Back in 2015, I spent a year at Nottingham as the regional fellow whilst on an OOPE from my training rotation in London. What made me travel to Nottingham? Well, I had heard the fellowship had been running for a number of years, they performed awake shoulder surgery under block only and they could offer me opportunities to develop my skills in regional anaesthesia (RA).

At the start of the fellowship, I had performed all the usual blocks during my training but had not found opportunities to perform them on a consistent basis nor the confidence to deliver regional anaesthesia for awake surgery. After a busy year rotating between lists at the Queen’s Medical centre and City hospital, I was ready to market myself as a regional enthusiast and share my experiences and knowledge with anyone who wanted to listen.

The fellowship offers a good balance between clinical and research opportunities and the faculty is led by Nigel Bedforth, who in my opinion is the Jedi master of regional anaesthesia. He has driven the fellowship from the beginning and its success is demonstrated by the subsequent appointment of fellows into consultant colleagues. Looking back at my logbook, I performed 420 blocks in total and most these blocks were distributed between shoulder lists, hand trauma, major trauma and emergencies and foot and ankle surgery. The main base of the job was housed at Queens Medical Centre (QMC), however the bulk of elective orthopaedic surgery actually occurred at City hospital and therefore I was encouraged to maximise my own learning and development by self-rostering to “regional lists” between the two sites. Most importantly, the fellowship was generally protected to RA friendly lists, and so I was rarely moved to cover other subspecialties and service commitment conveniently involved trauma or hand theatres.

The research part of the job, however was something I enjoyed just as much as the clinical aspects. That particular year, there were two regional fellows, therefore between the two of us we got involved in two separate studies which culminated in publications, an international oral presentation and a few other abstracts being presented- a definite boost for the CV and plenty for discussion when it came to consultant interviews. We both had a research day every week and the department was very accommodating when extra time was needed to complete projects.

As part of the job, there is an “on-call” commitment however the rota is configured to cause minimal impact on daytime lists. It consisted of night shifts at the QMC covering neuro-emergencies as well as helping with emergency theatres and trauma. It is busy, but there is plenty to learn and a fair amount of RA can be performed at night- most commonly rib fractures or perineural nerve catheters for acute pain issues.

And so finally, would I recommend the regional fellowship at Nottingham? It’s a resounding yes! By the end of the year, from a clinical perspective I felt like a regional anaesthetist. This meant I happily undertook block lists, supported colleagues in the department with differing RA techniques, facilitated teaching for other trainees and unwittingly became an active member of the acute pain team. More importantly, in terms of my own training, it confirmed the type of consultant job I wanted and I felt ready for the next phase in my professional career…..and now I’m regional anaesthetist in a tertiary orthopaedic centre counting every drop of local anaesthetic I inject for a block.