Vocational Training Guide - New (Feb 2004)
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HONG
KONG COLLEGE OF ANAESTHESIOLOGISTS
VOCATIONAL
TRAINING GUIDE FOR ANAESTHESIOLOGY
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1. VOCATIONAL TRAINING PROGRAMME
1.1 Only
Members of the College who are registered as trainees with the Education
Committee of the College may have their experience accredited towards their
vocational training programme requirements as described hereunder.
1.2 These
requirements will apply to all trainees joining the training programme on or
after 1st January 2005 unless otherwise specified.
1.3 Members
of the College must register as trainees with the College within six months of
the start of training for the training experience to be accredited, otherwise
they will have their experience assessed and accredited as for anaesthetists
being trained overseas as specified under Section 1.4.
1.4 Trainees
with previous training in overseas training programmes or other non-approved
positions will have their experience considered and accredited
individually. A fee for such an
assessment will be charged in proportion to the duration retrospectively
approved subject to a minimum charge.
The fee will be determined by Council from time to time. They will need to become Members of the
College and register as trainees before any further experience can be
considered for accreditation.
1.5 Vocational
training in anaesthesiology shall consist of not less than six years after full
registration with the medical registration authority.
1.6 The
six-year vocational training programme in anaesthesiology shall be full-time
and shall consist of the following components :-
1.6.1
Non-anaesthetic clinical experience 6
months
1.6.2 Clinical
Anaesthesia 48
months
1.6.3 Intensive /
Critical Care Medicine 3
months
1.6.4 Elective Options 15
months
1.7 Non-anaesthetic
clinical experience [referred to under section 1.6.1] must be obtained in
training
units
approved by an Academy College in Hong Kong. Training in the other units will
be individually approved by the College. Internal medicine, paediatrics,
emergency medicine, intensive care and pain medicine are examples of recognised
non-anaesthetic clinical experience.
1.8 The
Clinical Anaesthesia experience [referred to under section 1.6.2 and 1.6.4]
must include an adequate exposure to all of the following CORE areas in
anaesthesia. To ensure adequate exposure, a trainee is expected to have managed
a minimum number of cases in each core subspecialty1 ( as defined in
the brackets ) over the 6 years of training
1.8.1 anaesthesia for general
surgery /urology /gynaecology (500 cases)
1.8.2 anaesthesia for
orthopaedics and traumatology (500 cases)
1.8.3 obstetric anaesthesia
(100 cases) and obstetric regional analgesia (50 cases)
1.8.4 neuroanaesthesia (100
cases)
1.8.5 thoracic anaesthesia
(50 cases)
1.8.6 paediatric anaesthesia
(100 cases of children < 6 years, including neonates)
1.8.7 anaesthesia for Head
& Neck / ENT/ Oro-facio-maxillary (100 cases)
1.8.8 emergency / trauma anaesthesia (500 cases)
1.8.9 acute pain management
(300 patient-days)
1.9 Apart
from the CORE areas, some experience in each of the following NON-CORE
subspecialties1 would be required, particularly for future
subspecialty development. Trainees will be required to complete two modules
from category 1 and a minimum of 20 cases from category 2.
1.9.1 Category 1 NON-CORE
modules
1.9.1.1 ophthalmic
anaesthesia ( 50 cases)
1.9.1.2 day surgery
anaesthesia ( 100 cases)
1.9.1.3 anaesthesia
in non-operating theatre locations including but not limited to Organ Imaging
Suite, Endoscopy Suite, Cardiac Catheterisation Laboratory, ECT (50 cases)
1.9.1.4 pain
medicine ( 50 chronic / cancer pain cases)
1.9.2 Category
2 NON-CORE Modules
1.9.2.1 major vascular
anaesthesia
1.9.2.2 cardiac
anaesthesia
1.9.2.3 transplant
anaesthesia
1.9.2.4 neonatal
anaesthesia
1.10 Elective
options [referred to under Section 1.6.4]
1.10.1 Trainees
may undertake the following or a combination of the following as part of their
elective training :-
1.10.1.1 clinical
anaesthesia
1.10.1.2 intensive / critical care medicine
1.10.1.3 pain medicine
1.10.1.4 other clinical
specialties apart from anaesthesia, intensive / critical care medicine and pain
medicine
(most of the hospital based specialties will be accepted except pathology)
1.10.1.5 research
related to anaesthesia and/or intensive / critical care medicine and/or pain
medicine
1.10.2 With
effect from 1st July 2004, training in elective options in clinical
anaesthesia, intensive / critical care medicine and pain medicine must occupy a
training post approved by the College. Training in elective options in other clinical
specialties must be in training units approved by the College or the respective
specialty College in Hong Kong. In
case of doubt, prior approval from the College will have to be sought. Research
positions must have prior approval of the College.
1.10.3 Elective
options are subject to the following limitations :-
1.10.3.1 Not more than
12 months may be spent in research.
1.10.3.2 Not more than 6
months in any clinical specialties referred to under 1.10.1.4
1.11 The
minimum period of hospital appointment for approved training is three months.
1.12 Vocational
trainees shall undergo rotational training in accredited hospitals in approved
rotation schemes / programmes
endorsed by the College.
1.13 All
trainees are required to carry out and submit a Project to the Education
Committee to demonstrate an understanding of research and research methods in
medical practice. The
submitted Project must have received approval from the Education Committee
before vocational training is considered complete.
1.14 All
trainees joining the training programme on or after 1st January 2005
are required to complete satisfactorily the EMAC (Effective Management of
Anaesthetic Crisis) course or its equivalent.
1.15 Registered
trainees may sit the Intermediate Fellowship examinations of the College at any
time. The Final Fellowship
examination may be taken after completing at least four years of approved
training with at least three years of approved anaesthetic training.
1.16 If
trainees fail to complete all requirements for Fellowship at the end of their six-year
vocational training period, they are given a further period of three years to
complete their Fellowship requirements without the need to occupy a training
post. If they fail to complete
Fellowship requirements within that time, they must rejoin the vocational
training programme for at least one year and until completion of all
requirements. During the
three-year non-training period pending completion of Fellowship requirements,
they must be in clinical appointments, otherwise they must be individually
considered by the Education Committee.
1.17 Trainees
who repeatedly fail at examinations should be counselled after every third
attempt for the same examination or at the end of the six-year vocational
training period if they have not completed all examination requirements.
1.18 Trainees
who, for whatever reason, stop vocational training and restart training must
not have an interruption of more than three years in order to have their
previous approved training counted fully.
The period of interruption must have been spent in clinical
appointments. If these conditions
are not fulfilled, their case will be assessed individually by the Education
Committee.
1.19 Vocational
trainees shall acquire their necessary clinical anaesthetic training experience
at accredited hospitals within the rotation programme involving more than one
accredited hospital.
1.20 Each
vocational trainee shall keep a LOG BOOK in the approved format to
document all cases handled. The HKCA electronic log-book will be compulsory for
trainees receiving their training in Hong Kong with effect from July 2004. The log book should be audited by the
Supervisor of Training of accredited hospitals at least annually to ensure
adequate exposure to the various CORE and NON-CORE sub-specialties available in
the hospital, having regard to the previous training experience of the
trainee. The Supervisor of
Training is responsible for the certification that the case load experience
meets the requirements that may be stipulated by the Education Committee from
time to time. The Log Book(s) will
be subject to the scrutiny of the Education Committee on demand.
1.21 For
the purpose of accreditation of training, individual hospitals shall be
accredited for training in clinical anaesthesia referred to under 1.6.2 in the
different CORE / NON-CORE subspecialties.
1.22 All trainees have to
undergo regular In-Training Assessments (ITA) with effect from 1st July 2004, in accordance with Administrative Instructions for In-Training
Assessment. This assessment complements formal College Examinations and is
intended to focus primarily on the
attainment of clinical skills, attitudes and behaviour for competent
professional practice. The College designated specialist trainers and
the Supervisor of Training will undertake ITA with formal
documentation. All trainee should have
completed ITA satisfactorily before being allowed to attempt the final fellowship examination or exit assessment. When a
trainee consistently ( 2 or more unsatisfactory ITAs) performs below expected
standard, not withstanding repeated documented attempts at remediation, the
Education Committee needs to be consulted. The trainee can appeal to the
College or the Hong Kong Academy of Medicine for any dispute of ITA.
2. FELLOWSHIP EXAMINATIONS
2.1 Candidates
for all examinations must be Members and registered trainees of the
College.
2.2 A
candidate would only be considered for admission to the examination if his
application to sit the examination is received together with the prescribed
fees on or before the deadline for application to sit the examination, which
shall not be more than eight weeks or less than three weeks before the date of
the written examination. Late
applications will not be considered.
2.3 There
shall be at least one overseas external examiner at each examination at the
invitation of the H.K. College of Anaesthesiologists.
2.4 Intermediate
Fellowship Examination in Anaesthesiology
2.4.1 The
Intermediate examination may be attempted at any time.
2.4.2 The
Intermediate examination shall consist of written papers and oral examinations
in the following subject areas :-
2.4.2.1 Physiology
and Principles of Measurement
2.4.2.2 Pharmacology
and Principles of Statistics
2.4.3 The
oral examination shall be held after the written part of the examination. The interval between the two parts of
the examination shall be determined by the Board of Examinations and shall not
be more than eight weeks.
2.5 Final
Fellowship Examination in Anaesthesiology
2.5.1 Candidates
for the Final Fellowship examination must be a Member of the College and a
registered trainee at the time of application. He/she shall also occupy an approved training position at
the time of the examination, except for the provisions under Section 1.16 of
the Vocational Training Programme.
2.5.2 Candidates
must have completed at least three years of approved anaesthetic training at
the time of the examination, and in their fifth or last year of vocational
training, except for the provisions under Section 1.16 of the Vocational
Training Programme.
2.5.3 The
Final Fellowship examination shall consist of written, oral, and clinical
examinations, the format of which will be determined by the College Council
from time to time on the recommendation of the Board of Examinations. Candidates will be examined in all
aspects of Anaesthesia and Clinical Practice.
2.5.4 The
oral/clinical examinations shall be held after the written part of the
examination. The interval between
the two parts of the examinations shall be determined by the Board of
Examinations and shall not be more than eight weeks.
3. ACCREDITATION
3.1 Members
of the College, who fulfil all requirements for training and examinations as
required under the applicable College Regulations & Bye-laws, are eligible
to apply for Fellowship of the College subject to its Memoranda and Articles of
Association.
3.2 The
application by an eligible Member for Fellowship must be supported by two
current Fellows of the College.
The application shall be considered by the Board of Censors and the
Council of the College in accordance with the Memoranda and Articles of
Association and the Regulations & Bye-laws of the College then in
force. The decision of the Council
to elect such a Member to Fellowship or otherwise shall be final.
3.3 Fellows
of the College are considered trained and qualified specialists in the
specialty.
4. The contents of this
document is taken from the relevant documents of the College for the guidance
of trainees and Supervisors of Training.
If any part of this document conflicts with the Memorandum and Articles
of Association, Regulations & Bye-laws, and Administrative Instructions of
the College, the latter documents shall prevail.
Footnote:
1: Please
refer to the Appendix on Definition of subspecialty experience
Promulgated
Jan 1995
Revised
Sept 1997
Revised
February 2004