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As I write this, we are finalising the 2025 Census, which we undertake every five years to get an accurate picture of the anaesthetic workforce across the UK.  

In previous years the Census has focused on asking Clinical Leaders and College Tutors for local data about the provision of anaesthetic services to patients, the composition of the workforce and anaesthetic education and training. This year, for the first time, we are also asking all practising anaesthetists in the UK to participate in the Census and tell us about your individual experiences at work.  

The Census launches in the first week of April. By the time you’re reading this you may have already received your unique link to complete it. I know you’re all very busy but taking a few minutes to complete the Census will make a huge difference. The more we know about your working patterns and challenges, professional development and wellbeing, the more effectively we can support you and advocate on your behalf. 

A novice anaesthetist will face a range of new environments, technical skills, knowledge, people and equipment. It is easy to feel that ‘the glass is starting to overflow’. However, an understanding of cognitive load theory can be used to optimise complex learning tasks. 

It’s beneficial for all anaesthetists to manage cognitive load at work, but also for anaesthetists to implement these principles when teaching in theatre.

Cognitive load theory has been developed from the Modal model of memory described by Atkinson and Shiffrin. This details how information is received, encoded, stored and retrieved during learning (see An illustration of the Modal model of memory by Dr Thomas Walters). Incoming information is consciously held and processed within working memory, before being encoded into long-term memory. Working memory has a limited capacity, and information within it is transient and forgettable. Once encoded into long-term memory, information is organised in schema, with a seemingly unlimited capacity. Working memory can hold five to nine pieces of information at a time. However, if required to process this information, capacity is significantly reduced.

The GMC has recognised that the quality of clinical care and the safety of patients are crucially dependent on the quality of training provided within the health service, not only in relation to skills and knowledge but also in relation to professionalism. The GMC has recognised for many years that trainers must be trained, accredited, supported and quality-assured.

Specialty and Specialist (SASs) and locally employed doctors (LEDs) are the fastest growing part of our workforce, with numbers increased by 40% over the last five years. Projecting forward, they are expected to be the workforce’s largest group on the GMC register by 2030 (GMC workforce report 2022). Not only will the NHS depend heavily on this part of the workforce to provide services to patients, but also to train future generations of doctors and other healthcare professionals.

The 2021 SAS contracts set a clear expectation that specialty doctors should get involved in non-clinical activities to develop their range of expertise as well as ensure their progress through the higher pay threshold. Varied and relevant non-clinical experience and activity is an essential requirement for appointment as a specialist. Our appraisal and revalidation system sets an expectation of all doctors, regardless of grade, to be active in quality improvement, and encourages teaching, leadership, management, research and innovation.

The event featured a number of key College stakeholders, including Council members Giovanna Kossakowska and Matt Tuck representing anaesthetists in training, plus other trainees with their own advice to share, alongside our President Fiona Donald and a host of others. 

Had your head buried very deeply in the sand for most of the last decade? Then it may have escaped your attention that the UK has cleaved itself away from the European Union. But fear not! The College and the Association of Anaesthetists are both still represented on the European Board of Anaesthesiology (EBA), the Anaesthesia section of the European Union of Medical Specialists.

Known by its French acronym, UEMS is a non-governmental organisation created in 1958 in the same year as the European parliament. The aims of UEMS are to improve patient care throughout Europe by developing and supporting excellence in specialist medical training and practice and, as a by-product, to promote free movement of medical specialists around the EU.

The UEMS represents more than 1.6 million specialist doctors from 41 countries:

• full UEMS members – EU countries plus Iceland, Norway, Switzerland, UK
• associate members – Armenia, Israel, Serbia, Turkey, Ukraine
• observer countries – Georgia, Iraq, Lebanon, Morocco, Tunisia.

It is not an understatement to say that resident doctors in training often face significant challenges when attempting to implement change initiatives. As they rotate through multiple hospitals, they may struggle to establish rapport and trust with established staff, making it difficult to garner support for new ideas. 

The fast-paced environment, heavy workload and burden of exams and portfolio, can leave little time for trainees to engage in the necessary discussions or meetings to advocate for change. Additionally, the hierarchical structure of medical training can inhibit resident doctors from voicing their ideas as they may not feel respected enough to have influence.

‘Safety and Quality Improvement’ is one of the generic professional domains throughout the anaesthetic training programme. Trainees are expected to conduct local quality-improvement projects, in addition to participation in regional or national projects.

It’s a sad truth that necessary change sometimes only comes in the aftermath of something going terribly wrong.

When I see a family that has suffered a tragedy calling for change – and it often seems to be a family campaign that makes the difference – I find myself in awe of their courage. Stephen Lawrence’s family working for a more equitable society, Molly Russell’s family calling for greater online safety and support for young people, Natasha Ednan-Laperouse’s family campaigning for better food labelling to protect allergies. I also wish that they’d never had to find themselves in that position.

Dr Hoo Kee Tsang tells us about the new Specialist Pain Medicine credential.

We’re pleased to announce the launch of the new Faculty of Pain Medicine (FPM) Specialist Pain Medicine credential – a new process to formally recognise a doctor's expertise in pain medicine to bring assured training and regulatory oversight.

GMC credentials were originally developed to focus on discrete areas of practice where consistent clinical standards are considered necessary to support better and safer patient care or where patients are at risk due to workforce gaps.