RCoA responds to national survey of UK anaesthetic trainees

The impact of the COVID-19 pandemic on anaesthetists – especially anaesthetists in training – has been, and continues to be, profound and unprecedented. The Association of Anaesthetists’ (Association) report, adds to the body of evidence on this issue, and for that reason, is welcome. However, the report also includes a number of comments which we do not agree with, about the way in which the Royal College of Anaesthetists (RCoA), our trainers, examiners, volunteers and staff have responded to this crisis, and we would like to make the following response on their behalf.

Throughout the pandemic, the RCoA has collaborated with partners including the Association to provide timely and effective solutions to the challenges being faced by our members, particularly anaesthetists in training. We continue to do all we can within our remit, to keep important membership services running during the greatest global health challenge for generations. This has been far from simple and we acknowledge that, as might be expected, mistakes were made. However, we feel it is important to note what has been achieved.

The RCoA has long called for an increase in anaesthetic training numbers. Over the past two years we have identified a 10 per cent vacancy rate among consultant anaesthetists, and an 18 per cent vacancy rate among SAS doctors which inevitably results in increasing pressure, stress and possible burnout in all grades of anaesthetist. We have made multiple representations to the national education authorities for an increase in the training capacity, and increased trainee numbers. The total number of trainee places is determined by the Statutory Educational Bodies in collaboration with the government in each country. We particularly welcome the decision by Health Education and Improvement Wales to increase training capacity by 30 per cent for August 2021, and call on the other nations to follow suit.

Responding directly to the Association’s report, the RCoA finds the narrative and tone around ST3 recruitment particularly unhelpful in terms of searching for a solution. Our previous statements have highlighted our position and the difficult decisions made to continue with recruitment and with the implementation of the 2021 Anaesthetics Curriculum. Delaying the curriculum implementation would have increased uncertainty and would be detrimental to the progress of the majority of anaesthetists in training. We want to emphasise that the flexibility included in the new curriculum will help those doctors unsuccessful in this year’s recruitment round to make the experience gained in locally employed positions count towards their training.

Despite enormous challenges in the past year the RCoA is proud of the success of the online exams and want to take this opportunity to recognise the enormous efforts of the examinations department and the examiners themselves for the benefit of our anaesthetists in training, many of whom have responded so candidly to this survey.

We will continue to do our utmost to ensure we support and protect our anaesthetists in training and advocate for a continued pathway for their career progression, in environments where they can work effectively and reach their potential. We do this not only for their sakes, but also because of our responsibility to the patients for whom they care, be that as part of the pandemic response or as they work to catch up with the backlog, and to relieve the suffering caused by delays in treatment.

The opportunity provided by this report is one of greater future collaboration, in support of the specialty as a whole, and we look forward to continuing to contribute to initiatives and importantly solutions, to the very serious challenges outlined within it.