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THE TRAINING PROGRAMME

IN ANAESTHESIOLOGY, PAIN
AND INTENSIVE CARE MEDICINE

MALTA
The official training programme leading to specialist registration in
Anaesthetics and Intensive Care Medicine in Malta.

-Association of Anaesthesiologists of Malta-

JANUARY 2015

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Table of Contents
Forward p3
Section 1: General Overview ............................................................................................ p4
1.1 Aim
1.2 Objectives
1.3 Entry Requirements
1.4 Minimum Duration of Training
1.5 Maximum Duration of Training
1.6 Suspension or Termination of training

Section 2: The structure of training ................................................................................ p7
2.1 Basic Specialist Training
2.2 Higher Specialist Training
2.3 Training modules

Section 3: Trainee Progression ......................................................................................... p10
3.1 Yearly progression
3.2 The first six months of training -The Initial certificate of competence
3.3 Progression from BST to HST
3.4 Completion of Training

Section 4: The evaluation of progress .............................................................................. p12
4.1 Workplace assessment tools
4.2 Annual in-training assessments
4.3 Annual appraisal with the training coordinators
4.4 Educational events
4.5 Audit, Research and other academic activities
4.6 Core Skill Lectures

Section 5: The European Diploma in Anaesthesiology and Intensive Care ..................... p17

Section 6: Certificate of Completion of Training and Inclusion in the Specialist Register p17

Section 7: Recognition of Training Institutions in Malta and abroad .............................. p18

Section 8: The training committee ................................................................................... p19
6.1 Composition
6.2 The Training Coordinators

Section 9: The Mentorship scheme.................................................................................. p 20

Section 10: Obligations of trainees and trainers .............................................................. p 21

References

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1 In the following text. race. The AAM committee ii) SAC approval date The Association of Anaesthesiologists of Malta (AAM) and the Maltese Specialist Accreditation Committee (SAC). v) Equal Opportunities This document aims to provide equal opportunities to all trainees irrespective of gender.i) Forward This document is a revision of the Anaesthesiology Training Programme Malta . religious beliefs and differently abled individuals. after consultation and to the best possible knowledge of all involved. We also hope that future graduates in anaesthesiology will remain loyal to our profession. approved this document as the sole and official training document leading to specialist accreditation in Anaesthesiology and Intensive Care to be followed in the Malta. be trustworthy and pass on their achievements to the next generation of anaesthesiologists.May 2008. the term Anaesthesiology is taken to refer to the specialty as whole. Our previous experience in training. 1 We are hopeful that following this curriculum. In this edition we have moved from a simple time based and rotation programme. has shaped this document. Any references in the text relating to the male gender are equally applicable to the female gender. who are able to train successfully to become independent specialists and professionals. which go beyond the basic clinical requirements and aim for excellence. sexual orientation. trainees in Anaesthesiology will become safe. We wish good luck to all future trainees. We have also introduced new achievements to be met. including Anaesthetics and Perioperative medicine. knowledgeable and skilled anaesthetists. The AAM will not accept any responsibility for any untoward consequences suffered by prospective candidates or third parties. This document has been approved by the SAC on the 13th January 2015 iii) Commencement date This document shall be the official anaesthetic training document to follow from the 1 st of February 2015 iv) Disclaimer This Document has been written in good faith. which is now beyond its tenth year. Page 3 . thus making the expectations of both trainees and trainers easier and clearer. Intensive & Acute care medicine and Pain management. We have set out new rules and boundaries. to a modular and competency based curriculum.

which includes Anaesthetics & Perioperative Medicine.  Registration with the Medical Council of Malta. Intensive & Acute care Medicine and Pain Management. This includes basic sciences.  Nurture team work and good character traits within the environment where the specialty is practiced. It is advisable that the members on the selection board should include one of the anaesthetic training coordinators. (On the Principal list).  Involvement in the improvement of work practices through audit and clinical guidelines.1 Entry into 1st Year Basic Specialist Training (BST) By the date of commencement of the BST post.3. acute medicine and resuscitation.3 Entry Requirements 1. Obstetrics. clinical anaesthesia. prospective candidates must be in possession of:  An Undergraduate Degree in Medicine and Surgery recognized by local authorities.  A License to practice medicine in Malta  The Foundation Achievement of Competence Document (FADC) or equivalent  Sufficient linguistic capabilities to communicate with patients and colleagues Work experience in the Accident and Emergency department. Prospective candidates should seek to attend an observational taster week in the specialty during their Foundation Years. The prospective candidates will be chosen after a competitive interview by a selection board. Candidates need to be certified ALS providers. intensive care medicine.2 Objectives  The achievement of in-depth.  Achieving excellence by facilitating the exchange of ideas. ENT and Cardiology are considered an asset during the selection process to join the anaesthetic training program. Paediatrics. accurate and up to date knowledge in the specialty of Anaesthetics and Intensive Care. 1. training in approved foreign institutions and research. acute and chronic pain.  Ensuring safety during clinical practice by encouraging governance. Page 4 .1 Aim The aim of the Training Programme in Anaesthesiology. Pain and Intensive Care Medicine in Malta is to offer an interesting and challenging framework for the postgraduate training of medical doctors committed to attain specialist status in the specialty of Anaesthetics and Intensive Care.  The achievement of skills necessary to work as an independent specialist in Anaesthesiology.Section 1: General overview 1. 1.

shall include duties in the Operating Theatres. may be counted towards attainment of specialisation in Malta. The maximum duration of training will be extended beyond the four years at BST level and hence beyond the total ten year period on a pro-rata basis. only. The out of hours work. A pregnant trainee has a right of up to a maximum of eighteen weeks of maternity leave (in addition to the normal entitlement of leave). 1. however the minimum number of hours worked in a week must be not less than equivalent half-time. Labour ward. Part-time duration is pro-rata. Trainees who intend to sit for the European exam in Intensive care medicine EDIC will need to have a minimum of 24 months experience. a minimum of 1 duty per week). according to current employment laws.1.e.4.1 are met.3. Any further parental leave will lead to the training being put on hold. However a maximum of one year training in approved foreign teaching institutions.3.2 Part-time Training Part-time training is allowed subject to approval by the training committee. The trainee can only secure a BST or HST post after being successful in a competitive interview. The time working in anaesthetics. All modules and competencies have to be completed none the less. as long as the criteria in 1. as described in section 2. that is. in a Maltese teaching hospital. 1. depending on individual experience and the modules which are being completed.4.2 Entry into subsequent years of training The training committee may approve entry into the training programme in subsequent years of training depending on the experience of the trainee.3. 1. On-call duty commitments must also be worked pro-rata and all necessary commitments have to be abided to. 1. as in full time training. Page 5 . cover for resuscitation and transportation of sick patients.1. It is recommended that the trainee performs a minimum of 48 hours/week on average of which approximately a third should be out- of-hours work (i. The rights of fathers to be are also respected.1 Intensive Care It is essential that the trainee spends a minimum of 12 months full time commitment in intensive care medicine during training.4 Minimum Duration of Training period The minimum duration of specialist training in Anaesthesiology shall be of 5 years in full time practice or equivalent part-time/reduced hours practice. a further year after the training period is finished.3 Training during pregnancy The training coordinators will try to assign modules so to accommodate the pregnant trainees’ requests. a number of modules may have to be repeated if deemed necessary by the training committee.4. If more than 18 months are spent out of training. can be counted retrospectively towards attainment of specialisation and provided the training curriculum is followed. Intensive Care Unit.

 Persistent failure on the trainee’s part to show interest in pursuing a career in anaesthesia  A long term illness/disability which may temporarily or permanently affect the potential of the trainee in becoming an independent specialist. Failure to complete the training within the stipulated time will inevitably lead to redeployment in the appropriate staff grade. The SAC may appoint a body of experts who will evaluate the case. Page 6 .1. The decision taken by the SAC shall be final.  A trainee commits a serious and deliberate act of unprofessionalism. excluding maternity. The trainee can appeal against the decision taken by the Training committee (TC) to the Specialist Accreditation Committee (SAC). Valid reasons include working in a specialty post abroad. The maximum allowable time for such leave is determined by the civil service rules. 1.4 Training Sabbaticals A trainee may request a sabbatical for up to a year. 1. it is up to the Chairman of Anaesthesia to grant any absence from work. may thus be reassigned according to the exigencies of the service. During suspension of training the time limits detailed in section 1.5 remain in place. A formal request in writing has to be received by the training committee at least three months in advance. voluntary work and family reasons as detailed in the civil service code of practice. The training committee.5 Maximum Duration of Training period The maximum time period allowed as a Basic Specialist trainee is 4 years. but the trainee. All the evidence must be presented in confidence. sick or responsibility leave as laid out in Medical Class Sectorial agreement. The appeal has to reach the SAC within forty five days from the date of communication of the TC’s decision. except in cases of sickness. Termination of training does not constitute dismissal from work. parental. The training program in anaesthesia has to be completed fully within 10 years from the start of specialist training.  The maximum time for training is exceeded. using a secret ballot.6 Suspension or Termination of training Training may be suspended or terminated at any time when:  A trainee is deemed responsible for a serious incident where the safety of patients or colleagues has been compromised. Although the training committee can give a positive recommendation. reserves the right to request the trainee to repeat a number of modules when more than 18 months are spent out of training. as laid out in Medical Class Sectorial agreement. as described above  The trainee wishes to discontinue his training The particular case will need to be discussed at trainee committee level and also through the civil service channels if necessary. however. At least five committee members should be in favor of suspension or termination.4.

5.2 Higher Specialist Training (HST) HST will be covered during the latter three years of training. including all the main specialties. which have to be used at all stages of training and which are assessed continuously during training. Thereafter they are allowed to work under indirect supervision. so that by the end of completion of training. Thus the minimum number of modules to be completed shall be fifteen. The first ITU module should be assigned in the second year. Trainees at any level of training are expected to discuss unfamiliar. is available on-site when help needed (HST. excluding cardiothoracic theatre cases and paediatrics cases under three years of age (or < 15kg). The duration of each module shall be of four months. Trainees at this stage can however use their skills in history taking. 2. The training programme in anaesthesia consists of a modular structure which is spread over a minimum of five years. Both Basic and Higher Specialist Training have to be completed within the time frame as detailed in Section 1. 2.5 During HST the trainee will be expected to consolidate the knowledge and clinical work in all fields of anaesthesia.1 Supervision during BST During the first 6 months of training basic specialist trainees should work in the theatre environment under direct supervision1. During this period the trainee will be exposed to general clinical work. The aim of this initial training is to grasp the basic knowledge and skills needed to work safely in anaesthesia and intensive care.1 Supervision during HST Higher specialist trainees are allowed to work under distant supervision3 during elective and on- call general commitments and in specialties after completion of the first module in that specialty. The aim of the latter years of training is to slowly shoulder more responsibility in patient care.1 Basic Specialist Training (BST) BST will be covered during the first two years of training. At the end of the 6 months.2. Page 7 . Discretion and common sense on part of the trainee are important non-clinical skills. unusual and difficult cases anytime with their immediate senior anesthetist. 3 Distant supervision: The trainee can work in theatre & ITU with a senior colleague readily available for advice. the trainee can work independently. 2. The above applies for both elective work and on-call commitments. resident specialist or Consultant grades). 1 Direct supervision: The trainee has to be constantly supervised in theatre & ITU at all times 2 Indirect supervision: The trainee may be allowed to work in theatre & ITU while a nominated senior person. 2. ITU and some subspecialties of anaesthesia. The BST has to be completed within four years as detailed in Section 1. clinical exam and obtain peripheral venous access under indirect supervision2.1. The list of competencies and assessments that need to be achieved will be provided by the training coordinators. the trainee has to achieve the initial competencies in anaesthesia.Section 2: The structure of training.

3 Training modules Trainees should rotate progressively through a minimum of fifteen modules during five years of training. 8 months  Urology and Vascular surgery One module at any level of training 4 months  Plastics and Dental surgery One module at any level of training 4 months  Neurosurgery. outreach and patient transport One module at BST level and Two modules at HST level 12 months  Obstetrics Two modules. Trauma and regional anaesthesia. 8 months  Paediatrics and ENT Two modules. One module at BST level and One module at HST level 8 months  Intensive Care including patient resuscitation. The first module should be completed within the first three years.  General Surgery module including Gynaecology One module at BST level 4 months  Orthopaedics. Occasionally extra-modules are assigned depending on overall availability of training slots. A certificate of completion of training cannot be issued unless all the fifteen modules below are completed. The first module should be completed within the first three years. Advanced General Surgery and Emergency anaesthesia One module at HST level 4 months  Chronic Pain One module at HST level 4 months  Cardiac and Thoracic One module at HST level 4 months Page 8 .2.

before the training can be recognized for the purposes of specialist accreditation by Maltese authorities.3. The Post-graduate training center may from time to time seek training agreements with foreign institutions for the pursuit of training abroad in anaesthesia and intensive care.1 Completion of Modules A module is completed when the following criteria have been met: 1.  maintenance of a detailed log book of all cases and procedures.1 to support his request.3. as determined by the training committee from time to time. will be at the discretion of the training committee who will advise the SAC accordingly. 2. Page 9 .3. The evidence necessary shall be determined from various sources.  any related courses or conferences 2.2.2 Training abroad Trainees are encouraged to get work experience in a foreign training institution during their HST years.1. the approval of training and work in teaching institutions abroad. The trainees are to present evidence of satisfactory completion of the modules undertaken as specified in section 2. The trainees are responsible to obtain approval by the Anaesthesiology Training Committee prior to the start of such training. The trainee has to provide equivalent documentation as described in section 2. The trainee has to provide evidence of satisfactory performance during his attachment. The trainee spends at least 75% of his elective work in relevant clinical and non-clinical duties pertaining to that specialty during each module. This should include:  attainment of signed competencies for each module. An adequate number of cases for the level of training will be ascertained by the training coordinators during the annual appraisal  satisfactory feedback and workplace assessments by the supervising consultants. The Anaesthesiology Training Committee is required to inform the SAC and the Post-graduate training center that the training abroad is of an adequate quality and is being undertaken in a training institution. The maximum time which can be approved is one year.3. In the case of doctors who wish to join the Maltese anaesthetic training programme at later stages of training. Whilst the trainees are strongly advised to participate. A maximum of one year training in an approved foreign institution will be recognized for the purposes of specialist accreditation by the Specialist Accreditation Committee (SAC). they should be reminded that by participating they will be bound by the terms and conditions specific for each agreement.

3  A satisfactory initial competence certificate  A pass in the second annual in-training assessment.  A satisfactory annual appraisal with the training co-coordinators Page 10 .Section 3: Trainee Progression 3. The following conditions have to be met:  Satisfactory completion of six modules as per section 2.2 The first six months of training .  A satisfactory annual appraisal with the training co-coordinators  A pass in the annual in-training assessment 3. sat within the first two years of training. needs to be completed before the trainee can proceed to his second year.3 Certificate of Completion of Basic Specialist Training (CCBST).The Initial certificate of competence Trainees are required to achieve the following basic competencies by the end of their first 6 months in:  Anaesthetic Machine Check  Safe Conduction of a Rapid sequence induction  Advanced life support  Pre-operative assessment  Advanced airway management  Safe delivery of a general anaesthetic to ASA1 and ASA2 patients for minor to intermediate surgery  Sound clinical judgment and behavior These shall be assessed formally using the validated tools provided by the training coordinators. A CCBST is awarded after satisfactory completion of a minimum of two years in anaesthetic training. This may include a separate MCQ assessment.1 Yearly progression A trainee has to achieve the following before he/she can be progress on to the next year of training:  Completion of the three modules which have been assigned during the previous year. 3. An initial certificate of competence supporting the above.

even if the appointment to an HST post is delayed for reasons beyond the remit of the trainee or the training committee. The appointment to an HST post is subject to a successful performance during a competitive interview. provided the progression of training is satisfactory.4 Progression from BST to HST Trainees are eligible to apply for HST after they are awarded the CCBST. for inclusion in the specialist register at the end of their training. Page 11 .2. which shall be said to be complete when all the following conditions are met:  a minimum of five years of approved anaesthetic training  completion of all fifteen modules with the relevant supporting documentation  a pass in at least five in-training assessments (see Section 4. Therefore the date of completion of training shall be the date when the last of the above is attained.5 Completion of Training The trainees are approved by the training committee and recommended by the AAM to the SAC.3. 3.3)  a pass in the final part of the European diploma in anaesthesiology (EDAIC)  a satisfactory final appraisal with the training co-coordinators All of the above conditions have to be met before the trainee can be recommended for inclusion in the specialist register. The training from BST to HST shall be deemed as continuous.

1. Eight TSAFs are to be completed at the discretion of the trainee.Section 4: The evaluation of progress Trainees’ progress shall be evaluated by using the following:  Workplace assessment tools leading to a Competency certificate for each module  Annual in-training assessments  Annual appraisal with the training coordinators  Attendance and participation in educational events  Completion of audit and research 4. 4. 4. while another two TSAFs will be allocated on the day by the training coordinator.1. The trainee should inform the consultant with whom he is attached ideally the day before. The cases ideally have to be assessed each by a different consultant in the specialty.1 Workplace assessments tools During each module the trainee has to achieve a safe level of competence in different aspects of the specialty. A competency certificate cannot be issued unless the training coordinator (or the clinician with special interest delegated) is positive that the criteria have been achieved. These objectives shall be given to each trainee at the start of each module. 4. A topic related to the module should be agreed beforehand which the trainee can prepare and expect to be asked about. A series of objectives have to be achieved by the end of the module. The criteria will be assessed in different ways.  In addition each trainee has to be assessed for a minimum of four other different cases in the conduct of an anaesthetic (or a related procedure) in theatre under supervision as relevant to the specialty.1. A list of DOPS that have to be achieved during the first 6 months and during each module shall be made available to the trainees. that an assessment form is to be completed. using a set of validated assessment tools and as specified in the specialty competency documents.1 Anaesthesia Clinical Evaluation Exercise (A-CEX)  Each trainee has to be assessed in the preoperative evaluation and anaesthetic planning for a minimum of four different cases relevant to the specialty. Page 12 .3 Theatre Session Attachment Form (TSAF) Trainees need to hand a total ten TSAFs during each module.2 Direct Observed Procedural Skills (DOPS) Trainees shall be formally assessed by direct observation while performing various skills throughout their training period. A list relevant to each module shall be made available to trainees.

Failure to achieve competence in the allotted time may require repetition of the module.6 End of Module Competency Certificate (CC) At the end of each module.5 End of module feedback (EMF) Near the end of each module. During the yearly appraisal the training coordinator shall make sure that the Competency Certificates for the essential modules from the previous year have been completed. with whom each trainee has worked during that module. during their five years of training. Trainees are exempted from the annual in-training assessment while they are pursuing their training in an approved center abroad. The trainees need to sit and obtain a pass in order to progress into the next year of training. Assessments from at least five different consultants should be obtained. During the ITU modules the Cobatrice template can be used to assess progression. The AiTA has to be taken at yearly intervals. using it as a tool for improvement in the trainee’s performance. It is important that half of the cases are actual patients that the trainee has been actively managing. 4. During ITU and chronic pain modules the equivalent forms shall be used.4 Case Based Discussions (CBD) The trainee has to complete a series of discussions about various aspects of case management. the training coordinators shall obtain in confidence. The Consultant should give feedback to the trainee (what went well and what can be improved). 4. a Competency Certificate shall be signed by the lead clinician in that specialty and a training coordinator.2 Annual in-training assessments (AiTA) A summative assessment shall be organized by the training committee at yearly intervals.1. These can be completed during theatre attachments or as a series of tutorials. The competency certificate for each module shall have a list of objectives that have to be met and the workplace assessment tools to complete them. Trainees need to sit and pass a minimum of five in-training assessments. However at the end of each module a signed document by two ITU consultants has to be handed to the training coordinators witnessing satisfactory completion of the module. The training coordinator can only sign the certificate when all the assessments and feedback have been received. in cases were the duration of training goes beyond the fifth year. 4. The aim of this feedback is both formative and summative. 4.1. The cases that need to be discussed are found in the list of competencies that need to be achieved for that module. Page 13 .1. at least three EMF forms from three different consultants.This form should be completed by the consultant at the end of the session and handed to the training co-ordinators by the trainees. The trainee cannot progress further until all modules have been signed off which may mean that the total training time has to be extended.

Thoracic & Neuroanaesthesia) Intermediate intensive care and emergency management Domains:1.2.6 and 2. Cardiac.5 4th to 5th year Advanced level case management for surgery.6 (Refer to EBA guidelines) 2nd to 3rd year A thorough understanding of basic scientific principles. Advanced intensive care and emergency management.1 to 1. Basic level case management for surgery including regional anaesthesia Basic intensive care and emergency management. & ENT/airway management) Intermediate intensive care and emergency management. 2. This document should guide the depth and breadth of the curriculum to be followed in Malta. Intermediate Specialty case management.1 to 1.2. 2.2.4 . Level Focus Topics for Annual In Training Assessment 1st to 2nd year An understanding of basic scientific principles Basic level case management for surgery. Page 14 .1 . Domains:1. subject to constraints in the local resources. Domains:1. Paediatrics. Common anaesthetic emergencies Domains:1. 2.1.1 Guideline topics for the in-training assessment The aim of the yearly AiTA should be to test on particular relevant subjects for the level of training.1 to 1.4.6 3rd to 4th year Intermediate level case management for surgery. Basic Specialty case management (Obstetrics. As a guide please refer to the table below.6. management and appraisal of literature All Domains The Maltese center has been accredited as an official training center for the preparation and sitting the European Diploma in Anaesthesia and Intensive Care Medicine.7 End of 5th year Advanced level case management for surgery.4. Ethical principles.6 and 2. 2.3. Pain and intensive Care” issued by the standing committee on education and training of the Section and Board of the European Society of Anaesthesiology.1 to 1. Basic Specialty case management (Pain. Hence the trainees and trainers should make themselves familiar with the “Syllabus to the post-graduate training in Anaesthesiology.

4 Resit sessions A resit session within six months shall be provided for candidates who fail the initial session. If the training is not complete after a year from passing the end of 5th year AiTA. During the remedial year. the trainee will have to repeat that year of training. this has to be repeated at yearly intervals. Good and adequate knowledge 1+: Fail.1+ in any of the sections. any of the available modules may be assigned as appropriate to the level of training. The minimum acceptable marks for a pass is 2.2 The structure of the AiTA The date and exact format of the in-training assessment shall be determined by the training committee at least three months before. each lasting 40 minutes. Thorough understanding of principles and clinical applications 2 : Pass. The training has to be completed within 1 year of the last AiTA. 4.2. Four separate marks should be obtained. Each viva is to be given by two different consultant anaesthetists. The trainees should be given at least two months notice of the agreed format. who will each give a mark on the performance of the candidate. Serious lack of understanding of basic principles or lack of safety 4. If a pass is not achieved in the resit session. Some deficiencies in knowledge are present in parts of the exam 1 : Bad Fail. once he/she become an independent practitioner. Page 15 . hence it is very important.2. Scoring 1 in any section is an outright fail and the candidate will have to do a resit.3 The end of the 5th Year AiTA The end of 5th year AiTA is usually the final assessment before the completion of training. Ideally one foreign examiner should be invited to participate in the assessments. The assessment may consist of two vivas. The main aim should be to ascertain that the trainee has attained the expected level of clinical acumen in all specialties of anaesthesia and is able to show an understanding of the responsibilities and roles which an anaesthetist is expected to fulfill.2. or at the first available date after the trainee fulfills the other criteria for completion of training. The trainee in such case should have an urgent meeting with the training coordinator detailing a way for improvement. The marks shall consist of the following: 2+: Outstanding performance.4.2. The trainee coordinator will inform the training committee regularly on the progression of the trainee.2.

Presentation of papers and posters at local and international events are also strongly encouraged. A signed attendance form by each teacher has to be kept for tutorials. 4.3 Annual appraisal with the training co-ordinators At least yearly. If this is not abided to.6 Core skills lectures Lectures in core skills are organized regularly by the postgraduate center.  Examination and yearly in-training assessment results  Their own portfolio with a copy of an updated CV This exercise is mandatory and any failings in the paperwork are taken very seriously.4. This is an opportunity for the training coordinator to go over the trainee’s progress.5 Audit. Feedback from the consultants will be provided to the trainee. 4.7 to 1. In addition. The trainees are expected to attend these lectures before they finish their training programme. A further period of fifteen days will be given to provide the required paperwork. Page 16 . During the appraisal the trainee needs to provide the following:  A structured logbook summary of cases performed during the previous year  The signed and completed. At least 80% of the tutorials have to be attended.10 of the EBA training guidelines. Research and other academic activities All trainees are expected to perform and present at least four audit projects during their five years of training. they should consider attending courses in specific aspects of Anaesthesiology/ Intensive Care that are held locally or abroad. they are strongly encouraged to participate in or initiate research projects within the department. These lectures cover domains 1. (but also when the need arises) an individual meeting between the training coordinators and each trainee shall take place. 4. CME meetings and Journal Clubs. the training committee will be informed with the possibility of putting the training on hold. The trainees should take an active role in all academic activities of the Department of Anaesthesia by participating and by helping in their organisation. end of module competency certificates  The mandatory workplace assessment tools.4 Participation to educational events The trainees are required to attend and participate in the tutorial program. In addition. tackle any problems and discuss achievements and aims for the next year.

Section Five: The European Diploma in Anaesthesiology and Intensive Care All trainees following this training program are to sit the European Diploma in Anaesthesiology and Intensive Care (EDAIC) examination. as a preparation for this exam. but these will not be considered as a replacement for the EDAIC examination. This is so that they acquire enough clinical experience to master the questions asked. In the future the OLA may also be used as part of the local AiTA. The final part of the EDAIC exam is to be sat during the last year of training. to attain the examination. The trainees can use the On-line assessment (OLA) organized by the ESA. Page 17 . the training program shall take into consideration the syllabus and rules. Since the European Diploma examination is the approved exit examination. The EDAIC examination is the approved examination that needs to be attained by the end of the training programme and thus essential for the award of Completion of Specialist Training in Malta. Trainees are welcome to sit for other postgraduate examinations within the training period. During such period the trainee will be assigned to modules which are available. The training committee shall confirm in writing to the examination board that the trainee is in his last year of training. from the date of appointment to the department of anaesthesia. The trainees are expected to sit for the first part EDAIC about half way through their training. Trainees who complete the five years of training but do not pass the final part of the EDAIC will have up to a maximum of ten years in their training post. (including any interim changes) pertaining to the EDAIC examination.

this can be approved retrospectively by the training committee and with the consent of the SAC. Section Seven: Recognition of Training Institutions in Malta and abroad Any training centre in Malta should comply with and maintain the standards as laid down by the Hospital Visiting and Accreditation Programme Joint Committee of the European Society of Anaesthesiology and the European Board of Anaesthesiology. the time spent abroad in a suitable center and a post approved for training. of the UEMS.Section Six: Certificate of Completion of Training. Trainee doctors in anaesthesia who meet the criteria in Section 3. The training coordinators shall inform in writing to the SAC that the trainee has completed his/her training. Trainees have to apply with the training committee before embarking to go abroad for a training experience. The training coordinators are duty bound to certify that all the necessary paper work. Page 18 . Inclusion in the Specialist Register On completion of the training programme. This time cannot exceed a year under any circumstance.5 are considered to have finished their training and are then eligible to apply for specialist registration in Malta. Currently the only training institution in the Maltese islands is Mater Dei Hospital. so that it counts towards specialization certificate from Malta. The SAC will award a Certificate of Completion of Training and recommend the name of the doctor for inclusion in the Specialist Register under the specialty of Anaesthetics and Intensive Care Medicine. This hospital received its accreditation on the 4th March 2010 and is due for renewal on the 4th March 2015. This is to ensure that the center and post abroad is suitable for training purposes and suffices the prerequisites of this training programme. the Anaesthetic Training Committee will recommend to the Specialist Accreditation Committee (SAC) those trainees who would have satisfied the requirements for completion of training. assessments and competencies have been completed. In exceptional circumstances. Tal-Qroqq.

The members should keep the results of the voting confidential. Page 19 . Only the final decision should be communicated on behalf of the TC. The chairman shall decide if a secret ballot should be taken. unless specified otherwise in this document. A simple majority rule shall generally be used if a vote needs to be taken on specific issues. The training committee (TC) 6. then the training coordinators shall express a single vote. o Maintaining standards in anaesthesia o Patient safety o Ensuring that the training conforms to this program and to European levels o Liaising with the SAC The training committee may at its sole discretion invite the trainee representative on the AAM to discuss specific issues. The TC should meet every six to eight weeks or whenever necessary. whose names appear on the Specialist Register: Two training coordinators: o One of the training coordinators shall chair the meetings. o Safeguard trainees’ rights and ensure they respect their obligations Three members representing the Department of Anaesthesia including: The Chairperson of the Department: o Safeguard the smooth running of the anaesthetic service o Providing and maintaining the facilities for training o Liaison with the hospital administration The Trainee Mentorship coordinator o Safe guard the well-being of the trainees o Advocating trainee issues The immediate past Trainee Coordinator o Liaison and continuity of the training programme Three AAM members including: The President and two members nominated by the AAM committee. This shall consist of eight member anaesthesiologists. o Minute taking o Update the TC on the implementation of the program and the progress of the trainees. If the number of members on the board is even.Section Eight.1 Composition The delivery and implementation of this Anaesthesiology Training Programme shall be supervised and coordinated through the Anaesthesiology Trainee Committee.

The duties of the Training Coordinator in conjunction with the Training Committee shall include:  Implementing this training program  Ensuring the timely and effective delivery of the core content of the curriculum. However if it is deemed that there are serious problems.  Coordinating the trainee rotations in order to cover all the modules  Organizing appraisals and assessments  Ensuring that all the necessary documentation is in order  Chairing the training committee  Liaison between the TC and the trainees  Promoting training of trainers  Communication with the Post-graduate center and the SAC  Budgeting relevant to this training program  Liaising with training in foreign institutions  Sitting on interviews for entry into BST and HST Section Nine: The Mentorship scheme The aim of this program is to provide the trainees with an honest and reliable person that they may relate to. The term served shall be of three years. Page 20 .2 The Training Coordinators The Training Coordinators shall be chosen after an internal call for applications. The mentor is also there to guide the trainee in his training and in achieving his potential. the trainee should be encouraged to disclose the relevant facts as well to the trainee coordinators. The applicants should be practicing anaesthesiologists and having been included in the specialist register for at least five years before the call for applications.6. colleagues or patients. The trainee can choose his own preferred mentor. if any personal difficulties arise during training. Further information on the subject can be found in the relevant document on the Mentorship scheme. Any issues which may arise should be dealt in confidence. This should be made clear to the trainee at the initial briefing between the mentor and the mentee. The Mentor is obliged to divulge any concerns to the training coordinators should he be very concerned with the safety of the trainee himself.

 Show professionalism in all aspects of clinical work.Section Ten: Obligations of trainees and trainers 10. lead and improve the teaching skills of the trainers in anesthesia.  Be committed to contribute to the professional growth of the department of anaesthesia.2 Obligations of the Trainers All specialists in anaesthesia have a moral obligation to pass on their knowledge.  Be fair in the assessment and treatment of the trainees. Trainers should:  Be committed to teaching by setting a good example to trainees.  Contribute to the ongoing development of the training programme.  Enrich their knowledge in all the realms of anaesthesia. The training coordinators should facilitate the teaching work of the trainers.  Record their training activities in a log book and keep a professional portfolio.  Cooperate with the training coordinators in filling the necessary documentation. skills and good personal qualities to their juniors. Hence they need to be up to date with medical science themselves. safeguard patients in their care and maintain confidentiality.  Teach the latest evidence based medicine. intensive care. acute and chronic pain.  Put an effort to learn all the necessary skills to practice the specialty.  Be proactive in their learning and aim for personal excellence.  Be respectful towards their trainers and colleagues 10.  Cooperate with the trainers and training coordinators to obtain and maintain the necessary documentation of their training.1 Obligations of the trainees Trainees shall:  Be committed to pursue the training in anaesthesia to the best of their abilities.  Contribute to the assessment of trainees. An adequate number of trainers should be available to support the training programme.  Maintain professionalism throughout. Page 21 .

The Anaesthesiology Training Programme Malta May 2008. Official adoption of the European Diploma of Anaesthesiology and Intensive Care (EDAIC) in Malta. PAIN AND INTENSIVE CARE MEDICINE. Postgraduate training program from the Standing Committee on Education and Training of the Section and Board of Anaesthesiology. Fifth Schedule (Article 31) Specialist registers. Fourth Schedule (Article 30) Professional Associations: Part I and Part II. ANAESTHESIOLOGY. The European Diploma in Anaesthesiology and Intensive Care.References: ANAESTHESIOLOGY. PAIN AND INTENSIVE CARE MEDICINE. Agreement between the Government of Malta and the Medical Association of Malta: 27th February 2013. Health Care Professions Act [CAP 464]. Code of Ethics. Syllabus to the Postgraduate training program from the Standing Committee on Education and Training of the Section and Board of Anaesthesiology. Chapter 497: Act I of 2009. UEMS/EBA GUIDELINES. Diploma Guide. * * * * * * * * * * * * * Page 22 . Public Administration Act.