The speciality - a summary
Many people think of anaesthetists as working solely in theatres, but in fact anaesthetists work in a number of different areas and can be found on labour ward, in ITU, seeing patients on the wards or in chronic pain out-patient clinics, to mention just a few.
Operating theatre work
Anaesthetists act as peri-operative physicians for surgical patients. This role starts with the pre-operative assessment when the anaesthetist must decide if the patient is fit for anaesthesia and surgery. The pre-operative assessment enables the anaesthetist to establish a rapport with the patient which helps to relieve anxiety and is a good time to discuss post-operative pain relief.
Once the patient reaches theatre, the anaesthetist tailors the anaesthetic to each patient's needs. Close attention is paid to the patient's condition during surgery and the anaesthetist responds quickly if any problems arise. At the end of the procedure, the anaesthetist is responsible for ensuring full recovery from anaesthesia and establishing good pain relief.
Sub-specialities
One of the best things about a career in anaesthesia is the fact that there really is something for everyone. These sub-specialities not only follow surgical ones (e.g. paediatrics, obstetrics, cardiac surgery, neurosurgery) but many have evolved in their own right. Anaesthetists are a multi-talented group and they have many skills which can be applied in different areas.
Intensive care medicine
Most intensive care doctors (93%) have an anaesthetic background. As a trainee in anaesthesia, you will develop skills in the management of profoundly ill patients in intensive care from your first year of training, and throughout the training programme.
Resuscitation and trauma management
Anaesthetists are core members of major trauma and resuscitation teams. In addition, anaesthetists are involved in the transfer of critically ill patients over long distances by land and air, very often being the only medical personnel present during the transfer.
Obstetrics
About 60% of women giving birth are likely to come into contact with an anaesthetist in some capacity.
Anaesthetists provide analgesia for labour, often in the form of epidurals, as well as anaesthesia for surgical procedures. In addition, obstetric anaesthetists play a leading role in obstetric high dependency units.
Pain management - Acute
Anaesthetists have the skills to provide excellent quality postoperative analgesia, using epidural and other techniques. Increased awareness of what we have to offer has led to the application of these techniques to other acute pain situations such as trauma.
Pain management - Chronic
Anaesthetists are ideally suited to this relatively new and evolving specialty. Most anaesthetists with an interest in chronic pain have outpatient consultation sessions and theatre treatment sessions. They are experts in invasive treatment techniques like nerve blocks, injection procedures and, in some centres, implantation of pain relieving devices. In addition, anaesthetists play a central role in multidisciplinary pain management programmes.
Academia and research
Academic departments of anaesthesia supervise the teaching and examination of undergraduates in anaesthesia, especially airway and resuscitation skills. Anaesthetists at all levels are encouraged to take an active role in this.
All trainees are encouraged to participate in research, which is a very enjoyable and rewarding experience. One of the attractions of the Welsh school of Anaesthesia is the very strong academic department at the University of Wales.
