Choose the route deliberately
Core Anaesthetics and ACCS Anaesthetics are different training experiences
Both routes can lead to competitive ST4 Anaesthetics recruitment. Core Stage 1 is indicatively three years; ACCS Anaesthetics is a four-year route with two generic acute-care years before two further anaesthetic years.
Core Anaesthetics
Stage 1 runs CT1–CT3. The early focus is general anaesthesia and perioperative care, the novice period and IAC, followed by broader Stage 1 domains, increasing independence and the Primary FRCA. Exact rotations are capability-led and locally organised.
ACCS years 1–2
The generic ACCS curriculum comprises four six-month whole-time-equivalent placements in Emergency Medicine, Internal Medicine, Anaesthetics and Intensive Care Medicine. It develops recognition and initial management of the acutely unwell patient through 11 learning outcomes.
ACCS years 3–4
Anaesthetics-parent trainees then complete two further years in anaesthesia to meet the relevant Stage 1 requirements for progression to ST4. Placement order varies, so do not assume anaesthetics is first.
Who may prefer Core
Applicants who want earlier sustained immersion in anaesthesia, a three-year indicative Stage 1 route and less rotation across medical and emergency departments may prefer Core. This is a training preference, not evidence of greater commitment.
Who may prefer ACCS
Applicants who value broader acute medicine, ED and ICU exposure and are comfortable with a four-year route may prefer ACCS. The breadth is particularly relevant to acute anaesthesia, but the route still requires full anaesthetic Stage 1 outcomes.
Questions to ask programmes
Ask about placement order, IAC timing, continuity with the anaesthetic department, exam support, educational supervision, how evidence is recorded across placements and how LTFT changes the sequence.
From understanding to practice
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