IAC Equivalence Form

The Royal College of Anaesthetists' (RCoA) Initial Assessment of Competence (IAC) is a formal milestone in the Anaesthesia CCT Curriculum, confirming that a resident anaesthetist can safely provide anaesthesia under appropriate supervision. It is not a mandatory component of the ICM Curriculum, but the capabilities it covers, safe and effective anaesthesia practice, are embedded within HILLO 10 (Anaesthesia) in the ICM Curriculum.  

Intensivists in Training (IiTs) from medical streams (i.e., Internal Medicine Training) often enter ICM training with limited or no prior anaesthetic experience. While the IAC is not required for progression in ICM, completing the IAC or equivalent evidence is strongly recommended as most regions expect this as a benchmark for safe anaesthesia practice, and without it, IiTs may face barriers to joining anaesthesia or airway rotas during their training. 

To address this gap:

• We have created an IAC Equivalence Form for IiTs undertaking theri anaesthesia block within the ICM CCT training programme.
• This form was developed in conjunction with, and approved by, the RCoA's Training Committee to ensure alignment with anaesthetic training standards.
• It certifies that the doctor has demonstrated capabilities equivalent to the RCoA's IAC milestone, based on supervised learning events (SLEs) and supervision.
• It ensures patient safety, supports local governance, and provides a clear process for evidencing competence without duplicating the Anaesthetics Curriculum requirements.

This approach aligns with the RCoA and FICM's best practice guidance for managing Single/Dual/Triple CCT IiTs, which emphasises equitable access to anaesthetic training and airway competence for IiTs from non-anaesthetic backgrounds.

Important Notes

• Completion of this form provides evidence towards HiLLO 10 (Anaesthesia) in the ICM Curriculum but is not sufficient on its own to complete HiLLO 10.
• The form should be uploaded to the FICM LLP as a supporting document to a Personal Activity linked to HiLLO 10.
• Additional evidence for HILLO 10 may include:
  • Anaesthetic Supervised Learning Events (SLEs) covering preoperative assessment and anaesthesia for ASA 1–3 patients, or scenarios of greater complexity (including non-theatre/ICU environments)
  • FICM Multiple Consultant Report (MCR)
  • Simulation training for life-threatening emergencies
  • eLearning modules
  • Logbook entries, personal activities and reflections
  • Attendance at difficult airway and transfer courses

Process

If required locally:

1. IiTs should contact llp@ficm.ac.uk to obtain the RCoA's EPA1 and EPA2 forms for the IAC.
2. Complete the EPA forms and the IAC Equivalence Form.
3. Upload all documents to 'Personal Activities' in the FICM LLP under HiLLO 10 in the ICM Curriculum.

Additional Useful Resources

• FICM Multiple Consultant Report
• RCoA's IAC Workbook