Intermediate and Higher Training



All trainees should be allocated an educational supervisor, usually by the College Tutor. Trainees should meet with their educational supervisor at the start of their placement and at three monthly intervals thereafter. A record of discussions should be kept by the educational supervisor.

 At the end of the first year and annually thereafter trainees will attend an annual review of competence progression (ARCP).

An Exit ARCP will take place within 3 months of CCT and subsequent to satisfactory grading an application may be made to PMETB and the RCOA for inclusion in the specialty register.
Trainees should aim to meet with the Programme Director to discuss career plans at suitable intervals throughout training.

Intermediate training

During this two year period the following modules must be completed:
Key Modules – ICM, Obstetrics, Paediatrics, Neuroanaesthesia, Cardiothoracic, Pain
General modules – Gen/Urol/Gynae, Orthopaedics, Trauma, Regional, Day surgery, Vascular, ENT
Training will normally consist of 1 year at either Heartlands/Solihull (BHH) or University Hospitals Coventry and Warwickshire (UHCW) and two 6 month placements at one of George Elliot Hospital Nuneaton (GEH), Warwick (War), Alexandra Hospital Redditch (Redd), Good Hope Hospital, Sutton Coldfield (GHH).
The neuro module will be at UHCW or UHB (for trainees not going to UHCW). Paediatric training and UHB neuro will take place at Birmingham Children’s Hospital (BCH) usually as a secondment from one of the district general hospitals.

In order to progress to higher training a trainee must:

1. Complete two years intermediate training.
2. Have a complete WPA for all the modules or prospective RCOA approval for deferral.
3. Pass final FRCA
4. Have a successful outcome at ARCP

Modules cannot be carried over to higher training unless prospective approval from the RCOA is applied for. In such exceptional cases the module must be completed in the first 6 months of higher training.

Higher training

The final three years may consist of higher and advanced level training in a number of modules. Essential modules include ICM (see ICM training), Obstetrics, Paediatrics, Neuro and Cardiothoracic anaesthesia. Other modules are not compulsory though many are desirable when applying for consultant posts. Trainees should meet the TPD to discuss suitable programmes and placements depending on the interests of the trainee and availability of training slots.
By its very nature higher level training is more flexible than intermediate training and should allow the trainee to develop their portfolio and prepare for a consultant post.

Requirements for module sign off are the same as for intermediate modules (see above).

Advanced training

A number of modules for advanced training are available. These modules are intended for trainees with a “special interest” for example in obstetrics, ICM, cardiothoracic etc. Details can be found on the RCOA website.

Intensive Care Medicine training

Training in ICM

Advanced level training is offered on a regional basis and posts advertised on NHS jobs.

The ICM training co-ordinator is Dr Mamta Patel

Completion of Unit of Training (CUT) forms 

These documents will be signed by a designated trainer when the criteria outlined in the intermediate training section above have been fulfilled. 

Out of Programme time (OOP)

Time may be taken out of programme for training (OOPT), research (OOPR),experience (OOPE) or carrer break (OOPC). This is normally done in ST6; trainees are required to be back in a UK training post for their last 6 months of training. Details of the application process can be found on the school website on the trainee information and paperwork page.

Non clinical training

Research – a one year research post at Heartlands Hospital forms part of the rotation and is appointed to via interview. This is usually undertaken in ST5 or above.
Management – trainees are required to attend post fellowship study days at Stafford. Towards the end of trainees attendance at a management course (usually at Keele or Warwick University) is encouraged. 


Prior to an ARCP a list of attendees will be circulated to College Tutors and trainees. Occasionally a trainee is omitted who should be attending and occasionally the opposite occurs. Please check these lists carefully and inform your College Tutor or Programme Director if this is the case. The panel is usually convened in January, April, July and October.
You will be informed of the date by which all paperwork should be submitted and of the date and time of the ARCP. Please ensure that all paperwork is submitted in a timely manner, failure to do so may result in the ARCP being deferred until the next panel convenes. 

Issuing of documentation may be withheld if evidence is not available. The panel consists of the programme director (chair), college tutors, consultant trainers, a regional advisor, a representative of the deanery +/_ and external assessor.

At the ARCP you will be expected to present a summary of your achievements for the year, the panel will review the paperwork, have an opportunity to ask questions and then a recommendation will be made. Details of the outcomes are outlined in the Gold Guide.


Leave allowance is 30 days annually and pro rata for less than full time trainees (LTFT). Study leave is also 30 days. Details of allowances can be found on the West Midlands Deanery Website. Private study leave is allowed and is allocated locally by individual hospitals. Leave can be tight at certain times of year so forward planning is essential. A minimum of 6 weeks’ notice is required for annual or study leave. Protected teaching is usually taken as study leave as is time spent teaching on provider courses as this forms part of CEPD.