How did you first get into medicine?
I wasn't sure what I wanted to do at school - I was mainly interested in biology and maths. This led me to a degree in physiology and pharmacology after getting advice from a teacher. In the end, I really enjoyed the practical aspects of my undergraduate thesis, like administering different strengths of smooth muscle agonists onto guinea pig ileum samples and developing dose-response curves.
In my final year, I had the choice of pursuing a career in pharmaceuticals or putting my practical skills towards a medical degree. St George's University of London had recently started their four-year graduate entry programme and the problem-based learning structure of the course appealed to me.
I was rather surprised to find myself as a medic; it was by no means a long-term ambition of mine to become a doctor, and I suffered from imposter syndrome from day one.
What inspired you to pursue your specialty?
Having struggled with juggling the many demands of multiple patients in my FY1 year, I was drawn to anaesthetics as it seemed possible to provide good care in a controlled and focused situation. My undergraduate science background was useful and I enjoyed the prospect of applying this in a clinical setting.
My real interest in obstetric anaesthesia developed while I was being taught basic level training by a great doctor at St Thomas' Hospital. I enjoyed the interface between developing my practical skills, often in difficult scenarios, and prioritising women's overall experience of childbirth.
How does your chosen specialty differ from other medical settings?
Anaesthetics is fairly unique in that you tend to only look after one patient at a time, and you only look after them in the immediate peri-operative period. We do talk to patients before they go to sleep, but the bulk of the care we give is while they're under anaesthetic.
The exception to this is in obstetrics, when women often remember their anaesthetist as the person who took away their pain, or who talked to them during their caesarean section. This is where we can really make the difference between a good or bad experience.
A big part of the college exams focuses on anaesthetic equipment with the technology evolving quite quickly, so it may appeal to the more tech-minded. It helps to be interested in studying the basic sciences, especially physics and physiology, and you're rewarded by applying these on a daily basis.
What additional skills have you learned as a result?
There's a comparison between flying a plane and delivering an anaesthetic - it requires concentration during take-off and landing, but cruising can often be done on autopilot.
However, when things go wrong, they happen quickly and dramatically, and you need to identify the problems and respond rapidly. It's often the anaesthetist who leads a team when managing a sick patient, and when positioned near a patient's head, may be the only consistent voice an unwell trauma patient hears and relies on.
Being an integral member of the theatre team demands good leadership skills to ensure the list keeps moving and patients are prioritised appropriately. This can involve acting as a mediator between different surgical specialties when limited theatre resources are in demand for their patients. It can sometimes feel like refereeing a football game, but certainly develops those people skills that help with good team working and mutual respect within a multidisciplinary team.
What advice would you give to a student who is considering this specialty?
The exams are tricky. The primary FRCA (the first part of the college exams) is mainly basic sciences and understanding anaesthetic equipment: think gas laws, alveolar dead space and pharmacodynamics of neostigmine.
The final FRCA is more clinical based but still challenging. It's not unusual for trainees to have several attempts before passing them all, but once you've passed them (usually during your fourth or fifth year of training) there are no more before becoming a consultant, unless you consider dual training in intensive care.
Getting through those exams was a huge achievement and felt like time well spent. I use the knowledge I gained during my revision every day on the job.
There are more anaesthetists than any other individual specialty in most trusts, so the support is usually great when revising for exams and you'll certainly be helped by senior colleagues at every stage. When you start anaesthetics, you are very well supervised by consultants and they often give you one-to-one teaching during an operation.
I have no regrets about pursuing anaesthetics; it's fun, rewarding and varied with plenty of practical skills. And tea breaks.
This page was correct at publication on 09/02/2023. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.
by Dr Jessica Lee Medico-legal fellow
Jessica Lee qualified in 2006. After foundation training, she spent a year in Australia in A&E, then South London for core anaesthetic training and Sussex for registrar training. She took an OOPE to do a masters in medical ethics and law and has been on GMC fitness to practice panels for the MPTS. She is now working as a medico-legal fellow at the MDU.