This fellowship has given me significant experience of how to anaesthetise high-risk patients, for high-risk surgery. It has provided me with confidence and competence to safely and effectively anaesthetise patients undergoing any form of major surgery. Some of the transferable clinical skills I have developed include insertion and management of double lumen tubes, along with subsequent management of patients on one-lung; total intravenous anaesthesia; insertion of thoracic epidurals; management of major haemorrhage, and assessment and counselling of patients pre-operatively. Many of these skills have proved useful in settings other than just thoracics and upper GI.

From a non-clinical point of view, I have used the opportunity to undertake numerous quality improvement projects, to include:

1) The background work on setting up an intravenous iron service for thoracic patients.

2) I have written a guide on anaesthetising patients for robotic thoracic procedures.

3) I have undertaken audit work looking at reconfiguring the way pre-operative assessment services are run, with a view to increasing the number of patients that are seen prior to the day of surgery.

During the fellowship I presented at international conferences, and have written an article for Anaesthesia Tutorial of the Week, which is currently undergoing peer review.

In summary, this fellowship has certainly given me a springboard to develop my clinical and non-clinical skills, and has shaped the way that I anaesthetise patients for major surgery. I have no reservations in recommending this as a fantastic fellowship within EMSA.