How to become an anaesthetist

What is an anaesthetist?

Anaesthetists provide anaesthesia care before, during, and after surgery. They also provide pain management support for childbirth and diagnostic procedures where a general or local anaesthetic may be needed.

As well as supporting patients during planned or unplanned surgery, anaesthetists also work in:

• pre-hospital emergency medicine
• intensive care medicine 
• pain medicine

They are qualified doctors who must be registered with the General Medical Council (GMC) to work in the NHS.

Starting your career as an anaesthetist

Choosing subjects at school

To get into medical school, useful school subjects include:

• Chemistry
• Biology
• Physics
• Maths
• English
• Religious, Moral, and Philosophical Studies
• Psychology
• Care

Speak to your guidance teacher or careers adviser about subjects offered at your school. You should also contact medical schools to learn more about their entry requirements.

Reach widening access project

Reach is a national project that supports senior school pupils from non-traditional backgrounds who want to study medicine. Universities offer on-campus events to help you gain insight into their undergraduate degree programme. You can also access the following:

• information sessions
• practical masterclasses
• UCAT preparation support
• UCAS application guidance
• personal statement workshops
• medical school interview practice and advice

Find out how Reach is widening access to medicine.

Education and training pathway

There are 5 universities where you can study medicine in Scotland:

• University of Aberdeen
• University of Dundee
• University of Edinburgh
• University of Glasgow
• University of St Andrews

If you’re at school, thinking about changing careers or returning to education as an adult learner, there are many different routes into medical school.

Batchelor of Medicine and Surgery degree

To become an anaesthetist, you’ll need to complete a degree in medicine (MBChB) at SCQF level 10.

Standard entry medicine

Standard entry medicine degree programmes take 5 to 6 years to complete, studying full-time.

You should contact each medical school to find out about specific entry requirements.

Scottish Wider Access Programme

Widening participation supports adult learners who want to go to university. If you’re an adult with few or no qualifications, you could get into higher education through the Scottish Wider Access Programme (SWAP).

This access programme will help you get the entry qualifications you need to study medicine. Find out more about SWAP Access to Medical Studies.

Medicine with a gateway year

Several gateway programmes are available at medical schools in Scotland. These programmes provide a supportive route to medical school if you're not immediately ready to start a degree course.

You should contact each medical school to find out more about their gateway programmes.

Graduate entry programme

If you already have an honours degree at SCQF level 10, you can choose this route to study medicine. Some universities offer an accelerated 4-year medical graduate entry programme. To apply, you must meet the academic and non-academic requirements set out by the universities.

Examples of graduate programmes include the following:

• Scottish Graduate Entry Medicine (ScotGEM) at the University of St Andrews and the University of Dundee
• Medical degree for healthcare professionals (HCP-Med) at the University of Edinburgh

You should contact each medical school to find out about their graduate entry programme requirements.

Aptitude tests

Medical schools select applicants for their degree programmes using aptitude tests, UCAS applications, academic qualifications, and interviews.

University Clinical Aptitude Test

If you apply to medical school via any of these routes, you’ll need to sit the University Clinical Aptitude Test (UCAT):

• standard entry medicine
• SWAP
• medicine with a gateway year

Find out more about the UCAT computer-based admissions test.

Graduate Medical School Admissions Test

If you’re applying for a graduate entry programme, you’ll sit the Graduate Medical School Admissions Test (GAMSAT).

Medical school

At medical school, you’ll have lectures, tutorials, and simulation-based learning where you’ll do the following:

• learn about body systems and anatomy
• develop your practical skills
• learn how to do basic clinical examinations
• interact with real patients
• practice clinical skills with simulation mannequins
• learn the skills needed for surgical procedures

You’ll also have clinical placements to help you get experience in a wide range of clinical areas, such as:

• general practice
• general medicine and surgery
• psychiatry
• obstetrics and gynaecology
• other hospital specialties and sub-specialties

Search for undergraduate medical degree programmes on My World of Work.

Applying for provisional registration

When you graduate from medical school, you’ll need to apply to the General Medical Council (GMC) for provisional registration with a licence to practise. This will allow you to take the next step in your medical training and join a foundation programme.

Find out more about provisional registration.

Foundation programme

A foundation programme is the first step in your postgraduate training after you graduate from medical school. You’ll also learn the skills you’ll need to deliver safe and effective person-centred care.

The Scottish Foundation School’s 2-year work-based training programme offers experience in a range of specialties and geographic locations. When you have a place on a foundation programme, you must apply for provisional registration with the GMC.

Foundation year 1

In your first year as a foundation doctor in training, you’ll develop the knowledge, skills, and competencies you gained in medical school. When you successfully complete your F1 year, you’ll be issued a Foundation Year 1 Certificate of Completion document.

The Scottish Foundation School will send a certificate of completion to the GMC so you can apply for full registration. You’ll also progress to the second year of the foundation programme.

Foundation year 2

During your F2 year, you’ll continue to develop your clinical and professional knowledge. This will prepare you for the next stage of your medical training.

At the end of your F2 year, you’ll be issued a Foundation Programme Certificate of Completion (FPCC), ready to apply for the UK anaesthesia training programme.

Find out more about foundation training in Scotland.

UK anaesthesia training programme

The UK anaesthesia training programme has 3 stages. Before you start training to become an anaesthetist, you should register with the Royal College of Anaesthetists (RCoA).

You’ll have practical assessments and written and oral exams. You must pass these to progress in the training programme.

Throughout your training, you’ll also be expected to undertake a range of other activities, such as:

• audit and quality improvement work
• teaching more junior team members and other NHS professional groups

These all form a key part of practising as a consultant in the NHS and performing your clinical duties.

Annual Review of Competence Progression

All doctors in training receive an annual review towards the end of their training year. The Annual Review of Competence Progression (ARCP) is used to:

• check that you’re meeting the standards required by the core or specialty training programme curriculum
• make sure you’re providing safe, effective, and high-quality patient care
• make sure you are developing non-clinical capabilities, such as teamwork, management, teaching, and quality improvement

A panel of senior doctors and medical educators decides ARCP outcomes. They will determine if you’re ready to progress to the next step in your training.

Stage 1

In stage 1, you’ll need to complete core anaesthesia training or the Acute Care Common Stem (ACCS) training programme. Entry to these programmes is through the Scottish national recruitment process managed by the Anaesthetics National Recruitment Office (ANRO).

Core anaesthesia training

Core anaesthesia training is a 3-year programme. You must sit and pass the Multi-Specialty Recruitment Assessment (MSRA) exam to apply.
During training, you’ll learn the basics of delivering anaesthetic care, including:

• gaining experience in a range of surgical specialties, pre-operative assessment clinics, obstetrics, and intensive care
• pre-operative assessment of patients to reduce the risk of complications during anaesthetic care
• preparing basic anaesthetic drugs
• simulation training, including critical incidents, airway management, and adult and paediatric resuscitation
• blood transfusion training
• providing general anaesthesia for patients having simple surgical procedures

An educational supervisor will support you throughout your training. You’ll also have a clinical supervisor for each hospital placement. Your supervised learning, activities, and reflections must be recorded in your ePortfolio.

You must complete the Initial Assessment of Competence (IAC) to progress to the second year of core training. At the end of your third year, you must take and pass the Fellowship of the Royal College of Anaesthetists (FRCA) primary exams. You can then apply to stage 2 of the UK anaesthesia training programme.

Find out more about core anaesthesia training.

Acute Care Common Stem training

Acute Care Common Stem (ACCS) training is a 4-year programme where a clinical supervisor will support you. Your main specialty will be anaesthetics, but you’ll also receive training in the following:

• emergency medicine
• intensive care medicine
• internal medicine

To apply, you’ll need to sit and pass the Multi-Specialty Recruitment Assessment (MSRA) exam. Within the first 6 months of training, you must complete the Initial Assessment of Competence (IAC).

Training is delivered in a range of ways, including:

• supervised clinical experience
• simulated practice
• supervised practice
• training courses
• eLearning modules

You’ll record all your learning in your logbook and ePortfolio. You’ll also have regular assessments, including workplace-based assessments and senior clinician panel reviews.

Once you’ve completed the ACCS curriculum, you can apply to stage 2 of the UK anaesthesia training programme.

Find out more about the ACCS training.

Stage 2

In stage 2, you’ll continue to develop your anaesthesia knowledge and skills. This includes training in subspecialties such as paediatric, neuro, and cardiothoracic anaesthesia. You’ll also receive training in intensive care medicine.

After you complete stage 2 training, you’ll take and pass the Fellowship of the Royal College of Anaesthetists (FRCA) final exams.

Find out more about the FRCA final written and oral exams.

Stage 3

In stage 3, you’ll progress to a level where you can practise as an anaesthetist unsupervised. You’ll also focus your training on one or more areas of special interest, such as:

• anaesthesia for bariatric surgery
• anaesthesia for cardiac surgery
• transfer medicine
• pain medicine
• safety and quality improvement
• education and training

Special Interest Area (SIA) training will help you prepare for:

• a career as a consultant anaesthetist in a specialised area of anaesthetic practice
• additional specialist training opportunities after gaining your Certificate of Completion of Training

Find out more about SIAs.

Certificate of Completion of Training

You’ll be issued a Certificate of Completion of Training (CCT) when you complete speciality training. You can then join the GMC Specialist Register and apply for consultant anaesthetist vacancies in the NHS.

Learn more about the GMC Specialist Register.

Learning and development

As an anaesthetist, you’re expected to engage in continuous professional development (CPD) activities to keep your knowledge and skills up to date. Seminars, webinars, and surgical skills courses to support your professional development are offered by the Royal College of Anaesthetists.

You can also find out more about CPD on the GMC website.

Revalidation

All doctors are legally required to revalidate to show that their knowledge and skills are up to date and that they are fit to practise. You’ll need to revalidate every 5 years to maintain your registration with the GMC.

Learn more about the revalidation process for doctors in the UK.

Career progression

You may choose to be a consultant anaesthetist throughout your medical career. You’ll keep up to date through CDP activities. Extra courses and workplace learning could lead to career progression. You could specialise in these areas:

• intensive care medicine
• pain medicine
• neuro anaesthesia
• cardiothoracic anaesthesia
• vascular anaesthesia
• paediatric anaesthesia

Some consultant surgeons take up teaching and research posts in the NHS, higher education, or the private sector.

Professional bodies

You can join the following organisations as a medical student or GMC-registered doctor:

• The Royal College of Anaesthetists
• The Royal College of Emergency Medicine
• The Faculty of Intensive Care Medicine
• The Faculty of Pain Medicine
• The Faculty of Pre Hospital Care
• Association of Anaesthetists
• Intensive Care Society
• British Medical Association

You’ll need a licence to practise in the UK to work as a consultant anaesthetist in the NHS. You must also be on the General Medical Council’s Specialist Register.

Find out more about the General Medical Council.