An Anaesthesiologist's Daily Schedule

The main duty of an anesthesiologist is to administer general anesthesia in order that a patient is placed in a medical coma. This is performed in order to allow surgery to be performed without the patient responding to pain or remembering the surgery. If general anaesthesia is not needed, or if it is contra-indicated, then local or regional anesthesia is performed in order to induce pain relief (analgesia) in a part of the body. In the case of a mother delivering her baby during childbirth, a way to reduce the pain would be by the administration of a local anesthetic via an epidural. This allows the mother to be awake and active in labor and during delivery of the baby. The administration of a general anaesthetic would not make this situation possible.

In general, the duties of an anaesthesiologist in the operating room include the following: 

• To provide medical care to patients in numerous situations, most of the time of which are acute medical issues.
• Pre-operative evaluation of patients.
• Creating a plan for the anaesthesia that is individualised for every patient - alternatives, risks and benefits of the chosen anaesthetic methods have be discussed with the patient before surgery in order to get informed consent from the patient.
• Consulting with the members of the surgical team to decide whether a patient can be operated on or not.
• Proper airway management and making sure they are prepared for a difficult airway.
• Intra-operative life support and providing pain control.
• Intra-operative stabilisation.
• Proper post-operative management of patients - making sure the patient is fully awake before they are taken back to the ward, or making sure that a patient is stabilsed for handover to staff in the intensive care unit (ICU).

Outside the operating room, an anaesthesiologist's duties can include dealing with:

• In- and pre-hospital emergencies.
• Critical care management in ICU's.
• Acute pain clinics and consulting with patients complaining of chronic pain. 

Training 

For a doctor to specialise in anaesthesiology, they have to complete the 5-6 year undergraduate degree first in order to become a medical doctor. Thereafter, depending on the country you live in, you have to perform 1-2 years of internship training before becoming eligible for a specialist post. These posts also have to be available at the institution you wish to train further at. If you have applied and were successful at the interview stage, then you will be placed in a specialist post to receive mentorship and training from an anaesthesiologist consultant.

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An anaesthesiologist will have to have adequate knowledge of the following areas in order to provide their services. 

• Pharmacology of the most commonly used drugs - these include the inhalational anaesthetics (sevoflurane, desflurane), intravenous anaesthetics (propofol, thiopentone), narcotic analgesics (morphine, fentanyl), vasopressors (adrenaline), muscle-relaxants (suxamethonium, pancuronium) and muscle-relaxant reversal drugs (neostigmine).
• Using and interpreting monitors such as electrocardiography (ECG), electromyography (EMG) and electroencephalography (EEG). Knowledge of neuromorphology, neuromuscular monitoring, entropy monitoring and cortical stimulation mapping is also important. 
• Using and knowledge of the different settings of mechanical ventilation.
• Anatomical knowledge of the nervous system in order to perform nerve blocks in different parts of the body.
• Knowledge in areas such as pulmonology, cardiology and obstetrics is important in order to be able to assess the risk of anaesthesia so that informed consent is given by the patient.
• Knowledge regarding how anaesthesia affects certain age groups such as babies, children and the elderly.

The Daily Schedule Of The Anaesthesiologist 

An anaesthesiologist in a rural area will be responsible for dealing with patients before, during and after their surgeries, and they will also be responsible for the health of patients in the intensive care units. Usually, these ICU's are split up into medical and surgical units, but rural hospitals will have 4-5 beds available that have to cater to all patients. The anaesthesiologist may see these patients 1-2 times per day or they will be consulted by the medical officer who is also taking care of the patients. 

Hospitals will have a group of anaesthesiologists available in order to provide services for all the surgical departments that are performing procedures on patients. Depending on the size of the hospital there may be 2-20 specialists available. 2-3 anaesthesiologists will also have to be on-call to provide anaesthesia for emergency cases and to see patients in ICU if they are responsible for those units. If anaesthesiologists are on call for a specific evening, then they are allowed time off the next day.

Monday

Anaesthesiology group practices will usually divide doctors to provide services to different surgical disciplines. Each anaesthesiologist will then provide their services to a specific discipline for a determined amount of time, if not indefinitely. The specialist will receive a list of patients that are being operated on and they will have to see them, depending on the procedure and the patient's health status, a day or so before the procedure or when they enter the operating room.

Patients with poor health and who have chronic conditions will be admitted to the hospital 3-4 days before their procedure so that the anaesthesiologist will consult with them and decide if referral to another specialist, like a cardiologist, is necessary and whether the procedure can still be performed or not. Patients with better health but who still have chronic conditions that need further investigating will consult with an anasthesiologist in their office.

Tuesday

The anaesthesiologist will provide anaesthesia and peri- and post-operative support for patients that have been operated on for the day. Once the list is completed, the specialist will then see the patients who are on the next day's surgical list.

Wednesday

The doctor will again manage patients accordingly that are operated on. Academic rounds in the ICU's can be done on these days if the doctor is involved in the under-/post-graduate training of doctors or if they are responsible for those units.

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Thursday

Administrative tasks are handled on mornings when the doctor was on call the previous evening, for this case we'll assume the doctor was on call Wednesday night. Thursday afternoon, the specialist will then go see patients on Friday's surgical list.

Friday

The anaesthesiologist will provide anaesthesia and management of patients that are operated on this day. The surgical list for the following week will be given to the specialist who will then decide which patients need to be seen before the week is done and who can be seen later. 

The continued management of any ICU patients will be handed over to the specialist on call if it isn't the doctor who is in charge of those patients.