anaesthetist

The work

Anaesthetists are commonly known as the doctors who 'put people to sleep’ before surgery. They are highly trained specialists whose practice includes pain management and intensive care medicine. They often deal with emergency situations, providing the ability to breathe, advanced life support, and resuscitation of the heart and lungs.

Other aspects of anaesthetists' work include:

• preparing patients for surgery
• relieving pain in child-birth
• easing post-operative pain
• managing acute and chronic pain
• helping psychiatric patients receiving electric shock therapy
• providing sedation and anaesthesia for patients having radiology and radio-therapy.

Anaesthetists use a range of techniques including local anaesthetics such as epidurals, and other nerve blocks.  During an operation, they continually observe patients, monitor their progress and respond to any changes.They work closely with other healthcare professionals to develop an integrated treatment plan for their patients.

Anaesthetists can work in areas ranging from high dependency units to cardiac arrest teams. Some anaesthetists lead a team or manage a department. Many are involved in teaching and supervising trainees or other groups such as undergraduate medical students, nurses, and paramedics.

Hours and Environment

As an anaesthetist you will work relatively long hours, especially as a junior doctor. You will work shifts and an out of hour’s rota system. Sometimes you may need to work for around 56 hours a week. By 2009 this will be reduced to a maximum limit of 48 hours a week.

Generally, working conditions in hospitals are clean, modern and comfortable. As an anaesthetist you may spend time in a variety of settings including consulting rooms, wards, operating theatres, and special units such as accident and emergency.

This work can be mentally and physically demanding.

Skills and Interests

To be an anaesthetist you should:

• be able to demonstrate integrity in both your personal and professional life
• have an interest in the well-being of patients
• have excellent communication skills, able to explain patient choices and share decisions
• be able to put people at ease and inspire trust and confidence
• be able to work both independently and as part of a team
• have the potential to manage a team or clinical unit
• have an interest and ability in science
• have strong analytical skills
• have the practical ability and manual dexterity for examining patients and performing clinical procedures
• be able to work under pressure and make quick, clear decisions
• have the skills to train, teach and supervise staff.

Entry

Anaesthetists are qualified medical doctors who have chosen to specialise in anaesthesia, intensive care medicine and pain management.

To become a doctor specialising in anaesthetics you need to complete:

• a degree in medicine, recognised by the General Medical Council (GMC)
• a two year foundation programme of general training (see Training section for details)
• an accredited specialist training programme in anaesthesia, intensive care medicine and pain management (see Training).

The GMC hold details of recognised degree courses, see Further Information for details. 

The entry requirements for a five-year degree in medicine usually include three A levels at grades AAB in subjects such as chemistry, biology and either physics or maths. If you have qualifications from Scotland you need H grades and Advanced Highers in subjects such as chemistry and biology. The subjects and grades you achieved at GCSE/S level will also be taken into account.

If you do not have qualifications in science, there is a six-year degree course in medicine that includes a one-year pre-medical (or foundation) course.

If you are a graduate with a first or upper second class honours degree in a science subject, you may be able to join a four-year graduate entry programme to medicine. Some universities will accept non-science graduates. The British Medical Association (BMA) website has details of course providers, see Further Information for contact details.

You may also be asked to take the UK Clinical Aptitude Test (UKCAT), which is used by 23 UK universities to identify students with the appropriate attitude, behavioural attributes and mental abilities for a degree in medicine. The university you wish to join will tell you if you need to take the test. For more details and to register for the test, go to the UKCAT website.

Before you apply for a course you can gain insight into this field by doing some relevant paid or voluntary work, for example working as a care assistant in a hospital, residential or nursing home. Some hospitals allow potential medical students to observe a qualified doctor at work. You can contact local hospitals directly to discuss these possibilities. 

Training

As a medical student you are exposed to many of the specialties within medicine, including anaesthesia. You will learn basic medical science, communication skills and practical clinical techniques. You will work, under supervision, in a range of areas such as general practice, accident and emergency, and outpatient clinics.

When you have completed your degree in medicine, you will need two further qualifications to become a consultant anaesthetist:

• a two-year foundation programme. This can include placements in acute care settings, mental health and general practice. Successful completion of year one (known as F1) leads to full registration with the GMC. During year two of the programme (F2) you will experience a range specialist areas, this can include anaesthetics. At the end of F2 you make your career choice to pursue specialist training in anaesthesia (leading to consultancy).

• a specialist training programme in anaesthesia (known as 'run-through' training). You will apply in open competition for a place on one of these programmes, which last approximately seven years. During the programme you will learn and practice in increasingly advanced areas such as paediatric anaesthesia, neuroanaesthesia and cardiac/thoracic. There are basic, intermediate, higher and advanced levels of training.

As a trainee anaesthetist you will be assessed in the workplace, and you will only progress to the next stage when you have met the required standard. During training you will sit formal examinations. Success in these, allows you to become a Fellow of the Royal College of Anaesthetists (FRCA).

When you have successfully completed the specialist training programme, you will be awarded the Certificate of Completion of Training (CCT). This means you will be eligible to join the GMC Specialist Register, and apply for consultant anaesthetist posts in the NHS.

As a consultant you are expected to continue learning throughout your career. Check The Royal College of Anaesthetists website for details on all aspects of training and continuing medical education for practising anaesthetists (see Further Information).  

This new way of training is part of the NHS Modernising Medical Careers Review. For more details, check the NHS Modernising Medical Careers website.

Opportunities

Competition for promotion through the various training grades can be strong as places on specialist programmes are limited in number. When you qualify as an anaesthetist, you may also need to relocate to take up a more senior position.

As a consultant anaesthetist with the NHS you will often find opportunities to work in the private sector. With experience, you may go onto lead a team or manage a unit. You may also progress to teaching and training students, trainee anaesthetists and other healthcare professionals.

Annual Income

Figures are intended as a guideline only.

Junior doctors, on the foundation programme, can earn between £21,000 and £26,000 a year.
Doctors in specialist training can earn up to £44,000.
In addition, doctors in training will receive extra payments depending on the hours worked, workload, and the amount of time spent working unsocial hours.

Consultants can earn between £70,000 and £94,000 a year.
With additional payments and merit awards, consultants can earn considerably more. 

Consultants often supplement their income with private work. Those working in private hospitals may negotiate higher fees. 

Further information

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