Anaesthetist

Anaesthetists are the largest group of specialist doctors in hospitals and provide anaesthesia and pain management to patients who are undergoing surgical, medical or psychiatric procedures

As an anaesthetist, you'll assess patients' health and discuss which type of anaesthetic is suitable for them (general, local or regional), administer appropriate anaesthetics before surgery, monitor their wellbeing during surgery and provide care after medical procedures. You'll also deal with emergencies in theatre.

Patients can range from babies to the elderly and may include pregnant women (during childbirth), those undergoing operations and those with chronic pain.

You'll spend the majority of your time in the operating theatre, although you may also work in other areas of the hospital, including wards. You can also lead intensive care units.

Responsibilities

As an anaesthetist you'll need to:

• assess whether a patient is fit enough to undertake an operation before surgery takes place
• agree on an anaesthetic plan
• reassure patients about what will happen during and after the operation
• get patients ready for surgery
• initiate anaesthesia, providing safe pre-operative care and pain relief to patients using anaesthetics and analgesics
• continue anaesthesia in the operating theatre
• monitor patients while they're under anaesthesia to make sure they remain in a stable condition, checking their blood pressure, heart activity, oxygen and carbon dioxide levels, breathing and body temperature, for example
• resuscitate and stabilise patients during emergencies
• reverse anaesthesia and relieve and manage post-operative pain to support patients' recovery
• provide care for patients in chronic pain clinics
• work with a range of other health professionals, such as surgeons, operating department practitioners, theatre nurses, radiographers and radiologists, to ensure patient wellbeing
• perform administrative tasks in areas which relate to the care of patients, including summaries of patient treatment and the writing of discharge letters
• attend multidisciplinary team meetings both on and off-site
• participate in an agreed on-call rota and take on an equal share in providing emergency cover
• train, teach and supervise more junior staff in both critical care and anaesthesia.

Salary

• The basic salary for junior hospital doctor trainees in England at Foundation Training level is £29,384 to £34,012. As a trainee doctor you'll receive a basic salary plus pay for any hours over 40 per week.
• As a doctor starting your specialist training, you can earn between £40,257 to £53,398.
• Salaries for specialty doctors (staff grade) range from £50,373 to £78,759.
• Salaries for newly qualified consultants start at £88,364 rising to £119,133 for consultants with ten to 19 years' experience.

Beyond trainee level, you'll receive allowances for working nights, weekends and being on call. You'll automatically be enrolled in the NHS pension scheme but are able opt out.

Consultants may apply for local and national Clinical Excellence Awards and are also able to supplement their salary by working in private practice.

Figures relate to the pay and conditions of medical doctors within the NHS - the largest employer of anaesthetists in the UK.

Income data from NHS Health Careers. For doctors salaries for the whole of the UK, see the BMA website.

Figures are intended as a guide only.

Working hours

Working hours can be long and may include nights and weekends, as well as on-call hours.

Realistically, a typical day can start before 8am and will often involve unsocial hours. However, once established, it's possible to arrange part-time hours or job sharing.

Although no two days are the same, anaesthetists often find a level of routine in their working hours which draws on their many skills and gives them a good level of job satisfaction and work/life balance.

What to expect

• You'll spend most of your time working in a hospital operating theatre but will also work in other departments such as resuscitation services, obstetric units, critical care services and emergency departments.
• Jobs in anaesthesia are available at NHS hospitals throughout the UK and in hospitals in the private health sector.
• The job can be emotionally and physically demanding as you'll be providing anaesthetics and pain relief to patients of all ages, from babies through to the elderly, sometimes in emergency situations. However, it can also be highly rewarding.
• An NHS uniform is the norm in surgical theatre in most hospitals.
• You may need to travel to attend training or meetings. There are opportunities to work abroad for qualified anaesthetists.

Qualifications

To become a consultant anaesthetist, you'll need to start by taking a degree in medicine recognised by the General Medical Council (GMC). This usually takes five to six years to complete, although if you've already got a degree in a subject other than medicine (usually a 2:1 or above in a science-related subject) you can apply for a four-year accelerated graduate entry medicine programme (also known as a graduate entry programme).

Your medical degree is followed by two years of Foundation Training, common to all medical graduates, where you work in a hospital as a junior doctor on a rotational basis in different departments, which may include an anaesthesia specialty.

After successful completion of the first year of Foundation Training, you can apply for full registration as a doctor with the GMC. On successful completion of the programme, you'll be awarded a Foundation Programme Certificate of Completion (FPCC). For full details, see the UK Foundation Programme.

In the second year of Foundation Training, you can apply for postgraduate training in anaesthesia. Currently, the application process involves submitting an application form and sitting the Multi-Specialty Recruitment Assessment (MSRA) to help form a shortlist of candidates to be invited to an interview, following which the highest ranking applicants are appointed to posts.

There are two postgraduate training routes into anaesthesia, which last seven to eight years in total. Each route starts differently:

• Core anaesthesia training (CT) lasts three years and focuses on anaesthesia and intensive core medicine.
• The Acute Care Common Stem (ACCS) route takes four years to complete. This route involves four, six-month placements in acute internal medicine, emergency medicine, anaesthetics and intensive care medicine, completed by two more years of training specifically in anaesthetics.

This is followed by four years of higher anaesthetic specialty training. During your training, you must also pass the Fellowship of the Royal College of Anaesthetists (FRCA) examination.

At the end of your postgraduate training, you'll gain a Certificate of Completion of Training (CCT) in anaesthesia, which enables you to join the specialist register in anaesthetics and apply for consultant-level posts. There's also an option to study for a dual CCT in anaesthesia and intensive care medicine. For more information, see the Royal College of Anaesthetists (RCoA).

Skills

You'll need to have:

• a comprehensive knowledge of anaesthetics and procedures
• the ability to organise and prioritise your workload
• strong communication skills, both written and spoken
• steady hand-eye coordination
• a knowledge of your clinical and professional strengths and limitations
• teamworking skills
• the ability to work well under pressure
• a compassionate attitude towards patients
• leadership qualities
• the ability to manage personal stress and fatigue
• decision-making and problem-solving skills
• situational awareness.

You'll also need to be professional, flexible and work ethically to a code of conduct.

Work experience

Entry to medical school is competitive and you'll be expected to have done some work experience or a placement in areas relevant to medicine to get a place. Contact your local hospitals to try and get some work or shadowing experience.

Volunteering or work experience as a healthcare assistant, porter or other related role will give you greater insight into healthcare and will show your commitment to medicine as a career.

During medical school, it's helpful to get additional work experience in a health environment. While on medical school placements and your elective, talk to anaesthetists to gain a greater understanding of their role and the part they play in the wider healthcare team.

Medical students are able to join the Association of Anaesthetists at a reduced rate. A number of universities have anaesthesia societies which offer careers events, mentoring schemes and other support for medical students. A list of some of these societies can be found at RCoA - Medical School Anaesthesia Societies.

During your two-year foundation training as a junior doctor, you can try to get onto an anaesthesia rotation. If that's not possible, try to talk to doctors working in anaesthesia to arrange a taster session. This will give you a good insight into what the work involves.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

The NHS is the largest employer of anaesthetists in the UK. There are also opportunities to work in the private sector and in the armed forces.

Qualified anaesthetists can also work overseas with aid agencies and other medical organisations.

Look for job vacancies at:

• BMJ Careers
• NHS Jobs (England and Wales)
• NHSScotland Jobs
• Jobs.hscni.net - health and social care jobs in Northern Ireland.
• Oriel - for anaesthetics specialty training.
• private healthcare websites.

Professional development

As a qualified anaesthetist, you'll be expected to continue learning throughout your career. Continuing professional development (CPD) is essential if you want to remain on the GMC register.

CPD activities include attending courses, conferences, meetings and workshops, as well as undertaking research and peer-reviewing journal papers. Resources to help with your CPD are available from RCoA - Events and Professional Development.

If you wish to integrate more formal teaching into your work, you can study for a qualification in medical education, for example the MMedSci Medical Education. Search postgraduate courses in medical education.

For an academic research career, you'll need to study for a PhD in an area of original research.

Many anaesthetists have an interest in a sub-specialty and will go on to focus on this one area, for example chronic pain management, intensive care medicine or paediatric anaesthesia. You may also specialise in specific sorts of pain, such as childbirth.

Career prospects

Although there can be some competition for entry-level roles, once established your job is relatively secure due to the highly skilled nature of the work and its importance in medical and surgical procedures.

The role can be fulfilling and offer opportunities for growth, specialisation and advancement. In the first five to ten years of your career you can expect to progress in both experience and pay.

As a consultant you'll gradually gain more clinical experience and take on more responsibilities. initially as a medical lead (a lead consultant for a team), then as a clinical director (a lead consultant for a department) and later as a medical director (a lead consultant for a hospital trust). Some anaesthetists go on to have responsibility for intensive care medicine as well as anaesthesia.

Opportunities also exist for teaching and training medical students, doctors in training and students in related professions such as nursing and midwifery. Anaesthetists interested in teaching future doctors may become a director of medical education, training programme director or associate dean in charge of the entire training programme.

If you wish to take up scientific research and an academic career, you'll need to start early during your Foundation Training, as this field is highly competitive.