Vocational Training Guide - Revised May 2015

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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 Board of Education 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 for anaesthesia trainee who joined on or after 1st January 2013 shall be full-time and consist of the following components:

 

1.6.1 Non-anaesthetic clinical experience: 3 months

1.6.2 Clinical Anaesthesia: 48 months

1.6.3 Intensive / Critical Care Medicine: 6 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 Board of Education to demonstrate an understanding of research and research methods in medical practice. The submitted Project must have received approval from the Board of Education 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 Board of Education.

 

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 Board of Education.

 

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 Board of Education from time to time. The Log Book(s) will be subject to the scrutiny of the Board of Education 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 Board of Education needs to be consulted. The trainee can appeal to the College or the Hong Kong Academy of Medicine for any dispute of ITA.

 

1.23 Part-time Training

Part-time training can be allowed during fellowship vocational training with effect from 1st Jan 2006 in accordance with Administrative Instructions for Part Time Training.     

 

1.23.1  Part-time training will be considered on an individual basis and must have prospective approval from the Board of Education.

                         

1.23.2         The specific part-time arrangements must be documented and supported in writing by the Trainee's Head of Department.

 

1.23.3  The trainee must have completed 12 months full time clinical anaesthesia training.

 

1.23.4         No training duration beyond one year of effective full-time equivalent (FTE) clinical anaesthesia training will be recognized in general.

 

1.23.5         Part-time training must result in the equivalent total training duration and training content as is required for full-time equivalent (FTE) Trainees. Out of hours duties may not be mandatory.

 

1.23.6         Duties of Part-time training must be assigned on a pro rata basis and must comprise a minimum of 50% of the commitment of a full-time trainee In general, one year of Full Time Equivalent Clinical Anaesthesia training can be converted to a maximum of two years of Part Time Clinical Anaesthesia training.

 

1.23.7         The minimum duration of part-time training applied for accreditation is 6 months.

 

1.23.8         Normally, the part-time trainee needs to occupy half a FTE training post, and two half-time trainees can share one FTE training post accordingly.

 

1.23.9         Part-time training must involve participation in cluster or hospital teaching activities.

 

1.23.10       Part-time Trainees must maintain an appropriate training record including eLogbook and In Training Assessment to be submitted to the Training Officer so that the workload and training experience can be evaluated accurately.

 

1.23.11       Part-time training requires registration with the College and normal payment of the full Annual Membership Fee as determined by the Council.

 

1.24      All trainees joining the training programme after 30th June 2012 are required to complete the EASE (Exposure to Anaesthesia Safety and Emergency) course in their first year of anaesthesia training.

 

1.25      All trainees joining the training programme after 30th June 2015 are required to complete the Advanced and Difficult Airway Management Workshop for Anaesthetists (ADAM-A) course after their first year of anaesthesia training.


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.

 

2.6 Exemption for non-local candidates: they must be registered trainees or equivalent of non-local postgraduate medical training institutes in anaesthesiology, intensive care medicine, or pain medicine as approved by Council.

 

 

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.

 

3.4       There must be a minimum of 2 years of clinical anaesthesia training after the first 3 years of training.

 

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

Revised November 2005

Revised May 2012

Endorsed by HKCA Council on 9 May 2012

Endorsed by HKAM Education Committee on 20 June 2012

Endorsed by HKCA Council on 5 Sepmber 2012

Endorsed by HKAM Council on 18 October 2012

Endorsed by HKCA Council on 17 June 2013

Endorsed by HKAM Council on 6 August 2013

Endorsed by HKCA Council on 13 April 2015

Endorsed by HKAM EC on 12 May 2015