Dr Ramai Santhirapala, Editor of the Bulletin, welcomes you to April 2023's anaesthetist in training (AiT) issue of the Bulletin and looks at why this year's theme 'Adapting to change' is very apt in these uncertain times.
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Dr Sharma and Dr Russell tell us about their climate change course for health professionals from across the globe.
This first report, an assessment of the scientific basis of climate change and its impacts and future risks, highlighted the importance of climate change as a global challenge with universal consequences which required international collaboration, cooperation and action.
Unfortunately, all these years later we haven’t made as much progress as we should have done across the world. The latest (2023) Lancet Countdown Report 'underscores the imperative for a health-centred response in a world facing irreversible harms. Climate inaction is costing lives and livelihoods today, with new global projections revealing the grave and mounting threat to health of further delayed action on climate change’. How can we take action? What can we do? You can all achieve so much more than you believe, and we would like to guide, support and empower you to do so.
It's time for us to take action together.
Dr Stephen Adshead, ST7, and Dr Matt Townsend, ST6, North Bristol NHS Trust discuss how there might be situations where it falls to anaesthetists to intervene.
Twenty five per cent of trauma deaths are directly caused by injury to the thorax and, while a minority will require emergency surgery, up to eighty five per cent of chest injuries can be managed without the need for formal surgical intervention.1 In these cases, rapid recognition and management of life-threatening conditions are key to successful resuscitation.
Thoracostomy (the creation of an artificial opening in the chest wall) is a procedure performed for decompression of the chest, usually by our pre-hospital, surgical or emergency medicine colleagues. It is also the first stage to placing a tube thoracostomy or ‘open’ chest drain. In the context of trauma, emergency lateral thoracostomy is indicated in the following circumstances:
- traumatic tension pneumothorax
- massive haemothorax
- traumatic cardiac arrest.
This article provides an update on all the great work done to improve the reliability, performance and general user experience of the Lifelong Learning Platform (LLP).
Maintaining and improving the LLP
Since its launch in August 2018, the College has committed to improving the reliability, performance and general user experience of the Lifelong Learning Platform (LLP) for our members. With the inclusion of three new curricula and of ICM users in late 2021, it became apparent that the added level of complexity and the need to support more users required additional funding, so a sizeable new budget was approved by the College’s Finance and Resources Board in August 2022.
This additional funding has allowed us to resolve many historic issues, keep the infrastructure and related systems up to date, as well as making significant improvements where needed. We still have a great deal of work to do, but as you will see below, we have already achieved a lot over the last year and have a clear plan of where we are heading in the coming months.
This article looks at how the UK’s changing workforce affects the role of the appraiser and provides some top tips on how to adapt to the current needs.
Our workforce is undoubtedly changing.
The latest GMC workforce report shows a striking 18% increase in the number of licensed doctors on its register between 2018 and 2022. Numbers have increased by 46%, most markedly among SAS and Locally Employed Doctors (LEDs), which is almost entirely down to a marked increase in the latter. LEDs are a very heterogenous group, including doctors just after foundation training (‘F3’), doctors in posts between core and specialty training, locum consultants and post-training fellows seeking further subspecialty experience. The biggest contingent however are trust-grade doctors and clinical fellows who arrive with medical qualifications gained abroad. The GMC currently registers significantly more international medical graduates (IMGs) than UK graduates every year at present.
There are also notable changes in employment behaviours among this cohort. Recently, significantly more of these IMGs have stayed in the UK beyond the short-term and more have entered training than previously. Some will seek entry to the specialist register via the portfolio pathway, but many hope to enter training in our specialty, typically at ST4 level.
Dr Sarah Hare, Deputy Director, RCoA Centre for Research and Improvement, welcomes us to the newly launched centre and gives us an overview of all its great projects.
Dr Ramai Santhirapala hopes you'll find this summer issue uplifting and re-energising during these uniquely difficult times.
Welcome to the summer issue of the Bulletin! As I write this, sunlight is streaming in through my window as an indication that British Summertime has finally arrived in more ways than just the clocks going forward. This issue of the Bulletin will arrive on your preferred digital platform as we come to the close of the term of a distinctly inspirational RCoA president, Dr Fiona Donald. While Dr Donald’s nature is one of immense humility, it is worth reflecting on the unique equanimity one needs as a leader at this time within the NHS (including our specialty) when facing immense challenges, turbulence and uncertainty.
She was the first woman to be elected dean of the Faculty of Anaesthetists in 1985. Congratulations on becoming a centenarian, Aileen!
Aileen Kirkpatrick Adams was born in 1923 in Sheffield, where she qualified in medicine in 1945. She trained in anaesthesia at the Royal Free and Edgeware hospitals in London and at Bristol’s Frenchay Hospital under Dr Tom Wilton, and worked in Oxford under Sir Robert Macintosh. She also enjoyed a sojourn at the Massachusetts General Hospital under Henry Beecher. Finally, she was appointed as a consultant anaesthetist in Cambridge, England.
Dr Hannah Bruce and Dr Mark Chen update us on the key role anaesthetists in training play in leading and effecting significant changes to all RCoA examinations.
This article provides an overview of the positive steps taken – since the publication of the FRCA examination review – to enhance the quality and effectiveness of the RCoA, FICM and FPM examinations.