Anaesthetist

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

As an anaesthetist, you'll assess patients' health and discuss appropriate anaesthetic options (general, local or regional), administer anaesthetics before surgery, monitor patients during surgery and provide post-operative care. You'll also respond to emergencies both in theatre and across the hospital.

Patients range from newborns to the elderly and include those having surgery, giving birth or living with chronic pain.

While much of your work takes place in operating theatres, you may also work in other parts of the hospital such as intensive care units, labour wards, pain clinics or emergency departments. Some anaesthetists also work in pre-hospital care or specialise in areas such as critical care or pain medicine.

Responsibilities

As an anaesthetist you'll need to:

• conduct a pre-operative assessment to check the patient's fitness for surgery
• develop and agree on an individualised anaesthetic plan with the patient and surgical team
• reassure patients about what to expect during and after the procedure
• prepare patients for anaesthesia and surgery, including administering pre-medication where appropriate
• initiate anaesthesia, providing safe induction and pre-operative pain relief
• maintain anaesthesia and closely monitor patients throughout surgery
• monitor patients under anaesthesia to ensure they remain stable, checking their vital signs such as blood pressure, heart rate, oxygen and carbon dioxide levels, breathing and temperature
• resuscitate and stabilise patients in emergency situations, both in and outside of theatre
• safely reverse anaesthesia and manage post-operative pain to support recovery
• contribute to the management of patients with chronic or complex pain, where relevant
• work collaboratively with other healthcare professionals, including surgeons, operating department practitioners, theatre nurses, radiographers and radiologists, to ensure patient safety and wellbeing
• complete accurate clinical documentation related to anaesthetic care
• attend and contribute to multidisciplinary team meetings both on and off-site
• participate in on-call rotas and share responsibility for providing emergency cover
• train, teach and supervise more junior medical staff and trainees in both anaesthesia and critical care.

Salary

• The basic salary during foundation training in England is £38,831 to £44,439. Salaries for doctors starting their specialist training range from £52,656 to £73,992.
• As a speciality doctor, you'll earn between £61,542 and £99,216. Salaries for specialist grade doctors range from £100,870 to £111,441.
• Salaries for newly qualified consultants start at £109,725, rising to £145,478, depending on the length of your service.

Resident doctors (formerly known as junior doctors) will earn a basic salary, plus pay for any hours over 40 per week, a pay enhancement for working nights, a weekend allowance and an availability allowance if you're on call.

High-cost supplements are available to anaesthetists working in London. You'll automatically be enrolled in the NHS pension scheme, but you can opt out.

Consultants in England and Wales may apply for local Clinical Excellence Awards and national Clinical Impact Awards. You should also be paid more if you take on extra responsibilities in, for example, management or education. In Scotland, you can apply for discretionary points. Consultants 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, which is the largest employer of anaesthetists in the UK.

Salary bands differ across the four countries of the UK. Pay negotiation happens annually at different times, so salaries will change when each country agrees their new pay award. For the most up-to-date NHS salary information, see BMA.

Income data from NHS Health Careers. Figures are intended as a guide only.

Working hours

Anaesthetists typically work between 40 and 48 hours a week, which may include nights, weekends and on-call sessions to provide emergency cover. Their time is divided between operating theatres, pre-operative assessments, post-operative care and managing emergency situations both in and outside the theatre.

Full-time NHS anaesthetists typically work ten Programmed Activities (PAs) per week, with each PA lasting around four hours. Most of this time is spent on direct clinical care, while a portion is allocated to Supporting Professional Activities (SPAs), which may include administration, teaching, clinical audit and professional development.

Although the schedule can be demanding, many anaesthetists achieve a reasonable degree of work-life balance. There are also some opportunities for part-time work and job sharing.

What to expect

• You'll spend most of your time in hospital operating theatres but will also work in departments such as emergency medicine, obstetric units, critical care, and other acute care areas.
• 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 provide anaesthetics and pain relief to patients of all ages, from babies to the elderly, sometimes in emergency situations. However, it can also be highly rewarding.
• In most hospitals, theatre staff, including anaesthetists, wear scrubs.
• You may need to travel to attend training or meetings. There are opportunities to work abroad for qualified anaesthetists.

Qualifications

To become an anaesthetist, you must complete:

• a degree in medicine recognised by the General Medical Council (GMC)
• a two-year foundation training programme of general training
• either three years of Stage 1 Anaesthetics Training or four years of Acute Care Common Stem (ACCS) (Anaesthetics) training, both of which lead to completion of Stage 1
• higher specialty anaesthetics training that takes four years to complete.

Medical degrees usually take five to six years to complete. However, if you've already got a degree in a subject other than medicine, you can apply for a four-year accelerated Graduate Entry Medicine course (also known as the Graduate Entry Programme). Medical schools usually ask for a 2:1 or above in a science-related subject, although some courses may accept a 2:2.

For a list of medical schools, see the Medical Schools Council.

This is followed by two years of paid work-based foundation training common to all medical graduates that allows you to develop your clinical and professional skills in the workplace. You must apply for a foundation training place via Oriel in your final year of medical school. During this training, you'll undertake a series of work placements in different departments that may include anaesthetics.

After successful completion of the first year of Foundation Training (FY1), you can apply for full registration as a doctor with the GMC. Full registration is granted at the start of Foundation Year 2 (FY2), subject to satisfactory completion.

For full details, see the UK Foundation Programme.

In the second year of Foundation Training, you'll apply for Stage 1 anaesthetic training via Oriel. There are two options:

• Stage 1 anaesthetics training - focuses on anaesthesia and intensive care medicine.
• the ACCS (Anaesthetics) training programme - the first two years involve four, six-month placements in acute internal medicine, emergency medicine, anaesthetics and intensive care medicine, followed by two more years of training specifically in anaesthetics.

You'll then need to apply again via Oriel for a further four years of higher anaesthetic specialty training. During your training, you must also pass the Fellowship of the Royal College of Anaesthetists (FRCA) examinations.

At the end of your training, you'll gain a Certificate of Completion of Training (CCT) in anaesthesia, which enables you to join the GMC 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).

The NHS employs a significant number of SAS (specialist, associate specialist and specialty) doctors who aren't consultants. You'll need a minimum of two years' specialist training to work as an SAS doctor. Find out more about anaesthetic SAS roles.

Skills

You'll need to have:

• a comprehensive and up-to-date knowledge of anaesthesia, critical care and pain management
• strong communication skills to collaborate effectively with colleagues and support patients and their families
• the ability to organise, prioritise and manage a clinical workload
• manual dexterity and steady hand-eye coordination
• situational awareness and the ability to anticipate and respond to rapidly changing clinical situations
• strong written communication skills for clear and accurate report writing
• the ability to work flexibly and collaboratively as part of a multidisciplinary team
• emotional resilience and the ability to remain calm in high-stress or emergency situations
• sound clinical judgement and confident, evidence-based decision making
• a compassionate and patient-focused approach to care
• keen observational skills and attention to detail
• leadership skills and the ability to supervise and support junior staff.

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

Work experience

Before applying for a medical degree, you're expected to undertake relevant work experience, either paid or voluntary. This experience shows your commitment to becoming a doctor and provides insight into the physical and emotional demands of the role.

Options include getting work experience at your local hospital, GP surgery or nursing home, working as a healthcare assistant or porter, or work shadowing a doctor. Contact your local healthcare providers to explore opportunities.

At medical school, try to choose modules in anaesthesia. Contact your local anaesthetics department to see if they can help you organise a student-selected clinical placement, elective or clinical audit, for example. Use these experiences to speak with anaesthetists and understand their role within the wider healthcare team.

Joining your university's anaesthesia society can also be helpful. These groups offer careers events, mentoring and other support. See the RCoA website for a list of medical school anaesthesia societies.

You can also join the RCoA or Association of Anaesthetists as a student member. Membership provides access to networking opportunities, resources and advice.

During your two-year Foundation Training, aim to complete an anaesthesia placement to gain direct experience. If this isn't possible, try arranging a taster session by contacting anaesthetists directly. Attend conferences and events to build connections and further your understanding of the specialty.

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
• HealthJobsUK
• NHS Jobs (England and Wales)
• NHSScotland Jobs
• Jobs.hscni.net - health and social care jobs in Northern Ireland.

Jobs are also advertised on the websites of private healthcare providers.

Professional development

As a qualified anaesthetist, you'll be expected to engage in continuing professional development (CPD) throughout your career to maintain your skills and remain on the GMC register. CPD activities may include attending courses, conferences and workshops, participating in audits, contributing to teaching or engaging in research and quality improvement projects.

Membership of the RCoA and the Association of Anaesthetists offers access to CPD resources, events, online learning and professional networks.

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.

You can also develop your management skills by taking a national NHS Leadership Academy p°ù´Ç²µ°ù²¹³¾³¾±ð.Ìý

Career prospects

Although there can be some competition for entry-level roles, once established you'll typically enjoy good job security due to the essential nature of the role in surgery, critical care and pain management. In the first five to ten years of your career, you'll increase your levels of responsibility, experience and pay.

The role offers varied opportunities for growth, specialisation and advancement. Common sub-specialties include intensive care medicine, obstetric anaesthesia, chronic pain management and paediatric anaesthesia.

As a consultant, you may take on increasing leadership, potentially progressing to roles such as lead consultant, clinical director or medical director. Some consultants have responsibility for both anaesthesia and intensive care medicine.

There are opportunities to get involved in teaching and training medical students, doctors in training and professionals such as nurses and midwives. Anaesthetists with a strong interest in education can become educational supervisors or progress into roles such as training programme director or director of medical education.

If you're interested in research or an academic career, you'll need to start early, often during Foundation Training, typically applying for an academic clinical fellowship or studying for a higher research degree such as a PhD.