Harry Thompson: I graduated in London in 2008. After various detours along the way, including some time in the military, I am now an ST6 Anaesthetic Trainee in Central London. I am undertaking my first advanced module in regional anaesthesia as one of the two fellows in the University College London Hospital. I work in the regional block room which provides a regional service for a large theatre complex.
Harry Thompson: I have always loved being involved when regional techniques have worked well and saved unplanned overnight stays, cancellations and even avoided ITU bed occupancy. I knew that I wouldn’t feel like I was doing my best by patients unless I was able to offer them these procedures. I knew that whatever sub-specialties I ended up doing, this fellowship would be useful.
Harry Thompson: As a fellow, you get treated more like a junior consultant. You are given management responsibilities and formal teaching slots. We organise courses, are involved in purchasing through company representatives and we introduce new systems into the patient pathways. Protocols, research and QI projects are all thrown at us. It is more difficult learning to say no to things than to find worthwhile projects to be involved with. You can make a real impact and also improve your application for consultant jobs; it strengthens your experience in the non-clinical aspects of our jobs.
Harry Thompson: I attend the morning handover and see which of the emergency patients may benefit from a block. I then look at all the 15 theatre lists and, along with a the very experienced and efficient block room ODP, we come up with a plan and a patient order for our morning. We aim to have patients ready for their surgery before the theatre is ready for them to improve throughflow and productivity. I perform between 5 and 10 blocks in a typical morning. We cover all sorts of surgery types, so the experience is broad. I always have a consultant supervisor in the theatre complex to ask for help with less common blocks or tricky sonoanatomy or sedation. In the afternoons, I am usually in an orthopaedic list which leads to a handful more blocks and even some airway management! We have dedicated research/management/teaching time which is great because we can achieve so much more without compromising on time with friends or family. We can make meaningful changes over our year there. I like to get the more junior anaesthetists involved with poster presentations and audit work because we can achieve so much more by working together and it helps them with specialty training applications in the future. I always leave work feeling like I have added to my skillset and experience. It is immensely satisfying to become somewhat proficient at something that was a complete mystery to me beforehand.
Harry Thompson: The good programmes, especially those with a dedicated regional block room, do tend to be popular in the UK. We had to be shortlisted to attend an interview, but the panel were very friendly. Fortunately, they were not looking at my level of previous regional experience. The fellowship is there to teach you that. Generic skills and attitudes are more important in making you a strong candidate. Some evidence of dedication to the sub-specialty is important too. Knowing when jobs are advertised and knowing when jobs were not filled is very important, especially if you are trying to fit in the fellowship around your formal training programme.
Harry Thompson: Throw yourself in and take every opportunity you can to learn from different mentors. I found that each consultant worked differently. It is nice to build your own approach by picking out the bits of style that suit you. Get ready to be overwhelmed with project ideas and teaching requests. Make sure you are careful about what you take on because stretching yourself too thin means you could end up achieving very little.
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