Intermediate Level Training (ST3/4)

Training Overview
 
Intermediate training is underpinned by the priniciples of Knowlegde, Skills and Attitude/Behaviour as set out in the Curriculum of the Royal College of Anaesthetists.  The knowledge element requires success in the Final FRCA (or equivalent) examination and in addition there are 18 units of training recognised by the Royal College of Anaesthetists for Intermediate Training during which competency will be assessed.
 
There are 7 essential clinical modules which must be completed plus 3 essential non-clinical modules:

• Cardiacthoracic Anaesthesia and Cardiac Intensive Care
• Intensive Care Medicine
• Neuroanaesthesia, Neuroradiology and Neuro Intensive Care
• Paediatric Anaesthesia
• Obstetric Anaesthesia
• Pain Management
• General Duties

The GENERAL DUTIES modules which all trainees are expected to complete are:

• Airway management
• Day Surgery
• Critical incidents
• General Surgery / Gynaecology / Urology (+/- Transplantation)
• ENT, MaxFax, Dental
• Regional Anaesthesia
• Respiratory and Cardiac Arrest
• Non theatre
• Orthopaedic Anaesthesia
• Sedation
• Transfer Medicine
• Trauma and Stabilisation

The 3 essential non-clinical modules are:

• Academic
• Teaching and learning
• Management

There are also 3 optional modules:

• Plastics / Burns
• Ophthalmic Surgery
• Vascular

 
Competency is assessed using logbook data in conjunction with evidence from a range of assessment tools and the Royal College now requires that a minimum of one Anaes-CEx, DOP and CBD should be undertaken for each subspecialty unit of training.   Paperwork and guidance on appropriate assessments can be found at the bottom of this page.
 
ARCP's
 
There will be an ARCP at the end of each year of intermediate level training and you will be sent a letter well in advance of the date(s) for the panel detailing what paperwork you must provide.  The ARCP at the end of Year 4 is a major review that draws everything together, including examination results, and confirms that the totality of the objectives of intermediate level training (ST years 3 and 4), including the assessment of 'attitudes', has been achieved.  Once these objectives have been met the Intermediate Level Training Certficate (ILTC) can be awarded and the trainee can progress to Year 5, Higher Training.  Without the certificate there can be no entry into higher and advanced levels of training.
 
Final FRCA Examination
 
The Final FRCA exam can be a major hurdle for many Intermediate Level trainees.  It is important to discuss your exam preparation with your Educational Supervisor/College Tutor early in Year 3 so that appropriate plans can be made.  Most departments will be very supportive in allowing study leave for exam preparation and there are a number of Final FRCA Examiners in Wales who can give advice.
 
Guidelines for management of trainees who have failed to pass the Final FRCA exam by the end of ST4
 
The School should be informed as soon as it is known that a trainee will not have completed their Final FRCA by the end of ST4.
At their ARCP if there are no other performance or behavioural concerns trainees will be given a one year extension to their training. During the one year extension trainees will be expected to :
· Attend classroom/exam teaching sessions
· Attend Performance unit/ISP if referred
· Demonstrate satisfactory attitudes and behaviour
· Show evidence of progress towards completion of final exam
Feedback from local trainers will be sought to verify that the above requirements are being met. Failure to fulfil these requirements may lead to termination of the training extension.
If the trainee has not passed the final FRCA by the end of their one year extension they may be considered for a further (second) one year extension in a training post. This is not guaranteed and will only be considered following an extensive review of the trainees performance in the first extension year. The above list of expectations must have been unequivocally met. If the trainee passes the final FRCA after the second extension year they will have to reapply for a training post if they wish to return to training.
 
Study Days
 
The Welsh School of Anaesthesia holds a Study Day for those trainees commencing Intermediate Level Training.  Please see the Study Day pages of the website for further information.