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• Dr Jaimin Arya, ST6, East Midlands Deanery

Perioperative Journal Watch is written by TRIPOM (trainees with an interest in perioperative medicine) and is a brief distillation of recent important papers and articles on perioperative medicine from across the spectrum of medical publications.

Over the years both the College and the ME Association have been receiving a number of enquiries from patients living with ME/CFS bemoaning the lack of information on how anaesthesia might affect their condition, but also seeking reassurances that their needs in the perioperative period would be met with understanding and compassion. 

The College acknowledged that there was not much in the way of information to support these patients nor the anaesthetists looking after them, and agreed that this gap needed to be addressed given the relatively high occurrence of the condition in the UK. Current reports estimate that there are 250,000 people living with ME/CFS at any one time in the UK, but this is likely to be a gross underestimate as traditionally it is poorly diagnosed, and many Long COVID patients fulfil ME/CFS diagnostic criteria. The most recent ONS survey reports 1.7 million people in the UK living with Long COVID.

This was new territory for the College, as producing information without a comprehensive body of evidence for such a poorly understood medical condition was something we had never done before.

In this short interview, Dr Sam Black, our Patient Information Lead, explores the key things to consider when communicating risk to patients with Leila Finikarides, Researcher at the Winton Centre, and Jenny Westaway, Chair of PatientsVoices@RCoA.

Since early 2024, the Patient Information Group has been working with the Winton Centre for Risk and Evidence Communication to ensure that our information for patients on risk reflects the latest best practice and learning from the work of the Centre.

We hope you find the interview an interesting insight into our work in this area.

This article looks at why the NHS needs international medical graduates (IMGs) and why we need to do better at integrating them into the workforce to maximise their contribution.

The General Medical Council’s Workforce report 2023 emphasises that the current reliance of the NHS on IMGs will continue in the future, despite an expansion of medical school places. The GMC predicts that almost a third of all doctors will be IMGs by 2036. It declares that the ‘integration and retention….must be improved’ and describes as essential that these colleagues are ‘welcomed into supportive teams’.

The way we welcome our international colleagues not only determines the extent to which they can contribute safely to the service, but also how easy it is to recruit and retain them. Our attitude should include a willingness to learn from their previous expertise and their ability to look at our services with fresh eyes.

Find out the latest appointments approved, and with sadness we record the deaths of some of our fellows. 

As the season of spring gently unfolds while I write this here in London, there is a sense of renewed fervour for times to come. I have the pleasure of celebrating two ‘New Years’ annually, a uniqueness which I have always appreciated for one reason – however the Gregorian new year starts, I have another to bring optimism, since once again find myself looking ahead to Tamil New Year on 14 April – Puthandu Vazthukal to all those celebrating this.

New chapters of professional life transitioning from one season to another is the subject of an article by Dr Lauren Elliott and Dr Nipun Agarwal, who eloquently detail the range of experiences that come towards the end of training – the consideration of location, colleagues and job plans blends excitement with an understandable anxiety. For those wanting to understand more about navigating this juncture in a career in anaesthesia, I wholeheartedly recommend the College’s Preparing for CCT and beyond podcast series as a supplement to the piece in this edition of the Bulletin.

Anaesthetists in training, whatever route they are taking, are the future of our specialty. This is a guiding principle of the College and it cuts across all aspects of our work.

I have always been incredibly impressed by the professionalism, compassion, skill and knowledge of the anaesthetists in training I work with and, as a prospective service user, I can see that the future is bright but that we need to play our part by supporting you to realise that promise.

I hear many positive things from anaesthetists in training, ranging from what you love about the job, to your well-deserved pride in your achievements and your commitment to supporting your patients and colleagues. But I also hear the negative aspects. I hear you when you tell me about training interrupted by the pandemic and the unaddressed trauma from that time. Or how your life and career have been impacted by frequent rotations, exam pressures or difficulty securing a higher training place.

Credential

Pain Medicine has now reached a milestone, and for the first time ever doctors trained in specialist pain medicine will be able to have this recognised by the GMC. The credential curriculum is now approved by the GMC and has been developed to take into account the different specialty backgrounds that doctors may come from, providing detailed information for both trainers and trainees alike. Credentialing will be integrated into the CCT curriculum for anaesthetics but will also open the route of training in other specialties.

Although many ICM doctors-in-training (DiTs) are now either training in ICM alone or with another partner specialty, just under half of our future ICM workforce are working towards a dual CCT with anaesthesia. 

Furthermore, many intensive care units around the UK rely on the knowledge, skills and experience brought by our anaesthetic colleagues in order to provide high-quality, patient-focused care. 

Consequently, anaesthetists will continue to hold a critical role in training the intensivists of the future.