Introduction
Anaesthesia is the largest single hospital
specialty in the NHS. The Royal College of Anaesthetists
(RCoA) is the professional body responsible for the specialty of
anaesthesia throughout the UK, and ensures the quality of patient
care through the maintenance of standards in anaesthesia, critical
care and pain medicine.
The Royal College of Anaesthetists has its foundations in the
Faculty of Anaesthetists formed in 1948 within the Royal College of
Surgeons of England. In 1988 the Faculty became the College
of Anaesthetists and was granted a Royal Charter in 1992. It
is located in its own premises, Churchill House in Red Lion Square,
London and has over 14000 Fellows and Members.
The College’s activities are varied, but include the setting of
standards of clinical care, establishing the standards for the
training of anaesthetists and those practising critical care and/or
acute and chronic pain management, setting and running
examinations, and the continued medical education of all practising
anaesthetists. The College is made up from an elected
Council of practising anaesthetists who elect a President and two
Vice-Presidents from among their members. The
administrative functions of the College are carried out by
approximately 60 members of staff, organised into four operational
Sections, Professional Standards, Education, Training &
Examinations and the Chief Executives Office.
More details about the
College can be found on their website.
Training
As an anaesthetic trainee you will receive
assistance and guidance from the RCoA from the start of your
training at CT1 either in Anaesthesia or Acute Care Common Stem
(ACCS) through to the end of your training at ST7. Details of
the anaesthetic
training programme and curriculum can be found on the College
website.
The College is intrinsic to all aspects of
your career and your progress through the training programme to the
achievement of a CCT will be supported by College representatives,
such as the College Tutors and Regional Advisers. These
experienced consultant anaesthetists will provide training and
advice throughout your time as a trainee.
The Training Department provides the
administrative functions to support the delivery of the Curriculum
and the training programme to the Schools of Anaesthesia and
Deaneries. The team is experienced and knowledgeable on all
aspect of training and can provide advice on issues including; Out
of Programme Experience and Training, Less than Full Time Training,
CCT information, training in Intensive Care and Pain Medicine,
overseas training schemes and many other training related
subjects.
Training in Intensive Care Medicine in the UK
is supervised by the Faculty of Intensive Care Medicine (FICM),
which includes representatives of the Royal Colleges of
Anaesthetists, Physicians and Surgeons. Following the approval by
the General Medical Council of the standalone CCT in Intensive
Care Medicine (2011), the Faculty and its partner
colleges have undertaken cross-mapping exercises to identify shared
competencies that can be dual counted as leading to dual CCTs in
ICM and one of the defined partner specialties.
Further details on ICM training, both as a single specialty and
as a dual CCT with anaesthesia can be found on the RCoA's
website.
The College launched an e-Portfolio for
training in August 2011 which enables trainees to manage their
training on line. More information on the
e-Portfolio can be found on the RCoA's website.
Further details on all aspects of the
College’s role in
training can be found on the College website.
The Faculties of Pain Medicine and Intensive Care Medicine
Pain medicine describes the work of specially
qualified medical practitioners who undertake the comprehensive
management of patients with acute, chronic and cancer pain using
physical, pharmacological, interventional and psychological
techniques in a multidisciplinary setting. The Faculty of
Pain Medicine is the professional body responsible for the
training, assessment, practice and continuing professional
development of specialist medical practitioners in the management
of pain in the United Kingdom. It supports a multidisciplinary
approach to pain management informed by evidence based practice and
research.
An announcement on the establishment of the
Faculty of Intensive Care Medicine of the United Kingdom was made
in May 2010. The Faculty will be located in and administered
from the Royal College of Anaesthetists and the initiative is
strongly supported by the Intensive Care Society and trainee
groups. The Faculty is formed to set and promote, on behalf
of parent Colleges, the best possible standards of care for
critically ill patients. This will be achieved through
development of the science of intensive care medicine and promotion
of career-long education, training and professional development of
medical practitioners to deliver intensive care medicine. In
composition and leadership, the Faculty will reflect the
multidisciplinary ethos of intensive care, which is a particular
strength of UK clinical practice within the specialty.
Information on both Faculties is available
online at:
Examinations
During the training programme, as a trainee
anaesthetist you will take an examination in two parts, the Primary
and the Final, called the Fellowship of the Royal College of
Anaesthetists (FRCA). This exam is set and supervised by the Royal
College of Anaesthetists. The standards are high and those doctors
who pass both parts can use the post-nominal FRCA.
The Primary Examination is mapped to the Basic
Level Training Curriculum (Annex B) and divided into 3 sections;
the multiple choice questions exam (MCQ) which
comprises; 90 MCQ questions in three hours, 60 x Multiple
True/False (MTF) plus 30 x Single Best Answer (SBA) questions
comprising of questions in; pharmacology, physiology including
related biochemistry and anatomy, physics, clinical measurement and
data interpretation. The MCQ section must be passed before the OSCE
and SOE sections can be attempted. The Objective Structured
Clinical Examination (OSCE) includes up to 18 stations in
approximately one hour 50 minutes. It involves a number of
‘stations’ covering: resuscitation, technical skills, anatomy
(general procedure), history-taking, physical examination,
communication skills, anaesthetic equipment, monitoring equipment,
measuring equipment, anaesthetic hazards, and the interpretation of
X-rays. There are two sub-sections to the The
Structured Oral Examination (SOE) section comprising of 30
minutes in pharmacology, physiology and biochemistry, followed by,
30 minutes in clinical topics (including a critical incident),
physics, clinical measurement, equipment and safety. The OSCE
and SOE sections must be taken together at the first sitting.
If a candidate fails one section but passes the other, only the
failed section needs to be retaken. Trainees are normally expected
to pass the Primary FRCA within Core Training and cannot progress
to intermediate training without it.
The Final FRCA examinations are normally taken
during ST3 and 4, and is a pre-requisite to obtaining the
intermediate level training certificate. The Final FRCA components
are mapped to the Intermediate Level Training Curriculum (Annex C).
There are two sections to the Final FRCA; there are two
sub-sections to the Final Written examination
comprising of; a MCQ paper: 90 MCQs in three hours: 60 x Multiple
True/False (MTF) plus 30 x Single Best Answer (SBA) questions,
comprising of: medicine and surgery, applied basic science
(including clinical measurement), intensive care medicine, pain
management, clinical anaesthesia, as well as a Short Answer
Question paper (SAQ) paper: 12 compulsory questions in three hours
normally on the principles and practice of clinical
anaesthesia. There are two sub-sections to the
Structured Oral Examinations (SOE)
comprising: Clinical Anaesthesia: 50 minutes comprising of
ten minutes to view clinical material, 20 minutes devoted to
clinical material and 20 minutes devoted to clinical anaesthesia
unrelated to the clinical material. Followed by:
Clinical Science: 30 minutes duration consisting of four questions
on the application of basic science to anaesthesia, intensive care
medicine and pain management.
The College also manages the administration of
the following Faculty examinations: The Fellowship of
Intensive Care Medicine examination (FFICM) comprising of; an MCQ,
OSCE and SOE. The Fellowship of the Faculty of Pain Medicine Royal
College of Anaesthetists (FFPMRCA) comprising of: an MCQ and an SOE
examination.
Further information on the
examinations is available at the RCoA website.
Education
The RCoA offers an extensive programme of
courses, events and educational activities, delivered both
regionally and at the College. These include exam preparation
courses. There are a number of committees and groups that aim
to promote the educational and research aspects of the practice of
anaesthesia. These include the National Institute of Academic
Anaesthesia (NIAA) and the Anaesthetists as Educators Group.
In addition the College is engaged on the development and
improvement of the use of simulators for training.
E-Learning for Healthcare initiative has
developed E-Learning Anaesthesia (e-LA). Written and edited
by anaesthetists, e-LA covers the knowledge and key concepts that
underpin the anaesthetic curriculum and will help trainees prepare
for the FRCA examination. The learning material is presented as a
structured series of bite-sized sessions and includes access to an
extensive e-Library, a self-assessment area, and e-CPD to support
continued professional development in anaesthesia. Further
information on e-LA can be found on the RCoA
website.
The College’s bimonthly journal The
Bulletin as well as The British Journal of Anaesthesia
(BJA) are two additional examples of the Colleges involvement
in the practice and science of anaesthesia.
Contemplating a Career as an Anaesthetist?
Further information and advice about a career
in anaesthesia can be found on the
career pages of the College website or contact the RCoA at
info@rcoa.ac.uk.