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An increasing number of residents are having children during training. While some of you might balk at the idea of combining nappies and sleepless nights with stages 1, 2 and 3 of training, others are very happy to go on this journey of paternal and professional bliss.

Many of us know that although parenting and training in anaesthesia are compatible, there are many challenges. Some of these could be addressed to the benefit of anaesthetists, anaesthetic departments and providers alike.

This galvanised us to run a national survey, looking at the impact of parenting on training in anaesthesia from both the parent and non-parent perspectives. 411 residents responded to the survey, with a higher proportion of respondents being white and heterosexual, and training less than full time. A similar proportion of men and women responded, highlighting how these issues affect everyone. We recognise that this is the opinion of one group, albeit a key stakeholder, in a complex situation.

This article highlights a few of the key findings.

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.

They're the fresh faces of anaesthesia and the future of our specialty.

We introduce you to some of our newest anaesthetists in training. We hope all of them and the rest of our trainees have very long, rewarding, and fulfilling careers as anaesthetists.

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.

Like Alexander of Macedon, the new curriculum has swept all before it. For Egypt, read regional anaesthesia; for the sacked cities of Tyre and Persepolis, read the subspecialties.

Although Pain may seem distant, much like Alexander reached India, the new curriculum has reached it.

In 2010 Pain featured as a module requiring a sign off (with 17 syllabus points) and Intermediate Level (18), and was optional at Higher and Advanced.

This has been replaced by compulsory HALOs at Stages 1, 2 and 3, with new and more generalised curriculum points.

• 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.

These colleagues are easily recognised and often appreciated but, with the merry-go-round of training and rotational placements, attaining formal acknowledgement of their work can be overlooked. 

We recently took steps to nominate our College tutor and were delighted when he received a President’s Commendation from our College.

Several years ago, Dr Minich took over the school-wide final FRCA teaching programme. With his dedication and blindingly structured approach, it quickly became clear that we were fortunate to have an excellent educator in our midst. To say we all benefited from the provision of exam-practice resources and Dr Minich’s efforts coordinating hours of SOE practice feels like an understatement; it simply does not portray the level of help and support Dr Minich provided to the trainee body preparing for the exams.

In this issue, we’re collaborating with the Association of Paediatric Anaesthetists of GB & Ireland (APAGBI) to focus on paediatric anaesthesia. The APAGBI have selected half a dozen resources from their own and our collection for you to enjoy, whether you’re an anaesthetist in training or an experienced consultant.

The rigorous demands of anaesthetic training in the UK are well known, with long hours, high-stress situations, and the constant need for precision and vigilance. Adding to this the stress of COVID, change in the curriculum, and a wedding to plan led me to look for ways to refresh and rejuvenate myself.

Looking through the Health Education England (HEE) Gold Guide, you can find the information about an Out-of-Programme Career Break (OOPC). OOPCs allow trainees an opportunity to step away from training to give them time to pursue other interests, including interests not connected with medicine. This is different from the other out-of-programme options which are more related to clinical training (OOPT), clinical experience (OPPE) or research (OOPR). This led me down a path I will never regret.