Anaesthetists are qualified doctors who work across many aspects of care, usually in a hospital. Their best-known role is to provide anaesthetic care before and during a surgical operation or medical procedure, but the work that they do goes far beyond that. They supply pain relief in other cases, for instance, to women during labour, and they care for people coping with chronic and ongoing pain. Known to other healthcare professionals as gas docs, the extent of an anaesthetist's role in medicine is often underestimated by patients.
Anaesthetists assess surgical patients ahead of operations, prepare them before a procedure and oversee their recovery. They provide treatment and resuscitation in accident and emergency (A&E) departments, and it's not unusual to find anaesthetists heading up an A&E department. Anaesthetists may accompany a severely injured or acute patient as they are transferred to a different unit or hospital. There are specialisations within anaesthetic medicine – for example paediatric (child) anaesthetics or spinal cord stimulation and because anaesthetists see patients across all aspects of care their wide-ranging knowledge makes them good clinical or medical directors. Anaesthetists have their own professional organisations, such as the Royal College of Anaesthetists, and the Scottish Society of Anaesthetists, and as is the case with all doctors, must keep up with new developments in their field and prove they are competent to practise on a regular basis.
Typical work activities include:
- checking a patient's health ahead of a procedure and preparing them for surgery
- giving anaesthesia to patients during surgery
- monitoring a patient's breathing, heart rate, blood pressure and consciousness during surgery
- planning pain relief for patients after surgery or a procedure
- working closely with surgeons, nurses, specialist doctors and operating department practitioners
- providing pain relief to women in labour or ahead of obstetric surgery
- monitoring a very ill or injured patient being taken to another hospital or facility
- heading a team resuscitating a patient after an accident or emergency
- taking responsibility for a patient after surgery
- training, teaching and supervising junior doctors.
An anaesthetist is usually based at a hospital, working in an operating theatre, intensive care unit, obstetric unit or at a pain clinic. They may also work in psychiatry and radiology providing anaesthesia for patients receiving electro-convulsive therapy (ECT) or scans. In addition, they may be employed in research, as a medical educator, or in senior managerial roles.
Most anaesthetists work a shift pattern on a rota with other anaesthetists so that days, evenings, weekends and emergencies are covered 24 hours a day. Though a planned shift may specify their hours, in reality an anaesthetist would stay at work, for example, if an operation took longer than expected or if they were dealing with a critically ill patient at the time their shift ended, rather than handing them over to another doctor. There are working options for careers in anaesthesia, known as less-than-full-time (LTFT), that offer flexible or more structured working hours.
Most anaesthetists in the UK work for public health providers, for example in a hospital for a healthcare trust. Some may work for a private practice in addition to their contracted hours for a public hospital, or they make work solely for private practices and providers.
Salaries are based on experience, and a doctor is still considered a junior, or trainee, until they are appointed to a consultant's position. A fully qualified consultant anaesthetist working in England, Scotland or Northern Ireland will have a basic first-year salary around £77,000 a year (2017-18 figures).
Anaesthetists apply to train in their specialty after completing a five- or six-year medical degree plus two years of foundation training. From that point, junior doctors train for another eight years on average, before their first appointment as consultant anaesthetist.
Anaesthetists' roles are advertised through official membership organisations, colleges and societies, through hospitals and healthcare trust websites and medical employers and in journals such as the British Medical Journal and their online equivalents. They may also be advertised in national and regional newspapers.
Personal Qualities and Skills
Key skills for anaesthetists
- Excellent communication skills with patients, families and colleagues
- Confidence and self-motivation
- Excellent clinical skills
- Good situation awareness
- Efficient and effective task management
- Good decision making skills, especially under pressure
- Excellent attention to detail
- An interest in new techniques and technical developments
- An interest in all aspects of surgery
Pay And Opportunities
Typical employers of anaesthetists
- Large public sector hospitals and national health trusts
- Private hospitals and healthcare providers
- Universities and medical education providers
- Relief work organisations.
Qualifications and training required
You can only start to train to become an anaesthetist once you have a degree in medicine plus two years of foundation training. Specialty training is overseen by the General Medical Council (GMC) and exams are set by relevant Royal Colleges or faculties. Qualification takes more than eight years of combined study and practical experience following foundation training, but appointment to a consultant position may take longer.
Roles associated with anaesthetics, such as physicians' assistant (anaesthesia) (PA(A)), operating department practitioner, and advanced critical care practitioner (ACCP), for which a medical degree is not required, are becoming an increasingly popular way of working in this field of medical practice. A PA(A) is employed in a team under a consultant anaesthetist and will have completed a PA(A) diploma from an approved organisation. They may administer local or regional anaesthesia, for such operations as cataract surgery or, for example, when a burns patient has dressings changed. An ACCP assesses patients' conditions and can work at an advanced level of practice to manage a critically ill patient.
Training as a consultant anaesthetist
The current process to train as an consultant anaesthetist involves the following...
Medical degree an approved course of usually five or six years, followed by two years of foundation training (F1 and F2). This is general training in different areas and specialties of medicine usually in a hospital setting. Core anaesthetics training (CT1-2) involves another two years of medical training and is followed by specialist training (ST3-7). Or an alternative is to follow years F1 and F2 with three years core training (CT1-3) and five years of specialist training (ST4-8). This professional experience and training includes examinations at various stages and supervised learning events (SLEs). All doctors have to demonstrate their fitness to practice and gain continuous professional development (CPD) points throughout the year in order to stay registered with the GMC.
Anaesthesia specialty training is coordinated by the Anaesthetics National Recruitment Office at Health Education West Midlands, which is responsible for recruitment on behalf of the RCoA through Britain and Northern Ireland.
Applying for medical degree courses
If you are considering applying for a medical degree, most medical schools require GCSEs, AS and A levels or the equivalent, with very good grades (AAA) in chemistry and biology plus another science or mathematics at AS level and one other good A level, which could be in a non-science-related robust subject, such as a language, music or geography. Scottish equivalent requirements might be, SQA Highers AAAAB by the end of S5 to include chemistry and two from biology, maths or physics (or a science in S6), SQA Advanced Highers in two subjects in S6 and one further subject at Higher or above, with preference for chemistry and biology/human biology. Other routes into medicine are available, for example, students who don't have the required A levels could study a six-year degree which includes a foundation year or pre-clinical course; students with an existing degree and relevant experience can take an intensive four-year medical degree.
Proof of commitment to medicine is usually sought by medical schools as a first step to gaining a place on a course. This could be demonstrated by a strong personal statement and practical evidence, such as work shadowing, regularly visiting elderly residents at a care home, or volunteering at a charitable organisation. Many universities and medical schools require candidates to sit the UK Clinical Aptitude Test (UKCAT) or BioMedical Admissions Test (BMAT) and applicants are usually, but not always, called to a face-to-face interview or assessment ahead of a university offering a place.
Candidates wishing to train as a PA(A) need a relevant biomedical or health science degree at 2:1 or above; or to be a registered healthcare practitioner with a degree or equivalent qualification. A PA(A) diploma requires studying a 24-month course made up of 12 modules, such as applied physics and anatomy, and includes exams at eight and 24 months, followed by an additional three months' probationary period. A qualified PA(A) is invited to become an affiliate of the RCoC and to register at the Association of Physicians' Assistants. Candidates wishing to train as an ACCP must already work as registered healthcare professionals, and, depending on the training school, must gain 180 credits over a four-year part-time course while also completing between 1,200-3,150 hours of associated clinical practice under approved supervision.