Core Anaesthetic Training Scheme

Core Training Overview

The Knowledge, Skills and Attitudes required for Core Training are set out in Annex B of the Curriculum of the Royal College of Anaesthetists. The knowledge element requires success in the Primary FRCA (or equivalent) examination and in addition there are 16 essential clinical units of training, following completion of the Initial Assessment of Competence and Introduction to Anaesthetic Practice.

Essential Core Training Units:

  • Airway management
  • Day Surgery
  • Critical incidents
  • General Surgery / Gynaecology / Urology (+/- Transplantation)
  • Head & Neck, Dental
  • Intensive Care Medicine (Annex F)
  • Regional Anaesthesia
  • Non theatre
  • Obstetric Anaesthesia
  • Orthopaedic Anaesthesia
  • Paediatric Anaesthesia
  • Pain Medicine
  • Perioperative Medicine
  • Sedation
  • Transfer Medicine
  • Trauma and Stabilisation

Competency is assessed using logbook data in conjunction with evidence from a range of assessment tools and Consultant feedback within each completion of unit of training sign-off. This should all be collated on the RCoA Lifelong Learning platform in accordance with the blueprint for workplace assessments mapped to core level training on the final page of Annex B

The Faculty of Intensive Care Medicine and the RCoA have revised the competencies to be signed off for ICM at each training level, please see Annex F

Core trainees will have to demonstrate that they are engaging in quality improvement, teaching, participation in departmental meetings, etc. The requirements are set out in Annex G of the curriculum.


There will be an ARCP at the end of each year of core level training. You will be sent information in advance of the date(s) detailing what evidence you must provide. ARCP dates can be found on ARCP webpage.
The ARCP at the end of Year 2 is a major review that draws everything together, including examination results, and confirms that the totality of the objectives of core level training (CT years 1 and 2), including the assessment of 'attitudes', has been achieved. Once these objectives have been met the Core Level Training Certificate (CLTC) can be awarded and the trainee can progress to CT3 year, to complete Stage 1 equivalent training. The RCoA permit entry to CT3/ACCS CT4 training units if the Primary FRCA exam is outstanding for a further period of 12 months. In this instance a Core Level Progress Report is signed, rather then the CLTC.

Primary FRCA Examination

The Primary FRCA exam can be a major hurdle for many Core Level trainees. It is important to discuss your exam preparation with your Educational Supervisor/College Tutor early in CT1 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 FRCA Examiners in Wales who can provide advice.

SWABS teaching is provided throughout the course of your Core Training, plus a number of local courses are provided to maximise your chance of success e.g. Cardiff Q and South Wales Anaesthetic Course. More information and how to book is provided on the Courses and Study days webpage.

The RCoA have decided that as a consequence of COVID and the 2021 Curriculum implementation, core trainees appointed from August 2020 would be allowed until the end of ST3/CT3 to pass all elements of the Primary FRCA examination. Trainees who do not have the Primary exam at the end of 3 years of core training or 4 years ACCS-Anaesthesia training would receive an outcome 3 at ARCP, with the start of a 6 month training extension and potentially 1 year if the trainee demonstrates no other performance or behavioural concerns.
Trainees must also demonstrate that they:

  • Attend classroom/exam teaching sessions
  • Engage with the HEIW Professional Support Unit
  • Demonstrate satisfactory attitudes and behaviour
  • Show evidence of progress towards completion of the Primary FRCA 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 Primary FRCA by the end of their one year extension they will not be entitled to any further extension to training. Only in exceptional circumstances, at the discretion of the Postgraduate Dean, will they be given a further training extension. If they leave the training scheme they will relinquish their NTN following receipt of an Outcome 4 at their ARCP.