How to Prepare for the Resuscitation Council UK ALS Course as an IMG Doctor
Many NHS posts in acute medicine, surgery, anaesthetics and emergency medicine ask for a current Resuscitation Council UK (RCUK) Advanced Life Support certificate. If you trained outside the UK, you may already know resuscitation well from ACLS or a national course, but the RCUK course has its own format, algorithm wording and assessment. This guide explains what to expect and how to prepare so you pass first time and feel confident at your first 2222 call.
Quick answer
The RCUK ALS course is a hands-on, assessed course for healthcare professionals who use advanced life support in their clinical work. You receive the manual about a month before, complete online modules and a pre-course MCQ, then attend face-to-face training at an approved centre. You are assessed continuously in simulations and finally in a cardiac arrest simulation. The certificate is valid for four years.
What you will learn in our free Advanced Life Support (ALS) — UK Guidelines course
Show you are ready for acute on-call work — and prepare for your Resuscitation Council UK ALS course at the same time. Our free online Advanced Life Support (ALS) — UK Guidelines course is written for NHS doctors and international medical graduates. You study at your own pace in 6 short modules, with worked examples, interactive exercises and a short quiz at the end. There is no sign-up, and your progress is saved so you can stop and come back.
The 6 modules
Foundations: the heart, the ECG and the chain of survival: Why this matters, The heart and its conduction system, ECG basics in five minutes, The chain of survival, Prevent the arrest
Basic life support, AED and airway equipment: Recognising cardiac arrest and calling for help, Adult basic life support — outside hospital, High-quality CPR — the foundation, Using an AED step by step, The defibrillator — pads and safety
Cardiac arrest: the advanced life support algorithm: The adult ALS algorithm — the overview, Shockable rhythm (VF/pVT) — step by step, Worked example — a VF arrest, minute by minute, Non-shockable rhythm (PEA/asystole), Drugs in cardiac arrest — one table
Core ECG rhythms: How to read any rhythm strip — six questions, The arrest rhythms, Fast rhythms (tachyarrhythmias), Slow rhythms and heart blocks
Peri-arrest care and cardiovascular emergencies: Bradycardia with a pulse (RCUK 2025), Tachycardia with a pulse (RCUK 2025), Acute coronary syndromes — the first minutes, Suspected stroke — time is brain, Leading the resuscitation team
After the arrest: After return of spontaneous circulation (ROSC), Decisions about CPR — DNACPR and ReSPECT, Families, documentation and debrief, Your next steps
By the end of the course you will be able to
Describe the heart's conduction system and read the basic parts of an ECG
Explain the chain of survival and deliver adult BLS with an AED
Choose and use basic airway equipment and understand advanced airways and capnography
Apply the adult cardiac arrest algorithm for shockable and non-shockable rhythms, with correct drugs and timing
Recognise the core arrest and peri-arrest rhythms on a rhythm strip
Manage bradycardia, tachycardia, acute coronary syndromes and suspected stroke in the first minutes
Lead a resuscitation team and start post-resuscitation care
Why it helps your NHS application
The full UK 2025 cardiac arrest algorithm, drugs and doses, with timed worked examples
Practise reading real-looking ECG rhythm strips
Strong preparation for the RCUK ALS provider course most NHS posts expect
How to write it on your NHS application
In your CV and on NHS Jobs or Trac: list it under "Courses and CPD" (or in the training and courses section of the form), for example:
Advanced Life Support (ALS) — UK Guidelines, online CPD course, CareerPro UK. Certificate of completion, [month and year]; verifiable online, ID CP-XXXXXXXX.
In your supporting statement: show what you learned and how you use it. For example (adapt it so it is true for you):
"To prepare for acute on-call work, I revised the current Resuscitation Council UK adult algorithms through an online ALS course, ahead of attending the RCUK ALS provider course."
At interview: the course also prepares you for questions such as "Talk us through how you would manage a patient in cardiac arrest."
Your certificate of completion
When you pass the quiz, you can download a certificate pack:
A verifiable PDF certificate of completion with your name, the course, your CPD time and a QR code that shortlisters and appraisers can scan
An appraisal-ready reflective note, pre-filled with the course learning outcomes
A ready-to-paste line for your NHS Jobs or Trac application and CV, and a one-click "Add to LinkedIn" button
Studying is free. The certificate pack is a one-off £5, and you pay only after you pass
Online course — not a Resuscitation Council UK ALS provider certificate and not evidence of resuscitation competence.
What the RCUK ALS course is, and why NHS posts ask for it
ALS is the standard UK provider course in adult resuscitation. RCUK describes it as teaching you to recognise and manage a deteriorating patient using a structured ABCDE approach, deliver standardised adult CPR, manage cardiac arrest within a multidisciplinary team, and use non-technical skills both as a leader and as a team member. It is aimed at doctors, nurses, paramedics and others who apply these skills clinically, and applicants need a professional healthcare qualification and a current clinical appointment.
NHS employers ask for it because any doctor in an acute hospital may be first at a collapse, and many posts list a valid ALS certificate as essential or desirable. Our guide to the NHS person specification explains how shortlisters score criteria like this, so it is worth reading before you apply.
Two practical points for IMGs. First, ACLS is a different course: whether an American Heart Association ACLS certificate is accepted instead varies by employer, so check the person specification. Second, places at RCUK-approved centres can fill quickly, so if you have just started a post, ask your trust's resuscitation team about local courses.
Course formats and the pre-course work
RCUK lists several routes to the same provider certificate. Check the current options on resus.org.uk and with your local centre, but in broad terms:
ALS (two-day course): face-to-face lectures, interactive workshops, skill stations and cardiac arrest simulation teaching.
e-ALS: a blended version with the same content, where part of the learning is done online in your own time before a single face-to-face day.
Modular ALS: offered at only a few centres, spread over several sessions. You must attend every timetabled part.
ALS recertification: a shorter course for people whose certificate is still valid or expired no more than twelve months ago.
Whichever format you choose, the pre-course work matters. You are registered on RCUK's learning management system, which holds the online modules and a multiple-choice question (MCQ) paper. The course manual arrives about a month before the course. RCUK expects you to read the manual and submit the completed MCQ paper before the course begins.
RCUK published new resuscitation guidelines in October 2025 and said updated courses and manuals would follow from January 2026. Make sure the manual and algorithms you study match the 2025 guidelines, not an older edition passed on by a colleague.
How you are assessed
RCUK describes ALS assessment at a general level. You are assessed continuously on your performance in clinical simulations throughout the course, and the practical components are tested at the end in a cardiac arrest simulation. You need to show competence in three areas:
Airway management, using basic techniques and adjuncts safely.
High-quality CPR and defibrillation, with minimal pauses and safe shock delivery.
Cardiac arrest management, including leading a team through the algorithm.
The e-ALS page also refers to a formal MCQ paper at the end of the course. The exact programme can vary by format and centre, so read the timetable your centre sends you.
The final simulation is not about trick knowledge. Instructors want to see you assess safely, recognise the rhythm, follow the algorithm in order, give clear instructions and keep compressions going. Practising out loud is the best preparation.
The key current UK algorithm points to know cold
These are the points from the RCUK 2025 adult guidelines that you should be able to say without thinking. Always check the full algorithm on resus.org.uk and follow your hospital's policy.
Recognise arrest early. Treat an unresponsive person with absent or abnormal breathing, including agonal gasping, as being in cardiac arrest.
High-quality compressions. Depth of at least 5 cm but not more than 6 cm, at 100 to 120 per minute, with as few interruptions as possible. Use 30:2 until an advanced airway is in place.
Minimise pauses. Aim to interrupt compressions for less than 5 seconds to shock, then resume CPR straight away without a pulse check.
Shock energy. The first biphasic shock should be at least 150 J (130 to 150 J for pulsed biphasic devices). Increase energy for later shocks if the device allows. If unsure, use the highest energy.
Pad position. Antero-lateral first, with the lateral pad below the armpit in the mid-axillary line. For refractory VF after three failed shocks, consider changing to an antero-posterior position.
Adrenaline. In non-shockable rhythms (PEA and asystole), give 1 mg IV as soon as possible. In shockable rhythms (VF and pulseless VT), give 1 mg after the third shock. Repeat every 3 to 5 minutes while ALS continues.
Amiodarone. 300 mg IV after three shocks, and a further 150 mg after five shocks. Lidocaine 100 mg is an alternative where amiodarone is unavailable or locally preferred.
Access. Try IV first. If it cannot be achieved within two attempts, intraosseous access is a reasonable alternative.
Airway and capnography. Start with basic techniques and progress stepwise according to your skills. Only rescuers with a high intubation success rate should intubate. Use waveform capnography to confirm tube placement and monitor CPR quality.
Reversible causes. Look for and treat the 4 Hs and 4 Ts throughout: hypoxia, hypovolaemia, hypo- or hyperkalaemia and other metabolic causes, hypo- or hyperthermia, thrombosis (coronary or pulmonary), tension pneumothorax, tamponade and toxins.
After ROSC. RCUK 2025 post-resuscitation targets include a systolic blood pressure above 100 mmHg, normocapnia, controlled oxygenation and preventing fever.
A useful self-test: say aloud, "Shockable: adrenaline and amiodarone 300 after the third shock, amiodarone 150 after the fifth, adrenaline every 3 to 5 minutes. Non-shockable: adrenaline as soon as possible." If you can say this while timing a two-minute cycle, you are ready for the scenarios.
A practical preparation plan
Book early and choose the format that suits your rota.
Read the manual as soon as it arrives, and complete the online modules and pre-course MCQ well before the deadline.
Draw the adult ALS algorithm from memory until you can do it without errors.
Practise rhythm recognition: VF, pulseless VT, PEA, asystole, and peri-arrest rhythms such as bradycardia, complete heart block, SVT and AF.
Rehearse leadership phrases, such as "Everyone off, oxygen away, shocking now", and closed-loop drug instructions: "Adrenaline 1 mg IV, please." "Giving now." "Given."
Attend local simulation or mock-arrest training, and find the defibrillator and emergency trolley on every ward you cover.
Our free Advanced Life Support (ALS) — UK Guidelines course takes you through this preparation step by step, from ECG basics and BLS to the arrest algorithm with timed worked examples, peri-arrest rhythms and post-resuscitation care. It is revision only. It does not replace the RCUK ALS course and does not certify competence in resuscitation.
How ALS shows up on your NHS application and at interview
On an application, list your RCUK ALS provider certificate with its expiry date in the qualifications or training section. If your course is booked, give the date. Record any online revision separately as self-directed learning, never as a provider certificate.
At interview, resuscitation often appears in clinical scenario questions such as "You are called to a collapsed patient on the ward. What do you do?" A strong answer is structured: safety, call for help, assess, start CPR, attach the defibrillator, follow the algorithm, treat reversible causes, hand over, document and debrief. Helping run mock-arrest training is also good evidence of teaching and teamwork, which our guide on how to show leadership on an NHS application explains further.
Start the free course
The free Advanced Life Support (ALS) — UK Guidelines course is split into short modules covering ECG basics, BLS and AED use, airway equipment, the cardiac arrest algorithm, core rhythms, peri-arrest emergencies and care after the arrest. It is free to study, ends with a quiz, and offers an optional verifiable certificate and a reflective note for your appraisal. If you would like your NHS application reviewed and rewritten (£35), email cvreviewexperts@gmail.com.
Frequently asked questions
How long is an RCUK ALS certificate valid?
An RCUK ALS provider certificate is valid for four years. You can recertify on a shorter course if your certificate is still valid or expired no more than twelve months ago.
Will an NHS trust accept my ACLS certificate instead of ALS?
It depends on the employer. Requirements vary between NHS trusts and posts, so check the person specification or ask the recruiting team whether an American Heart Association ACLS certificate is accepted.
Do I need to read the ALS manual before the course?
Yes. RCUK expects candidates to read the manual, which arrives about a month before the course, and to submit a completed pre-course MCQ paper before the course begins.
When is adrenaline given in the UK ALS algorithm?
In non-shockable rhythms, adrenaline 1 mg IV is given as soon as possible. In shockable rhythms it is given after the third shock. In both cases it is repeated every 3 to 5 minutes while resuscitation continues.
Can an online course replace the RCUK ALS course?
No. ALS certification requires an accredited, hands-on, assessed course at an RCUK-approved centre. Online revision can help you prepare, but it cannot certify your resuscitation skills.
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