Intermediate Training – ST3 and ST4

Advantages of training in the East of England

Unlike many other schools, successful trainees are aware of the location of all five years of their training programme soon after appointment, which helps domestic planning. Later changes may be possible with mutual agreement at the annual ARCP meetings. The East of England School of Anaesthesia is located in a large region but as a school we prioritize arranging rotations to prevent unreasonable commuting distances. See the below FAQs for details. We do not rotate trainees to hospitals that are an unreasonable commute. For example, Luton and Great Yarmouth will not be part of the same rotation.

The world renowned centres in Cambridge and Papworth deliver neuro- and cardio thoracic anaesthesia training respectively. The Chief resident programme, run in conjunction with The Judge Business School Cambridge, gives senior trainees world class management training and opportunities to deliver QIPs. Many of our trainees have completed Post Graduate Certificates in Education, sponsored by the School. Trainees meet up at funded simulation courses and regular regional teaching delivered at a number of sites.

In addition to well established academic clinical fellow and clinical lecturer programmes within the region, there is the opportunity for post FRCA trainees to spend a year within the University Department of Anaesthesia in Cambridge, developing research interests.

The East of England provides a high standard of living combining city, country and coast, internationally recognised teaching and research, and great weather!

Repatriation

The Repatriation project, commencing February 2017, will see the gradual return of ST posts to the East of England. These posts are currently aligned with the London Schools of Anaesthesia. 55 Anaesthesia ST posts will return to the East of England School over a 5-year period at a rate of 11 posts per year. The posts are based at the following hospitals: Chelmsford, Colchester, Southend, Basildon,Princess Alexandra (Harlow), and Lister (Stevenage). Watford is still under discussion. For more information see the repatriation page for the school of anesthesia.

How is the region broken down geographically? Will I have to do lots of communting?

The East of England School of Anaesthesia is located in a large region but as a school we prioritize arranging rotations to prevent unreasonable commuting distances.The five year specialty training programme is organised into the following pattern:

Training is based on a Hub and Spoke model. The Hubs are Cambridge University Hospitals (Addenbrookes) , Norfolk and Norwich University Hospital, Mid Essex NHS Trust (Broomfield Hospital in Chelmsford), and the East and North Hertfordshire NHS Trust (The Lister Hospital in Stevenage). The aim is that 50% training time will be spent in two of these Hubs with the remainder 50% in DGH’s (Spokes).

Hospital Groupings

As a school we try to make rotations based on hospital groupings which are geographically close together, however there will be an element of commuting due to training needs.

Here are some examples of rotations with each hospital being of 1 year duration from ST3 to ST7.

Cambridge, Cambridge, DGH1, DGH2, Norwich; with DGHs chosen from West Suffolk, Peterborough, Ipswich, Bedford and Luton.

Norwich, Norwich, DGH1, DGH2, Cambridge; with DGHs chosen from West Suffolk, James Paget, Queen Elizabeth and Ipswich.

Lister, Lister, DGH1, DGH2, Cambridge; with DGHs chosen from Bedford, Luton and Harlow.

Chelmsford, Chelmsford, DGH1, DGH2, Cambridge; with DGHs chosen from Basildon, Colchester, Southend and Harlow.

At times the rotation may start at a DGH for 6 to 12 months followed by the indicative two years at a major centre/Hub.

Please note all rotations include 3 months Neuroanaesthesia in Cambridge and 3 months Cardiac Anaesthesia in Papworth (this may take place for some at Basildon Cardiac Centre in the future). These generally run consecutively.

Rotations may change due to many reasons including LTFT, maternity, Dual training with ICM, PHEM, Pain, Exam issues, OOPT(E)(R).

The initial plan was to reconfigure the rotations because of repatriation with ST3 spent in a DGH/spoke before moving on to a major centre/Hub for ST4. This may be the norm in the future when all posts are repatriated and the system settles. For the present time however, rotations will vary depending on spaces/repatriated posts coming in the system with some of the traditional rotations remaining as they are until reconfigured.

 

When will I know my rotation?

We pride our School in our ability to give trainees their full 5-year rotation placements at the beginning. This may however be adjusted by mutual agreement. Drivers for this are the need to extend training time beyond the minimum 5-year period. Suitable examples are maternity leave, exam problems or Out of Programme Training / Experience / Research.

How many posts are there each year and what hospitals are in the East of England?

On average, there will be 30 posts per year with 10 in each of the three areas – East (around Chelmsford), West (around Stevenage) and North (around Norwich).

The following hospitals are part of the East Of England region.

Larger centres/ HUBS District General (DGHs) / Spokes
Addenbrooke's Hospital, Cambridge Bedford Hospital
Norfolk and Norwich University Hospital Ipswich Hospital
Papworth Hospital James Paget University Hospital, Great Yarmouth
Chelmsford Hospital Luton and Dunstable Hospital
Lister Hospital, Stevenage Peterborough District Hospital
  Queen Elizabeth II Hospital, King's Lynn
 

West Suffolk Hospital, Bury St Edmunds

  Princess Alexandra Hospital, Harlow
  Southend
  Colchester
  Basildon
  Watford (under discussion)
What units are delivered and where?

The modules for Intermediate training are currently delivered during the first 2 years (ST3 and 4) usually at a major centre/Hub. This time will include secondments of 3 months for Neuroanaesthesia in Cambridge and 3 months Cardiac Anaesthesia at Papworth (this may take place for some at Basildon Cardiac Centre in the future).

It is envisaged that the majority of general duties and Intensive Care Medicine will be delivered in a DGH/spoke after reconfiguration in the future.

What teaching is run in the region?

During the first two years, teaching is directed towards attainment of the final FRCA. Exam orientated teaching is provided by a day-release course throughout the year (except holiday periods). This comprises all-day teaching on alternate Tuesdays currently shared between Cambridge and Norwich (occasional days hosted by a DGH), which all candidates are expected to attend. Twice a year, before each sitting of the examination, there is a three-day FRCA revision course, alternating between Cambridge and Norwich. Study leave will be required for all these courses. The teaching programme is available here http://heeoe.hee.nhs.uk/node/3468

 

When will we be able to provide a preference for which area within the region we wish to be based (north, south or west)? How will these posts be allocated? Can you upgrade if your first choice is not initially given?

Preferences for which area or part of the region you wish to be based around can be chosen at the application stage.

This will be subject to ranking at interview.The rotation placements are constructed prior to the interviews and distributed by HEE to successful candidates based on a combination of your preference order and ranking. If you are ranked first then you will get your first rotation choice.

Upgrading is possible, but tends to not occur due to the ratio of successful candidates to jobs.

Is there any consideration to where trainees live?

Yes, consideration to where you live may be made. When a rotation has been chosen and if there are issues with the placements, these may be adjusted if there is any scope within the program, although this cannot be guaranteed. Flagging this up early is important.

Will there be flexibility in changing areas within the deanery? Can you move from an East rotation to the North for example if life circumstances change?

Yes. This can be discussed before and during the ARCP

How long might you need to spend in more distant hospitals?

Placements in any one DGH/Spoke are generally one year at most, but will be shorter for the Neuro and Cardio-thoracic anaesthesia blocks (3 months each). We do not rotate trainees to hospitals that are an unreasonable commute: for example, Luton and Great Yarmouth will not be part of the same rotation.

 

 

 

 

 

 

 

 

What research opportunities are there?

Since September 2001 we have been running a one-week SMART course (Scientific Methodology and Research Training). This aims to provide all post-fellowship trainees with a solid introduction to research ethics, funding issues, protocols, critical appraisal, statistics, presentation and publication skills.  For those with a genuine research interest there are opportunities to spend 12 months attached to the University Department in Addenbrooke's. This option will be available to all trainees within the region, but may be competitive. Several trainees have stayed on in the University department after gaining national grants to complete a PhD or MD under Prof Menon's guidance. For further details on academic training, please see link in main menu  http://heeoe.hee.nhs.uk/anaesthesia_academic

Who can we contact in the School to discuss subspecialty interests e.g. obstetric anaesthesia, paediatrics, airway, neuro, etc.?

Useful points of contacts are the School Officers. Their contact details are on our School website and if necessary they will then direct you to the best placed person to give advice. We find this method provides you with most up to date information regarding the curriculum requirements, ensures that your needs are met by accessing the correct training location and also provides you with additional advice on CV development.

https://heeoe.hee.nhs.uk/anaesthesia_contacts

Can we get involved with teaching? For example, simple training in education and opportunities to develop those skills?

We encourage trainees to do a teaching course e.g. Teaching the Teachers to Teach or a PGCert in Medical Education. You may apply for deanery funding (available for up to two trainees per year) to do a PGCert. We expect all trainees to put into practice the skills gained from these courses in teaching activities in their base hospitals and around the region.

Will we be eligible for time Out of Programme? Does the School support taking time out to develop other skills such as Developing World anaesthesia / teaching? If so at what stage of training? What resources are available?

Yes. However, we only allow OOPE for curriculum requirements e.g. Emergency Medicine for PHEM or Medicine for ICM. Otherwise all training undertaken outside the region must be classed as OOPT (Training) or OOPR (Research) and therefore count towards the CCT. The earliest this can be done is ST6. The maximum time allowed is one year. We can help to point interested trainees in the right direction, however there are no other resources available. We will sign the relevant applications to the RCoA / HEE.

Will there be any geographical links in ICM training - i.e. if you dual train in anaesthetics/ICM will the ICM training be in the same area?

Your location in the region will be taken into account when the ICM TPD plans your ICM training. The aim is to give trainees the best training possible in ICM. The majority of stage 3 ICM training posts are based in the centre of region although we also have posts based in Norwich and Chelmsford.

What is the timeline for applications to the East of England School of Anaesthesia?

 

more information is available here  http://anro.wm.hee.nhs.uk/ST3

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