In year 5 trainees should develop their special interest and this does not have to be in a post in this Region or indeed the UK. The School has a number of year 5 posts, however, there may need to be some form of competitive process, possibly during SpR 3, for specific year 5 posts if they are oversubscribed. 

In general year 5 posts within the school will consist of two 6 months placements.  As the vast majority of trainees will take consultant posts in District General Hospitals, it is important that they do not feel "labelled" by a specific sub-specialty as a result of the training in SpR 5.  It is for this reason that two six month placements have been arranged, rather than a whole year in one sub-specialty.  Clearly, this may not suit all trainees' aspirations, and it may be possible to alter year 5 training within the school on an individual basis by discussion with the Programme Director.  In order to allow for trainees to take part in a competitive process, or arrange year 5 training abroad, you will be asked for your year 5 preferences during SpR 3.

Some trainees decide to work abroad in their fifth year. Australia and New Zealand are common destinations. If you would like to work abroad, you will first need to complete read the latest regulations on training abroad from the RCA (click here), and then fill in a SESA "year 5 application form".  This is different from an out of programme experience form (OOPE). After completing the year 5 form (click here to obtain one) send it to the Programme Director for signing, and he/she will organise for the RA to sign it and then will return a copy to you.  It is this form which demonstrates to the RCA that the STC has given you its approval.  Clearly, approval from all of these agencies must be in advance.  The Programme Director will need a minimum of 6 months notice of a trainee taking time out from the scheme. All forms can be obtained from the SESA training office, or it can be downloaded from this site.

Finally, SpR 5 can be taken as any year from SpR 3 on.  That is to say, that if you wished to go abroad for your year 5, you may do this at any time (with notice and permission) from your entry into SpR 3.  There are advantages and disadvantages to taking SpR 5 "early".  The advantages are that you will have more time in the UK prior to you looking for a consultancy.  Also, the Royal College of Anaesthetists (RCA) rules state that "normally" a trainee must be in the UK  for 6 months prior to gaining the Certificate of Completion of Specialist Training (CCST).  This is because the RCA feels that it is not correct to sign off a trainees 5 years of training just after he/she has stepped off a 'plane after a year abroad.  The disadvantages are that you will not recently have completed you sub-specialty training when you apply for your consultancy.  That is to say, that if you went abroad to study, for instance, intensive care medicine (ICM) in year 3, then when you are applying for a consultant post at the end of the 5th year of your training, it will have been 2 years since your specialist training.  You may at interview have to show how you have maintained your skills, as opposed to another candidate who has just completed his/her specialist year.  Moreover, if you leave the scheme during SpR 3, when you return after SpR 5 to complete year 3, you may not be able to go back to the same DGH's that you were originally programmed to rotate to.  The programme director will have to place you into any gap that he can, and this may not be entirely of your liking!  Clearly, your training needs will come first in any decision.  The balance of advantages/disadvantages depends upon in what way you wish to use SpR 5, and whether you can achieve similar training within SESA or not.