The East of England ICM Training programme is designed to deliver the ICM Curriculum with the primary aim of supporting Intensivists in Training to become specialists in Intensive Care Medicine.
Please find this page a helpful resource to understanding the EoE ICM's Training Programme. Further guidance is also provided in the East of England ICM Induction and Higher Specialist Training Handbook, which residents receive on entering the regions Higher Specialist Training Programme.
Following successful appointment via the National Recruitment programme led by ICMNRO Intensivists in Training enter the programme from a wide variety of training backgrounds and core programmes or equivalent and can enter on single, dual, or triple CCT training pathways. This makes the programme complex and diverse; where on entry to the programme not all Intensivists in Training will have had an identical training experience. The first up to two years of higher ICM training are designed therefore to enable all Intensivists in Training to achieve the same learning outcomes and level of competency by the end of Stage 1 training.
Your individual training pathway including Stage 1 requirements will be reviewed at your initial induction and onboarding meeting held with the ICM TPDs and ICM RA.
Stages of Training and Location
Training in ICM is divided into three stages. You will enter the programme in Stage 1 (very occasionally there are bespoke individual circumstances where this is not the case), but depending on your previous training and completed placements as well as your allied specialty requirements if dual or triple CCT, the time spent in Stage 1 can be very variable.
Stage 1
Stage 1 is an indicative minimum of 4 years, which can include any core training programme (or recognised equivalent) that can count towards a CCT in Intensive Care Medicine. At the end of Stage 1, all Intensivists in Training regardless of their core programme will have completed an indicative minimum of 1 year of Anaesthetics, 1 year of Acute Internal Medicine and 1 year of Intensive Care Medicine.
Stage 1 Training Locations
With a large region, the differing programme requirements of each Intensivist in Training entering the programme and the need to co-ordinate with partner specialties for Dual/Triple training we try not to dictate where people will train in Stage 1. Early after appointment at national recruitment, we meet with you and discuss how your ICM training in Stage 1 can integrate with any personal circumstances and existing training plans. While it is not feasible to allow total freedom of choice this system means that you are able to plan accommodation and commuting. We will consider your individual training requirements alongside where you live and always try to allocate you to hospitals that minimise your commuting distance, where possible.
With this in mind, we have divided the hospitals into 4 broad areas:
North East (in no particular order): Norwich, Kings Lynn, Great Yarmouth, Ipswich, Bury St Edmunds
North West (in no particular order): Peterborough, Cambridge, Bury St Edmunds, Stevenage, Luton & Dunstable, Bedford, Harlow
South West (in no particular order): Watford, Luton & Dunstable, Stevenage, Bedford, Harlow
South East (in no particular order): Harlow, Chelmsford, Southend, Basildon CTC, Colchester, Ipswich
Please note that the borders of the areas are not defined and that cross over between areas is possible depending on your personal circumstance. Sometimes cross over may be necessary depending on post availability and your exact Stage 1 training requirements.
Stage 2
Stage 2 training is for an indicative two years: a Speciality ICM year and a Special Skills Year (SSY).
The Specialty ICM year is predominantly spent in Cambridge, with 3-month modules each in Neurosciences ICM (Addenbrooke's), Cardiac ICM (Royal Papworth) and Paediatric ICM (Addenbrooke's). Paediatric ICM is either provided by placement to PICU or PaNDR (Paediatric and Neonatal Decision Support and Retrieval Service) depending on your individual background and training requirements.
Note however, for dual CCT Anaesthesia trainees the dual counting of the paediatric anaesthesia block is enhanced by specific day release, 10 days in total, to PICU during this block and not a designated 3-month PICU placement. Dual Anaesthesia trainees also have a combined Cardiac Anaesthesia and ICM 3-month placement, as well as a 3-month Neuro Anaesthesia placement and a general 3 month ICM placement on NCCU to top up Neuro ICM as well as gain general ICM capabilities.
The Special Skills Year (SSY) is a year dedicated to a special or complementary skill development. For those of you undertaking Dual or Triple CCT accreditation the Special Skills Year (SSY) is undertaken in and coordinated by your partner specialty. Within the East of England, we are able to offer a wide variety of Special Skills Year Modules across the region. The list of modules offered is increasing year on year. We advise you to consider your choice of SSY early in your training so that this can be planned with your TPDs. Some SSYs do take time to arrange.
For progression from Stage 2 you will need to have completed the above training, gained the required competencies, as well as completed the Fellowship of the Faculty of Intensive Care Medicine (FFICM) Exam.
Stage 3
Stage 3 ICM training is the final stage of training and is for an indicative 12-month period. It is the ‘advanced’ year spent within Intensive Care Units, designed to consolidate your capabilities, and acquire the high-level management and leadership skills in preparation for becoming a consultant.
Upon successful completion of Stage 3 you will be recommended for your CCT in Intensive Care Medicine.
Stage 3 Training Locations
Currently Stage 3 training is offered in Addenbrooke's (General and Neuro ICM units), Royal Papworth (Cardiothoracic Intensive Care unit), Norwich, Chelmsford, Peterborough, Stevenage (Lister), West Suffolk, Ipswich, and Colchester.
We are flexible about which Stage 3 training units Stage 3 trainees attend. Stage 3 rotations are adapted to suit individual training requirements, personal circumstances including potential future career aspirations and to ensure a breadth of senior pre-Consultant experience.
You can do a minimum of 3 months or maximum of 6 months in a training unit, however we do strongly recommend that at least 6 months of this time is spent in a DGH to benefit from the acting up experience and advanced management and training opportunities that this brings.
The Faculty of Intensive Care Medicine
The Faculty of Intensive Care Medicine is the professional body responsible for the training, assessment, practice and continuing professional development of ICM Doctors and ACCPs in the UK. The FICM website contains a wealth of information regarding ICM training; you can access it here.
The new ICM curriculum Supporting excellence was introduced in August 2021 in accordance with the GMC's Excellence by design framework.
A link to the curriculum can be found HERE
The curriculum is delivered over 3 stages of training and is based around Spiral Learning where competencies are developed with increasing capability level within 14 High Level Learning Outcomes (HiLLOS) over each stage of training.
The ICM curriculum remains the same whether you are a single, dual or triple trainee. If you are a dual or triple ICM trainee, the separate specialty CCT curricula are combined into a dual/triple programme with mapped capabilities gained in the combined programme placements.
Dual / Triple CCT Guidance
ICM High Level Learning Outcomes (HiLLOs) & Capability Levels
There are 14 HiLLOs for each stage of training. These are divided into 10 specialty specific and 4 generic professional HiLLOs. Each HiLLO describes the overarching learning outcome in the relevant area of practice expected at each stage. Within each HiLLO, several key capabilities are described which can be used to guide you towards achievement of the HiLLO for that domain.
Other key documents relating to the curriculum:
Your ARCP for ICM typically will occur in June of each year, as ICM specialty intake occurs once a year in August.
There may also be additional review points with the TPD/Regional Advisor or ARCP panel if required at particular milestones of training.
To aid ARCP preparation, FICM have produced an ARCP checklist and guidance for Intensivists in Training and Educational Supervisors on completing Educational Supervisor Structured Reports (ESSRs).
As a minimum ARCP evidence should include:
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A Structured Report from the Educational Supervisor (ESSR) reviewing your portfolio, including:
- HiLLO progression and completion
- An appropriate mix of SLEs
- Evidence of personal activities including clinical governance, quality improvement and continuous professional development activities, with evidence of reflective practice
- Examination progress
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1 MSF per training year
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A procedural logbook (or summary logbook).
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A form R for revalidation should also be uploaded to the LLP and linked to the ESSR.
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A Multi Consultant Report (MCR) for each ICM placement, alongside a contemporaneous anonymised case-mix logbook whilst not mandatory are also highly recommended.
Please note that there is currently no ICM-specific logbook on LLP. FICM provides the following guidance on maintaining an ICM-specific logbook.
For any queries related to the organisational aspects of ARCP should be directed to Katarzyna Scigala (katarzyna.scigala@nhs.net)
If you have any comments/ suggestions, advice for those preparing for the FFICM or stumble across any good resources, please email the regional trainee representatives.
Official examinations website
- Full details are available on the FICM website here.
Useful resources
Refer to the exam page of this website
Educational Supervision
Those responsible for planning and delivering your training within the East of England Intensive Care Higher Specialist programme are:
The Training Programme Directors (TPDS)
Dr Natasha Lawrence (Single CCT TPD) and Dr Coralie Carle (Dual/Triple CCT TPD) are the current ICM Training Programme Directors responsible for Intensivists in Training within the East of England Deanery. Although they are responsible for different ICM training pathways / programmes they work together in many areas of the training programme and are happy to be contacted by any of the Intensivists in Training. The TPDs are responsible for the delivery of the East of England ICM training programme including planning your individual training pathway and your allocation to specific training attachments. They will also lead your annual review and progression through the training programme.
The Regional Advisors (RA)
The role of the ICM RA is to represent the Faculty of Intensive Care Medicine within the East of England. Dr Vikram Malhotra is the Deputy Regional Advisor for the East of England, and works closely with the TPDS, the School of Anaesthesia and ICM and the Deanery. The RAs will advise on appropriate training placements, training pathways and available training resources ensuring that the needs of the ICM curriculum are met. The RAs, together with the TPDs, review your progress annually and are responsible for approving your End of Stage certificates as you advance through the programme.
Faculty Tutors (FT)
Each hospital that is involved in ICM training will have one (or more) Intensive Care Consultants nominated as FTs. The role of the FT is to provide the best training conditions possible during placements, ensuring that the placement meets the relevant requirements of the curriculum, as well as assigning you an appropriate Educational Supervisor for your training placement. The FT will also usually be involved in the local regional teaching programme and will frequently liaise with the TPDs regarding the development and needs of the individual Intensivist in Training.
Educational Supervisors (ES)
At all times throughout your training (including time in partner specialties), you will require a named ICM ES to help guide the development of your ICM training capabilities. This ES is usually in the same hospital as your placements but for some speciality placement rotations it is acceptable to maintain your ES at your base hospital/a separate ES and have a locally appointed Clinical Supervisor (CS).
Your ES will conduct supervisor meetings with you throughout the academic year. It is advised that you have at least 3 meetings with your ES/CS during each placement: at the beginning, middle and end. Outcomes of these meetings should be documented in a placement meeting within your LLP. An End of Placement Report (written by the placement supervisor) for each ICM programme placement during the year (including medicine, anaesthesia, subspeciality ICM blocks) should be uploaded and linked to appropriate HiLLOs in your LLP.
Your ES, and sometimes your CS during the Speciality ICM placements, is responsible for reviewing and signing your Learning Objective Completion forms for the 14 HiLLOs when you feel you have achieved and evidenced the required capabilities for each. It may be therefore appropriate in some placements that your LOC form replaces your end of placement form.
Your ES will also complete your ESSR with you prior to the annual review (ARCP).
Assessment process
The ICM Curriculum has 14 HiLLOs for each stage of training. Each HiLLO describes an overarching Learning Outcome expected at each stage. Within each HiLLO, several key capabilities are described, together with suggested types of evidence which can be used to guide you towards achievement of these key capabilities and the HiLLO for that domain.
Evidence of completion of all the 14 HiLLOs for a stage of training, at the required capability level for stage, is required before proceeding to the next stage of training, recorded on the FICM specific eportfolio: Lifelong Learning Platform (LLP). Once the learning outcome for a HiLLO has been achieved a Learning Outcome Completion (LOC) form can be generated and signed by your Educational Supervisor, with them having reviewed the evidence including placements undertaken as part of this process.
End of Stage Certificates:
There are three main progression points: from Stage 1 to Stage 2, from Stage 2 to Stage 3 and from Stage 3 to completion of training.
At the end of each stage of training an End of Stage Certificate should be generated by the Intensivist in Training on completion of the following:
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All mandatory placements have been undertaken
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All capabilities of the curriculum have been developed, evidenced and reviewed to the required capability level
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All 14 Learning Outcome Completion forms have been completed.
The RA will then review and sign the End of Stage Certificate.
For Stage 2 certificate completion this will also require a pass in full of the Fellowship of the Faculty of Intensive Care (FFICM) Final examination.
For Stage 3, the end of Stage completion date will be the same as your CCT date and will be the same across all your allied speciality programmes if a dual / triple CCT trainee.
For residents undertaking Dual or Triple CCT accreditation your end of Stage dates should align across all of your CCT specialties ensuring that all required placements and capabilities across both curricula have been achieved.
Please also note, that due to the varied training pathways onto the programme an End of Stage may not temporally correlate with an Annual Review of Competency Progression (ARCP). Where this is the case your individual training journey will be reviewed by the TPDs and RAs alongside your ES/FTs considering your nearest ARCP outcome and developmental and training needs.
At the time of your ICM National Training Number offer you will receive an East of England Welcome Letter outlining the need to organise an Onboarding Induction Meeting with your ICM TPDs and Regional Advisor within the East of England as part of the initial onboarding process.
At this initial meeting your training history will be reviewed and your remaining Stage 1 requirements will be agreed. Potential post allocation will also be discussed as well as whether you wish for any prior training outside of the ICM HST programme or core UK programmes to be recognised towards your ICM Higher Specialist training.
Please note that should you wish for prior unapproved training outside of the ICM HST programme to be counted you will be registered with FICM on the Combined Programme (previously known as CESR-CP route) but will be eligible for a CCT on the completion of the rest of the ICM CCT programme.
To complete the Onboarding Process, you should also:
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Complete the FICM registration process by:
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Reviewing the FICM Onboarding for the ICM CCT Programme information
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Completing the FICM online ICM CCT Registration form
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Review the ICM curricula and training documents relevant to your individual ICM training pathway.
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Review FICM’s Guide to Training for the ICM CCT Programme.
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For those wishing to have prior unapproved training recognised, review FICM’s Guidance on the Combine Programme Route to CCT which outlines the recommended process to be followed for this.
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Obtain a login to the Lifelong Learning Platform and familiarise yourself with the site, including the FICM Learning and e-ICM resources which are available to support you in your training. The LLP login will be sent to you by the Faculty following your registration.
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Consider making contact prior to your first placement with your allocated hospital’s Faculty Tutor to introduce yourself and provide an opportunity for you to ensure that your training requirements are known, and any leave requirements can be requested / discussed.
Tips for getting started in your ICM Training:
In August at the start of your first placement we recommend that you:
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Ensure that you have an ICM Education Supervisor (ES) allocated to you and aim to hold an initial meeting with them within the first month.
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During this meeting your training requirements for this placement should be reviewed together with a review of your previous training capabilities acquired and a plan made to develop your remaining required capabilities.
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At all times throughout your training, you will require a named ICM ES to help guide the development of your ICM training capabilities. This ES is usually in the same hospital as your placements but for some speciality placement rotations it is acceptable to maintain your ES at your base hospital and have a locally appointed Clinical Supervisor (CS).
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Ensure you have LLP access. Once available:
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Start populating your LLP with key evidence from your previous training that is to be recognised towards your ICM CCT. This may include previous ARCP outcomes, key milestones, ESSR reports / educational meetings, certificates of training, exam results, module sign offs relevant to ICM programme, courses attended, logbooks and key SLEs that you feel are important etc.
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Undertake a gap analysis with your ICM ES / Faculty Tutor to review uploaded evidence from prior training and undertake a gap analysis of remaining stage 1 curriculum requirements.
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Make contact with other Intensivists in Training.
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Please consider joining the Intensivists in Training WhatsApp group by emailing the trainee reps.
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Plan and attend the East of England ICM Regional Teaching Study days, remembering to register through the East of England online learning platform, currently PGVLE.
Within the East of England, we have an established monthly two-year rolling Regional ICM study day programme aligned to the FFICM syllabus and the ICM HST Curriculum.
This teaching programme targets the FFICM exam alongside specific skills, knowledge and ICM competencies required of the ICM Higher Specialty Trainee. Local FFICM OSCE/VIVA exam preparation days run ahead of the FFICM exam within our two-year rolling teaching programme.
Every effort should be made to attend these regional teaching days – persistent non-attendance will be discussed with you directly.
For further information with regards the East of England Regional Teaching Programme please go to:
This link also contains further information on Study Leave within the East of England Deanery as well as the online virtual learning platform that supports the delivery of our regional teaching programme.
Regional School Training Opportunities for East of England Intensivists in Training
Alongside the Regional ICM Study Day Programme there are other regional school approved and funded courses / training days available for you to access and supplement your development throughout your training. These include:
Simulation Sessions:
Anaesthetic Critical Incident Simulation
Transfer Training
Paediatric simulation
Practical skills
ICM US basic skills
Airway Simulation Course
Tracheostomy simulation
FUSIC / POCUS
SuppoRTT:
RESTART: Return to Anaesthesia Simulation course
New to the NHS)
Other:
SMART Course
Perioperative medicine and assessment skills
Novice Anaesthesia Programme - (for ICM resident doctors during Anaesthesia attachment)
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Novice Induction Day Virtual event
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Novice Pre-Op Assessment and Equipment Lecture Day (Anglia Ruskin University-Chelmsford)
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Drug day Virtual event
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Airway day NNUH
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Novice simulation (There will be 8 sessions to choose from, held at various locations across the region, including Anglia Ruskin University- Chelmsford, Lister Hospital, West Hertfordshire Hospitals, and West Suffolk Hospital)
Please do review these especially the simulation days and cross reference them to your HiLLOs.
Event details and registration for these courses are via PGVLE.
Please note that registration will operate on a first-come, first-served basis.
On registration with FICM as an Intensivist in Training you will be setup on the ICM ePortfolio: the ‘Lifelong Learning Platform’ (LLP). The LLP is the primary means of demonstrating progression in your training and recording capability development.
Progression of your training via the LLP will be reviewed formally at the end of each academic year. It is, therefore, essential that you become familiar with its operation early in your training. You can view the current LLP guidance on the FICM website via:
Please make sure:
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That your profile details and placement details are always correct and that you always have a named ES.
For Doctors on a Dual Anaesthetic and ICM CCT programme you can replicate placements on your RCOA and FICM LLP, assigning different ICM and Anaesthetic Educational Supervisors to the same placement if required. Advice on how to do this can be accessed here.
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To frequently update your LLP and upload any certificates or completed courses.
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To record all your Educational Meetings on the LLP. This may include uploading ‘summary’ attachments from these meetings generated by your Educational Supervisor, as your ES will not be able to record any meetings or activities directly on your portfolio.
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To link appropriate SLEs and Personal Activities to all appropriate HiLLOs.
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To carefully name each Personal Activity for clarity and for easier linking.
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It is important also to note that only you can generate Learning Outcome Completion (LOC) forms and Stage certificates on the LLP, which will then need to be sent to your Educational Supervisor and Regional Advisors, respectively, to sign.
For non-anaesthetic dual/triple trainees your e-Portfolio from your other programme will not automatically link with your ICM LLP account. This means that you will need to maintain a separate e-Portfolio for your partner specialty programme and upload relevant SLEs / personal activities to both eportfolios.
For Anaesthetic and ICM Dual learners the LLP has the ability to create an Anaesthetic or ICM SLE and link it to both curricula as long as there is a current active placement in your RCOA and FICM learner tabs. Please click here for further advice.
Please note that not all Anaesthetic Supervisors have automatic access to the ICM LLP. Please do check whether an individual supervisor does have access. The LLP team are happy to add individual supervisors without access to the ICM LLP.
LLP Trouble shooting
Please do utilise your ICM Regional Training Representatives / fellow Intensivists in Training network to help solve any problems or issues that you may encounter with the LLP. They are often a fountain of knowledge!
Should you require further help however then the FICM LLP team can be contacted on:
Email: llp@ficm.ac.uk
In alignment with FICM’s guidance on EDT we support that Intensivists in Training in Stage 1 and 2 should have up to two hours/week EDT, and those in Stage 3 up to 4 hours/week. This time should be adjusted pro rata for those in less than full time training and can be flexible in delivery so that an average amount is taken over time.
EDT is in addition to local/regional teaching sessions and does not form part of the study leave allowance. EDT must be discussed and planned with your ES in all cases with specific objectives to be completed, aligned to the learning outcomes in the curriculum. All EDT activity should be logged on the LLP.
Appropriate use of EDT time may include:
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Educational activity and preparation of educational materials
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Quality Improvement Projects
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Research
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Management and Leadership Activity
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Activities which support the development or maintenance of specific specialist skills such as: airway and anaesthesia skills in theatres, specialist clinics, Echo and Point of Care Ultrasound