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Ask the Graduate: trainee anaesthetist

RO Central Team - Monday, April 01, 2019
Posted 6 months ago

April 2019

Will Green: A day in the life of an anaesthetist

Hello! I’m Will, I studied medicine at Newcastle University and graduated in 2013. I am currently a trainee in anaesthetics.

When I wrote my personal statement, I said that the best thing about medicine is that it isn’t a path from A to B, but a starting point to any number of possible destinations, and I very much still believe that! A day in my life is very different to a lot of my colleagues who have chosen different specialities, even in my short career I have had the opportunity to try my hand at lots of different branches of medicine!

My day starts at 07:30, when I go and see patients on the operating list for that morning. I go over their history, look at their blood tests and work out what the best anaesthetic for their operation. Once all the patients have been seen, we have a meeting with the consultant anaesthetist, the surgical team and the nursing team and go over the morning’s work. We then get cracking, in turn, getting the patient into theatre, getting them sorted and then off to sleep for their operation, and getting them safely woken up afterwards. It’s very satisfying and interesting work, however I think I’m a bit biased when it comes to anaesthetics!

My career started in 2013, when I rotated through my “foundation years”, doing 4 month stints in respiratory medicine, general surgery, orthopaedic surgery, paediatrics, A&E and GP. I then started my specialty training in anaesthetics. Every doctor does a two year foundation period where they rotate through different specialties, but it is after that point that the real fun begins!

The degree itself is great fun, a good mix of core science, practical skills and patient encounters. As some of you may know it is a bit different from other degrees in that it is longer (5 years) and you spend a lot of time on placement in hospital as opposed to the lecture theatre. The overall aim is to get the knowledge needed and learn the essential skills to be a competent doctor. Throughout the degree you will get exposed to many of the possible avenues of the medical profession.

There is a match for every skill set in medicine. Some careers rely on practical skills, some rely on a purely cerebral approach. Some problems require assertiveness, some require negotiation. The common denominator is that every branch of medicine focuses on solving problems to help the patient. Some medical specialties do not have direct patient contact (microbiology, radiology, public health to name a few) but still have vital roles in providing patient care. You work in a wider team of not just medics, but nurses, allied healthcare professionals and non-clinical team members, and interacting with so many different people, all with their role to play, is one of the best bits about the job. The big joy comes from interacting with patients, providing not just healthcare but support and compassion. You see people at their best and worst, at their strongest and at their most vulnerable and it is a privilege to be part of it.

Common skills needed for success would be an aptitude for science, problem solving and tenacity. Every specialty involves working in a team, and good team playing skills are vital to any role. As you are often looked to as a leader, it is helpful to be able to demonstrate leadership skills. It is not an easy life, resilience is a helpful skill, but you have a good support network with your friends and other staff members.

The NHS is changing, and I am sure the NHS that you will graduate into will be very different to the NHS in which I started working. Many of the difficulties are faced by a lot of the public sector, cuts, mismatch of expectations and what is realistic to deliver and political interference. That said, what will carry the future of healthcare in the UK will be the skilled and dedicated staff, who will do whatever it takes to provide care to their patients, and if you have the intelligence, dedication and skill to join us as a doctor then it will be a pleasure to count you among our colleagues.

Good luck!

Answers from Will Green, Trainee anaesthetist

1. What was the hardest part about studying medicine at university? What is the hardest part of practising medicine at the moment?

I think for me the hardest part of studying was adjusting to the different style of exam. In my day (wow I sound old!) the A levels were very much a case of doing lots of past papers, and the syllabus was the sort of size where you could learn it all pretty well, whereas in medical school it’s all so vast you have to accept that you are not going to know it all! That is reflected in the pass marks, the average pass for a written paper was about 50%, but it’s really hard to get into that mind-set! The other hard part for me was adjusting from the direct learning of college to the more independent uni style, the lectures and sessions were there to guide you, but you had to go and do a lot by yourself, a lot of slogging through big textbooks!

Through the other side, and at my stage now I think the hardest thing for me is juggling working full time with post-graduate exams. The exams are pretty hard and you are putting the revision around working, which can be a work/life balance challenge! The biggest clinical challenge I have is probably people management, I’m at a stage where I am sometimes supervising more junior trainees and knowing when to step in and when to step back is something I’m still getting the feel of and nobody really teaches you!

Good questions, well done and good luck

2. Hi. I'm an A-level student in a sixth form studying law, English literature and psychology. Since you're a successful medical student, I had a really important question to ask you based on your degree. So I really want to do something along the lines of a science based career e.g. pharmacy/ optometrist, etc. With the subjects that I'm doing right now, will there be a chance of doing a foundation year in science in any university? (If so, would you know of any which do?) Thank you for your time!

 Usually, entry requirements for sciences foundation degrees will include at least one science subject (usually Chemistry/Biology/Physics/Maths). The best thing you can do is use a search tool (like this UCAS one) to check all of the courses you are interested in, as it can vary by course and university. You can also check out different routes to the careers you’re interested in, such as https://www.prospects.ac.uk/jobs-and-work-experience/job-sectors/science-and-pharmaceuticals/pharmacy-courses to explore your options.

3. When you move city/country and try to get a new job at a new hospital do they judge your competency as a doctor based on the university you went to? I hope not.

No! Obviously you put where you got your qualification, but you wouldn’t be judged for that! Each job will have an application process which will look at a lot of different aspects. From a competency point of view, if you are in training you have a portfolio, with outcomes you have to meet and have something called an Annual Review of Competency Progression, where people go over your portfolio and make sure you’re up to speed, if you pass those your ability is taken as a given and the rest of the stuff comes down to interview etc.

4. How did you know you wanted to go into anaesthetics?

It was a happy accident! I hadn’t done any when I applied for the job. I wasn’t sure what I wanted to do, and as I said medicine is great because you could do so many things with it! When I finished my foundation training, I went on to a training program called ACCS, which is essentially the first year of acute medicine, A&E, anaesthetics and ITU condensed into 2 years, with my main focus being anaesthetics, and when I did the job I loved it!

The main draw for me was that it was a good balance between practical skills and more cerebral stuff, so very varied! Also you can give your whole attention to one patient at a time, no being pulled in every direction like some of my colleagues are. It is a very personal job, people are often very anxious before they go off to sleep, and you see them through that, and help them be as comfortable as you can. You’ll be the last thing they see before they go off to sleep, and they are trusting you to look after them while they are asleep, it’s a big honour to be given that responsibility!

5. I want to do medicine because I am personally motivated (so not for money) but realistically can a doctor afford a Lamborghini (£135k)? Second question, are foundation courses more/less or similar in terms of competitiveness to get into in comparison with normal 5 year courses of medicine?

Erm, I think you’d struggle unless you are a good little saver! In your younger years the money isn’t to the level where you could afford that, and in your consultant years there are mortgages and children and other expensive things to think about! I drive a Ford Focus…

I’m not sure about your second question as I didn’t apply for a foundation course. I think the best thing to do is use a search tool (like this UCAS one) to check all of the courses you are interested in, as it can vary by course and university.

6. How do you deal with stress and expectations from the people you know?

Badly? Haha! No - that’s probably a question to ask my other half! I think the important thing is to be honest with what you can do, and make sure the people around you understand your workload and what may be expected of you. Especially if you are not a medic, it can be really hard going out/being friends with a doctor because we work weird hours, talk in our own language and can get a bit too much into it! My brother is a surgeon and his wife is constantly having to phone up the hospital to see where he is, only to find he has just lost track of time in theatre and stayed 4 hours late!

From a stress point of view, at work it’s a case of getting your head down and powering through, no matter what happens you need to have your game face on for the next patient. But at home, it’s about having your own time and doing what you enjoy. If you’re outdoorsy, go on a walk or a bike ride! If you’re musical, have half an hour playing something you love! If you’re a grown up child like me, settle down with the Xbox. Have your own space to relax, unwind and do some reflection.

7. Was there a point during your year of studying medicine where you found something hard and felt like giving up?

Yeah, in my 4th year I failed an exam and that was pretty rubbish! To be fair it was my own fault, I wasn’t working as hard as I could have been and took my eye off the ball a bit, doing other things with student societies I was part of. It was good for me though, gave me a good kick up the bum! Everyone has wobbles, there is a lot of support available, informal through friends and family, and formal through the uni, its worth remembering that everyone else is going through the same thing!

8. How did you manage your time between studies and leisure time at university?

You’ve got to be disciplined, you have to be very self-motivated! I found living with other medics helpful because if they were working, I should have been working!

It is important to find a balance, being at uni is great, and it is as much about the lifestyle as it is about the studying.

I would advise joining a couple of clubs at the beginning and seeing how it goes, if you are feeling overwhelmed by it all, it’s a good hint to step back from one, remember at the end of the day you need to pass those exams! I felt loads better in my 4th year when I stepped back from a few of the societies I was in, and in my final year I didn’t really do anything extra-curricular.

9. What tips do you have for studying medicine at university?

Do you mean actually studying on the course? Use the lectures as a framework for your further reading, and don’t worry if you can’t remember everything! You’ll be using these massive textbooks which are impossible to memorise, so use them as references, dip in and out and use them to reinforce your knowledge.

The clinical years are a lot more practical, learning history and examination techniques, going through diagnosis and management plans, it is all practice! Get stuck in, take every opportunity to chat to patients and get hands on.Especially in your later years, people won’t be keeping an eye on you so you’ve got to be independent, make your own learning opportunities and don’t pass up on anyone who offers to teach you. We’re a friendly bunch on the wards!

10. What tips do you have for students currently in 6th form who aspire to study medicine?

 Good question! So you need to be studying relevant subjects (Chemistry and Maths are a must, Biology is a bit of help but I don’t think it is mandatory, double check with each uni though!). The other hoop is the UCAT, there are loads of practice books for that and it is a game of practice, practice, practice!

It’s not all academia though, and the best doctors are well-rounded people. The qualities you want to demonstrate are team working, leadership, dedication to medicine and interpersonal skills. You will probably find some overlap between them. Lots of people get very focused on medical experience, and that is all well and good, however it is a bit of a lottery as whether you can get it or not. If you are struggling, volunteering is a good way of getting experience in care, for example lots of care homes have volunteer posts, and that can give you invaluable insight into care, and how people live with multiple long term health conditions, as well as an insight into the challenges of caring for the aging population (buzzwords!). You will see hardworking care workers doing their jobs with a smile and see the true meaning of the word “care”. It is good to give up a bit of your time for something altruistic, it demonstrates good character! Don’t worry if you can’t get in with a hospital/doctor, we know it is hard! If you can get experience that is great, however make sure you reflect on what you have learned. I would set your internet browser homepage to the BBC news health page as well, and take note of interesting things going on. Closer to interview time, it is worth going over the structure of medical training, so you know what you are going in to! It shows you have bothered to look it up, and it is asked a lot! Leadership and teamwork kind of go hand in hand, most clubs/teams will fall into that category. Have in your mind what kind of course you want to do (on the scale of traditional vs PBL), and look up what each university offers. It can seem like a lot, and it is a lot, but I can guarantee it is worth it !Good luck (there is a lot of luck involved unfortunately!) but you are making a good choice 

11. What are you study tips for Meedicine?

Please see question 8 

12. Do you have any regrets relating your time at university or your career, if so what are they and why?

Good question! I had a great time, I was pretty active, was VP of the medical society for a year, worked with Anthony Nolan Trust for a while, did a musical, all sorts! I wouldn’t say any major regrets. The good thing about uni is that you have so much freedom, you can get involved as much or as little as you want in the lifestyle.

Career wise, I think in hindsight I would have liked to maybe take a year out and practice in a different country, which a lot of my friends have done. When I was applying for training there was a bit of uncertainty around what training was going to be like, so I decided just to take the plunge and chance it, and I’m glad I did that, however I would have liked to see how another country does things. Maybe before I become a consultant!

Regrets about my choice of career though? Never.

13. How can I get work experience from the NHS?

With great difficulty! There is a lot of who you know unfortunately, however most hospitals have more formal work experience stuff due to safeguarding and stuff. Google work experience at [your nearest hospital] and see what comes up.

The Royal Voluntary Service (RVS) is amazing. They do such good work in hospitals all over the country and are usually on the lookout for eager young folk

https://volunteering.royalvoluntaryservice.org.uk/volunteering-in-hospitals?gclid=EAIaIQobChMIv5efv8Xr4QIVAQbTCh3ILQWyEAAYASAAEgJS-vD_BwE

Have a gander, they do so much in hospitals, helping staff and patients alike, completely altruistically, and you’ll learn a lot from just being in that environment.

14. How did you decide which university you wanted to go to? What made you think 'I have to go to this university'?

 Honestly? My older brother didn’t get an offer from Newcastle so I was like “I have to go there!”. He was a year older than I was so when he went to look at places, I went with him, and I just loved the feel of the place! This was reinforced when I came for open days and interviews, it just felt like the right fit for me. Also when you buy a sandwich from a shop, the person is always really friendly and chats to you, this put me in a good mood! It’s the little things.

I would try and visit as many places as possible, walk around the city and the campus and see if it feels like the right fit for you. Chat to the people there, ask them why they like it!

From a more academic point of view, I think the course at Newcastle really hits the balance between traditional lecture-based teaching and clinical skills in the first couple of years, and the hospital teaching you get is fantastic.

Also the North East is an amazing place to live and work, there is so much in a comparatively small area, beaches, countryside, city living, it’s all here! The training is great, you are looked after, what is not to love?!

15. What made you stand out when applying to universities? Any key tips on writing personal statements for medicine/dentistry? Thank you.

It is really difficult to stand out, which is why the UCAT is important to do well on, lots of places will pick the top UCAT scores and interview them, so work hard at it, practice, it is worth investing time into it!

Once you get to that stage, they will look at your statement in more detail. My advice is this, look at every sentence you write and imagine the interviewers reading it out to you and saying “so what? Why would this make you a good doctor?” If you can’t answer that, take it out. If you can, prepare an answer for that!

Lots of people will say they want to do medicine because they like science and they want to help people. That is true for a lot of you, however you are trying to stand out, so if you have a personal reason that is a good thing to declare.

The qualities you want to portray are leadership, teamwork, dedication to medicine and interpersonal skills (see above question) and in the interview you need to go about demonstrating these qualities in whatever way suits your personality best. We love reflection in medicine, if you had a personal experience and have reflected on it then talk about this! Likewise, don’t just say you did something, e.g. you volunteered with the RVS and saw x,y,z, make sure you explain how this helped you develop, blah blah blah. Stuff like this shows you have not just done stuff for the sake of it, you have learned from the things you have done.

I struggled a bit writing mine because it can seem a little big headed writing this thing saying “I’m great, I’m the best, you want me” but put that in a box, because you are trying to sell yourself to them! Your statement will be all the interviewers will have to know about you before they meet you, so it is worth reading it back and making sure you sound good but not big headed. Statements of fact go a long way, and if you have something interesting about yourself, shot it on there! If I had read 30 identical statements then saw that someone was regional runner up in the 2018 regional fire eating championship for Yorkshire I would be buzzing to meet that person!

Last hint, get as many people as possible to read it, make sure it makes sense and be able to defend what you have written, be prepared for that “so what?” question, and get a good answer. And revise for that UCAT!!

16. Do different types of patients require different types of anaesthesia?

Oh yes! That is why the job is fun. The cliché in medicine is that once the patient is asleep, we put our feet up and read the paper and that is outdated nonsense. Nowadays we have apps on our smartphones!

That was a joke. We are spending our time watching and making admittedly normally micro-corrections to keep everything fine for the patient and the surgeon. I like the analogy of being on a ship, and looking out and seeing an iceberg, if you adjust your course a little bit early, you avoid it, whereas if you leave it, you will have to take more dramatic action later. You are giving pain relief, adjusting how much anaesthetic you are giving, changing the settings on the life support machine, all adjusting it to your patient’s individual needs, and all getting to a point where you can wake them up at the end and they will be comfortable.

Some patients may not get a general anaesthetic, either because they don’t want one, or because there is a good reason not to, be it to do with the patient or the surgery, for example today I have done some caesarean sections under spinal anaesthetics, because we like mums to be awake when their babies are born.

When we see patients on the day of surgery, we discuss options available and come up with a plan of action, it’s a bit of joint decision making, and it keeps it fun for us! Because there are so many options it is important that our patients know this, and know what their choices are. Sometimes we have to say no to certain things for a number of reasons, but it’s about communicating why you think that is the case.

17. What is the best Russell Group University to study Forensic Science?

What’s ‘best’ really depends on what matters to you. Does student satisfaction matter most to you? Or perhaps employability figures such as average income of graduates? You can use different comparison tools to make a decision about which Forensic Science course is best for you. Unistats https://unistats.ac.uk/is owned and operated by the Office for Students- an independent public body funded by the government so is a really useful and impartial tool!

18. Hi, my question is, in your opinion, what do you think the most important thing is in gaining entry into medical school?

Please see question 9

19. What A Levels did you do? And in what way did your personal statement stand out in order for you to pursue the career you have now?

I did Maths, Biology and Chemistry for A levels, and did an AS level in History. In my day Maths and Chemistry were a must, I don’t know if it is different now. History was fun, but the problem was that if you did 3 A-levels they asked for 3 As, if you did 4 a-levels, they asked for 4 As, so I didn’t want to risk it!

See question 14 for personal statement answer

20. When you look back to your university years do you regret anything? What would your advice be to a student that wants to study medicine?

Please see questions 11 and 14

21. How do you deal with an uncomfortable situation?

Honesty. You are going to have difficult encounters in medicine, be it breaking bad news, explaining about a mistake that has happened, or telling someone you are not going to do the thing that they want you to do. The common one I get at the moment with my job is explaining the limits of care we would deliver to someone, sometimes saying that we would not take someone to intensive care, or not resuscitate them (DNACPR, hot topic!).

The unifying way to approach this is with honesty, the patient and family need to understand what the situation is, why people are doing the thing that they are doing and if possible being made part of the decision making which tends to make these things easier.

22. How can you mention extra reading in interviews and personal statements?

In your statement, I would just say you have kept up to date with medicine and stuff by reading X, Y, Z.

In your interview just drop it in if you have anything relevant, use it as a way of backing up your answer. Try and have a bit of reading for common questions, and sprinkle your answers with them

23. I am looking to apply to study medicine. Would you recommend applying to a medical course with a foundation year as my 5th choice? Also, would it be a bad idea to apply to the same university for medicine and for medicine with a foundation year? Thanks!

 

Lots of universities recommend that your fifth UCAS choice should be a non-Medicine course- but it’s really up to you to weigh up your options. There’s little point in applying to a course that you wouldn’t want to do at all, so look at the bigger picture to weigh up your options.

For the question about applying to the same university for both Medicine and Medicine with a foundation year, we would recommend talking to each university to which you are interested in applying as they may have recommended alternate course. For example King’s College London include information about alternate courses students to which RO students may wish to apply: http://www.realisingopportunities.ac.uk/_assets/reports/RO_Recognition_Guide_2020_Entry/index.html#7/z

24. Hello I am currently doing AS level in college and working as a volunteer in the hospital. I still need to do my personal statement and apply for universities next year. Do you have and tips for me please? I would really appreciate it! Thank you.

For statement- question 14

For unis, question 13

25. What were your A Level options?

Please see question 17

26. How many hours do you work as an anaesthetist?

It varies hospital to hospital, most of us do an average 48 hour week over the course of a rotation, so in some weeks you may do more, but others you will do less, it is all about the average!

27. When you were at university did you live in student accommodation or at home?

I come from Hull, so lived out in all 5 years. My first year I lived in halls of residence, and the other years I rented houses with friends. Halls in first year are a really good way of meeting people, everyone is in the same boat as you, makes getting a group of friends much simpler! For the other years, student houses are great, I saw it as a real rite of passage!

I think living at home can also be good and means you hopefully have a constant support network from the word go. Whether you live in student accommodation or at home I think you should make time in your studies and uni life to try and make some like-minded and good friends.

28. What extracurricular activities do you believe demonstrate the best skills that medical schools/ courses are looking for? Also what kind of work experience did you do?

As I’ve mentioned - team working, leadership, dedication to medicine and interpersonal skills are all attributes that medical schools look for. Any activities that you can get involved where you can develop these skills will be a bonus and be prepared to talk about this in your personal statement and interviews. For example, if you have a part time job in which areas of it do you use the skills I’ve mentioned?

I was very fortunate because a member of my family is a GP so I had the opportunity to do work experience alongside them before attending university. I found this really interesting and rewarding and it definitely fed my appetite to study medicine and become a doctor. Of course I know that not everyone is in the position I was but, as I’ve mentioned in my answer to question 13, there are opportunities out there, they sometimes take some finding though!

29. What guidance or tips do you have for writing your personal statement? What key things should be included, and was there anything that you added that you believe made yours stand out?

Please see question 14.

From June the RO Central Team will be offering an early applicant support service where you can put your questions to an undergraduate student at one of the RO Partner universities who has experience in making an early application. They will also be able to look over your personal statement and provide helpful hints and tips on making a good UCAS application.

30. Have you got any tips on how to revise for exams?

Make it manageable! It can seem a bit overwhelming at the beginning when you are sitting down, so take it at a reasonable pace and give yourself plenty of time. 

Practice makes perfect, so try and do as many past questions and papers as you can, to get a feel for the question styles.

I find working in groups is much better than working alone, it keeps you motivated and varies your learning. There are some things you will be able to grasp quicker than your peers, and some things your peers will understand better than you, and can explain to you in a different way.

It is a very individual thing though, find what works for you!

31. In your opinion what do you think is the best part about university?

The freedom! You get to develop as a person, and grow up in the way you want to.

The course is interesting and all, but you do change a lot in those 5 years.

You make the friends you are going to have for life as well, you live together, study together, it is intense but in a really good way.

I think different people enjoy different parts of it, you only have one way to find out!

32. Are you on call a lot or is it a regular 9-5 job? Do you have lots of time to spend with family and doing things you like- are your weekends free?

We are on call a fair bit, usually 1 in every 3-4 weekends and its pretty normal to do a week to a week and a half of nights a month. It’s also pretty normal to do one or two long days (8am to 8pm) a week.

It is pretty intense, you just make it work! Your family will understand your work commitments. It can be hard juggling it all, especially when you have young children, you just have to make it work

33. How do you find working in a hospital setting? How did you deal with stress and time management during placements and university?

I love working in a hospital, it is a huge place full of people, impossible not to find someone you like!

There are all the different teams, working together, and all the different support staff as well – this is what keeps the whole place moving and you really feel like part of a huge team.

Time management wise- question 7

34. Is there any way you can become an anaesthetist without doing medicine? I'm wondering as I've chosen a science degree but am interested in going down these medical routes instead.

Anaesthetics is a medical specialty (like surgery, GP etc.), so you have to be a doctor to do it. Some hospitals have physician assistant roles in anaesthesia, but I don’t know what the requirements are for training, to the best of my knowledge they are normally recruited from allied healthcare professionals.

If you want to do a medical job, you can apply for a normal undergraduate degree, or if you have your degree you could apply for an accelerated programme at certain universities.

35. Studying medicine, did you have any periods where you felt it was overwhelming or you just wanted to give up?

Please see question 6