Home School Information Stages of Training ST5 to ST7 - Higher and Advanced Training

ST5 to ST7 – Higher and Advanced Training

Higher and Advanced Training – ST5, 6, & 7
Annex D and E of curriculum

Once a trainee has passed the final FRCA, we will plan the higher and advanced training years.

Trainees can start to work towards higher clinical competencies once they have completed intermediate training units even if they have not passed the final FRCA examination by the time they start ST5. If a trainee has not achieved exam success by the time they have completed six months of ST5 they may be offered further extension to training by the Postgraduate Dean, pending review at ARCP.

There are general and specialist modules to this part of training.

Essential specialist higher units of training (4 in total):

  • Anaesthesia for neurosurgery, neuroradiology and critical care
  • Cardiothoracic anaesthesia and cardiocritical care
  • Paediatrics
  • Intensive care medicine

General higher duties 

There are 4 essential general duties

  • Airway management
  • Preoperative medicine
  • Management of respiratory and cardiac arrest
  • Obstetrics

Trainees must also do an additional 5 units from the general duties listed in annex D of the curriculum.

Trainees must complete two years of higher training and one year of advanced duties (annex E of curriculum). We would expect a trainee to complete 1 year of general duties at higher level (which can be in DGH or teaching centres), Trainees must also complete 3 months each of ICM, Cardio-thoracic, and neuroanaesthesia at higher level.

The advanced year may be in more than one unit of training and may be in ST6 or ST7.

For example, a trainee might choose six months of general duties at the Royal Marsden Hospital followed by six months of obstetrics at Queen Charlottes Hospital. Alternatively, they might choose to complete a whole year in paediatrics at Great Ormond Street Hospital or a year of advanced Liver Transplant Anaesthesia based at the Royal Free Hospital. We also have some very exciting opportunities for advanced clinical research and education based at UCH.


ICM and Pain

Trainees wishing to dual CCT with ICM will spend their advanced year in “step 3” training in ICM.

Trainees who want to train in advanced pain will spend their advanced year doing pain medicine.


Planning rotations and OOPEs

As soon as a trainee passes the final FRCA, they will have a rotation planning meeting with the TPDs to formulate a bespoke training programme to suit the particular career aspirations for their intended consultant career. We encourage adequate preparation for this meeting by talking with trainee peers and trainers about what might be desired in advanced training; there is a wealth of expertise within the school to support trainees in making the best decision for their career ambitions.

We actively support OOPE and OOPT applications that might enhance higher and advanced training experience and we are well equipped to advise in this area.