Advanced Pain Training

What is Advanced Pain Training?

Advanced Pain Training (APT) is delivered over a minimum 12 month period in designated multi-disciplinary specialist centres where trainees are expected to undertake a wide variety of training in pain management spanning the full range of pain medicine treatment options and plans. Trainees should acquire a comprehensive knowledge of Pain Medicine service delivery as well as being able to assess a wide variety of patients with pain and becoming technically proficient in a range of procedures used in Pain Medicine.

Where does it happen?

This period of training should take place primarily within a Pain Medicine environment.  It is considered unlikely that trainees who spend time outside of the Pain Medicine environment engaged in general anaesthetic duties will be able to successfully obtain all of the competencies required to complete Advanced Pain Training. Therefore the expectation is that trainees will need to spend substantially the whole of their daytime working hours engaged in Pain Medicine-related duties. This of course would not prevent pain trainees being used on occasion to provide general anaesthetic cover for unforeseen emergency cases.

What will I learn?

Advanced Pain Training is considered essential for those aiming for a consultant appointment with sessions in pain medicine and the Faculty of Pain Medicine recommend that those who are appointed as Lead for Acute Pain Services should have completed this training.

Preparing for the milestones of APT


Register as early as you can with the Faculty of Pain Medicine, as this will ensure you are on a training updates mailing list and connected into training activities. 

Ensure you have familiarised yourself with the Advanced Pain Training curriculum which sits within the CCT in Anaesthetics.

Trainees are required to maintain a pain logbook; an example of which may be found on the FPM website with links to download all the necessary software. For further information, please visit the logbook section of our assessments page

It is also advisable to contact your Faculty Tutor (Pain) prior to starting as this will enable you to have a better knowledge of what resources are available to you and start to timetable these into your year to ‘hit the ground running’.  You may also like to make contact with your Regional Advisor in Pain Medicine (RAPM) as they have a wealth of knowledge and experience.  

  • Register with the Faculty of Pain Medicine at the Royal College of Anaesthetists.
  • Familiarise yourself with the advanced curriculum requirements.
  • Set up and familiarise yourself with the faculty of pain logbook.
  • Make contact with your new Pain Department.

During the departmental induction ensure you familiarise yourself with the location of outpatient clinics, examination rooms, theatres and associated departments (palliative care, paediatrics etc.). 

It is also useful to meet the pertinent professionals in allied departments, for example physiotherapy, psychotherapy, occupational therapy, pain nurses and secretarial staff.

Meet with the College Tutor and the Faculty Tutor (Pain). Check that on call arrangements will allow you to gain maximum pain exposure. The Faculty advise that emergency anaesthetic work should not take place during normal working hours with the exception of unforeseen emergency situations.

Please see the assessments page for details of the assessments you need to complete in order to be signed off at the end of your Advanced Pain Training.  Complete the Quarterly Assessment Review form prior to this meeting. You will also need 1 x CBD, 1 A-CEX and 1 x DOPs assessment completed as a minimum. These can be recorded on the e-Portfolio or as paper versions which can be downloaded from the assessments page. Your logbook will be used to sign off your completion of Advanced Pain Training. 

It is a requirement to have completed 6 months of Advanced Pain Medicine Training prior to the SOE. See the FFPMRCA Examinations page for dates and details.  The FFPMRCA examination is not required to complete your Advanced Pain Training and obtain your CCT in Anaesthetics. It is however, mandatory to become a full Fellow of the Faculty. 

  • Ensure you are familiar with the final criteria for the completion of Advanced Pain Training.
  • Arrange your Quarterly Review
  • Ensure your logbook is up to date
  • Consider when you would like to sit the FFPMRCA

By the end of your first 6 months of Advanced Pain Training you should have completed: 

  • 2 x A-CEX, 2 x CBD, 3 x DOP
  • 1 x MSF
  • 2 x Quarterly reviews – with a completed and up to date logbook

You may also have sat the written part of the FFPMRCA or have considered if/when you would like to do this. The Faculty of Pain Medicine runs an Exam Tutorial Course at the RCoA twice a year to assist trainees in preparing for the exam; these are interactive days covering a wide range of topics through workshops and lectures. Trainees are expected to do some preparation for the day to encourage discussion and interactive learning. Please visit our FFPMRCA Exam Tutorials page for further information. 

Visit the Examinations webpages for more information on the exam and resources.

After 9 months of Advanced Pain Training you should have completed: 

  • 3 x A-CEX, 3 x CBD, 4 x DOPs
  • 3 x Quarterly reviews
  • A completed and up to date logbook

You may also have sat the second (Structured Oral Examination) part of the FFPMRCA or have considered if/when you would like to do this.

At 11 months you should have almost completed your Advanced Pain Training. During this month you should forward your logbook to the RAPM to check competency prior to the completion of your Advanced Pain Training year.  Your RAPM should be able to advise on any areas you're lacking so you can rectify these before your final meeting. 

Ensure that all WPBAs are up to date and collated.

After 1 year you need to arrange a meeting with your RAPM to sign off your Advanced Pain Training. At this stage you should have completed: 

  • 4 x A-CEX
  • 4 x CBD
  • 6 x DOP
  • 4 quarterly reviews
  • 16-20 sessions of cancer pain
  • all competencies prescribed in the Advanced Level curriculum
  • On the e-portfolio, all workplace based assessments should be linked to the curriculum.

Now you've completed your training, you need to consider the type of department you would like to work in as a Consultant in the future. The FPM website has some guidance on Preparing for a Consulant Post, which you may find useful.  

If you're not at the end of your training, you will need to think about how to maintain your APT skills during the final part of your Anaesthetic training. The FPM has produced some guidance on this in the training FAQs section and advises that you should try to maintain at least one session in Pain Medicine per week. You should discuss this with your RAPM and TPD early to avoid rota and administrative issues. 

If you have passed or are planning to pass the FFPMRCA Examination, you will become a Fellow of the Faculty on completion. Pain Medicine consultants without the exam may still join the Faculty as Affiliate Fellows.  Both routes come with membership benefits that are worth investigating and will keep you connected into the wider Pain Medicine community. Please visit our Membership page for further information.

Advanced Pain Trainee Study Days

Study days are organised by the Education Steering Group of the London Pain Training Advisory Group (LPTAG). They are open to ALL Advanced Pain Trainees and there is no need to book in advance. If you would like any more information, please contact the LPTAG Trainee rep Dr Eleanor Hyde or Dr Sandesha Kothari at

Are you interested in subspecialty pain training?
Read on to find out more about these modules.