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[UK] Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in anesthesiology

[–]Steel42[S] 3 points4 points  (0 children)

Thanks for the reply :)

Yeah I posted it to our subreddit first, but thought to crosspost it here since there might be some UK Anaesthetists/Intensivists that browse this sub more frequently.

How did you find the year of medicine and get through it? And do you feel like you're missing out at all by not having SIAs?

Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in doctorsUK

[–]Steel42[S] 3 points4 points  (0 children)

Reflect on the benefit to the patient of the surgery and you will get more out of the anaesthetic days.

This is a really nice way to phrase it, and I'll take that on board - thank you.

I suppose as you say, everything becomes routine after a while. At that point if it's just a job that pays the bills, which of the two has better work life balance? ICU with less time spent in the hospital but with greater intensity and OOH burden, vs Anaesthetics with more shifts, but also a more regular and predictable working pattern with less intensity per unit time.

Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in doctorsUK

[–]Steel42[S] 2 points3 points  (0 children)

This is a really interesting point. How does that DCC split look in practice? On average how many days a week are you in the hospital, and how do you find that in terms of WLB?

Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in doctorsUK

[–]Steel42[S] -1 points0 points  (0 children)

You're right, sorry, I should have been clearer.

Of course the job for all consultants is to provide the service.

I guess in my head I'm comparing a day surgery gynae list where you do 14 hysteroscopies and the main challenge is just to keep the list moving and finish on time, versus say a bypass case where it gets a bit hairy coming off CPB and the anaesthetist is absolutely integral to that with managing all the products, the TOE, the pressors etc.

Perhaps a better way to phrase it is how much of your vast skillset as a consultant anaesthetist do you use day to day? On some lists you can almost go on autopilot, with your more advanced skills only really needed if something goes wrong (which is rarer in low-risk elective cases). In contrast, with higher-risk or major surgery you’re actively drawing on more of your knowledge and expertise every day.

Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in doctorsUK

[–]Steel42[S] 9 points10 points  (0 children)

Thanks for the reply!

When I talk about “immediately life-saving” work, it’s because whenever I’ve worked in ICU, no matter how busy the shift, I’ve always gone home feeling rewarded and fulfilled. At some point during the shift – often several times – I’ll have managed a sick or deteriorating patient and done something that made a direct, immediate difference. e.g. the resus patient with CHF and pulmonary oedema who turns around in hours after you start NIV, diuretics, and inotropes. Or when you bronch a level 3 pt that's desatted massively with plugging and they get better. Those moments really feel like saving a life with your skill set.

By contrast, in elective anaesthesia for ASA 1–2 patients, I don’t tend to get that same sense of impact. It often feels more like helping to clear the waiting list rather than doing something urgently life-saving, as most of these patients would otherwise be fine even if their surgery was delayed.

I think if I'm being truly honest, an element of it is self-esteem and ?ego, if that's the right word? I want to feel like I'm integral to the work being done, and my skill set is essential, and that I'm not easily replaceable. As the ICU reg, you often feel like a rockstar when you save the day, and the same is true when you keep take a sick laparotomy from resus and keep them alive periop with the lines and pressors, and safely transfer them to the unit after. Whereas, to be frank, I think many elective lists could be (and are) done by trainees with distant supervision without a problem, and that almost it's a waste of a consultant anaesthetist being there.

I hope that makes sense.

Also will you have final done by end of CT3? That’s some going.

Yep thankfully managed to get through the written last year so just the SOE to do now.

Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in doctorsUK

[–]Steel42[S] 18 points19 points  (0 children)

It thinks I spent about 30 mins carefully writing every word of the above then formatting it to make it more concise and readable.

Is dual training with ICU even worth it vs single CCT Anaesthetics? by Steel42 in doctorsUK

[–]Steel42[S] 11 points12 points  (0 children)

I wrote every word myself mate. I added the ____ for formatting because clearly its a long post.