much flexibility as possible so that trainees can tailor their training to fit in with their individual career requirements. One of the three years will be spent in a DGH, where the trainee can adopt a role of 'Senior Registrar' and adopt some management roles. Up to one year, but not longer, can be spent in a single subspecialty e.g. Pain, ITU or Cardiac.
The other two years are based around the specialist hospitals in the rotation and the teaching hospitals. We plan rotations on an individual basis to fit in with individual career plans and subspecialty interests. We also encourage trainees to work in outside centres and to take part in research and other academic endeavours. Out of programme time is happily assimilated into your programme but planning is greatly encouraged as retrospective approval is never given.
Overall you will be expected to achieve 6 months training in intensive care during the registrar years. At the end of the 7-year program, all trainees are entitled to a six month 'Period of Grace'. This is an extension of the program to allow people to look around for an appropriate Consultant or other job to go to. During the Period of Grace you are considered as being 'trained', and your placement will partly be determined by local manpower requirements, rather than specific training needs. You must liaise with the programme director about your plans at the end of your training and 3 MONTHS notice is expected when you wish to leave the rotation.
Joint and Dual CCT in ITUJoint CCT in ICM is undergoing its last iteration this year.
Entry into a joint CCT in ICM is from a parent specialty most often anaesthesia.
Entry requires the applicant to have done : 3 months basic ICM, 6 months anaesthesia (at CT level) and 6 months of Acute Medicine. In addition the applicant will have to do Intermediate ICM training (a further 6 months of ICM) before they undertake their Advanced ICM training (12 months ICM training which used to be known as step 2 training).
There is competitive entry into the pan London joint CCT in ICM training program with a National advert and interview.
The timing depends on the availability of slots within the Joint Program, but usually trainees would do this in their last two or three years.
Dual/Stand Alone Training in ICM was introduced in August 2012. Entry is possible from Core Anaesthetic Training or via ACCS.
Further information is to be found on here and here.
Information on National Recruitment in ICM can be found here here.
Further details of these programs can be obtained from Angela McLuckie/Ros Tilley via the London Deanery.
Less than Full Time (LTFT) TrainingThe Central School of Anaesthesia runs the only discrete LTFT training programme for Specialist Trainees in the country, and we currently have 25 trainees on this rotation, both men and women. Training is coordinated across the East, West and Central Schools of North London which increases training opportunities. Flexible trainees from the School have all gone on to secure consultant posts comparable to their full time colleagues.
Any trainee is eligible to apply to the Deanery's Flexible Training Office for approval and funding to train flexibly if they have a "well founded individual reason". The most common reason is child care, but some trainees may wish to train flexibly in order to care for another relative, or because of personal disability or religious commitments. There may also be funding available for trainees wishing to pursue an outside course of study or other academic interest particularly if would enhance personal or professional development.
Trainees may work a minimum of 50% and a maximum of 90% of full time with the majority opting to do 60 -70%. The majority work as slot shares. Some flexible posts are supernumary. PMETB has recently demanded that all trainees workin in supernumary posts seek prospective approval from them.
Flexible training prolongs the training time. It also attracts lower pay. It is therefore not ideal for everyone. Conversely, flexible trainees can experience a fuller range of training opportunities as they are in the school for longer.
Trainees who are considering a period of flexible training are invited to discuss their career plans with us informally. Because of possible difficulties with funding, it is very helpful if we are given ample notice. Opportunities for CTs to train flexibly also exist and early discussion with the LTFT Training Programme Director is recommended.
Further information can be obtained from:- Dr Anna Fowler, Consultant Anaesthetist at the Royal National Throat, Nose and Ear Hospital or Dr Mira Tewari, Consultant Anaesthetist at University College Hospital, Joint LTFT Training Programme Directors. Contact
Entry Points and Start DatesThere are at least 3 entry points into the scheme.
- CT1 Entry for trainees with no anaesthetic experience (usually direct from Foundation Years) or less than one year in the specialty.
- CT2 Entry for trainees with at least one years experience (but not more than three years)
- ST3 Entry ( ‘Headroom Entry’ ) for trainees with Primary FRCA, a Basic Level Training' certificate, or equivalent experience, and at least two years experience, at least one of which must be in UK.
Visiting Attachments and Clinical Observers
We regret that we do not have any facilities for Visiting Attachments or Clinical Observers.