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What does an anaesthetist do? - cross post from surgery

Discussion in 'Anaesthetics' started by sweetie-pie, Apr 22, 2006.

  1. sweetie-pie

    sweetie-pie New Member

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    What exactly an anaesthetist does depends on what area they specialise.
    In general, will see and assess pre op patients for suitability for anaesthetics and consider which drugs to use if special considerations need to be made. Administer and monitor patient during op, manitain optimum conditions (fluid balance, BP, temp), keep them paralysed (if required) pain free and unaware. Insert lines for during and post op period, intubate or privide airway.
    Post op pain relief.
    Some do chronic pain, some acute management, regional and general anaesthesia.
    Sub specialty generally ITU/ICU anaesthetics, in which case everything in a critically ill patient, monitoring and treating all physiological systems. Not good for pateint communication as most are sedated/unconscious, but challenging as no patient report of whats going on, and lots of interaction with family.
     
  2. Mattie

    Mattie New Member

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    Thank you for that. Sound interesting although fairly limited but I might be wrong.
     
  3. simac

    simac New Member

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    Well when you consider than many consultant surgeons would be so specialised they would simply perform one operation, its not that narrow a field.
     
  4. Mattie

    Mattie New Member

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    I guess so. I like the idea of general surgery but I think there are becoming fewer and fewer jobs in this area.
     
  5. simac

    simac New Member

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    I suppose it makes more sense for trusts to employ surgeons who are going to be excellent at one or a couple of operations, rather than a jack of all trades. I suppose there would be some specialites though, neurology, orthopeadics, where youd see a lot of trauma cases, so that would keep variation i guess.
     
  6. sweetie-pie

    sweetie-pie New Member

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    you wouldn't say limited if your saw the post grad exams for Anaesthetics, the knowledge required is awesome and incredibly broad! Rumour has it they're some of the toughest ones out there as even in routine ops require attention to detail.
    As for surgery, I'd say it was probably more limited and will become more so with MMC, what is needed are those to do routine stuff, not those skilled to deal with every likelihood, baically senior registrars who can cope with non complicated stuff
     
  7. elky

    elky New Member

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    you know Guy from Green Wing...
     
  8. andy2

    andy2 New Member

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    Anaesthesia is the art of keeping the patient alive despite the surgeons - the maintainence of homeostasis in the face of significant surgical insult is hardly a narrow or limited field. If you add in looking after the sickest patients in the hospital (on ITU) it can be exciting, challenging and very broad. This week I've looked after patients with liver failure, myasthenia gravis (neuromuscular disorder), uncontrolled diabetes, major trauma and post-op following major bowel surgery. Anaesthetists are in some ways the last of the hospital generalists, along with emergency physicians and some geriatricians.
     
  9. andy2

    andy2 New Member

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    oh, and communication is vital -pre-op allaying patients fears, and post-op on the wards. Dealing with relatives of the critically ill and dying also requires careful communication.
     
  10. Mattie

    Mattie New Member

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    Take, your points. Thank you. I didn't know much about the role of an anaesthetist but now i have a better understanding. Thanks a bunch.
     
  11. racheljane

    racheljane New Member

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    I spent some time shadowing anaesthetists on work experience and their work was way more interesting and varied than I had ever thought it would be. One was telling me about travelling with a neonate in an ambulance that broke down, and having to make some really vital decisions on that and other occasions; another was describing the difficulties of treating such a wide variety of people, different every time in weight, age, sex, physiology, allergies, conditions etc. I did get the feeling that it would be a very interesting specialty, much more than I would have thought before.
     
  12. M Clayton

    M Clayton Moderator type bloke

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    I'm doing a placement in anaesthetics (and critical care, but I've limited my contact with ITU) at the moment and it's been fantastic.

    It's grounded in really good physiology, but still allows you to practice the "art of medicine" - patients that are ostensibly the same react entirely differently to anaesthetic drugs. You really have to think on your feet!
     
  13. pipedreamer

    pipedreamer New Member

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    I never thought much about anaesthetics until I spent some time in theatre with anaesthetists - then I found it absolutely fascinating! The anaesthetists I've met have been great people who are really knowledgeable about the physiology of the patient, how all the equipment works and how all the drugs act, and most of them seem friendly and keen to teach as well and will have me doing things like working out how long a patient can survive without ventilation after being given 100% oxygen for a few minutes first.

    It seems to be a challenging job as there are so many factors interacting with each other e.g. the patient's heart rate increases and the anaesthetist has to figure out if it's the surgery, an effect of a drug, the patient getting light, fluid balance or something more serious like malignant hyperthermia - and then decide what to do about it!

    I also liked seeing the communication side of it: I always thought that it was a specialty with very little (awake) patient contact but it's the anaesthetist chatting to and reassuring the patient pre-op and then when surgery is over the anaesthetist is the one waking the patient, talking to them, managing their pain, handing them over to the recovery staff etc. whilst the surgeons have often gone for a coffee!

    It's definitely a specialty I'm considering and I'd advise any med students who don't really know what it's about to try and spend some time with the anaesthetist next time they're in theatre.
     
  14. the_last_1_left_again

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    ummmmm.......interesting!!!!.... admittedly, having never worked in a surgical ward, i never actually thought much of an anaesathist...... i was under an impression that its quite a repetitive job where u use 1-method-fits-all approach 2 every case n u r jst stuck on da sidelines while da surgeons have all da fun slicing n dicing....and take all da credit for da good work.....

    it does sound quite fascinating line of wrk.......

    few questions though..... how competitive is anaesthesia, say as compared to general sugery? and wots da training structure like? wot abt pay? working hours etc? do u get any time for research or other medical-related activities?
     
  15. andy2

    andy2 New Member

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    Certainly no two anaesthetics are quite the same, and whilst you may use similar drugs it is using them in the correct dose and at the correct time that makes a good anaesthetic. Like swans paddling, it all looks smooth on the surface -but if you ever see a bad anaesthetic it will increase your respect for anaesthetists no end.

    Competition has been increasing in recent years, and the post-grad exams are arguably harder than most - as there are more anaesthetists than any other single in-hospital specialty there are fewer applicants per place than for general surgery or cardiology so it is in that way less competative.

    Training structures are all about to change (thank you MMC) -but it will probably look like - Foundation years, then apply for anaesthesia training - 2 years as a junior trainee and get your first part exam (FRCA primary) then five years senior during which you would get your final FRCA. Some folk will come through an acute specialties common training programme (A+E, Acute medicine, anaesthetics and ITU) and will probably do one year less at junior level (i.e. 8 in total rather than 7 if you just do anaesthesia).
    Pay is on the same scale as all other NHS doctors - and there are reasonable private practice oportunities if you like that sort of thing.

    Hours of work - depends on what you do -as a trainee a lot of anaesthesia occurs durign the day time, but emergency surgery, ITU and obstetrics need out of hours cover. As a consultant if you stay away from ITU/obstetrics then the out of hours work is not too frequent.
     
  16. tarja

    tarja New Member

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    im a bit confused here....so to qualify as an anesthetist 14 yrs r required? 5 yrs of med school, 2 yrs pre-registration and another 7 for specialisation? im going into med school in october and i find anaesthetics particularly fascinating but 14 yrs seems like an awful lot to me....
     
  17. Huw

    Huw New Member

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    is it like 7 years post grad training for this career???
     
  18. Jake

    Jake Enigmatic Moderator

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    No one knows - its all up in the air.
     
  19. sweetie-pie

    sweetie-pie New Member

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    It is up in the air, but most surgical and allied specialties will all but certainly require no less than 5-7 years post Foundation programme, exactly how that is organised if you come through different streams will alter things. (see jchst website - that is joint committee for higher surgical training). Medical is estimated at present but excected 4-6 years post FP.
    All very difficult to predict as this assumes direct entry to specialty training, and doesn't encompass more generic training streams feeding in later, and that you get your preferred specialty post FP in the first place.
    Yes when you add in medical school it is a long time for any specialty, its rare to find a consultant at 30 (from 1st degree) under current training, so 14 years not extreme.
     
  20. andy2

    andy2 New Member

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    14 years is a completely reasonable length of time to train to become a fully independent specialist in an area of medicine - the majority of this time will be spent as a doctor, working in medicine. To be able to function independently requires years of training and experience.
    14 years sounds like for ever when you are 17 (being over 3/4 of your life so far). It dosen't sound so long when you pick up your consultant's name badge for the first time.
     

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