The ARCP panel will want case numbers by subspecialty, airway grade distribution, your regional anaesthetic breakdown by technique, and evidence of adequate supervision at each stage of training. None of that comes from a memory of how busy the list was. It comes from a log that captures the right fields, every case, from the first day of the rotation.
Airway Management as Structured Evidence
Airway Tube, Airway Grade, Airway Adjuncts, and Did I do airway? constitute the airway portfolio within each case record. The distinction between the grade of laryngoscopy and the equipment used to manage it is the distinction that matters most in airway training documentation. A Cormack-Lehane grade 3 managed successfully with a bougie and videolaryngoscopy is a different record than a grade 3 managed with multiple blade changes — both are grade 3, but the technique record tells the supervising consultant something about the trainee's skill set.
Did I do airway? — the boolean confirmation field — addresses a specific documentation problem in theatre: cases where the trainee is present but the airway is handled by the consultant because of urgency or difficulty. The field doesn't imply the trainee failed; it records the learning opportunity structure accurately. A portfolio that shows two hundred anaesthetics with only sixty independent airway confirmations may prompt a training conversation. A portfolio that misrepresents that number creates regulatory exposure for the trainee.
Did I do access?, Did I do procedure?, and Did I do regional? apply the same logic to IV access, the primary anaesthetic technique, and regional blocks respectively. Four confirmation fields rather than one creates a granular independence record that is far more useful to a training program director than a simple case count.
ASA, Supervision, and the Complexity Index
ASA and Priority together create the case complexity index. An elective ASA I shoulder arthroscopy is not the same training exposure as an emergency ASA IV laparotomy, even if both appear as one case in the log. Structured severity fields mean the portfolio can be filtered for high-acuity cases separately — the FRCA evidence requirements around complex case exposure are not met by total case volume alone.
Supervision and Supervisor document the oversight structure for each case. In training environments, the spectrum from fully supervised to operating under distant supervision matters both for training progression and for medico-legal clarity about decision-making authority. The supervisor's name attached to the case creates a verifiable chain if a case is ever subject to adverse event review.
Specialty and Operation create the subspecialty distribution record. Adequate exposure to obstetric, paediatric, cardiac, and regional anaesthesia cases is a RCOA curriculum requirement. A log that fields both the specialty and the specific procedure allows the trainee to run their own gap analysis months before the ARCP.
The Physiological Record
weight, height, and BMI in the case record are not incidental. Drug dosing in anaesthesia is weight-based, and in obese patients — BMI above 35 — the pharmacokinetics of induction agents, neuromuscular blocking drugs, and opioids shift enough to change the clinical approach. Having the patient's anthropometrics in the same record as Medications and Primary Anaesthetic technique means the dosing decisions can be reviewed in context.
PMHx and Other Past medical history capture the relevant medical background. Come from ICU? and Go to ICU? document the patient's trajectory before and after the case — the ICU-to-theatre-and-back pathway is a high-risk transition that training programs track specifically because it concentrates complication risk.
Adverse events with Notes closes the record with the information that matters most when things don't go as planned. An adverse event logged contemporaneously, with the case context still intact, is the documentation that supports both the incident review and the reflective portfolio entry that demonstrates learning from the event.