Anaesthesia

 

Section 1: Information about the writer

Ibrahim Mohamed

ST4 Anaesthesia

West Yorkshire

Section 2: Scope of practice in the UK:

Anaesthesia form the largest single hospital medical specialty. Whilst the perioperative anaesthetic care of the surgical patient is the core of specialty work, many anaesthetists have a much wider scope of practice which may include:

• The preoperative preparation of surgical patients
• The resuscitation and stabilisation of patients in the Emergency Department
• Pain relief in labour and obstetric anaesthesia
• Intensive care medicine
• Transport of acutely ill and injured patients
• Pre-hospital emergency care
• Pain medicine including:

1. The relief of post-operative pain
2. Acute pain medicine and the management of acute teams
3. Chronic and cancer pain management

• The provision of sedation and anaesthesia for patients undergoing various procedures outside the operating theatre. Examples of this include different endoscopic procedures, interventional radiology and dental surgery (this list is not exclusive).

Section 3: Type of Training/ Route to Training:

• CCT (Certificates of Completion of Training): Requires completion of recognised Foundation program, Core training and Specialist training program.
• CESR (Certificate of Eligibility for Specialist Registration): Requires completion of work based assessments and training blocks similar to formal training process but without recognised training program.
• MTI (Medical Training Initiative): 2 years experience only.

Section 4: Sub-Specialties

• Intensive care medicine
• Pain management
• Cardiothoracic anaesthesia
• Neuroanaesthesia
• Paediatric anaesthesia
• Obstetric anaesthesia
• Regional anaesthesia
• ENT and airway
• Hepatobiliary
• Prehospital care

Section 5: Application Process:

Anaesthetics National Recruitment Office at Health Education West Midlands is the responsible organisation for coordinating CT1 and ST3 recruitment to Anaesthetics specialty training posts (including ACCS Anaesthetics) within the NHS. This responsibility is carried out on behalf of the Royal College of Anaesthetists throughout Great Britain and Northern Ireland.

Recruitment to anaesthetics training programmes is conducted twice-yearly for August and February commencement.

Please check the link below which has useful information about the recruitment process and how to apply

http://anro.wm.hee.nhs.uk

Section 6: Requirements To Get Into Training (Person Specification):

http://anro.wm.hee.nhs.uk

Check link to Person specification for CT1 and ST3

Section 7: Important CV/Portfolio Perks (How To Achieve Them):

• Self assessment criteria for ST3

http://anro.wm.hee.nhs.uk/Portals/3/Documents/National/ST3%20Self%20Assessment%20Criteria%202016%20-%20FINAL%20v1.2.pdf?ver=2016-02-10-103350-557

• Portfolio preparation:

http://anro.wm.hee.nhs.uk/Portals/3/Documents/ST3%20August/Portfolio%20Preparation%20-%20ST3.pdf?ver=2014-01-14-135101-107

• National interview scoring guide

http://anro.wm.hee.nhs.uk/Downloads

Section 8: The Interview:

A standardised interview/selection format is in place, which is mandatory for all Anaesthetics interviews, to ensure that there is a consistent national standard. The standardised format incorporates a generic scoring system and structure for interviews across all UoAs but allows the addition of locally preferred stations to complement the nationally standardised stations.

At each of the standard stations, you will be assessed by a minimum of two consultant assessors.  Each assessor will score you independently.

The national stations are as follows:

Global Rating

In addition, for each of the three national standard stations, you will be given a score from each assessor on their overall view of your performance at the station; this is commonly referred to as a ‘Global Rating’.

Locally Preferred Additional Stations

Individual UoAs are able to supplement the above three standardised stations with additional, locally preferred stations.  If used, these will be designed to test attributes described in the national person specification.  If UoAs choose to adopt local stations, it is expected that applicants would be informed of this and the attributes that are being tested.

Section 9: Competition Ratio:

Example of Applicants per post at CT1 level

• 2015- 2.06
• 2014- 2.1
• 2013- 2.5
• 2012- 2.0

Please refer to ANRO website in Section 5 for further details.

Section 10: Offers and Visa Issues and HEE

• After the interview candidates are classified into “appointable” and “unappointable”.
• Candidates who are not appointable will receive an email within days after the interview to inform them that they were unsuccessful.
• All offers will be made on the Oriel System by the ANRO. If you are made an offer, you will need to respond to this on Oriel.
• Offers that are declined will be recycled and offered in rank order to other applicants.
• If you do not have right to work in the UK i.e you are not British or EU citizen and not on a training programme (e.g. core Anaesthetic training) at the time of application you will be informed that you will not be offered a job until the resident labour market test is met.

 

Section 11: Speciality Exams

• Primary FRCA (Written and SOE/OSCE): will need to be completed prior to application for ST3 NTN.
• Final FRCA (Written and SOE): Will need to be completed prior to progression to ST5.
• Additional exams depends on subspecialty: FFICM for Intensive care medicine, FFPMRCA for Pain management, Specific diplomas for Transthoracic Echo, Regional anaesthesia etc.

Section 12: Speciality Courses/Societies

• There are desirable courses listed on the person specification that will give you points in the application process e.g: ALS/ATLS/APLS/IMPACT
• There are also wide range of courses available on the RCOA (Royal college of Anaesthetists) and AAGBI (Association of Anaesthetists of Great Britain and Ireland) websites.

Section 13: Rotations

• Anaesthetic training consists of 2 years core training and 5 years specialist training (2 intermediate-2 higher-1 advanced).
• You will get enough exposure to all surgical specialties as well as intensive care medicine, pain management and obstetric anaesthesia.
• This include a combination of tertiary centre and district general hospital experience.
• Rotations to different training blocks is very flexible and can be discussed with your local TPD (training programme director) according to your training requirements.
• For full details of training scheme, please check the RCOA website training section.

 

Section 14: Ranking of Deaneries

• Anaesthetic training is standardised across all deaneries. Therefore ranking usually depends on personal preference e.g: family ties. However applying for a deanery with large number of NTN posts increases your chance of getting a job. Few years ago applying to certain deaneries used to be more competitive than others but with the shortage that the NHS is facing currently, this difference is gradually fading away.

 

Section 15: Wages / Take Home Cash

• The salary system in UK is complicated and there are multiple factors that influence the exact take home money. To complicate things further the pay system is going to change from August 2016.
• Roughly an anaesthetic ST3 (first year registrar) currently takes home after tax and deductions around £3000 /month (£2973). This used to increase annually by around £150 to a maximum of £3846 /month.
• The main change from August 2016 is that there will not be an annual increase i.e ST3 will have the same salary as an ST7. However the salary will likely be somewhere between £3400 -£3600 (not yet finalised). So it will be good for newly starting ST3’s but not good for those who are on the higher side of the scale.

Section 16: MTI

• This is an excellent route for Sudanese doctors who already completed anaesthetic training outside UK to get into the UK training system.
• NHS hospitals across the country are increasingly employing overseas doctors to this training scheme.
• Duration is 2 years.
• You will be allocated a supervisor who should address your educational needs and help you achieve your goals from the programme.
• What usually happens during the last few months of MTI period you get an alternative certificate of core competencies signed off by your supervisor which could be used for ST3 NTN application.
• For full details on what the scheme involves and application requirements please check the MTI section of the RCOA website.

 

Section 17: Experience of Sudanese Doctors:

• Sudanese junior anaesthetists are involved in wide range of anaesthetic practice. This include training programmes such as core training or specialist training, MTI, Non training route to obtain CESR or service posts.
• For training program application following the applicant guide including person specification and self assessment criteria is very important in preparing for application and interview. All relevant information are available on the ANRO website.

 

Section 18: Important Links and Websites

• http://anro.wm.hee.nhs.uk
• http://specialtytraining.hee.nhs.uk
• http://www.rcoa.ac.uk
• http://www.aagbi.org/professionals/trainees
• http://www.frca.co.uk