Hospitals in our School

Teaching Hospitals Royal Free Hospital University College Hospital (UCH) (DGH) District General Hospitals Barnet General Hospital Chase Farm Hospital Colchester Hospital King Georges Ilford and Queen’s Hospital Romford Lister Hospital - Stevenage North Middlesex University Hospital Princess Alexandra Hospital - Harlow Whittington Hospital

Specialist Hospitals Great Ormond Street Hospital Harefield Hospital Moorfields Eye Hospital National Hospital for Neurology and Neurosurgery Queen Charlottes Hospital Royal Brompton Hospital Royal National Orthopaedic Hospital Royal National Throat Nose and Ear Hospital The National Heart Hospital

Core Training - CT1 and CT2

We 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. The majority of Anaesthetic CT1 posts will be placed at one of the two Teaching Hospitals (Royal Free and UCH) for six months during their first year. The intention is to get people rapidly up to speed with elementary anaesthetic practice. We provide a School ‘Introduction to Anaesthesia’ Day-release course held on Fridays. This course introduces the basic rudiments of the specialty and includes a day on the anaesthesia simulator. We also expect trainees to attend a course for Primary FRCA and to pass the Primary in their first two years.

CT2 Entry is intended for more senior trainees, who have some previous experience in anaesthesia.

During the CT1/2 years trainees will spend six months in a Teaching hospital and eighteen months in DGHs. During this time, they will spend 3-6 months in Intensive Care and the remainder in theatre.We will attempt to match your choice of hospital with geographical and other specific requirements.

ACCS - Acute Care Common Stem

ACCS is one of the significant improvements that MMC has produced, and allows anaesthetists to braoden their training and exerience. We fully support it.

In essence it is 36 months spent (usually) in 3 blocks of 12 months - 12 months split between Emergency Medicine and Acute Medicine, 12 months split between anaesthetics and ICM and then a further 12 months of anaesthetics training.
It will be of particular interest to anaesthetists who wish to pursue a career in Intensive Care Medicine, but is open to all entrants.

Under ACCS, trainees will do one additional year, and the total duration of the program will be 8 years. The ‘year out’ in Emergency & Acute medicine will be spent in either ST1 or ST2. The remaining seven years will be similar to a standard anaesthetic training program.

Less than Full Time (LTFT) Training

The Central School of Anaesthesia runs the only discrete LTFT training programme for SpRs 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 SHOs 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.  

Intermediate level - up to Final FRCA

Years 3 and 4 are spent in Intermediate training, a stage which correspondes to SpR1/2 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 of pain, ITU, obstetric anaesthesia, paediatric anaesthesia, neuroanaesthesia and cardiothoracic anaesthesia. Cardaic and neuro can be carried through to ST5 but the others 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.

Higher Training - the Senior Years

During 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.

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. Overall you will be expected to achieve 6 months training in intensive care during the registrar years. All trainees who are likely to be on a general on call rota also have to have 6 months of higher paediatric training, which may be at a specialist children's hospital or may be obtained at other hospitals on the rotation where you are involved in the treatment of children.

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 liase 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 CCT in ITU

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 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.

Further details of this program can be obtained from Angela McLuckie.

Visiting Attachments and Clinical Observers

We regret that we do not have any facilities for Visiting Attachments or Clinical Observers.

Entry Points and Start Dates

There are at least 3 entry points into the scheme.

• ST1 Entry for trainees with no anaesthetic experience (usually direct from Foundation Years) or less than one year in the specialty.


• ST2 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 'Completion of SHO Training' certificate and at least two years experience, at least one of which must be in UK.