A trainee perspective | Association of Anaesthetists

A trainee perspective

What makes a good department? A trainee perspective

As trainees, we rotate often and so we see the good, the bad and (very rarely) the ugly. We all know what a good department looks like when we see it, but we appreciate this model may look different between different hospitals. With this experience, trainees are in a unique position to suggest changes. From a trainee perspective, we want to be supported in terms of clinical, educational, wellbeing and morale aspects. However, this cannot be done without the support and buy-in from departments to help implement recommendations and improve the working lives of trainees.

Access to good clinical and educational supervisors to ensure our training needs are met, and to help with the timely sign-off of work-based assessments, is important. A department that focuses much of its educational activity and in-house teaching programme around examination topics, and support trainees with their exams, are good models. More importantly, a good department needs to adequately support trainees who are in difficulty, whether it relates to examinations or otherwise. Supervisors and departments also need to help trainees, through mentorship and coaching, to achieve their future career goals. A good department guides its juniors in their training aspirations, including how to access less-than-full-time training, out-of-programme experience, or fellowships locally or abroad. Additionally, the increasing demand on trainees to engage in audit, research and quality improvement needs to be supported with allocated and protected SPA time, to reduce the risk of burnout.

Most trainees rotate around hospitals frequently, and therefore must go through the induction process regularly; making this a seamless process with all the necessary information is paramount. A good anaesthetic department ensures trainees are given rotas in a timely manner, and departments support leave for educational and professional activities and provide flexibility with annual leave. They must also guarantee that their trainees are paid the correct salary on time, and liaise closely with human resources to achieve this. Anaesthetic departments that fight on behalf of their trainees to retain adequate and readily available car parking and on call rest facilities need to be commended.

From a personal point of view, the most important aspect of a good department is how it welcomes and integrates its trainees. Those that promote a ‘family’ feel, and place emphasis on the wellbeing of their trainees and colleagues, are particularly well-regarded. Good departments are those that put in the effort to get to know their trainees – whether this is through welcome drinks, regularly organised social events or even a sit down in the coffee room!

These measures help to promote morale and the welfare of trainees. They show that departments care, and this is one of the reasons trainees may request to return to these hospitals. For an anaesthetic department to function well, it needs to extend beyond the confines of ‘team anaesthesia’. The hospital itself needs to promote a work culture and ethos to ensure trainees are well supported, and trainee wellbeing is an integral part of ‘Trust values’.

As trainees we are not demanding or expecting 5-star on-call facilities, the newest anaesthetic machines, or the best coffee machines money can buy. Don’t get me wrong, this would all be very nice, but would be seen only as an added benefit. From a trainee perspective the definition of what makes the best department will vary depending on personal preference; however we can all reach a consensus that a good anaesthetic department means one that cares for its trainees.

Sally El-Ghazali
Association of Anaesthetists Trainee Committee Chair