Anaesthetic Associate discussion

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Helenia
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#1
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#1
(Original post by Anonymous)
haha yes...
but whats the point in training any at all? Yes, they can review patients but they always have to report to someone (even an F1). I also heard about specialist PAs like for ED and anaesthetics. Can these do procedures such as lines and intubations? (... kinda doubting my career choice- half the amount of training for a good wage... and probs a better work-life balance/less responsibility!)
Anaesthesia Associates are becoming more of a thing. Very controversial though. We don't have any in our trust but in some places they can do intubations, epidurals/nerve blocks etc. Raises a lot of questions about supervision and training though.
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malshoha
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#2
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#2
(Original post by Helenia)
Anaesthesia Associates are becoming more of a thing. Very controversial though. We don't have any in our trust but in some places they can do intubations, epidurals/nerve blocks etc. Raises a lot of questions about supervision and training though.
Anaesthesia associates are a little different to PA's, whereas PA school teaches you a little about a lot, anaesthesia associates focus on anaesthesia for the whole duration so they are pretty skilled and come of school as experienced as an anaesthetic SHO, and with experience post-grad, can be as effective as a junior/mid level registrar. supervision and training depends on with who and where you work, so if a consultant is happy for the AA to work solo then who can argue with them.
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ecolier
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#3
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#3
(Original post by malshoha)
Anaesthesia associates are a little different to PA's, whereas PA school teaches you a little about a lot, anaesthesia associates focus on anaesthesia for the whole duration so they are pretty skilled and come of school as experienced as an anaesthetic SHO, and with experience post-grad, can be as effective as a junior/mid level registrar. supervision and training depends on with who and where you work, so if a consultant is happy for the AA to work solo then who can argue with them.
And this, ladies and gentlemen, is why reddit / more and more junior doctors are not happy about the future of medicine / medical training here.

No offence to AHPs, but what's the point of studying medicine and then specialising for years to decades, passing post-grad exams, moving across the country for training if someone who have had a few years doing this can become the equivalent of a junior / mid level registrar?
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Democracy
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#4
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#4
(Original post by malshoha)
Anaesthesia associates are a little different to PA's, whereas PA school teaches you a little about a lot, anaesthesia associates focus on anaesthesia for the whole duration so they are pretty skilled and come of school as experienced as an anaesthetic SHO, and with experience post-grad, can be as effective as a junior/mid level registrar.
Lol what "school" are these AAs attending where they come out as experienced as SHOs? Hogwarts?

What a load of nonsense.

supervision and training depends on with who and where you work, so if a consultant is happy for the AA to work solo then who can argue with them.
Me
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GANFYD
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#5
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#5
(Original post by Democracy)
Lol what "school" are these AAs attending where they come out as experienced as SHOs? Hogwarts?

What a load of nonsense.



Me
Me too!! I don't want someone there to deal with the 99+% of the time it all goes fine, I want someone who knows what to do when the proverbial hits the fan. I understand autopilot will land a plane just fine, most of the time, but I want a Sully behind the controls when we are coming down in the Hudson!
I know experienced Consultant Anaesthetists who have lost patients due to complications, so goodness knows how many more might die if the person in charge was not even medically trained?

The longer you are involved in medicine, the more you realise you don't know. OP is training to be an ODP, it seems, and is a classic demonstration of Dunning-Kruger in action
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Helenia
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#6
Report Thread starter 2 months ago
#6
(Original post by malshoha)
Anaesthesia associates are a little different to PA's, whereas PA school teaches you a little about a lot, anaesthesia associates focus on anaesthesia for the whole duration so they are pretty skilled and come of school as experienced as an anaesthetic SHO, and with experience post-grad, can be as effective as a junior/mid level registrar. supervision and training depends on with who and where you work, so if a consultant is happy for the AA to work solo then who can argue with them.
Well that's the thing - a lot of the consultants aren't that happy about it.
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Etomidate
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#7
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#7
(Original post by malshoha)
Anaesthesia associates are a little different to PA's, whereas PA school teaches you a little about a lot, anaesthesia associates focus on anaesthesia for the whole duration so they are pretty skilled and come of school as experienced as an anaesthetic SHO, and with experience post-grad, can be as effective as a junior/mid level registrar. supervision and training depends on with who and where you work, so if a consultant is happy for the AA to work solo then who can argue with them.
This **** needs to be nipped in the bud asap. AAs should not be a thing lest we follow the American model. Wouldn’t want them touching my friends or family with a barge pole and personally would resist being involved in any part of their training or supervision.

A big nope from me. Go to medical school and sit the FRCA like the rest of us.
Last edited by Etomidate; 2 months ago
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Mushi_master
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#8
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#8
(Original post by Etomidate)
This **** needs to be nipped in the bud asap. AAs should not be a thing lest we follow the American model. Wouldn’t want them touching my friends or family with a barge pole and personally would resist being involved in any part of their training or supervision.

A big nope from me. Go to medical school and sit the FRCA like the rest of us.
Quoted for truth.

The attitude feels highly disrespectful of our whole specialty. Yeah sure be a doctor and do the FRCA and be able to deal with the myriad of medical things we do day in day out, but someone without that background can do my job? Belittling to say the least. Like saying an anaesthetist doesn’t need to be a doctor.

Not sure the wider theatre team would be happy either, we are so frequently used (rightly) as the peri operative physician in theatre and another senior decision maker along with the surgeons. Them having to go through barriers will not go down well.

Also, not having to do the on calls and geographical instability over long training and then do the ‘same job’ but the easier patients? **** off with that. Consultant anaesthetists need some ASA 1-2 patients too as they will burn out otherwise. Whole idea stinks.
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Helenia
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#9
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#9
(Original post by Mushi_master)
Quoted for truth.

The attitude feels highly disrespectful of our whole specialty. Yeah sure be a doctor and do the FRCA and be able to deal with the myriad of medical things we do day in day out, but someone without that background can do my job? Belittling to say the least. Like saying an anaesthetist doesn’t need to be a doctor.

Not sure the wider theatre team would be happy either, we are so frequently used (rightly) as the peri operative physician in theatre and another senior decision maker along with the surgeons. Them having to go through barriers will not go down well.

Also, not having to do the on calls and geographical instability over long training and then do the ‘same job’ but the easier patients? **** off with that. Consultant anaesthetists need some ASA 1-2 patients too as they will burn out otherwise. Whole idea stinks.
And trainees need ASA 1-2 patients to get experience of "normal" - hard to do if they're all creamed off onto the AA's list.
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Mushi_master
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#10
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#10
(Original post by Helenia)
And trainees need ASA 1-2 patients to get experience of "normal" - hard to do if they're all creamed off onto the AA's list.
Yep and to learn not every ASA 1-2 will be plain sailing. Whole concept drives me nuts tbh.
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malshoha
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#11
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#11
(Original post by Democracy)
Lol what "school" are these AAs attending where they come out as experienced as SHOs? Hogwarts?

What a load of nonsense.



Me
Usually University of Birmingham or UCL, by the time you finish you'll probably have about a year of experience which puts you roughly at ST1/ST2 level, there's not much an SHO can do that an AA cant
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malshoha
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#12
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#12
(Original post by ecolier)
And this, ladies and gentlemen, is why reddit / more and more junior doctors are not happy about the future of medicine / medical training here.

No offence to AHPs, but what's the point of studying medicine and then specialising for years to decades, passing post-grad exams, moving across the country for training if someone who have had a few years doing this can become the equivalent of a junior / mid level registrar?
This is a fair point, though the path is still sort of long, it requires a 3-year bachelors + 3 years experience + 2 years master's. so that's 8 years to be qualified, then a few years of experience after that, you can be skilled enough as a junior/mid level registrar. So 10+ years, its not really a quick shortcut. through the medical school route, after 10 years you'll be a registrar, but obviously you'll continue your training all the way to consultant level which allows you to do pretty much anything and take on complex cases and further specialization, whilst AA's are pretty much limited to ASA 1/2 cases.
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malshoha
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#13
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#13
(Original post by Etomidate)
This **** needs to be nipped in the bud asap. AAs should not be a thing lest we follow the American model. Wouldn’t want them touching my friends or family with a barge pole and personally would resist being involved in any part of their training or supervision.

A big nope from me. Go to medical school and sit the FRCA like the rest of us.
Whys that? would you be against an ST 1/2 providing anaesthetic services?
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malshoha
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#14
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#14
(Original post by Mushi_master)
Quoted for truth.

The attitude feels highly disrespectful of our whole specialty. Yeah sure be a doctor and do the FRCA and be able to deal with the myriad of medical things we do day in day out, but someone without that background can do my job? Belittling to say the least. Like saying an anaesthetist doesn’t need to be a doctor.

Not sure the wider theatre team would be happy either, we are so frequently used (rightly) as the peri operative physician in theatre and another senior decision maker along with the surgeons. Them having to go through barriers will not go down well.

Also, not having to do the on calls and geographical instability over long training and then do the ‘same job’ but the easier patients? **** off with that. Consultant anaesthetists need some ASA 1-2 patients too as they will burn out otherwise. Whole idea stinks.
pretty sure they do on calls too, but they're not taking away ASA 1/2 cases, they still require consultant supervision, so it's still your case. The way a registrar isn't stealing your cases, they are still ultimately under your care. Sometimes the consultant would like an extra pair of hands. It isn't like the american CRNAs who don't go to med school yet, practice independently.
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malshoha
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#15
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#15
(Original post by Helenia)
Well that's the thing - a lot of the consultants aren't that happy about it.
Very true, though in my experience the consultant anaesthetists are unaware AA's even exist
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malshoha
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#16
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#16
(Original post by GANFYD)
Me too!! I don't want someone there to deal with the 99+% of the time it all goes fine, I want someone who knows what to do when the proverbial hits the fan. I understand autopilot will land a plane just fine, most of the time, but I want a Sully behind the controls when we are coming down in the Hudson!
I know experienced Consultant Anaesthetists who have lost patients due to complications, so goodness knows how many more might die if the person in charge was not even medically trained?

The longer you are involved in medicine, the more you realise you don't know. OP is training to be an ODP, it seems, and is a classic demonstration of Dunning-Kruger in action
Ultimately, though the AA is trained in emergencies, the responsible consultant anaesthetist is always in close proximity, the RCoA say the consultant needs to be a maximum of 2 minutes away, and if they're not to be found the emergency buzzer isn't far. No Dunning-Kruger here I am well aware of my extremely limited knowledge, but the things I'm saying can be found online, mostly on the RCoA website, I just read up on it here and there, even though I have no plans to become an AA. If I've said something incorrect please correct me, I don't want to misinform.
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Mushi_master
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#17
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#17
(Original post by malshoha)
Usually University of Birmingham or UCL, by the time you finish you'll probably have about a year of experience which puts you roughly at ST1/ST2 level, there's not much an SHO can do that an AA cant
Besides practise medicine. Which ultimately is the point and massive difference in breadth of experience, anaesthetists don’t practise in a silo.
Last edited by Mushi_master; 2 months ago
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Mushi_master
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#18
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#18
(Original post by malshoha)
Ultimately, though the AA is trained in emergencies, the responsible consultant anaesthetist is always in close proximity, the RCoA say the consultant needs to be a maximum of 2 minutes away, and if they're not to be found the emergency buzzer isn't far. No Dunning-Kruger here I am well aware of my extremely limited knowledge, but the things I'm saying can be found online, mostly on the RCoA website, I just read up on it here and there, even though I have no plans to become an AA. If I've said something incorrect please correct me, I don't want to misinform.
Sounds like a right headache for the consultant anaesthetist if I’m honest. Hard enough supervising junior trainees - and they have GMC registration and accountability independently.
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Democracy
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#19
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#19
(Original post by malshoha)
Usually University of Birmingham or UCL, by the time you finish you'll probably have about a year of experience which puts you roughly at ST1/ST2 level, there's not much an SHO can do that an AA cant
Sorry but this is magical thinking. There is absolutely no way that an AA is working at ST1/2 level, let alone a freshly graduated one.
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malshoha
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#20
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#20
(Original post by Mushi_master)
Sounds like a right headache for the consultant anaesthetist if I’m honest. Hard enough supervising junior trainees - and they have GMC registration and accountability independently.
This is a fair point, the AA profession is relatively new and local governance plays too much of a role in their training and supervision, there is a lack of standardization and registration. Though the GMC plans to one day have AAs on their register and assess them for fitness to practice, they don't seem to be in a hurry to do it any time soon.
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