How To Choose An Overseas Anaesthesia Fellowship
What is an Anaesthesia Fellowship?
Why do an Anaesthesia Fellowship?
The UK Royal College of Anaesthetists training scheme has a broad curriculum, but with so many areas to cover it can be difficult to get more experience in areas that interest you. Doing a fellowship means spending more time in that area of interest to enhance your skills and knowledge, allowing you to bring back that expertise into your clinical practice at home. Usually your fellowship will be in a different healthcare system, which offers insight into different ways of practice that you would not otherwise gain.
However, taking a fellowship usually requires you to take time out of training or delay a stage of training (or the start of a consultant post if you have already finished training). This can be difficult to coordinate. Financial considerations will also play a part, as some fellowships will be entirely voluntary or offer modest compensation, but will not cover the mortgage bills at home or large financial outgoings while there. Some fellowships may be paid at a similar rate to at home. An overseas fellowship also requires you to move to a different country, which is likely to bring several extra factors into account including visas, work permits, registration in that country, as well as differences in culture and in clinical practice, which can be interesting but challenging.
How to Choose the Focus of Your Fellowship?
You may already have an idea of what you would like to focus on during your fellowship. If not, then consider which areas of anaesthesia you enjoy working in or find stimulating, or would like to see developed more in a hospital where you will work in the future. A fellowship can be a ‘generalist’ one, covering all areas of anaesthesia, or a ‘specialist’ fellowship, which will have an emphasis and particular area of focus. For some, a fellowship may be an opportunity to work in a different healthcare context, such as a resource-poor environment or remote setting. Perhaps you would like to focus on non-clinical areas of practice, such as teaching or simulation training, or leadership and management opportunities.
Is there a skill you would like to enhance, or a particular area of anaesthesia that you feel you would like to personally advance? Is there a system or structure you wish to learn in order to bring it back to your hospital, such as a pre-assessment clinic or a regional anaesthesia ‘block’ room? Is there a style of teaching you wish to develop, or a system that will allow you to advance your leadership and management abilities with the aim to translate them into your practice at home? Do you want to work in a low- or middle-income country and gain experience in a resource-poor environment?
Which Countries Can You Do An Anaesthesia Fellowship In?
You can do a fellowship almost anywhere in the world! Fellowships in high-income countries are more likely to be ‘specialist’, in a specific area of anaesthesia with a clinical workload that will be based around the sub-specialty e.g. regional or paediatric anaesthesia. In contrast, a fellowship in a low- or middle-income country may be less focused on one area of anaesthesia and may involve a variety of clinical work as well as teaching, quality improvement projects and management roles, often involving patients with pathologies you have never encountered before.
Anaesthetic Fellowships is a great starting point to finding anaesthesia fellowships.
It is possible to arrange your own fellowship, but it will require a lot of organisation and motivation. From initial contact and expressions of interest, you will need to agree with them your role, appropriate supervision, medical registration support, salary (or lack thereof), clinical obligations and non-clinical roles. While potentially hard work to set up, a self-organised fellowship can be extremely rewarding and targeted to your interests.
What Other Factors Do You Need To Consider When Doing an Overseas Fellowship?
If you’ve chosen your specialist area of interest – or kept it general – and chosen your destination country, then there are a few other factors that will come into play. These will include:
- Funding – are you being paid, partially funded or entirely self-funded? How will you manage your finances while you are away from your job at home?
- Duration – how long do you want to be there for? A longer fellowship allows you time to settle in, integrate more into the country and department, learn more and implement more change, but it comes at the cost of life at home with family, work and friend considerations, to say nothing of the financial implications.
- Timing – when should you do the fellowship? Do you wait until the end of training, go early in your career or time it for the middle of specialty training? There is rarely a ‘perfect’ time to go, but choosing a time best suited to you is key.
- Training – if you are in training, are you able to step out? Fellowships during training will require Out Of Programme (OOP) organisation through your school of anaesthesia and the Royal Collage of Anaesthetists (if you are UK based).
- Exams – pursuing a fellowship may have to be timed around exams, and some schools of anaesthesia may want you to have finished certain exams before releasing you for your OOP.
- Company – who is going with you? Can you bring your family with you? Would they want to go? If moving abroad for a prolonged period of time, it might be possible to bring partners +/- family with you, if it suits you.
- Health and Insurance – how will you look after your health and wellbeing while abroad? Have you found appropriate insurance and indemnity to cover a likely prolonged period of absence from the UK?
Whether self-organised or formal set-up, self-funded or salaried, an overseas anaesthetic fellowship is a fantastic opportunity to see the world of anaesthesia (and the world in general) from a different perspective and allow you to develop countless skills – both clinical and non-clinical – to enhance your abilities. While not always a straightforward undertaking, it will be a rewarding and stimulating period that will provide valuable insight and experience for your future career.