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Critical terms must be clearly and consistently used. 

For example, UK law recognises protected titles; ‘general practitioner’, ‘registered nurse’, or ‘paramedic’ have specific meanings, and to use one carries legal weight. Interestingly ‘surgeon’ appears on the GMC’s list of legally protected titles, but ‘anaesthetist’ does not.

While meaning can appear clear from context, ambiguity creates risk. It need not be highly technical terminology to cause problems. Misunderstanding of ‘OK’ contributed to the 1977 Tenerife air disaster, where a tower controller probably intended ‘I acknowledge your request to take off’, but the flight commander understood ‘you are giving me clearance for take-off’. The Boeing 747 accelerated down the runway, and shortly thereafter collided with another aircraft.

Jono Brüün, Chief Executive Officer of the Royal College of Anaesthetists looks at the benefits of research and why it will always be at the centre of our activities, creating significant impact for patients and the public.

I doubt there are many Bulletin readers who are old enough to remember the 1963 Disney film ‘The Incredible Journey’. Luath – a golden labrador, Bodger – an aging bull terrier, and Tao – a Siamese cat make a perilous journey across the Canadian wilderness to get to their home 300 miles away. As a little girl I sat in the Ritz Cinema with tears flowing because it seemed inevitable that Bodger had died in the final few miles of the journey. Of course he hadn’t. He trotted over the horizon to an ecstatic welcome from his animal and human family.

I was reminded of Bodger and his fictional achievement when I read about a dog called Pip. Last year Pip’s owner took him for a run in Leigh Woods, a beauty spot in Bristol. They became separated, and Pip’s frantic owner took to social media to get help finding him. Pip was soon spotted on the city’s security cameras. He crossed Brunel’s iconic suspension bridge, ran past the famous BBC studios in Whiteladies Road and was captured on camera running by the steps of the museum. Somehow he safely negotiated the notoriously dangerous traffic in the city centre and found his way to his front garden in Bedminster – about four miles from where he’d left his owner. In fact he got home before she did!

In this issue, we focus on revalidation guidance for doctors returning to clinical practice after a period of absence. This is an issue which our helpdesk receives a number of enquiries about.

The revalidation cycle typically allows for short periods of absence during a five-year cycle. Some types of supporting information – such as colleague and patient feedback – don’t need to be collected each year, and where doctors have been unable to collect sufficient supporting information, their responsible officer may recommend a deferment of their revalidation to the GMC in order to allow them sufficient time to address these gaps.

I have recently been appointed as an Examiner for the Royal College of Anaesthetists FRCA examination. It was a moment of great pride and achievement for me, but also very humbling and surprising to know that I was the first SAS doctor to be appointed as an examiner for the College. It has made me reflect on my journey as an SAS doctor and how I got to become an examiner.

I completed my undergraduate medical and postgraduate anaesthetic training in Mumbai, India. Like a lot of doctors from India in the early 2000s, I chose to come to the UK on a ‘permit-free training’ visa to train and work in the NHS, be better paid, and have a better balance between work and life. I first applied as a clinical observer at Basingstoke hospital and then was successful at interview for the senior house officer (SHO) post in August 2003. This was the first time that I became aware of the SAS grade of non-training doctors in the UK. In 2003, Basingstoke already had six SAS doctors on full-time or part-time contracts. They were a motivated group of doctors who had their own fixed lists and worked independently anaesthetising for complex cases. But at that time, like everyone else, I was intent on trying to train and become a consultant.

Authors:

• Dr Gemma Summons, Perioperative Medicine Fellow/SpR Anaesthetics, University College London Hospital
• Professor Tarannum Rampal, Consultant Anaesthetist and Lead, Perioperative Prehabilitation Unit, Princess Royal University Hospital (PRUH), King’s College London NHS Foundation Trust
• Ms Shana Hall, Specialist Physiotherapist, Cancer Rehabilitation, Princess Royal University Hospital (PRUH), King’s College London NHS Foundation Trust

John is a retired white British man, who drove to clinic and has a good rapport with his doctor. He feels motivated by the exercise classes at his private gym and tracks his progress using prehab apps and his FitBit. His wife (who does all the cooking) finds the dietary advice helpful because it gives healthy alternatives for traditional British food that they eat.

Winnie is from Barbados. She had to get the bus to clinic (and now she’s late for her shift). She’s offered exercise sessions, if they can fit around work, but the bus links are awful. The dietary information is unhelpful as she can’t get the ingredients from Brixton Market and her budget is tight. She doesn’t have the time to learn lots of new recipes.

He famously declared that he wouldn’t want to belong to a club that would have him as a member. We’ve been thinking about how we can attract people who might not usually think that ‘our club’ is for them.

The challenges we face in reaching a wide range of patients are common to the ones many of you experience when engaging with patients locally. Perhaps you were trying to audit or redesign services, or prepare or revise patient information. Some of the responses to these challenges are also common.

PatientsVoices@RCoA is a group of volunteers who help the College improve the delivery of safe, more effective, patient-centred care to enhance patients’ experience of anaesthesia and perioperative care. It’s vital for us to understand and represent the views of diverse communities, as we live in one of the most multicultural countries in the world.

Authors:

• Dr Hannah Headon, Medical Education Fellow, King’s College NHS Foundation Trust, Anaesthetics South East London
• Dr Christopher James, ST6 Anaesthetics, Guy’s and St Thomas’ NHS Foundation Trust
• Dr Kate Millar, ST4 Anaesthetics, Guy’s and St. Thomas’ NHS Foundation Trust
• Dr Joseph Lipton, Consultant Anaesthetist   Guy’s and St. Thomas’ NHS Foundation Trust

On 10 June 2022, the sun was shining and I was on my way to present at the RCoA’s College Tutors’ Meeting in Cardiff, feeling increasingly nervous and eager to share our hard work. 

However, my nerves were misplaced: the meeting was extremely friendly and our project, ‘The birth of the generic professional capabilities learning hub’, was well received – to the extent that it came second in the competition for the Singhota Family prize, awarded in memory of Dr Jasjot Singhota.