Anaesthetics involves providing patients with anaesthetics during surgery, managing those in intensive care units, and working in obstetrics teams. It can take up to eight years to become a consultant anaesthetist.
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Entry Route into Anaesthetics
Applicants must complete the two-year Foundation Programme before training in Anaesthetics, with the full programme taking seven to eight years to complete, depending on the pathway chosen at ST1. Selection takes place before entry to ST1 and ST3, and trainees must demonstrate the core competencies and achieve set milestones to progress to the next year of training. For trainees undertaking a dual-CCT in Anaesthesia and Intensive Care Medicine, the minimum duration of training is eight and a half years. About 25% of anaesthetists work in Intensive Care Medicine (ICM) as well as Anaesthesia.
There are two training pathways for ST1:
- Core Anaesthetics Training, which takes two years; or
- The Acute Care Common Stem (ACCS) in Anaesthetics, which takes three years to complete – two years of general ACCS training followed by one year of speciality-specific training in anaesthetics.
Job Progression as an Anaesthetist
After completion of intermediate, higher, and advanced Speciality Training (ST3-7), trainees can obtain their CCT and join the Specialist Register in Anaesthetics – a pre-hospital medicine subspeciality. Many anaesthetists also develop an interest in a clinical or research subspeciality such as ICM or Resuscitation and Trauma.
Trainees can apply for consultant positions six months before obtaining their CCT, and there are opportunities to work in management as a clinical lead, or a clinical or medical director. There are also formal opportunities to become involved in the education and training of junior doctors by working as
- a director of medical education overseeing postgraduate medical training,
- a training programme director responsible for the education of trainee doctors in the local region, or
- an associate dean responsible for managing the training programme.
Academic Anaesthetics Roles
Trainees interested in an academic career can apply for an academic clinical fellowship. Alternatively, trainees can continue the ST clinical training programme after ST4 level – eventually becoming a consultant anaesthetist.
Competition for Anaesthetics Posts
In 2017, the competition ratio at ST3 was 1.24 with 495 applications for 398 posts. The competition ratio at CT1/ST1 was 1.99 – including ACCS applicants – with 675 applications for 340 posts.
In December 2017, there were
- 6,522 consultants,
- 264 associate specialists,
- 1,035 speciality doctors,
- 21 staff grades,
- 2,651 speciality registrars,
- 1,285 core trainees,
- 98 F2 trainees, and
- 115 F1 trainees.
Salaries in Anaesthetics
The salary for a consultant anaesthetist ranges from £76,000 to £102, 500, and for a speciality doctor from £37,500 to £70,000. The salary for a doctor in training ranges from £26,350 to £45,750.
A Day in the Life of a Consultant Anaesthetist
A consultant anaesthetist has a significant role in the management of patients undergoing surgery. They also see to those admitted to critical care or high dependency units, and those in need of resuscitation. After learning basic anaesthetic skills during the first few years of training many anaesthetists develop a specific expertise. Nearly half their time is spent in the operating theatre, although they may also see patients in ICUs, obstetric wards, and in A&E.
A typical day starts before 8am with visits to pre-op patients before surgery begins. The on-call requirement varies but may typically require one night a week and one-in-five weekends.