Supporting Information
1. ANAESTHETICS EXPERIENCE & QUALIFICATIONS
Do you have Full Primary FRCA? (Yes | No)
2. ADDITIONAL UNDERGRADUATE DEGREES AND QUALIFICATIONS
Please list any additional completed undergraduate qualifications with dates. Include intercalated BSc/ equivalent degree here, if you have one. Do not include details of your pre-university school education/ exam results.
If you do not have any additional undergraduate degrees and qualifications please add and just enter none
For each qualification enter:
- Name
- Qualification
- Place of Study
- Grade / Result
- Date Completed
3. POSTGRADUATE DEGREES AND QUALIFICATIONS
Please give details of any completed postgraduate medical qualifications/ other degrees/ diplomas/ certificates (e.g. MD, MRCP, etc.). Where a qualification is partly completed please state your exam status e.g. MRCP (Part 1) etc. For an MD please state whether this is linked to your primary medical qualification or the result of an independent research thesis. Please include here any relevant qualifications listed as desirable on the person specification.
If you do not have any postgraduate degrees and qualifications please add and just enter none
For each qualification enter:
- Name
- Subject / Qualification
- Place of Study
- Grade / Result
- Date Completed
4. ADDITIONAL ACHIEVEMENTS – PRIZES, AWARDS, AND DISTINCTIONS
Prizes, awards, and other distinctions (please include specialty and qualifying distinction). Please indicate whether these were awarded to you as an undergraduate or postgraduate.
If you do not have any additional achievements please add and just enter none
For each prize/award/distinction enter:
- Name
- Prize/Award/Distinction
- Awarding Body
- Date Completed
5. TRAINING COURSES ATTENDED
Include in this section the most relevant training courses to this specialty that you have attended and details of courses that you are currently undertaking. Please include any Advanced Life Support or similar courses mentioned in the Person Specification.
If you do not have any training courses please add and just enter none
For each course enter:
- Name
- Course Title
- Training Provider
- Duration of Course
- Date Completed
Self-Assessment
ST4 SELF-ASSESSMENT
Additional degrees and qualifications
- I have no additional degrees or qualifications. : 0
- I have a 2:2 or 3rd class BSc (or BA) prior to starting medicine. OR I have an additional degree in a non-science related subject prior to starting medicine. : 1
- I have a 1st class or 2:1 BSc (or BA) prior to starting medicine. OR I have a postgraduate certificate in a relevant field (excluding education/teaching). OR I have a part 1 of a postgraduate exam e.g. MRCP/FRCEM etc. : 2
- I have a 1st class BSc AND part 1 of a postgraduate exam e.g MRCP/FRCEM etc. OR I have a postgraduate diploma in a relevant field (excluding education/teaching). : 3
- I have an additional full postgraduate medical qualification e.g. MRCP/FRCEM etc. OR I have a postgraduate masters/MSc in a relevant field (excluding education/teaching). : 4
- I have an MD (Res). OR I have a PhD in a subject not relevant to medicine. : 5
- I have PhD in a subject related to medicine. : 6
Additional achievements, prizes and awards relative to medicine
- I have no additional awards. : 0
- I have a prize or award from my foundation training or equivalent e.g. certificate of merit. : 1
- I have a prize or an award from my hospital or Trust from my Stage 1 training or Equivalent e.g. Greatix award or learning from excellence award. : 2
- I have a prize awarded at post graduate level awarded by a regional medical organisation. : 3
- I have a prize awarded at postgraduate level by a national or international medical organisation. This includes prizes in the Primary FRCA. : 4
Postgraduate clinical experience in other specialities (excluding Foundation Programmes, Anaesthesia, research and teaching)
– Complementary speciality to be defined in guidance
– Up to 1 year of adult ICM can be included
- No experience in a complementary specialty by time of appointment. : 0
- At least 5 months experience in complementary specialties by time of appointment, without evidence of achievement of all expected outcomes, anywhere in the world. : 1
- 5 to 12 months experience in an appropriate/relevant complementary specialty by the time of appointment, with evidence of achievement of all expected outcomes, anywhere in the world. This includes 6 months acute medicine and 6 months emergency medicine during ACCS training. OR more than 36 months experience without evidence of expected outcomes. : 2
- More than 36 months in complementary specialties by time of appointment, with evidence of achievement of all expected outcomes, anywhere in the world. : 3
- 13 to 24 months experience in an appropriate/relevant complementary specialty by the time of appointment, with evidence of achievement of all expected outcomes, anywhere in the world. : 3
- 25 to 36 months experience in an appropriate/relevant complementary specialty by the time of appointment, with evidence of achievement of all expected outcomes, anywhere in the world. : 4
Quality Improvement Projects (QuIP) – can include audit as a tool to demonstrate quality improvement work in this section and trainee research network projects
Do not include activity from an additional degree course.
- I have not participated in any quality improvement learning events or projects. : 0
- I have taken part in other people’s postgraduate (non-anaesthetic) audits. OR I have taken part in QuIP since starting anaesthetic training (i.e. data collection or made other minor contributions, but not led or designed the project). OR I have completed bronze level QuIP or equivalent. : 1
- I have made a significant contribution to audit projects or quality improvement work as a postgraduate. This includes co-designing or joint leading a quality improvement or audit project and making recommendations for changes to practice based on audit findings OR closing the audit loop. : 2
- I have made a significant contribution to quality improvement work since commencing my core or stage 1 anaesthetic training OR equivalent. This includes co-designing or joint leading a quality improvement or audit project at my hospital and making recommendations for changes to practice based on findings OR closing the audit loop. : 3
- I have been the LEAD for one audit/QuIP since commencing my anaesthetic training. This includes making recommendations to change /practice based on findings OR closing the audit loop. OR I have led a regional TRN QuIP/audit project. : 4
- I have been the LEAD for more than one audit/QuIP since commencing my anaesthetics training. This includes designing, leading and managing QuIP and implementing changes to practice based on audit findings and closing the audit loops. OR I have led a national TRN QuIP/audit project. : 5
Research (excluding that completed during a PhD course or an undergraduate BSc)
- I have not been involved in research. : 0
- I have assisted with data collection for ongoing studies. : 1
- I have been involved with recruitment of participants to research projects (including TRN and NIHR CRN Portfolio studies). : 2
- I have enrolled in or completed an NIHR associate principal investigator scheme. OR I have had personal and direct involvement (as a co-investigator) leading, planning or running a postgraduate research project prior to anaesthetic training. : 3
- I have had personal and direct involvement (as a co-investigator) leading planning OR running a postgraduate research project since starting anaesthetic training. OR I have led a regional TRN research project (this cannot be the same project as Domain 4). OR I have been the principle investigator of a funded study or co-applicant on a successful grant application. : 4
- I have led a national TRN research project (this cannot be the same project as Domain 4). OR I have been the chief investigator of a funded study or lead applicant on a successful grant application. : 5
Teaching
- I have not contributed to formal teaching. : 0
- I have some experience in formal teaching for health professionals. OR I have some experience of formal teaching health-related topics to a non-medical audience. OR I have attended a teaching the teachers course, generic instructors course or similar. : 1
- I have made a major contribution to a local teaching programme including developing/organising a programme. OR I have instructed on an ALS /ATLS course, or similar. OR I have organised a one-day teaching programme and delivered a topic(s) on it. : 2
- I have obtained a postgraduate certificate in education/teaching. : 3
- I have made a major contribution to a regional or national teaching programme including developing/organising a programme as a postgraduate. : 4
- I have made a major contribution to a regional or national teaching programme including developing/organising a programme during my anaesthetic training. OR I have obtained a postgraduate diploma in education/teaching. : 5
- I have undertaken a major dissertation and been awarded a Masters in medical/clinical education. : 6
Academic publications
- I have not published anything. : 0
- I am a co-author of (PubMed listed OR peer reviewed) one or more case reports OR one or more clinical / scientific abstracts OR one or more letters OR one or more editorials. : 1
- I am first author of (PubMed listed OR peer reviewed) one or more case reports OR one or more clinical / scientific abstracts OR one or more letters OR one or more editorials. : 2
- I am a co-author of (PubMed listed OR peer reviewed) one or more pieces of original research OR one or more narrative reviews. : 3
- I am first author of (PubMed listed OR peer reviewed) one or more pieces of original research OR one or more narrative reviews. : 4
- I am first author of (PubMed listed OR Peer reviewed) more than one piece of original research. : 5
Presentations and Poster Presentations (see exclusions in applicant guidance)
- I have given no presentations nor presented any posters. : 0
- I have given one local/departmental presentation at any time during postgraduate training. : 1
- I have given more than one local/departmental presentation at any time during postgraduate training. OR I have given one local/departmental presentation since commencing anaesthetic training. : 2
- I have given more than one local/departmental presentation since commencing anaesthetic training. : 3
- I have given a POSTER presentation at a regional, national or international meeting at any time during postgraduate training. OR I have given an oral presentation prior to anaesthetic training at a regional, national or international meeting. OR I have given an oral presentation at a regional meeting since starting anaesthetic training. : 4
- I have given an oral presentation at a national or international meeting since commencing anaesthetic training. : 5
- I have given an oral presentation at more than one national or international meeting since commencing anaesthetic training. : 6
Continuing Professional Development in Stage 1 Training or Equivalent (CT1- CT3)
- No evidence of CPD. : 0
- I am able to demonstrate evidence of mandatory training /local online training. : 1
- I am able to provide evidence of mandatory training/local online training plus one educational event/CPD event of 1 day duration (see guidance document if no mandatory training evidence). : 2
- I am able to provide evidence of mandatory training/local online training, plus 2 educational events/CPD of 1 day duration (see guidance document if no mandatory training evidence). : 3
- I am able to provide evidence of mandatory training/local online training plus 2 educational events. One of which is related to simulation or regional anaesthesia AND one of which is more than 1 day duration (see guidance document if no mandatory training evidence). : 4
- I am able to demonstrate evidence of mandatory training/local online training, plus 3 educational events. At least one should be related to regional anaesthesia or simulation, one is more than 1 day duration AND one includes a national; or international CPD event related to anaesthesia (see guidance document if no mandatory training evidence). : 5
Activities demonstrating leadership and/ or management inside or outside of work
Leadership during school years will not be counted in this section
- I have not been involved in significant activities outside of medicine and I have not had opportunity to demonstrate leadership within my medical career to date. : 0
- I am an active member of a group, club or organisation promoting recreation, charity, community activities etc. and/OR I have demonstrated leadership as part of a small team within my hospital(s) and/OR I demonstrate significant time management outside of work. : 1
- I can demonstrate significant leadership or management as an undergraduate locally or nationally inside or outside of medicine. : 2
- I can demonstrate significant leadership or management as a postgraduate locally or regionally inside or outside of medicine and/OR including partaking in clinical leadership fellow post. : 3
- I can demonstrate a national or international commitment to leadership or management inside or outside of medicine such as expedition leadership Duke of Edinburgh leader and/OR I sit/sat as trainee representative at a national committee/working party OR I have significant responsibility within e.g. BMA, GMC, RCoA. : 4