Higher Training


** The Royal College of Anaesthetists is currently working with its members to re-write the anaesthetic curriculum in line with new GMC standards that were published in May 2017.  The proposed 2020 Anaesthetic CCT Curriculum is currently under review by the General Medical Council (GMC).  Follow this link for further details regarding the 2020 curriculum.  

The information below will be updated once the Curriculum has been approved. **

The aim of Higher and Advanced Level Training is to produce trainees competent for INDEPENDENT PROFESSIONAL PRACTICE in their chosen consultant career path. To allow this to take place there is some degree of flexibility in the last three years of training, consisting of the essentials for completion of CCT combined with optional choices pertinent to the consultant pathway you have chosen e.g. paediatric, obstetric, cardiac etc. The minimum time required for essential units in ST5 to 7 is two years. This allows one year to further any personal interests within your career.


It is important that the CCT for Higher Training Level is read as it is more complex than both the Basic and the Intermediate versions. You are required to complete FIVE essential units at a higher level. They are:


Essential (Key) Units


  • Neurosurgery

  • Cardiothoracic

  • General (completion of  a minimum of NINE, those marked with an asterisk are mandatory), which consist of

- Airway management*

- Day surgery

- Head, neck, maxillo-facial and dental surgery

- General, urological and gynaecological surgery

- Management of respiratory and cardiac arrest*

- Non-theatre

- Obstetrics

- Orthopaedic surgery

- Perioperative medicine*

- Regional

- Sedation

- Transfer medicine

- Trauma and stabilisation

- Vascular surgery

  • Intensive Care Medicine

  • Paediatrics


The School also expects all trainees by the end of their ST7, to have completed a 1220 module at the Royal London Hospital.


Optional Units


  •  Ophthalmic

  • Pain Medicine

  • Paediatric intensive care medicine

  • Plastics & Burns

  • Anaesthesia in developing countries

  • Conscious sedation in dentistry

  • Military anaesthesia

  • Remote and rural anaesthesia 


The minimum time spent undertaking any of these modules is three months, but this maybe longer, depending on your individual requirements. There is ample opportunity for gaining further clinical experience in a variety of disciplines within the School and trainees are encouraged to do so much as possible.


In addition to the clinical experience the following simulation courses are required:

  • Patient Safety in Anaesthesia Simulation Course - ST5

  • Difficult Airway Management, Information & Techniques (DAMIT) Simulation Course - ST6

Please click here to view the BLSA checklist for the requirements to achieve Higher Competencies in Anaesthesia

Advanced Training

Advanced Training Domains 1 - 6


  • Domain 1 - Clinical practice

  • Domain 2 - Team working

  • Domain 3 - Leadership

  • Domain 4 - Innovation

  • Domain 5 - Management

  • Domain 6 - Education


Each of the advanced training domains need to be signed off as a Unit of Training before your final ARCP.  If you look at the curriculum blueprint most of this can be done by linking to the MSF.  Domain 1 can also be done through ALMAT, ACEX & CBD and Domain 2 via an ALMAT.  You will be required to provide evidence on the Unit of Training form to allow your Educational Supervisor to sign it off


In addition to the clinical experience the following are expected to be achieved:


  • Management Course

  • Acute Paediatric Life Support (APLS)

  • Audit/Re-audits

  • Research Methodology/Research

  • Publications

  • Active involvement with the School/Deanery/College

  • Presentations at Local and Regional level


If you still have any questions having read the 'CCT in Anaesthesia', then please contact your Education Supervisor/College Tutor for further discussion.


Please click here to view the BLSA checklist for the requirements to achieve Advanced Competencies in Anaesthesia