ANAESTHESIA
Anaesthesia isn't just putting patients to sleep and waking them up again - ask any woman in labour who has had her pain relieved by an epidural.
If you choose to follow a career in anaesthesia, you will work with sick patients at crucial moments of their illness. You will generally be part of a multidisciplinary team, working with surgeons, obstetricians, radiologists, physicians and even psychiatrists.
You will be part of the team right from the start of your training, which will give you a good grounding in physiology, pathology, pharmacology and physics. On top of this you'll gain practical learning in general medicine and anatomy.
Your training will take you to all parts of the hospital - from the pain clinic to the emergency theatre - working with all kinds of patients, from those about to give birth to those undergoing major operations.
The specialty is challenging because anaesthetists work under great pressure - just ask anyone trying to cannulate a patient in shock because of a leaking aortic aneurysm. You will master techniques that can be technically testing and work with skilled practitioners and specialist equipment, such as fibre-optic tracheal intubations.
Your work will be a mixture of analysis and practical dexterity; blood gas and ECG interpretation may be promptly followed by the insertion of a pulmonary artery flotation catheter. The work can be intensely satisfying, with results sometimes apparent almost immediately. It is often demanding, mentally and emotionally.
Anaesthetists are the single largest group of hospital doctors and your skills will be used throughout the hospital in patient care. The role is widening beyond providing anaesthesia during surgery, to take in the preparation of surgical patients, the relief of post-operative pain and the provision of sedation and anaesthesia for patients undergoing radiology and radiotherapy procedures. You might work in obstetric units, cardiac-arrest teams, intensive care units, A&E departments, pain-management teams, and dentistry and even in psychiatry with patients receiving ECT.
Entry, qualifications and training
Entry to ST1 is by direct entry from FY2 with no previous experience in anaesthesia. SHOs with less than 12 months' previous experience at SHO level by August 2007 in anaesthesia also enter at ST1. Relevant competencies will be assessed according to duration of previous experience.
For entry to ST2:
- 12-36 months' experience at SHO level by August 2007, including passing the Initial Assessment of Competency. Other relevant competencies will be assessed according to duration of previous experience
- up to three months' ICM experience may be counted as part of anaesthetic training. Experience outside anaesthesia (for example, in emergency or acute medicine) does not count towards anaesthesia training time
- trainees who started anaesthesia in August 2006 should apply for ST2 posts. It will be necessary for you to have completed the Initial Assessment of Competency and have achieved other appropriate competencies. It will not be necessary for you to have done intensive care in the 12 months leading up to August 2007 because you can do this in your ST2 year
- trainees appointed in August 2005 will have done two years by August 2007 but, if you do not have the Primary FRCA or an equivalent qualification, you must apply for ST2.
For entry to ST3:
- at least 24 months' experience at SHO level by August 2007
- attainment of SHO training certificate or a letter of confirmation from the college tutor that the certificate will have been awarded by 31 July 2007
- attainment of the Primary FRCA (or recognised equivalent qualification) by closing date for applications
- experience outside anaesthesia (for example, in emergency or acute medicine) does not count towards anaesthesia training time.
Personal qualities should include:
- self-reliance and the ability to assess the severity of life-threatening conditions and to initiate emergency treatment
- understanding your own limitations and the need to ask for help
- attention to detail, especially with regard to monitoring and record- keeping
- good communication skills
- good interpersonal skills to deal with all members of the theatre team.
To find out more about the qualifications and personal qualities you need to enter anaesthesia training, take a look at the person specification
The future
The future of anaesthesia is exciting. Anaesthetists are centrally placed in the acute services of hospitals and are facing the challenges of a 21st Century NHS. New technologies such as ultrasound-guided nerve blocks and new surgical techniques mean that anaesthetists have become crucial in the peri-operative period.
Allied specialties of anaesthesia are also burgeoning; chronic-pain treatment has an expanding pharmacopoeia and critical care is now being taken throughout the hospital with 'Outreach' and the Hospital at Night project. Anaesthesia is central to these.
