Find out more about the job of anesthesiologist: role before, during and after surgery, training, skills required and career prospects.

Indispensable for all surgical specialties, the médecin anesthésiste-réanimateur plays a crucial role before, during and after an operation. He or she is responsible for putting patients to sleep before surgery, monitoring them throughout the operation until they are discharged, and managing post-operative pain to ensure their comfort. This specialist ensures that the patient's vital functions are maintained throughout the operation, adjusting the anesthesia and acting immediately on the slightest alert to guarantee the patient's safety. The scope of his work extends beyond the operating theatre: as an anesthesiologist, he acts as a facilitator, and as a nurse, he is involved in the care of the patient: 400;">, he or she can also be called upon to treat critically ill patients in the emergency room (for example, in the event of cardiac arrest or serious trauma).

After a long course of medical studies (around 11 years of training after the baccalaureate), the anesthesiologist obtains a diploma in anesthesiology;siste obtains a specialized diploma in anesthesia and animation, enabling him or her to practice this highly qualified medical profession. The road to success is demanding, as are the day-to-day skills required. In this article, we describe the role of the anesthetist before, during and after an operation, the key skills required to practice this profession, and the training required to become an anesthetist;ciality, as well as the career prospects of an anesthesiologist.

The missions of the médecin anesthésiste

Préparation of the patient before the procedure

The first intake of the anesthetist takes place prior to the procedure, during the pre-anesthetic consultation (mandatory before any scheduled operation). During this interview, the doctor assesses the patient's state of health, taking stock of his or her medical history (allergies, current treatments, past operations, etc.). This risk assessment enables you to choose the most suitable anesthesia technique (general anesthesia or locoregional anesthesia) and plan the necessary precautions before the operation. The anaesthetist also takes advantage of this consultation to inform and reassure the patient, explaining the procedure, the protocols to be followed, the recovery conditions and pain management after the operation. The psychological dimension is of prime importance at this stage: the doctor must therefore be pédagogue and reassuring in order to reduce the patient's anxiety.

Monitoring during surgery

During the operation, the anesthesiologist is continuously present in the operating room, alongside the surgical team. He/she administers anesthetic agents for the purpose of the operation, whether it be general anesthesia or sedation as part of a surgical procedure;He then adjusts the doses in real time throughout the surgical procedure to maintain the appropriate level of anesthesia. He constantly monitors the patient's vital signs (blood pressure, heart rate, oxygen level, etc.) using sophisticated monitors and equipment, ready to detect the slightest anomaly. If necessary, the anaesthetist can intervene immediately in the event of a problem during the operation: for example, by injecting a drug, performing an emergency maneuver (assisted ventilation, cardiac massage, defibrillation) or adjusting the depth of anesthesia as required. He works in tandem with the nurse anesthetist (IADE), who assists him in monitoring the patient and applying safety protocols during the procedure.

Post-op follow-up and pain management

After surgery, the responsibility is to accompany the patient to the recovery room (post-interventional care unit) to ensure safe, conscious recovery. It monitors the recovery phase, ensuring that the patient gradually emerges from anesthesia without any immediate complications (respiratory distress, heart rhythm disorders, hæmph, allergic reaction, etc.). An essential task at this stage is the management of post-operative pain: the anesthesiologist assesses the patient's pain and administers the appropriate analgesics to relieve it (morphine, local anesthetics via catheter, paracetamol, etc.). He adapts the analgesic treatment according to the intensity of the pain and the specific needs of each case, to ensure optimal comfort. This post-operative follow-up continues until the patient has returned to a stable state. Lastly, the anesthesiologist remains vigilant until the patient is transferred to the inpatient ward, or to a rehabilitation ward if his or her condition so requires, thus guaranteeing continuity of care after the operation.

The skills needed to practice

Specialized medical knowledge

• Maîtrise des produits anesthésiants : ça goes without saying, but the anesthesiologist knows perfectly well the effects, interactions and dosages of the drugs used to put patients to sleep, keep them in a stable state and treat vital complications.
  
  
• In-depth knowledge of equipment operation: uses complex devices such as anesthesia machines, ventilators and monitors on a daily basis, and masters their operation to ensure safe patient care.
  
  
• Précision in the réalization of technical gestures : a high degree of dexterity is essential when performing locoregional anesthesia (pediatric, nerve block) or invasive technical procedures in the field, such as tracheal intubation or central venous catheterization.
  
  
• Maîtrise des procédures désie et de soins intensifs : the anesthetist rigorously applies proven protocols, adapted to each clinical situation, guaranteeing patient safety at every stage of care.
  
  
• Cross-disciplinary knowledge in medicine : They take charge of patients with a wide variety of pathologies, and must therefore have a solid grounding in disciplines such as cardiology, pneumology, neurology and diabetes, in order to anticipate the risks associated with the patient's overall state of health.

Activity and stress management in critical situations

• Réactivité : the ability to act immediately is essential, particularly in the event of a serious complication in the midst of surgery such as massive hemorrhage, anaphylactic shock or cardiac arrest on the table. The anesthesiologist must know how to make critical, split-second decisions to save a life.
  
  
• Maîtrise du stress : whether in the operating room or in reacute, this doctor must keep his cool in all circumstances. He works in a context where the pressure is constant and where the slightest error can have vital consequences.
  
  
• Lucidité : he must remain precise, methodical and focused, even when he has to intervene without preparation, for example, to operate on an emergency patient who is not fasting, or whose medical antecedents are unfamiliar.
  
  
• Capacité d’adaptation : each clinical situation is unique, and the anesthetist must adjust his or her protocols, dosages and technical réflexes according to the patient's condition, the type of procedure and any imprecisions that arise during the course of treatment.
  
  

Human and relational qualities

• Empathy and benevolence : the anesthetist is often the last face the patient sees before falling asleep. He or she must be able to establish a climate of trust, reassure and explain the procedure clearly, while taking into account any anxiety or apprehensions.
  
  
• Peacute;dagogy and communication: he informs the patient and his family at every step of the care journey, using accessible words and a constant concern to be understood.
  
  
• Résilience émotionnelle : confronted with serious medical situations, disasters or life-threatening emergencies, the anesthetist must be able to manage his or her own motions while remaining available, professional and supportive to others.
  
  
• Ability to work as part of a team: both in the operating room and in the field, you'll be constantly collaborating with surgeons, nurse anesthetists (IADE), instrument technicians and other specialists. Good communication and a collaborative attitude are essential to ensure a safe and efficient procedure.
  
  
• Écoute and flexibility in professional relations : he must demonstrate openness, know how to adapt his posture according to the interlocutors, arbitrate medical choices in a team, and integrate harmoniously in multidisciplinary environments.

The training path to become an anesthesiologist

The academic path required in order to become an anesthesiologistis demanding and rigorous. It requires the acquisition of advanced medical skills, both theoretical and technical, as well as solid practical training. The curriculum begins with a first year in the Parcours Accès Santé Spé (PASS) or Licence avec Accès Santé (L.AS), followed by two years of general medical studies leading to the Diplocirc;me de Formation Générale en Sciences Médicales (DFGSM). The student then goes on to study for a further three years to obtain the Diplôme de Formation Approfondie en Sciences Médicales (DFASM).

At the end of these six years, he will have to take the end-of-clerkship tests (EDN and ECOS), the results of which will determine his specialization. To become an anesthesiologist, he will then complete a five-year internship in anesthesiology, divided between hospital internships, university training and on-call duty. At the end of this course, he will obtain a DES in anesthesiology and will be able to practice as a specialist physician.

To find out more about études d’anesthésiste, find our fiche études médecin anesthésiste.

After this training, doctors can choose to specialize in certain fields, such as surgical reanimation, anesthesia and surgery;anesthésie pédiatrique, l’anesthésie obstétricale, la prise en charge de la douleur ou encore la médecine péri-op& ratoire. These specializations open the way to highly sought-after positions in public and private structures.

The scope of practice for anesthesiologists

The profession of anesthesiologist-restorer is practiced mainly in hospitals, whether in the public sector (university hospitals, hospital centers) or in private clinics. On a day-to-day basis, the anesthetist divides his or her activities between several complementary locations and departments, and works in close collaboration with many other medical professions.

Working in the operating theatre

Most of the activity of a médecin-anesthésiste takes place in the operating theatre, at the site of surgical procedures. For every operation, whether scheduled or emergency, the presence of an anesthesiologist is essential to the surgeon. He or she is responsible for anesthetizing the patient at the start of the operation, and for monitoring the patient throughout the procedure, right through to the recovery room. An anesthetist may perform several operations in a single day, working in a wide range of specialties (orthopedic, abdominal, cardiac, neurological, etc.), making his or her schedule often dense. Before each operation, he carefully prepares and checks the anaesthetic equipment, to avoid any eventuality. During the operation, the anesthesiologist continuously adjusts the anesthetic parameters to suit the operating schedule and the surgeon's needs, requiring close coordination with the surgeon. At the end of the operation, he/she accompanies the patient to the recovery room to continue care (as previously described), before eventually moving on to the next patient scheduled for the day.

Interventions in réanimation or emergencies

Outside the OR, anesthesiologists frequently take on the rôu;le médecins réanimateurs en services de soins intensifs (la spécialité est d’d'ailleurs intitululée officiellement anesthésie-réanimation). In a reanimation unit, the anesthesiologist takes charge of critically ill patients with serious life-threatening conditions (coma, acute respiratory distress, hemorrhagic shock, sepsis, etc.). His role is to stabilize these patients, diagnose and treat the cause of their condition, and try to save them or improve their prognosis. He uses advanced treatment techniques adapted to each case: respiratory assistance on a ventilator, dynamic support with vasopressor drugs, dialysis in the event of renal failure, etc. At the same time, anesthetists are called upon to manage life-threatening emergencies within the hospital. Likewise, in the event of emergency surgery, it is they who perform the anesthesia in an emergency situation, even without prior patient preparation.

The anesthesiologist can also intervene in the emergency department to secure difficult intubation or sedation of an agitated patient. These out-of-operatory procedures are an integral part of his job, and are performed during night shifts, weekends or public holidays. The 24-hour continuity of care in hospitals (emergencies, maternity wards, etc.) means that anesthetists must be on call at all times, which means that they are regularly on call at nights and weekends. This rhythm of on-call work is part of everyday life in the speciality, although some structures offer more regular conditions.

Collaboration with surgeons and other specialists

The anesthesiologist always works as part of a team and in coordination with other caregivers. In the operating room, they form an indispensable pair with the surgeon: the two must synchronize throughout the operation, with one adapting the anesthesia to the other's movements and vice versa. 

The anesthesiologist also supervises the OR nursing team: In particular, he/she supervises and collaborates closely with the nurse anesthetist (IADE), who prepares the equipment, monitors the parameters and assists the doctor during the operation and in the recovery room. 

In réanimation, the work is just as collective: the anesthesiologist-animator is part of a team that includes intensive care physicians (if available), intensive care nurses, orderlies, physiotherapists and so on., each contributing their expertise to ensure the best care for critical patients. 

The anesthesiologist can work with many other specialists depending on the patient's case: for example, with cardiologists or neurologists in the delivery room for a specialized opinion, with obstetricians for the management of obstetric anaesthesia (pétrales in the delivery room), with obstetricians for the management of obstetric anaesthesia (pétrales in the delivery room), with obstetricians for the management of obstetric anaesthesia (pétrales in the delivery room);This constant interdisciplinary collaboration demands a high level of expertise, which is why we work in close collaboration with all our specialists. This constant interdisciplinary collaboration demands excellent communication skills and unfailing cooperation on the part of the anesthetist. In fact, the anesthesiologist is often perceived as a conductor discreet, but indispensable, liaising between the various players to ensure that everything runs smoothly.

Évolution de carrière et perspectives professionnelles

Spécialization or over-spécialization

Thecareer of an anesthetistcan be enriched by additional skills or competencies acquired over time. As soon as they have completed their internship, future anesthesiologists can opt for additional training courses (speciality options or cross-disciplinary training courses) to develop their particular expertise, for example in paediatric anesthesiology, in order to focus on children. 

Throughout his practice, he also has the opportunity to pursue continuing education and add new strings to his bow: some choose to train further in chronic pain management (algology), medical hypnosis, advanced locoregional anesthesia, and so on. On an institutional level, there are a number of ways in which a doctor can complement his or her specialization: he or she can apply for a new option or FST (transverse specialized training) linked to anesthesia, in order to deepen his or her knowledge in a particular field without having to repeat an entire internship. 

It is even possible, for the most ambitious, to take a second DES (diploma in specialization) in order to practise another specialization in addition to the first; in addition to anesthesia (for example, some combine anesthesia with a specialty such as emergency medicine or medical animation). Although lengthy, these over-spécialization paths help to broaden professional prospects and enrich practice.

Responsibilities in the hospital environment

Professional challenges for a young qualified anesthesiologistare numerous, especially as the specialty is in short supply: there are only around 10,000 anesthetists in France, and the profession remains underfunded, with vacancies in many establishments (public hospitals, private clinics, emergency departments, etc.).).