Top tips for applying to anaesthetics

Since COVID there have been a few changes to the application process for anaesthetics training in the UK.

I will try to give a brief summary of the components of an application and what you can do depending on what grade you are to help this process. I confess now that I am a firm believer that there is more to life than medicine and so will go through the things that are the best “bang for your buck” and will be the most beneficial for your career progression without taking up all of your time.

The application:

1. Core Training (3 or 4 years)

Components:

• 15% MSRA exam
• 85% interview: ⅓ 15 min clinical scenario, ⅓ 15 min general interview, ⅓ global rating

Deciding between Core vs ACCS training

• Core training (6 months ITU, 2 years 6 months anaesthetics)
• ACCS anaesthetic exit (9 months in total ITU, 6 months medicine, 6 months A+E, 2 years 3 months anaesthetics).

See below to help decide.

2. Specialty Training (4 years)

- Self-assessment scoring to shortlist for interview

More detail about the application process can be found here: https://anro.wm.hee.nhs.uk/downloads

Choose your stage:

I am a medical student

If you are a medical student with an interest in anaesthetics there are a few things you can do to both help you decide if it is the right specialty for you whilst helping your application without too much hassle.

• If your university offers an elective or some kind of student selected component then do this in anaesthetics. There tends not to be too much anaesthetics on the curriculum as it is a postgraduate specialty so getting some more clinical experience will give you a flavour of the job and will show commitment to speciality.
• When ranking F1/F2 jobs, try and get an anaesthetics/ITU job. As well as again showing commitment to speciality this will also give you a decent amount of time to work alongside trainees who will be able to offer advice on what other opportunities are available to make your CV look better.
• If you have the opportunity to do audits/quality improvement projects in anaesthesia during your medical school years then I would take them but I wouldn’t go out of my way to do this. Honestly you will already have enough to talk about at your interview and this is not something the interview panel will expect. You already have enough on your plate at medical school!

I am a foundation doctor

• Organise a taster week in anaesthetics during your foundation years. This no longer counts as a specific point in the application but the process is constantly changing and it gives you a week off the wards so I don’t think it's a bad idea!
• Check out our post on optimising your taster week experience here
• This is the time when you can work on projects that you can potentially talk about at an interview. The domains the interview assesses you on are: commitment to specialty, reflection, teaching, quality improvement, audit and research. I do think that if you are aware of these things from the beginning of the foundation programme and are proactive in finding opportunities it will mean you don’t have the mad rush trying to find things just before the application (like I did!)

I am just about to apply

• My main tip here is do not stress. You have now done all you can do for the application and the main focus now is to prepare for the interview. Quality is much more important than quantity; the explanation of how what you’ve done will make you an excellent trainee is all they are looking for.
• I can’t give any advice on the MSRA as I did not take it myself but bear in mind the interview is worth 85% of the application so it is worth spending more time preparing for this than revision for the exam.
• You can read our post on how to nail the MSRA here

The interview

The interview has a few set components to be familiar with.

Clinical scenario

• This is not related to anaesthetics and will be on something you have covered at medical school
• They are looking for the basic things that I’m sure you know: ABCDE approach, calling for seniors at an appropriate time, initiating basic management and reassessing etc.
• The specific domains they are assessing are: decision making, team working, reflection and working under pressure. If you can pass finals you can score well in this

General interview

• I think interview preparation is quite individual. Some people like to write out answers and learn them parrot-fashion whereas others like to think of answers on the spot
• My advice would be to do whatever makes you feel the most comfortable and will give you the most confidence going into the interview
• Make sure you have examples for all of the domains they are examining and do some practice with seniors (preferably anaesthetists if possible)

Core or ACCS?

When applying for anaesthetics training, a decision you will have to make is whether you would prefer a core job or an ACCS job.

The differences between the programmes are briefly described above. From what I have gleaned the main reason to do the ACCS programme is if you are keen to dual train in ITU (this will be done at the specialty training level).

To do this you require to have done 6 months of medicine (not including foundation years) and ACCS provides this. A misconception which I often hear is that ACCS is a good thing to do if you do not know what you want to specialise in. However, this is not true as you cannot apply for ACCS alone. You apply for the exit that you want so either through the anaesthetics, A+E or medical application process. It is very hard to swap exits once you have started the programme.

Therefore for us anaesthetists, when you come to rank jobs all of the Core and ACCS jobs will be visible to you and you can then rank whichever ones you would like.

Overall, I would like to reassure you by saying that I got an anaesthetics core training job with a very very scanty CV so it can be done!

The specialty is very competitive so please do not be disheartened if you do not get a job initially. It does not mean you would not make a good anaesthetist, it is often purely bad luck. There are many things you can do if you do not get in first time: get an ITU fellow job to help boost your CV, locum to get some money or take the opportunity of not being in training to travel and have some fun before you reapply next year!

I wish you all the best of luck!