Dr Sanjoy Saha loves his job as an anaesthetist, because he gets to apply his pratical expertise and look after patients as part of a team. He explains what the job involves and why work experience is important.
Name: Dr Sanjoy Saha
Company: Royal Free Hospital
What is your job? Anaesthetic Registrar
How long have you been doing this job? 10 years
University: Barts & The London School of Medicine, Queen Mary University of London
Degree subject: Medicine (MBBS)
A-levels: Biology, chemistry, maths
1. What was your very first job?
Working at WH Smith stacking shelves after I finished A-levels to help fund my gap year.
2. What did you want to do when you were at school?
I knew I preferred and was better at the science subjects throughout school, but wasn’t sure about medicine until I started my A-levels. Then I started to think about what I wanted to study at university, and do as a career. I realised that I didn’t want a job where I sat at a desk or lab all day; I wanted a job where I could work with people, was dynamic and where I could apply my interest in the science subjects.
3. What made you want to do your current job?
I really enjoy anaesthesia as it requires an understanding of how the body works, both when it’s healthy and when it has a disease. It then requires applying that knowledge to look after patients through their operation. It means caring for some of the sickest patients in the hospital, which is interesting and challenging at times.
The nature of the job means it is a ‘hands-on’ specialty. You need expertise in a number of different practical procedures, and you look after each patient throughout their procedure as part of a team, which I love.
4. How did you get there?
I studied the required subjects and achieved the grades to apply for medical school. Being able to talk about the work experience I did was very useful when it came to the medical school interview.
I spent a week doing work experience in my local hospital's accident and emergency department, shadowing junior doctors. I saw patients with a range of conditions. This included a lady with a cut on her hand from a knife, which needed injecting with local anaesthetic, cleaning and stitching closed. I also remember an elderly man who needed admitting to hospital because of pneumonia. These are cases that I talked about in my interview (which I still remember 20 years later!)
I also volunteered with MENCAP, which is a charity for people with learning disabilities. This involved helping my local MENCAP group organise and run activity sessions such as crafts, dancing and bowling.
Friends of mine did work experience in other departments or in a GP practice, worked as healthcare assistants, porters in a hospital, or carers in a nursing home. Some have taken administrative roles like a ward clerk or filing notes in a GP practice. I don’t think it matters how you gain you the experience.
Once at medical school I followed the usual path to becoming an anaesthetist. This included six years at university (including one year for an intercalated BSc) which involved regular exams and assessments.
After that I completed my first two years as a doctor (foundation programme) on general rotations. To become an anaesthetist, I needed to apply through competitive process both at SHO and registrar stages and pass the anaesthesia exams. There is a similar process with all specialties.
5. What is a typical day like?
On a normal day I arrive at work by 7.30am, and start seeing patients that I will be anaesthetising for their surgery that day. When I see the patients I perform an anaesthetic assessment, which involves an examination and discussion about the patient's health.
I‘ll then discuss the anaesthetic options, what we'll do while they are asleep and the minor and major risks associated with having surgery. This will vary between patients and different operations; with major cases requiring a more detailed discussion. In my current job I look after patients having major liver or pancreas surgery; often these are elderly frail patients with cancer.
Before starting the anaesthetic, surgical and theatre staff team meet and discuss the cases to iron out any outstanding issues. We start aim to start the first operation by about 8.30. A consultant, an anaesthetic nurse and I are in charge of the anaesthetic. This requires consideration of monitoring and maintaining physiological stability, starting, maintaining and ending the anaesthetic, administering a variety of drugs, and considering the pain relief options after surgery.
At the end of a major case we will transfer and handover the patient to the intensive care unit for a period of further monitoring and stabilisation. There are a lot of staff in theatres with other roles but we all work together to look after the patients.
6. What's the best thing about your job?
I really enjoy anaesthetising patients, and the variety it can bring, whether it’s a gas induction for a child, a difficult airway case, a massive haemorrhage case or looking after a patient having major surgery. Its also great that anaesthesia gives you the opportunity to get involved in many other roles such as teaching, management and research. I really enjoy working in a team!
7. What is the most challenging thing about your job?
Working night shifts become harder, and recovering from them takes longer as you get older!
8. What advice do you have for people who want to do what you do?
Be prepared for periods of intense study to get through the various exams.
9. What things do you wish you’d known before starting your career?
For many hospital specialties, training requires moving jobs regularly, often every three months with anesthesia, which can make it difficult to make life plans and settle in a department.
10. Where would you like to be in five years?
Working as a consultant anaesthetist in London looking after a mixture of adults and children for their operation.