These years are spent at District General Hospitals. Clinical modules of further training in intensive care and obstetric anaesthesia and analgesia are provided, together with focused training in specialties that may be individually available at each hospital, such as vascular surgery, local anaesthesia, pain relief, and maxillo-facial surgery. Alongside these are organised training and experience in management and administration, audit, and teaching and training. There is ample opportunity to conduct clinical research.
In most cases the District General Hospital for the third year (ST5) of the rotation is selected at the time of appointment, and is usually one of those closer to the Hospitals selected for ST3/4. Arrangements for the fourth year (ST6) are more flexible, but in principle this year will be spent at another District General Hospital that contrasts with the previous unit.
Possible OOPT aspirations are discussed at the ARCP meetings or by contacting the senior Training Programme Director. Trainees need to be post FRCA, and ST5, 6 or 7. If OOPT is outside the UK, trainees must be back in this country for six months prior to the award of the CCT. Further information is available here: http://heeoe.hee.nhs.uk/out_of_programme