Sub-topics

Medical practitioners
Non-medical practitioners
Other assistants

Medical Practitioners

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If you live in Australia, Canada, New Zealand, South Africa, or the United Kingdom, your anaesthetic will most likely be given by a specialist doctor. Depending on the country, this specialist is known as the anaesthetist or anaesthesiologist or anesthesiologist.

After graduating from medical school, these doctors have undertaken several years’ additional training in anaesthesia. Anaesthetic training is usually under the direction of a professional body, such as the Australian and New Zealand College of Anaesthetists, the Royal College of Physicians and Surgeons of Canada, or the Royal College of Anaesthetists in the United Kingdom. The training varies in content and length, depending on the country in which it is undertaken. In those countries mentioned above, the training is for a minimum of several years and equal in length to that of other specialists, including surgeons. The process to become a specialist anaesthetist includes intensive assessment and written and verbal examinations. If successful in passing the examinations, the anaesthetist becomes a Fellow of the national professional accrediting body, such as one of the Colleges mentioned above.

In Canada and the United States of America, specialist anaesthetists are known as anesthesiologists. American anesthesiologists have always been known by this term, to distinguish these doctors from Certified Registered Nurse Anaesthetists or CRNAs (see below). There are no nurse anaesthetists practising in Canada, Australia, New Zealand or the United Kingdom.

In the United States, at the completion of anaesthetic training, the doctor takes a written examination. The successful candidate must then pass an oral examination to become a Board Certified anesthesiologist. In Europe and many other countries, specialist anaesthetists are known as anaesthesiologists. This again denotes the distinction from 'nurse anaesthetists' who practise with specialists in many European countries.

After qualification, anaesthetists are strongly encouraged to continue their education throughout their professional lives. Most Colleges or other regulatory and licensing bodies now require some on-going evidence that the anaesthetist is keeping up to date. The degree of professional regulation depends on the country in which the anaesthetist practises.

In Canada, the Canadian Anesthesiologists’ Society is a professional organisation that has undertaken development of Guidelines to the Practice of Anaesthesia. These provide recommendations as to how anaesthetics are given - for example, which monitors should be used during an anaesthetic. The Royal College of Physicians and Surgeons of Canada (RCPSC), which regulates training and certification of anesthesiologists, plays no further specific role in the regulation of anaesthetic practice. However, the RCPSC does direct a system of continuing medical education, to enable specialists to continue learning and keep up to date.

By way of contrast, in Australia and New Zealand, the College of Anaesthetists (ANZCA) has developed guidelines for anaesthetic practice. In addition, the College directs a Continuing Professional Development (CPD) program in which any anaesthetist can participate.

In some countries, non-specialist doctors may also give anaesthetics, most often in rural areas. Smaller communities depend on non-specialist anaesthetists because the amount of work available is not sufficient to support a full-time specialist. These doctors have not usually had full specialty training, and tend to give anaesthetics for less complex operations; however, they also participate in programs aimed at maintaining skills and knowledge. Many non-specialist anaesthetists also continue to work as Family or General Practitioners.

Non-medical practitioners

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In some countries, particularly in Europe, nurse anaesthetists give anaesthetics under the supervision of a specialist anaesthesiologist. Often they will work as a team, with one nurse anaesthetist and one anaesthesiologist for each patient. In other areas, nurse anaesthetists give anaesthetics under the direction of the surgeon, cardiologist or radiologist who may be operating or performing a procedure on a patient at the same time. In a few countries, nurse anaesthetists are legally allowed to practise without any supervision by a doctor.

Other assistants

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In the Operating Room, your anaesthetist usually has the help of an assistant. This person could be a nurse, respiratory therapist or an anaesthetic technician. Ideally, the assistant has undergone formal training and examination, although this is not always the case. Anaesthetists value good assistants, who carry out many differing tasks. These tasks include preparing and checking drugs and equipment, and obtaining extra equipment from outside the Operating Room. The assistant may also attach various monitors to patients, such as an automatic blood pressure cuff, and then may record heart rate, blood pressure and other measurements on the anaesthetic record. In addition, the assistant hands drugs or equipment to your anaesthetist, and is generally available to help at all times, particularly at the beginning and end of the anaesthetic.

Depending on where you live and where your hospital is, a number of the people described above may be involved in providing your anaesthesia care. In addition, some hospitals also train other health care workers, such as ambulance attendants and paramedics, who may be present in the Operating Room and help with part of your anaesthetic.