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It has both a favourable side-effect profile compared with traditional anticholinesterases and allows for emergency reversal.

With the expiry of its original patent last year, high cost is no longer a factor prohibiting its use, which will invariably further increase. In this article, we seek to highlight the resulting increased potential for contraceptive failure and propose methods to better inform and protect patients.

The risk of contraceptive failure

Due to its ability to encapsulate progesterone – present in contraceptive pills, vaginal rings, implants and intra-uterine devices – the administration of sugammadex may reduce their biological effect and cause contraceptive failure. This was identified in in-vitro studies, using isothermal microcalorimetry, performed as part of the drug’s development. While in-vivo studies to quantify the reduction in serum progesterone concentration following sugammadex administration have not been performed, these results have shaped current manufacturer guidance.

We hope you will find this information useful in helping all anaesthetic staff within your department access the educational supervision or mentorship they require.

Introduction

In addition to consultants and doctors in formal training, anaesthetic departments frequently contain SAS and Locally Employed Doctors. SAS doctors are employed on national SAS contracts, the current of which are ‘Specialty Doctor’ and ‘Specialist’. Locally employed doctors (LEDs) are employed on non-national Trust-derived contracts. LEDs have multiple titles including ‘Clinical Fellow’ and ‘Trust Doctor’. Medical Training Initiative (MTI) doctors are also commonly employed as LEDs and form part of this latter group. 

Within this combined cohort are doctors at all stages of their careers, with individual development needs. To maximise the potential of the existing anaesthetic workforce, it is imperative that these doctors are offered support to achieve their potential and reach their career goals. These goals may include broadening their role into non-clinical domains, (re)entering formal training, becoming consultants through the GMC Portfolio Pathway or becoming Specialists. 

Transitioning from Full-Time (FT) to Less-Than-Full-Time (LTFT) training has been a journey in revealing LTFT training disparities and discovering a new Health Education England (HEE) LTFT funding policy.

The Gold Guide’s latest guidance suggests that any trainee can apply for LTFT training (including those not yet in post but who have received an offer) provided they have a ‘well-founded individual reason’. In Yorkshire and Humber Deanery, the number of anaesthetic/ICM LTFT trainees has nearly tripled in the last five years. We anticipate LTFT numbers increasing in the future as more trainees seek better work–life balance. Training Programme Directors (TPDs) are encouraged to slot-share LTFT trainees, as this decreases gaps in rotas and continues to maintain recruitment (as LTFT training prolongs training pro-rata). This is important as the RCoA estimates that there will be a shortfall of 11,000 anaesthetists by 2040. If not slot-shared, a solo LTFT trainee does reduced sessions in a single FT slot.

At the end of January 2024, the GMC published an updated version of Good Medical Practice, the core guidance for all registered doctors. This has been accompanied by guidance on a number of other areas, including confidentiality, consent and research, and legal and regulatory proceedings, all of which can be seen on the GMC website.

The opportunity has been taken to conduct a major review of the College’s supporting information for appraisal and revalidation.

I'm the RCoA’s Dinwoodie Simulation Fellow and an ST5 anaesthetist in training in the Thames Valley region. I’m pleased to take the opportunity to update you on some exciting developments in simulation.

Anaesthetics was an early pioneer in utilising simulation, recognising its benefits in rehearsing uncommon emergencies and how it can be used to develop non-technical skills. Anaesthetists in training can now expect simulation-based education to feature frequently throughout their training as they develop skills and practise the management of critical incidents, and it will continue to feature throughout our careers. Anaesthetists are also frequently seen delivering the simulation-based education, whether that is for peers or other members of the multidisciplinary team. Simulation as an educational tool has many guises, including part-task trainers to rehearse a skill before performing on a patient, sessions in a dedicated simulation suite and, most recently, immersive technologies such as virtual reality.

In this second of our ‘Education resources of the quarter’ feature, we’re taking a look at recent College talks and podcasts on airway matters, and taking videos from our events and podcast programme from the last few years and re-sharing them here.

Dear Editor

With the start of 2024 we will each have set our own resolutions and goals for the year ahead, both personally and professionally. But to achieve these we will be relying on our healthcare system to do the same. The NHS Long Term Plan delivers many promising messages, but there appears to be an ever mounting number of constraints and challenges to overcome, too.

It goes without saying that a swift resolution to the pay dispute is essential to prevent any further distress for both staff and patients. With waiting lists spiralling out of control, the pressure on us to work harder and longer is very real. We need to collaborate effectively with non-clinicians and service users alike to come up with realistic solutions to curb the demand and supply imbalance. In the meantime everybody needs to remain proactive in taking simple measures to improve our daily working conditions and ensure we feel valued.

Have you missed a Bulletin issue or perhaps you’d like to re-read a past issue? Our full selection of back digital issues has you covered and will keep you up-to-date and informed on what’s happening in our specialty. We hope you continue enjoying your membership magazine.

Understandably, well-being means something different to all of us, but does it have more awareness and recognition than 20 years ago?

Dr Marie Nixon, Consultant Anaesthetist and Dr Thom O'Dell, ST7 Trainee discuss their experiences of wellbeing and what it means to them. 

Dr Richard Knight looks back at the turbulent 1970s – a decade well known as a time of crisis both economically and politically.

What comes to mind when you think of the 1970s? Flared Jeans, David Bowie, Dallas? Well, it wasn’t all Happy Days (forgive the pun) – this decade was also very much about skyrocketing inflation and unemployment, the Winter of Discontent, strikes, power cuts, and states of emergency.