Anaesthesia as a career

Have you considered anaesthesia as a career option?

Anaesthetists must be good all-round doctors. They play a major role in the perioperative care of surgical patients and are closely involved in several important fields. One fascination of the specialty is the way in which physiological and pharmacological manipulations can be used to benefit patients with a wide variety of conditions. Associated areas include care of the very sick in intensive care (critical care) medicine and management of acute and chronic pain (pain medicine).

Why anaesthesia?

• Relief of pain and suffering is at the centre of the practise of anaesthesia. Anaesthetists aim to facilitate surgery and uncomfortable procedures and to aid with recovery after surgery, in childbirth or in the care of those with acute and chronic pain. Close and empathetic interaction with patients is integral to anaesthetic practice.

• Clinical anaesthesia is built on a knowledge of physiology and pharmacology and the ways in which patient responses are altered by their state of health, as well as the manipulations that are part of the anaesthetist’s work. There are many opportunities for teaching and research.

• There have been many recent advances in the science of anaesthesia. Monitoring devices, computer technology and the advent of drugs with fewer undesirable side effects have made the specialty safer and more sophisticated. The specialty is challenged by an ageing population, who present with co-morbidities of increasing incidence and severity.

•  Anaesthetists work together with many other specialists. There are opportunities to develop special interests in areas such as paediatrics, obstetrics, orthopaedics, otorhinolaryngology, gynaecology, neurosurgery, cardiovascular and thoracic surgery, trauma management, respiratory medicine, hyperbaric medicine, intensive care medicine and pain medicine.
  

• There are opportunities to practise in public and private hospitals. Clinical research may be carried out in either of these settings.
  

• Anaesthetists are team members and have an essential role in promoting the effective coordination and utilisation of medical, nursing and technical resources, especially during the perioperative period. The anaesthetist must work with colleagues to ensure the best possible treatment for all patients.
  

• Anaesthesia can be demanding and stressful during both the training period and years spent working as a specialist. Work patterns and training programs can be adapted to the needs of practitioners to suit their personal and professional lives.
  

• Anaesthesia is a developing and expanding specialty. There are shortages of trained anaesthetists, particularly in rural areas of Australia and New Zealand. Shortages are even more marked elsewhere in the world.

Training in anaesthesia

Anaesthetists training in Australia and New Zealand must obtain the Diploma of Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA) to be recognised as specialists.

Training in pain medicine can be associated with training in anaesthesia and the Faculty of Pain Medicine within the College is responsible for training in that discipline.

The assessment of trainees in anaesthesia is principally by examination, but includes formative assessments by the staff of the hospitals in which trainees work. Trainees must achieve specific goals which are summarised below. The College regularly inspects the hospitals that it approves for training to ensure that there are high standards of teaching, supervision and clinical care.

Before formal approved vocational training in anaesthesia commences, trainees must complete at least 24 months of general hospital experience - postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) - after graduating from medical school. This ensures a grounding in general medicine and in disciplines other than anaesthesia. A maximum of 12 months of anaesthesia and/or intensive care is permitted during this time. Many successful applicants for training positions have had additional experience, often in anaesthesia, after completing PGY2.

Vocational training in anaesthesia consists of two years of basic vocational training and three years of advanced vocational training.  Approved training comprises 33 months of clinical anaesthesia, three months of intensive care medicine and 24 months of other disciplines. These may include clinical anaesthesia, intensive care medicine including neonatal intensive care, clinical medicine, emergency medicine, pain medicine or other related disciplines.  Vocational training requires completion of 12 training modules in clinical anaesthesia, intensive care medicine and pain medicine, together with modules on education and scientific enquiry, professional attributes and professional practice.  Emphasis is placed on the trainee developing a continuous personal record of training objectives, experiences and achievements (learning portfolio).  This record also includes in-training assessments and details of the formal project.

The major examinations are:

• The primary examination: basic sciences. This examination is based on a high standard of knowledge of physiology and clinical pharmacology relevant to anaesthesia. There are multiple choice, short answer and Viva components. The examination can be taken at a minimum of 12 months after graduation in medicine. Although some trainees have completed the examination by the time they commence approved vocational training, the primary examination is not intended as a prerequisite for the selection of new trainees. The primary examination must be passed before advanced vocational training is commenced.

•  The final examination: anaesthesia and medicine. This examination has multiple choice, short answer, written and Viva components.

With prior approval from the College, flexible (part-time and/or interrupted) training is possible under specified circumstances, as is some overseas training.

When you register with the College, you will receive a manual detailing the structure and aims of the training program.

Transitions in education

ANZCA was reviewed by the Australian Medical Council (AMC) in 2002 and was awarded the AMC’s highest level of accreditation. This comprehensive review examined the structure and organisation of the College, its processes of education and training and its procedures for accrediting hospitals for training. It looked particularly at selection of trainees, supervision and assessment of trainees, and professional development programs.

ANZCA has been reviewed twice by the Australian Medical Workforce Advisory Committee (AMWAC) and regularly provides input to the Australian Medical Training Review Panel (MTRP).

ANZCA strongly supports maintaining continuity in medical education from medical school through the prevocational years, then specialty training and beyond into practice years, via its Maintenance of Professional Standards (MOPS) program.

Entering a training program

If you are considering a career in anaesthesia, you should attempt to get a feel for the specialty as early as possible. An elective in anaesthesia is frequently possible during senior undergraduate years. The College and some medical school departments offer prizes in anaesthesia at undergraduate level to encourage trainees. Some experience in anaesthesia as part of the first two postgraduate years is also valuable.

Talk to anaesthetists. Training hospitals have both directors of anaesthesia and College supervisors of training on staff. These people can assist with information, job prospects and contacts. They also can advise you on how to apply for training positions advertised by hospitals and health jurisdictions.

For further information and copies of the College’s information booklets for trainees, please contact:

Chief Executive Officer
Australian and New Zealand College of Anaesthetists
630 St Kilda Road
Melbourne VIC 3004
AUSTRALIA 

Tel:       +61 3 9510 6299

Fax:      +61 3 9510 6786

E-mail:   ceoanzca@anzca.edu.au

 

Further information is available from the College’s regional committee offices in Australia's state capitals and the New Zealand National Committee in Wellington, New Zealand.