This blog aims to give a brief overview of the CESR process for an Anaesthetics Doctor. The indicative period of training for a CCT in anaesthetics is seven years and it is unlikely that a trainee would achieve all the learning outcomes required for a CCT in a shorter period of time.
This needs to be taken into account when gathering and submitting evidence for the CESR application process. The structure of the programme (in indicative timescales) is three years at Stage 1 training - CT1, CT2, CT3 (or two years in Acute Common Stem (ACCS) plus two additional years in anaesthesia, followed by two years at Stage 2 training – ST4, ST5 and then two years at Stage 3 training – ST6, ST7 including Special Interest Areas.
For overseas Doctors that wish to obtain specialist registration they will need to submit a CESR application to demonstrate that they have achieved the Stage 3 High Level learning outcomes for 14 Domains - seven Generic professional capability Domains and seven Clinical domains, and at least one Special Interest Area. There are additional Stage 2 key capabilities from Domain 9 that need to be evidenced.
For Anaesthetics the types of evidence are divided into fourteen different domains.
Domain 1 - Professional behaviours and communication. Stage 3 High Level Learning Outcome
Domain 2 - Management and professional/regulatory requirements. Stage 3 High Level Learning Outcome
Domain 3 - Team working. Stage 3 High Level Learning Outcome This is the specialty specific guidance for Anaesthetics updated November 2021 Please make sure you are reading the latest version. You can find all the guidance you need at www.gmc-uk.org.
Domain 4 – Safety & Quality Improvement. Stage 3 High Level Learning Outcome
Domain 5 – Safeguarding. Stage 3 High Level Learning Outcome
Domain 6 – Education and Training. Stage 3 High Learning Outcome
Domain 7 – Research and Managing Data. Stage 3 High Level Learning Outcome
Domain 8 – Perioperative Medicine and Healthcare Promotion. Stage 3 High Level Learning Outcome
Domain 9 – General Anaesthesia. Stage 3 High Level Learning Outcome and Stage 2 key capabilities M,N,O,P,Q,R,
Domain 10 – Regional Anaesthesia. Stage 3 High Level Learning Outcome
Domain 11– Resuscitation & Transfer. Stage 3 High Level Learning Outcome
Domain 12 – Procedural Sedation. Stage 3 High Level Learning Outcome
Domain 13 – Pain Medicine. Stage 3 High Level Learning Outcome
Domain 14 – Intensive Care. Stage 3 Learning Outcome
It is important to note that you will not be able to compensate for shortfalls in your evidence of training and experience in a particular area of the curriculum by providing extra evidence in other areas.
In order to demonstrate your competencies in all 14 Domains you will need to collate evidence. Below is a list of possible types of evidence that can be used, it is important to note that these are just some examples and not an exhausted list.
- Experience & Logbook
- Supervised Learning Events (SLEs) can be used to demonstrate:
• Ability to manage lists as a sole anaesthetist including areas of special interest (ALMAT)
• Leadership when discussing the care of a complex patient with the multidisciplinary team
• Evidence of effective shared decision making with patients and colleagues
- Courses and eLearning
It is important that you anonymise your evidence before you submit it to us. You must remove:
• All patient identifying details
• Details of patients’ relatives
• Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted.
• Names (first and last)
• Contact details such as phone numbers or email addresses
• NHS numbers
• Other individual patient numbers
• GMC numbers
The following details don’t need to be anonymised:
• Date of birth It is your responsibility to make sure that your evidence has been anonymised. Evidence which has not been anonymised will be returned to you. More information can be found on their website.
- Testimonials and letters from colleagues
- Thank you letters, cards from colleagues and patients
-Complaints and responses to complaints
It is our experience that applications from doctors in the specialty of Anaesthetics are often submitted with inadequate or poor evidence in the following areas:
• Applicants do not provide evidence to cover the full breadth of the CCT curriculum. If you have not covered a specific area of the curriculum in the past five years it is advisable to postpone an application until you have been to gain or revisit this experience. Applicants must ensure they can provide primary contemporaneous evidence of their learning outcomes and key capabilities in all areas of the curriculum.
• Applicants do not have current certification in resuscitation. Applicants must provide valid certification in advanced life support skills e.g. ALS.
• Applicants provide poor evidence of clinical governance. Applicants must provide evidence of various audits in which you played lead role, together with contributions to service improvement and risk management projects. The verified audits are required as evidence, not just email correspondence or statistics. Evidence of service improvement, risk management projects or other clinical governance activity is also needed.
• Applicants provide poor evidence of teaching, training and assessing junior colleagues. These may not form part of your role, however it is essential that evidence is supplied that confirms that you have the skills. This is best demonstrated by attendance at a course and the training or supervision or more junior colleagues. You must also provide evidence of your competence in teaching in the form of presentations or PowerPoint slides, in addition to evidence of feedback from students on your teaching skills and evidence of feedback you have given to students. The latter could take the form of assessments, multisource feedback, reference letters and constructive advice that you have provided to students, junior doctors and colleagues.
• Applicants provide poor evidence of managements skills. It is recognised that you may not have experience of managing a department, however some forms of management should be demonstrated e.g. rota management, budget management, leading ward rounds, leading theatre operating lists, leading on educational or research related activities.
Many of the positions we have in Anaesthetics are able to support you with your CESR application. If you would like to speak to our team about these opportunities do send your CV to [email protected].
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