My life as a Anaesthetic post-Registrar

What training are you in & what stage of your training are you in?

I’ve just completed my specialty training programme and obtained my CCT in July!

Where are you based?

I trained in the North West London School of Anaesthesia.

What stage did you decide on your speciality & what other specialities were you considering?

I decided I wanted to be an anaesthetist in my fourth year at medical school. At that time I knew I wanted to train in a hospital specialty and I had considered paediatrics as well at the time.

It was during my surgical attachment that I noticed the anaesthetist. I was intrigued by their calm and controlled composure, and I loved that the consultants were directly involved in hands on patient care rather than being stuck behind a desk or supervising juniors.

How have you found the exams so far? How did you revise for them?

Anaesthetic exams are completed quite early on in the registrar training programme. They’re fellowship exams – there’s the primary FRCA which we take before starting specialty training. Then there’s the final FRCA which we must have passed before we start our ST5 year.  Exams did totally take over my life whilst I was preparing for them – and they were very tough as they involved a lot of physiology, pharmacology and physics. It required a lot of sacrifice and dedication. But I enjoyed learning new things I hadn’t learnt in medical school.

How is your day job split up – when you’re not on-call?

During our theatre blocks we are allocated to theatre lists each day. We pre-assess our patients before going to theatres to prepare our drugs and equipment and do a team brief before each list. If the lists are split into morning and afternoon lists we then need to go and see our patients for the afternoon list after the morning list is finished. Trainees can do lists directly supervised (by a Consultant or senior trainee) and also indirectly supervised, where they are in charge of the list by themselves with senior help on hand if they need it.  We also have training blocks in other departments where anaesthetists are present, such as the Maternity Suite, ITU and Pain Clinics.

What aspects of being an Anaesthetist have you enjoyed the most?

I continue to love the new challenges Anaesthetics throws at me, which varies depending on my stage of training, and from hospital to hospital. I really enjoy the fact that I can focus my clinical energy and attention on one patient at a time once I have anaesthetised them.  

I love the subtle variations that exist from anaesthetist to anaesthetist in how we carry out our procedures, and learning from each other is how we strive to improve our own practice. And we do it continuously. We’re constantly learning new and better ways of doing things at work.  

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What has been hard?

It can be a very busy and demanding job physically, mentally and emotionally – and requires an immense amount of organisation and coordination. This can be hard to do in the chaotic world of the NHS, but it’s our job to turn chaotic situations into controlled ones!

What’s the best thing about being an Anaesthetist?

The large variety of things that we can do within our specialty.

What’s the worst thing about being an Anaesthetist?

The early starts and late finishes. I am not a morning person!

Could you share with us your most challenging moment as an Anaesthetist?

The most challenging time I’ve had as an anaesthetist is when there is more than one pressing emergency requiring my presence. Anaesthetists are often called when patients are in extremis (this may be for emergency surgery or rescue care on the wards or in A&E). I’ve noticed this happening more and more especially as other specialties get busier.  

When we are needed in more than one place, we have to work as a team with the other doctors to ensure all the patients needing our immediate attention are getting it safely. This often means calling in the Consultant as well (they always come in when asked).

What’s your response to those who say you’re just putting people to sleep and that your job seems boring?

I can see why from the outside looking it it may seem like we are just sitting around during surgery, or not doing much. The reality is we are using all of our senses to keep an eye on what is happening moment by moment, ready to launch into action as soon as needed as often there is very little time to react during emergency situations.  Our job is about anticipating and trying to minimise the chances of things going wrong, and being prepared for action if they do. Staying in control during emergencies is our job so whilst on the surface we may appear calm I can guarantee inside we are buzzing! It’s anything but boring and after 11 years of doing this job I still find new challenges every day.

Many members of the public (and some doctors!) think of anaesthetists as technicians. How do you deal with that having gone through so much training to get to where you are?

I don’t let it get to me. It’s easy to criticise from the outside and everyone’s perceptions are different. I know that when we have doctors or nurses come and observe us they always leave enlightened as to what our jobs are really like.

What do you think are the most critical personality traits that a doctor should possess for a career in anaesthetics?

I think all of the non-technical skills such as teamwork, communication, organisation, thinking ahead and decision-making are extremely important for anaesthetics.

What needs to be done to make anaesthetics training fit for purpose?

I think the actual training curriculum for anaesthetics as a specialty is actually fine. I think the main factor contributing to low morale amongst junior doctors is understaffing and underfunding in the NHS – alongside increased service demands. We have to manage the conflicting demands of training and service provision. This is where things need to change in order for morale to improve.

A concern of many trainees applying for anaesthetics training is the work-life balance; how do you cope with incessant nights and weekends?

Lots of forward planning to give myself things to look forward to when I’m not due in at work! It does require a lot of understanding and flexibility from family and friends and I had to accept that there were some social events I would have to miss. I try to ensure that when I’m not at work I’m taking a complete break – and not using all of my limited free time doing extra locums or portfolio work!

What’s your number one piece of advice to junior doctors who are considering applying for anaesthetics training?

Try and do some taster days in your hospital to get an idea of what it’s really like. That’s the only you’ll find out what the job is really like – it can look very different from the outside.

Speak to current anaesthetic trainees who will be more than happy to answer your questions. Remember that training experiences can vary from region to region as well.