An anaesthetist is a medical doctor who is specialised in taking patients through the entirety of any anaesthetic administration. This includes pre-screening the patient to determine any anticipated issues or challenges with anaesthetic, ensuring the safety of the patient whilst under anaesthetic and throughout surgery, and maximising patient outcomes upon emerging from anaesthesia.
Specialist Anaesthetists first become medical doctors, then work for at least 2 years to obtain general hospital experience, before undergoing selection for anaesthesia training. The training program is selective and each year hundreds of highly qualified applicants apply with only a handful who are selected to commence training. The training program is prescribed and administered by the Australian and New Zealand College of Anaesthetists (ANZCA), and involves a minimum of 5 years of experience rotating through all subspecialty areas of anaesthesia. There are two rigorous examinations including a primary examination that covers physiology and pharmacology, and the final fellowship examination which covers all aspects of clinical anaesthesia. Upon graduating with the Diploma of Fellowship of ANZCA, a Specialist Anaesthetist is required to partake in annual continuing professional development to ensure knowledge and skills remain current.
Australia and New Zealand are world leaders in anaesthesia safety due to the extensive training programs which are completed by specialists at the Australian and New Zealand College of Anaesthetists (ANZCA).
[What is an anaesthetist – FROM ANZCA]
In some instances, non-specialist doctors may give anaesthetics. These are often doctors who primarily specialise in general practice, who have completed a minimum of one year of work-based training (called the diploma of JCCA, endorsed by the ANZCA and the colleges of general practice) which allows these doctors to gain skills in anaesthetising the type of patients that are likely to present to rural and regional hospitals and the types of surgery that are likely to be performed there. GP Anaesthetists play a vital role in the Australian healthcare delivery model by ensuring that anaesthetic care is available in rural and remote settings which do not have the caseload to support full time Specialist Anaesthetists. Some GP anaesthetists do choose to work in metropolitan areas, so do not assume that if you are having a procedure in a metropolitan area that you are automatically getting a Specialist Anaesthetist.
In Australia, there are practitioners calling themselves sedationists (or other similar titles) who are neither Specialist Anaesthetists nor GP Anaesthetists. They might work in various settings such as cosmetic or dental clinics just to name a couple, and they may tell patients that they provide the same sedation as an anaesthetist. It is important to recognise that they are NOT anaesthetists and have NOT undergone anaesthetic training endorsed by the Australian and New Zealand College of Anaesthetists (the training body authorised by the Australian Medical Council to set the professional standards for anaesthesia in Australia). Many of these sedationists are NOT registered medical practitioners.
Contrary to what you may be told, there is no such thing as “just sedation”. It is often times more dangerous than general anaesthesia if the conditions are not right. For example, since your airway is not protected during sedation, it is often inappropriate for operations in your mouth where tooth fragments, secretions (containing all sorts of bacteria) and blood may track into your lungs and cause pneumonia and other complications. A properly qualified anaesthetist will be able to help you decide whether sedation is appropriate. He/she is also qualified and experienced to convert your sedation to general anaesthesia during a procedure if the situation were to necessitate doing so, whereas sedationists cannot do this as they are not qualified to provide general anaesthesia.
Anaesthetists and Anaesthesiologists are not the same in some countries, while in others they are used interchangeably. In many countries, including the USA, the term “Anesthesiologist” refers to what we would call a Specialist Anaesthetist in Australia. Whereas in these countries, the term “Anaesthetist” refers to non-specialist anaesthetic providers such as GP anaesthetists or nurse anaesthetists.
If you are in a metropolitan or large regional centre, you should always insist on having a Specialist Anaesthetist who is a Fellow of the Royal Australian and New Zealand College of Anaesthetists (FANZCA). They are available to work in public and private hospitals as well as dental and cosmetic clinics that are appropriately set up to provide anaesthesia and sedation.
If you are in a smaller regional centre or rural area, if a FANZCA is not available, you should put your trust in your local highly experienced GP Anaesthetist.
However, if your surgeon/proceduralist is telling you to undergo an anaesthetic or sedation procedure with another type of practitioner in Australia, you should seriously be asking why!
The Australian Health Practitioner Regulation Agency (AHPRA) website allows you to search your provider and check that they are registered as a Specialist in Anaesthesia, that their registration is current, and that there are no conditions imposed on their practice of anaesthesia or medicine overall. If your anaesthetist is a specialist, their AHPRA record should look like this:
