How to become an anaesthetist

CONTENTS

1. Routes to becoming an anaesthetist

2. Specialty training

3. Registration

4. Skills you’ll need

5. Gaining experience

6. Exams required

7. What it’s like

8. Specialisations

9. Career prospects

10. Is this right for you?

Anaesthetists deliver and manage anaesthesia for surgery and monitor vital signs throughout the process. Every patient is different, and the job requires a delicate balance of calculations and decisions to ensure both safety and comfort. 

If you want to be an anaesthetist (in America, they are sometimes referred to as an anesthesiologist), expect a long but well-structured journey. You’ll start with a medical degree, followed by two years of foundation training and around seven to eight years of specialty training. That’s roughly 14–15 years from A Levels to a consultancy post for a typical trainee, so it’s worth giving plenty of thought to whether it’s something you are motivated to pursue. 

This guide lays out a clear, practical roadmap showing the routes to getting qualified. It covers the exams you’ll need to pass, skills you’ll need to build, and some insights into the realities of working life, so you can decide whether it’s the right career for you. 

Routes to becoming an anaesthetist

Medical degree 

First, you’ll need a GMC-recognised medical degree. This typically takes five years, or four with graduate entry. Uou’ll need excellent A Level grades, and will also take the University Clinical Aptitude Test (UCAT). Relevant medical work experience is essential, and you will also need to demonstrate commitment to medicine to stand out from the competition. 

Foundation training 

After graduation you’ll join a Foundation Programme for two years. During this time, you’ll rotate through different specialties, gaining supervised experience in different areas. FY1 leads to full GMC registration, and during FY2 you’ll have increasing independence as you build clinical competence and leadership skills. 

Specialty training

Specialising from a GMC registered doctor to a qualified anaesthetist takes a further seven to eight years, and follows these three stages. 

Stage 1 (3-4 years)

• Complete either Core Anaesthesia training (three years) or the Acute Care Common Stem (ACCS) programme (four years) 
• Pass Initial Assessment of Competence (IAC) in the first six months of training 
• Pass Fellowship of the Royal College of Anaesthetists (FRCA) Primary exams before the end of year three 
• Pass Multi-Specialty Recruitment Assessment (MSRA) for ACCS 

Stage 2 (~3 years)

• You’ll focus on developing advanced skills and subspecialties such as paediatric, neuro, and cardiothoracic anaesthesia 
• Intensive Care Unit (ICU) training, which involves continuous monitoring for organ systems, advanced respiratory and cardiovascular support, and complex pain management 
• Pass final FRCA written and oral exams 

Stage 3 (~1-2 years)

• Unsupervised practice 
• Focus on developing special interests within anaesthesia 
• Successful completion of this stage leads to receiving the Certificate of Completion of Training (CCT), marking the end of specialty training 

Training is long and rigorous, as is necessary for a profession whose role is to keep patients safe when they are at their most vulnerable. You can expect annual reviews (ARCPs) during training, as well as keeping logbook evidence of your experience, and reflections on your progress as you move through the stages of accreditation. 

Registration

To practise as an anaesthetist in the UK, you must hold full GMC registration, demonstrating that you meet the required professional and ethical standards for practise. Anaesthetists also register with the Royal College of Anaesthetists (RCoA), which oversees training and professional development.  

Revalidation is required every five years, alongside a commitment to regular Continuing Professional Development (CPD) activities throughout your career. 

Skills you’ll need

Anaesthesia is a highly technical and responsibility-heavy role within medicine. Key skills include: 

• Clinical knowledge: You’ll need a strong grasp of pharmacology, physiology and resuscitation principles to safely manage patients before, during and after anaesthesia. 
• Decision-making: Anaesthetists must stay calm and make rapid, informed choices when managing critically ill or unstable patients in high-stress situations. 
• Technical skills: You’ll perform practical medical procedures such as airway management, partial or localised anaesthesia and inserting lines into blood vessels with precision and confidence. 
• Monitoring and interpretation: The role requires continuous observation and analysis of blood data and other physiological readings, to guide treatment decisions in a surgery setting. 
• Communication and teamwork: Anaesthetists work closely with surgeons, theatre nurses and intensive care teams, ensuring good coordination and patient safety at every stage. 
• Stamina: Some operations last many hours, and you’ll need to be alert and adaptable for long periods of time. Physically, you may be standing for hours at a time, or working night shifts under high pressure. 
• Emotional resilience: Emergency callouts, end-of-life care, and unsuccessful operations are all part of the job. These can be emotionally taxing, and you may occasionally need a strong positive outlook to get you through. 

Gaining experience

If you’re at school or university, get as much clinical work experience as you can. This can be varied, including places like GP offices, hospital shadowing, BMA placements, healthcare assistant roles, even volunteering in international aid organisations abroad. State this clearly on your applications and be ready to discuss details of your experiences. 

Choose a medical school with strong peri-operative teaching department or placement options. Competing placement years while at university will boost your application strength. 

As a doctor, use FY2 to demonstrate your clinical competence and gather references for your specialty training application. Try to get experience in anaesthesia and intensive care before applying for higher training posts. 

Exams required

There are a lot of exams you’ll need to pass before becoming a fully-fledged anaesthetist. Here they are, in order: 

• UCAT: Taken before applying to medical school. 
• Undergraduate medical exams: Completed during your medical degree (varies by school). 
• Foundation programme assessments: Workplace-based assessments and portfolio reviews over FY1 and FY2. 
• MSRA: Required if you apply through the ACCS route. 
• ARCPs: Completed throughout specialty training to assess progress each year. 
• Primary FRCA: Taken during core anaesthetic training (Stage 1), after initial competencies such as the IAC are achieved. 
• Final FRCA: Taken during higher training (Stage 2 or 3). Written papers must be passed before the structured oral/clinical exam. 

What it’s like

Much of your work will take place in operating theatres, however you’ll also perform pre-operation assessments, as well as working in recovery areas and intensive care units.  

During training you’ll work shifts, nights and on-call. As a consultant you’ll usually have a regular contract (roughly 40–48 hours weekly on average) but with on-call and potential out-of-hours commitments.  

The job is known to be emotionally and physically demanding. The stakes are high, but it’s also highly skilled and variable work, often on the cutting-edge of clinical technology, as well as being highly meaningful. 

You’ll have the option to work in either the public or private sector, and salaries will vary accordingly. However typical figures for NHS pay bands are: 

• FY1: £32,398 
• FY2: £37,303 
• ST1-ST3: £43,923-£63,152 
• ST4+: £58,398-£83,571 
• Consultant: £93,666-£126,281 

Specialisations

The demand for capable anaesthetists is widespread across medical care, and there are a number of areas in which you can build a specialisation. These include: 

• Pain management 
• Cardiac anaesthesia 
• Paediatric anaesthesia 
• Neuro-anaesthesia 
• Obstetric anaesthesia 
• Intensive care 
• Regional anaesthesia 
• Hospice and palliative care 

Career prospects

Anaesthesia is one of the largest hospital-based specialties in the UK, with strong demand across NHS and private sectors, providing you with stable employment opportunities across the whole country.  

Although your training will be long and intensive, once you have qualified and established yourself within a medical team, you’ll likely enjoy flexible working options and a good work-life balance.  

Your progression will typically follow this route: 

• Trainee  
• Senior trainee  
• Consultant 

You can also pursue academic posts, leadership roles, or private practice. This variety allows anaesthetists to tailor their careers according to their professional interests and life priorities 

Is this right for you?

Anaesthesia is intense, however the rewards are significant. If you can handle critical decision making, high-level teamwork and enjoy the idea of steering patients safely through surgery and major illness, then anaesthesia could very well be something to consider. 

The good thing is that you’ll need to start with a five-year medical degree anyway, so you can begin to tailor your work experience towards specialising in anaesthesia, but do this with the knowledge that you’ll have several years of medical training to figure out if it’s exactly what you want to do in the long-term.