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Visitors
The Department warmly welcomes visits by anaesthetists, surgeons, perfusionists, technicians, physiotherapists, nurses and medical students from other cardiothoracic centres.
Individuals or groups wishing to visit the Department are invited to contact the Departmental Chairman by mail, fax or email.
We respectfully request that applications from students and doctors in training be accompanied by a letter from their educational supervisor and/or head of department outlining the purpose of the visit and any educational goals.
Papworth Hospital policy requires that visitors sign a patient confidentiality agreement.
Visitors who are not registered with the UK General Medical Council are not permitted direct clinical patient contact.
Company representatives may visit the Department by consultant invitation.
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Medical Student Electives
The Department warmly welcomes elective medical students from the UK and overseas.
Medical students wishing to spend their elective with the Department are invited to contact the Departmental Chairman by mail, fax or email.
We respectfully request that applications from prospective elective medical students be accompanied by a letter from their educational supervisor outlining their educational goals and method of assessment.
Elective medical students are required to register with the Cambridge University School of Clinical Medicine.
Elective medical student positions in the Department of Anaesthesia are generally uncompensated (unpaid).
Elective medical students involved in clinical and/or basic science research projects may be compensated.
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Observers
The Department warmly welcomes anaesthetists, surgeons, perfusionists, technicians, physiotherapists, nurses and medical students from other cardiothoracic centres who wish to spend several weeks at Papworth as observers.
Individuals or groups wishing to visit the Department as observers are invited to contact the Departmental Chairman or College Tutor by mail, fax or email.
Observers who are not registered with the UK General Medical Council are not permitted direct clinical patient contact.
The Department does not generally accept requests to observe programmed educational events such as the course in transoesophageal echocardiography.
The Department currently has no Senior House Officer posts and, therefore, is not in a position to sponsor registration with the Royal College of Anaesthetists or the General Medical Council.
Observers in the Department of Anaesthesia are uncompensated (unpaid).
Observers are responsibile for their travel, accommodation and subsistence expenses.
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Clinical Attachments
Doctors coming from overseas to work in the UK for the first time are strongly advised to undertake a period of clinical attachment to observe UK medical practice. Where possible this should be arranged before travelling to the UK. The specialized nature of anaesthetic and critical care practice at Papworth Hospital is not typical of most UK hospitals. The hospital is not, therefore, suitable for doctors seeking orientation in the UK National Health Service prior to applying for a substantive SHO post in anaesthesia.
The Department warmly welcomes trained anaesthetists who desire further clinical experience before taking up an appointment to a UK consultant post with sessions in cardiothoracic anaesthesia and/or critical care. Applicants must hold a Certificate of Completion of Specialist Training in anaesthesia.
The Department also welcomes applications for short (1-8 week) clinical attachments from anaesthetists in UK training posts who are considering further training, or a career, in cardiothoracic anaesthesia. Applicants must have passed part 1 of the diploma of Fellow of the Royal College of Anaesthetists examination (i.e. MRCA) or hold an equivalent qualification. Applications from anaesthetists in training must be supported in writing by the relevant Royal College tutor or educational supervisor.
The Department does not generally accept requests to observe programmed educational events such as the course in transoesophageal echocardiography.
Applications for clinical attachments should be made in writing using the downloadable application form. All applications must be accompanied by the appropriate fee, which covers the cost of administration, theatre attire, other disposables and beverages
Doctors who are not registered with the UK General Medical Council are not permitted direct clinical patient contact.
Applicants are bound by the terms and conditions of the Trust's Visitor Policy during the duration of their clinical attachment.
Clinical attachments within the Department of Anaesthesia are uncompensated (unpaid).
Doctors are responsibile for their travel, accommodation and subsistence expenses.
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General Medical Council (GMC) Registration
Applications from overseas doctors for full registration by virtue of entry to the Specialist Register is subject to rigorous statutory control by the Specialist Training Authority (STA) and the RCA.
In December 2003 the GMC relaxed its regulations for granting limited registration to doctors from abroad. Prior to this change, doctors from overseas wanting limited registration first had to obtain an "educationally approved post in the NHS". This meant that they had top be appointed to a deanery funded SHO post which could be counted towards the time needed for FRCA examinations and a CCST. In practice the Royal College of Anaesthetists (RCA) was prepared to recognize supernumerary SHO posts towards the Primary FRCA examination (but not CCST) time if the Regional Advisor or RCA Tutor produced a statement confirming that the doctor had received the same training as someone in an educationally approved post.
Under the new regulations the requirement for limited registration is that the doctor must have obtained "a supervised post in the NHS". For anaesthesia direct supervision is defined as: "... the trainee is working directly with a supervisor senior to themselves who is actually with the trainee or can be present within seconds. This proximity maintains patient safety but when appropriate allows a trainee to work with a degree of independence in order to develop confidence."
It is important that doctors coming to the UK from overseas with the expectation of completing a CCST programme recognize the difference between "educationally approved" SHO posts and "supervised" posts providing service at SHO level. Only time spent in educationally approved and deanery funded SHO posts will be recognized towards a CCST. The existing policy of allowing supernumerary SHOs to sit the Primary FRCA examination if they are supported by their Regional Advisor or RCA Tutor will be reviewed.
Before considering a post a foreign doctor should ask the following questions:
- Does the post have educational approval?
If the answer is "no", it may not count towards completion of basic specialist training.
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- Will you receive appropriate induction?
This is important if you are new to UK medical practice and the NHS.
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- What training and educational facilities does the post offer?
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- Will the post allow you to get further training in the speciality and will it be recognized by the relevant training authority?
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- Will the post help you to realize your training & career objectives?
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- When, and how often, will you get feedback on your performance?
This is important for your continuing professional development.
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- If you take a series of short-term locum posts, how will you meet your training needs?
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The current fee for initial grant of limited GMC registration is £390.
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The Overseas Doctors Training Scheme
The ODTS explained (by Dr Preman Jeyaratnam, the RCA Bernard Johnson Adviser)
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 BMJ Career Focus
BMJ Careers 2004;328(7454) - 19 June
According to the GMC, nine out of ten overseas doctors find their first job within 12 months of passing the PLAB. The views expressed in this issue of Career Focus seem at odds with this assertion.>>> What do overseas doctors think?
Download the entire article [PDF 712 kb; 33 pages] or view the index.
Other BMJ Careers articles of interest:
 26-06-04 PLAB is good for you
05-06-04 Writing a winning CV
05-06-04 Growing your CV
05-06-04 European Working Time Directive: the final countdown
29-05-04 How to pass the FRCA
29-05-04 Misinformation, poverty, and overseas doctors
15-05-04 How to many yourresearch and audit work
03-04-04 Modernising Medical Careers - what's all the fuss about?
03-04-04 Swapping on-call shifts: a guide for junior doctors
28-02-04 What will happen in the UK when the 10 accession states join the EU?
10-01-04 The Hospital at Night
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PLAB Examination exemption
For doctors who have qualified outside the UK of European Economic Area the normal requirement for limited GMC registration is passing the Professional and Linguistic Assessments Boards (PLAB) test. In certain cases, however, the GMC will grant exemption from the PLAB test to doctors who are sponsored by the RCA's Overseas Doctors Training Scheme (ODTS).
The GMC's minimum requirements are:
- A basic medical qualification acceptable to the GMC.
- A minimum of 12 months as an intern / pre-registration house officer.
- To have been qualified for at least 3 years and be in 'good standing' with their Medical Regulator.
- To demonstrate a knowledge of English (at least band 7.0 in each of the four parts of the IETLS test).
- To have not previously attempted any part of the PLAB test.
The RCA's requirements are:
- To be working, or have worked within the last 6 months, in their home country.
- Supportive references from two supervising consultants or recent employers.
- A postgraduate qualification in anaesthesia requiring at least 3 years of clnical training, awarded by a national qualifications board (e.g. India: Diplomate of the National Board; Hong Kong: Fellowship of the Hong Kong College of Anaesthesiologists; Pakistan: Fellowship of the College of Physicians and Surgeons of Pakistan).
In special circumstances the RCA may agree to sponsor doctors who do not fulfil this criterion when;
(i) the applicant's overseas referees are distinguished medical prcatitioners who hold the FRCA or equivalent qualification and are known personally by a UK based consultant, and
(ii) the UK based consultant is prepared to assist the applicant in securing a suitable training post and ensure appropriate supervision.
Entry to the specialist registrar (SpR) grade and CCST programmes is competitve and by no means gauranteed. A minimum of 12 months experience in a medical specialty other than anaesthesia is usually required.
Once accepted for sponsorship by the ODTS applicants are responsible for finding a suitable training post. The post must be approved for training by the Postgraduate Dean (i.e. SHO, SpR, FTTA).
In exceptional circumstances sponsorship may be granted to a doctor who is offered a post that is not recognized by the Postgraduate Dean (e.g. Clinical Fellow, Research Fellow), where training objectives can be identified by the educational supervisor and approved by the RCA. Time spent in such posts will not count towards the CCST programme.
The current fee for administration of sponsorship by the RCA is £530.
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IELTS Examination
The International English Language Testing System (www.ielts.org) is a test of English for people who do not speak English as their first language but intend to study or train in English. It tests reading, writing, listening and speaking ability and provides results in an easy-to-understand band score.
The test consists of four parts, taken in the following order:
Part
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Description
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Time
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Listening
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4 sections, 40 items
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30 minutes
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Reading
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3 sections, 40 items
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60 minutes
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Writing
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2 tasks, 150 & 250 words
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60 minutes
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Speaking
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3 sections, Introductions & General Questions, Short Presentation, Discussion
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10-15 minutes
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FRCA Examinations
See: http://www.rcoa.ac.uk/docs/2002-2003examregs.pdf
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Primary FRCA
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90 MCQs
Pharmacology, physiology, biochemistry, physics and clinical measurement (3 hours)
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Objective structured clinical examination (OSCE)
16 stations in 100 minutes
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Structured viva voce examination I
Pharmacology, physiology, biochemistry (30 minutes)
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Structured viva voce examination II
Physics, clinical measurement, equipment, safety, clinical topics (30 minutes)
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Final FRCA
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90 MCQs
Medicine, surgery, anaesthesia, pain management, basic sciences, clinical measurement, intensive therapy (3 hours)
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Short answer question (SAQ) paper (12 compulsory questions)
Principles & practice of anaesthesia (3 hours)
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Clinical anaesthesia viva voce examination (50 minutes)
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Clinical science viva voce examination (30 minutes)
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Candidates for the Primary FRCA examination must
- be eligible for full or limited GMC registration, and
- be registered with the RCA as a postgraduate trainee in anaesthesia - or be exempt from registration by virtue of not being in a UK training post at the time of sitting the examination, and
- have completed of 12 months in UK or Republic or Ireland training posts approved by the RCA / FARCSI.
Doctors are not eligible to enter for the Primary FRCA examination if they have attempted and failed
- part 1 of the three part FRCA examination 6 times, or
- the Primary FRCA examination 4 times, or
- the Primary FRCA examination twice and not attended mandatory guidance.
Candidates for the Final FRCA examination must
- be registered with the RCA as a postgraduate trainee in anaesthesia - or be exempt from registration by virtue of not being in a UK training post at the time of sitting the examination, and
have passed the Primary FRCA examination, and
- have completed 30 months in UK or Republic or Ireland training posts approved by the RCA / FARCSI, and
- have less than 5 years of training remaining, and
- be in good standing with the RCA.
Doctors are not eligible to enter for the Final FRCA examination if they have attempted and failed
- the Final FRCA examination 6 times, or
- the Final FRCA examination 3 times and not attended mandatory guidance,
Candidates for the Final FRCA examination may be exempt from passing the Primary FRCA examination if they hold any of the following:
- Part II FRCA or Primary FFARCSI on or after October 1999
- Part II FFARCSI prior to October 1999
- FFARCSI
- MD(Anaesthesiology) - University of Columbo, Sri Lanka
- Master of Anaesthesia - University of Khartoum Sudan (1989, 1990, 1992-)
- Master of Medicine (Anaesthesia) - National University of Singapore (1991-)
- Fellowship in Anaesthesiology of the College of Physicians & Surgeons Pakistan (April 1998-)
- FANZCA
- FCA(SA)
- Certificate of the American Board of Anesthesiology
- Fellowship in Anaesthesia of the Royal College of Physicians of Canada
- Fellowship of the Bangladesh College of Physicians & Surgeons (July 1999-)
- Fellowship of the Hong Kong College of Anaesthesiologists (Jan 2001-)
- European Diploma in Anaesthesiology and Intensive Care of the European Academy of Anaesthesiology
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General Warning:
The information provided above has, in part, been obtained from a number of on-line sources, including:
The information provided is only a guide and subject to change. No warranty is given to its veracity.
Doctors from overseas who are interested in seeking training and/or a career in cardiothoracic anaesthesia and/or critical care are strongly advised to contact the above agencies directly for the latest information.
JEA/JHM 2003 (Rev 01,05-2004)
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