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Pending change to anaesthesiology CSCST title sparks concern

By Catherine Reilly - 17th Mar 2024

CSCST

The Medical Council has agreed to “delay” implementing a change to the title of the certificate of satisfactory completion of specialist training (CSCST) for the anaesthesiology training programme. The decision follows concerns expressed to the Council by the CEO of the College of Anaesthesiologists of Ireland, Mr Martin McCormack.

The six-year specialist anaesthesiology training (SAT) programme incorporates not only specialist training in anaesthesiology, but also training in intensive care and pain medicine.

The award title since the promulgation of the SAT programme is ‘CSCST in Anaesthesiology, Intensive Care Medicine (ICM), and Pain Medicine (PM)’, Mr McCormack informed the Medical Independent.

When a trainee completes the SAT programme, they are eligible for registration on the Council’s specialist register for anaesthesiology. Their scope of practice also includes ICM and PM.

“In our model three hospitals, for example, over 120 ICU beds nationally are rostered by consultant anaesthesiologists and their teams, including specialist anaesthesiologist trainees,” noted Mr McCormack.

If a doctor who completed the SAT programme wishes to become an ICM ‘intensivist’, they complete a two-year supra-specialty programme with the Joint Faculty of Intensive Care Medicine Ireland; or undertake a recognised course in another jurisdiction.

These doctors’ scope of practice in ICM would be different to colleagues who solely completed the SAT programme.

According to the Medical Council, it is crucial that the CSCST title precisely represents the field of anaesthesiology, without causing any public misunderstanding that could associate it with separate specialty registers in PM and ICM.

Mr McCormack said the College “understands and respects” this risk, but believes consideration must be given at this stage to the impact of the decision. “At all times, patient care must remain the focus of any decision. The Medical Council have acknowledged those concerns and have agreed to a period of clarification.”

He also confirmed the Council was legally entitled to change the CSCST title.

The matter was raised by the Council during the accreditation of the SAT programme in 2020. As part of this review, the Council indicated it would communicate with the College regarding the CSCST nomenclature, stated Mr McCormack.

On 9 February 2024, the Council communicated that the title would be changed to ‘CSCST in Anaesthesiology’ effective from 1 March.

According to the Council, “comprehensive consultation and extensive deliberation with stakeholders has taken place on this matter since 2019.”

The Council appreciated there “may be concern” among trainees about the change.

In the “interest of complete clarity”, the Council noted the clinical indemnity scheme provides doctors with indemnity based on their professional role in a hospital, irrespective of the CSCST title.

The pending change “does not affect the quality of the qualification”, nor require any changes to the SAT programme’s content or delivery. “The HSE has confirmed that reverting to the approved title of ‘Anaesthesiology’ would not affect their recruitment strategy,” the Council added.

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