Anesthesiology is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine.
What an anesthesiologist does?
Anesthesiologists are medical doctors who administer anesthesia and manage pain. Some anesthesia numbs a small area of the body. General anesthesia makes you unconscious (asleep) during invasive surgical procedures.
Is Anaesthetist a doctor?
Anaesthetists are specialist doctors who are responsible for providing anaesthesia to patients for operations and procedures. They are doctors who have chosen after qualifying to undertake postgraduate specialist training of at least seven years in anaesthesia, intensive care medicine and pain management.
Is anesthesiologist easy?
How Hard Is It to Become an Anesthesiologist? As with all medical professions, becoming an anesthesiologist is a rigorous process. Prospective anesthesiologists must hone their science, math, and critical thinking skills through medical school, clinical rotations and residencies.
Below are Requirements To Study Anesthesiology In South Africa
Diploma in Anaesthetics of the College of Anaesthetists of South Africa: DA(SA)
Structure and Fees for the Diploma in Anaesthetics of the College of Anaesthetists of South Africa
| Part | Fee | |
 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa | R 10100 |
CMSA Appeals Mechanism
PLEASE NOTE that candidates that wish to lodge an appeal against the outcome of his/her written examination results must do so in accordance with the provisions of the CMSA’s Appeals Mechanism Policy.
Multiple Choice Questions (MCQ) are not made available to candidates for review in accordance with the CMSA’s Appeals Mechanism Policy. A copy of the Appeals Mechanism Policy is available at www.cmsa.co.za
Examination Structure
CONDUCT OF THE EXAMINATION
1.1 Three written papers consisting of
1.1.1 Paper 1: short answer questions 3 hours 20%
1.1.2 Paper 2: 90 SBAs 2 hours 20%
1.1.3 Paper 3: Clinical data Interpretation 2 hours 20%
Paper 1 will be written on the first day and Papers 2 and 3 will be written on the following day.
Important Notice
Please note that this examination can only be written at a South African venue, from Second Semester 2017 you can write in all our venues.
Medals
In 1998 THE SASA JOHN COUPER MEDAL replaced the South African Society of Anaesthetists Medal which was endowed in 1979. This change was made to pay tribute to the life-long contribution of the late Professor John Couper to the affairs of anaesthesia, and in particular his contributions to anaesthetic training and practice in South Africa. The medal is awarded to candidates who achieve excellent results in the Diploma examination of the College of Anaesthetists of South Africa.
Requirements
6 months supervised training at a teaching or CMSA-approved hospital OR 3 months supervised training at a teaching or CMSA-approved hospital and 500 points in a completed logbook
Scheduled dates and locations for the Diploma in Anaesthetics of the College of Anaesthetists of South Africa
| Date | Details | More Info? | |
 | 31/08/2021 08h00-12h00 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa: Written: Paper 1 – Short answer questions Multiple CMSA Examination Venues | |
| 01/09/2021 08h00-12h00 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa: Written: Paper 2 – Short answer questions Multiple CMSA Examination Venues | |
| 03/11/2021 08h00-16h00 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa: Oral/OSCE Various | |
| 07/02/2022 08h00-12h00 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa: Written: Paper 2 – Short answer questions Multiple CMSA Examination Venues | |
| 08/02/2022 08h00-12h00 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa: Written: Paper 3 – Objective Test Multiple CMSA Examination Venues | |
| 09/02/2022 08h00-12h00 | Diploma in Anaesthetics of the College of Anaesthetists of South Africa: Written: Paper 1: MCQ Multiple CMSA Examination Venues |
Anaesthesiology and Critical Care
Education
Postgraduate training
MMed Anaesthesiology
Part 1
The practice of anaesthesiology and intensive care is based upon a deep understanding of human physiology and pharmacology. The insight gained from studying these subjects is critical for subsequent understanding and management of the pathophysiology of diseases encountered in anesthesia and critical care.
The practitioner needs a firm grasp of the principles of how anesthesia-related equipment functions. It is imperative that the anesthesiologist-intensivist appreciates the principles whereby monitoring equipment works so the limitations thereof can be appreciated.
An understanding of basic statistical principles is essential to equip anesthesiologists to perceptively interpret the growing body of research, or conduct their own research.
Part 2
The specialist anaesthesiologist deals with vulnerable, critically ill patients who may have dysfunction or failure of many organ systems. Appreciation of both the underlying pathophysiology, and of the best practice evidence is essential to ensure excellent patient outcomes. The scope of anaesthesiology is widening with pain medicine, regional anesthesia, vascular access, and peri-operative care all falling within the scope of the anaesthesiologists’ practice.
The very young and the aging population, changes in location where anesthesia services are required, the advent of ultrasonography as a treatment and monitoring modality, increasing patient expectations, and better patient safety are current challenges that anaesthesiologists have taken up.
Informed practitioners can function as leaders and patient advocates. The depth of knowledge, skill sets and understanding required by practitioners is great. The field is therefore challenging, but rewarding.
Prospective anesthesiologists require great dedication to cover the requisite material. Our part 2 training is focused on preparing our trainees for these challenges in order to develop world class South African specialist.
Anesthesia in South Africa
Anaesthesiologists are trained at seven Medical Schools in South Africa. The Faculty of Anaesthesiologists of the College of Medicine of South Africa regulates standards and examinations.
The specialist qualification is FCA(SA) i.e. Fellow of the College of Anaesthesiologists of South Africa is equivalent to the British FRCA .The various Medical Schools also offer the M.MED(Anaes) degree which is more or less equivalent to the fellowship. The South African Society of Anaesthetists is busy implementing a CME, Credentialling and Recertification program.
The South African Society of Anaesthesiologists arranges an annual congress with international participants. This is usually combined with a weekend refresher course. The Anaesthesiology Foundation based in Johannesburg also organizes an excellent annual refresher course.
Several of the teaching departments organizes special training courses for examination candidates. Special courses like airway management is occasionally arranged.
Pain management is being taught and practiced to an increasing extent, but mainly in the academic centers at present. Critical Care training is an essential part of the training of anaesthesiologists with a variable period of Residency.
Critical Care units exist in many peripheral hospitals but often function as high care units only due to lack of equipment, funds or trained medical and nursing staff.
Previously many SA anaesthesiologists (and other professionals alike) left the country for political reasons. Nowadays even more leave due to financial considerations. This has a major impact both in academic and private hospitals.
The excessive work load and decreasing income in real terms forces more and more anaesthesiologists to leave academic medicine or even the country. This has been less of a problem in the private sector where each patient pays for equipment used.
However with Managed Health Care coming this may also soon change. The major academic centers are still centers of excellence but private funding has become essential.
The number of specialists trained are far too few to render adequate anaesthesiology service at all levels. General Practitioner anaesthetists carry a huge part of th e burden. Unfortunately not all are adequately trained for the task.
The SA College of Medicine runs a six months diploma course, the DA(SA), at the various teaching hospitals and some recognized peripheral hospitals. This definitely improves the standard at a primary level.
Consultant cover at peripheral hospitals is very rare, even in the major cities. The factors mentioned above, namely lack of equipment, poor remuneration, excessive workload, lack of support of administrators, are the major reasons.
The recommended private fee for a caesarean section lasting forty minutes is SA1722.20. Most patients are however charged less. The scales of benefit fee (Medical Aid fee) is R 624.87. For comparison a major car service excluding parts costs SA1722.20 .
Equipment quality varies from the very best to very poor. The Academic and certain private hospitals having the best and smaller state hospitals are much worse off. Just about all American, British, European and Japanese manufacturers sell there equipment locally.
This huge variety makes maintenance and repair a bit of a nightmare. Operation of equipment unfamiliar to new staff obviously carries its own risks. New drugs are freely available except in non-academic state hospitals.
How does anesthesia work?
Anesthesia temporarily blocks sensory/pain signals from nerves to the centers in the brain. Your peripheral nerves connect the spinal cord to the rest of your body.
Who performs anesthesia?
If you’re having a relatively simple procedure like a tooth extraction that requires numbing a small area, the person performing your procedure can administer the local anesthetic. For more complex and invasive procedures, your anesthetic will be administered by a physician anesthesiologist. This medical doctor manages your pain before, during and after surgery. In addition to your physician anesthesiologist, your anesthesia team can be comprised of physicians in training (fellows or residents), a certified registered nurse anesthetist (CRNA), or a certified anesthesiologist assistant (CAA).
What are the types of anesthesia?
The anesthesia your healthcare provider uses depends on the type and scope of the procedure. Options include:
Local anesthesia: This treatment numbs a small section of the body. Examples of procedures in which local anesthesia could be used include cataract surgery, a dental procedure or skin biopsy. You’re awake during the procedure.
Regional anesthesia: Regional anesthesia blocks pain in a larger part of your body, such as a limb or everything below your chest. You are can be conscious during the procedure, or have sedation in addition to the regional anesthetic. Examples include an epidural to ease the pain of childbirth or during a cesarean section (C-section), a spinal for hip or knee surgery, or an arm block for hand surgery.
General anesthesia: This treatment makes you unconscious and insensitive to pain or other stimuli. General anesthesia is used for more invasive surgical procedures, or procedures of the head, chest, or abdomen.
Sedation: Sedation relaxes you to the point where you will have a more natural sleep, but can be easily aroused or awakened. Light sedation can be prescribed by the person performing your procedure, or together with a regular nurse, if they both have training to provide moderate sedation.
Examples of procedures performed with light or moderate sedation include cardiac catheterization and some colonoscopies. Deep sedation is provided by an anesthesia professional because your breathing may be affected with the stronger anesthetic medications, but you will be more asleep than with light or moderate sedation. Although you won’t be completely unconscious, you are not as likely to remember the procedure.
How is anesthesia administered?
Depending on the procedure and type of anesthesia needed, your healthcare provider may deliver the anesthesia via:
Inhaled gas.
Injection, including shots or intravenously (IV).
Topical (applied to skin or eyes) liquid, spray or patch.
PROCEDURE DETAILS
How should I prepare for anesthesia?
Make sure your healthcare provider has a current list of the medications and supplements (vitamins and herbal medications) you take. Certain drugs can interact with anesthesia or cause bleeding and increase the risk of complications. You should also:
Avoid food and drinks for eight hours before you go to the hospital unless directed otherwise.
Quit smoking, even if it’s just for one day before the procedure, to improve heart and lung health. The most beneficial effects are seen with no smoking for two weeks before.
Stop taking herbal supplements for one to two weeks before the procedure as directed by your provider.
Not take Viagra® or other medications for erectile dysfunction at least 24 hours before the procedure.
You should take certain (but not all) blood pressure medications with a sip of water as instructed by your healthcare provider.
What happens during anesthesia?
A physician anesthesiologist:
Administers one type or a combination of anesthetics listed above pain therapies, and possibly anti-nausea medications.
Monitors vital signs, including blood pressure, blood oxygen level, pulse and heart rate.
Identifies and manages problems, such as an allergic reaction or a change in vital signs.
Provides postsurgical pain management.
What should I do after getting anesthesia?
For procedures using local anesthesia, you can return to work or most activities after treatment unless your healthcare provider says otherwise. You’ll need more time to recover if you’ve received regional or general anesthesia or sedation. You should:
Have someone drive you home.
Rest for the remainder of the day.
Not drive or operate equipment for 24 hours.
Abstain from alcohol for 24 hours.
Only take medications or supplements approved by your provider.
Avoid making any important or legal decisions for 24 hours.
RISKS / BENEFITS
What are the potential side effects of anesthesia?
Most anesthesia side effects are temporary and go away within 24 hours, often sooner. Depending on the anesthesia type and how providers administer it, you may experience:
Back pain or muscle pain.
Chills caused by low body temperature (hypothermia).
Difficulty urinating.
Fatigue.
Headache.
Itching.
Nausea and vomiting.
Pain, tenderness, redness or bruising at the injection site.
Sore throat (pharyngitis).
What are the potential risks or complications of anesthesia?
Every year, millions of Americans safely receive anesthesia while undergoing medical procedures. However, anesthesia does carry some degree of risk. Potential complications include:
Anesthetic awareness: For unknown reasons, about one out of every 1,000 people who receive general anesthesia experience awareness during a procedure. You may be aware of your surroundings but unable to move or communicate.
Collapsed lung (atelectasis): Surgery that uses general anesthesia or a breathing tube can cause a collapsed lung. This rare problem occurs when air sacs in the lung deflate or fill with fluid.
Malignant hyperthermia: People who have malignant hyperthermia (MH) experience a dangerous reaction to anesthesia. This rare inherited syndrome causes fever and muscle contractions during surgery. It is important to relate a personal or family history of MH to your physician anesthesiologist before your anesthetic to avoid drugs that trigger this reaction.
Nerve damage: Although rare, some people experience nerve damage that causes temporary or permanent neuropathic pain, numbness, or weakness.
Postoperative delirium: Older people are more prone to postoperative delirium. This condition causes confusion that comes and goes for about a week. Some people experience long-term memory and learning problems. This condition is known as postoperative cognitive dysfunction.
Who is at risk for anesthesia complications?
Certain factors make it riskier to receive anesthesia, including:
Advanced age.
Diabetes or kidney disease.
Family history of malignant hyperthermia (anesthesia allergy).
Heart disease, high blood pressure (hypertension) or strokes.
Lung disease, such as asthma or chronic obstructive pulmonary disease (COPD).
Obesity (high body mass index or BMI).
Seizures or neurological disorders.
Sleep apnea.
Smoking.
RECOVERY AND OUTLOOK
How long does it take to recover from anesthesia?
Anesthetic drugs can stay in your system for up to 24 hours. If you’ve had sedation or regional or general anesthesia, you shouldn’t return to work or drive until the drugs have left your body. After local anesthesia, you should be able to resume normal activities, as long as your healthcare provider says it’s okay.
WHEN TO CALL THE DOCTOR
When should I call the healthcare provider?
You should call your healthcare provider if you’ve had anesthesia and experience:
Difficulty breathing.
Extreme itching, hives or swelling.
Numbness or paralysis anywhere in your body.
Slurred speech.
Trouble swallowing.
ADDITIONAL DETAILS
How does anesthesia affect pregnancy?
Local anesthesia affects a small area of the body. It’s considered safe for pregnant or breastfeeding women. Many pregnant women safely receive regional anesthesia, such as an epidural or spinal block, during childbirth. Your healthcare provider may recommend postponing elective procedures that require regional or general anesthesia until after childbirth.
How does anesthesia affect breastfeeding?
Anesthesia is considered safe for breastfeeding mothers and their babies. Medications used in all types of anesthesia, including general anesthesia, leave the system quickly. It is often recommended for patients to express their first breast milk after a general anesthetic before resuming breast feeding their infant.
How do I become an anesthesiologist in South Africa?
In order to become an anaesthetist the doctor has to undergo six years of undergraduate training at medical school like every other doctor. After this a year of internship is required, and then a year of community service.
What subjects do you need to be a anesthesiologist?
The association recommends specifically taking courses in calculus, general chemistry, biology, physics and organic chemistry. Your undergraduate major does not have to be specifically related to medicine, so long as you manage to take a few courses in these categories.
How many years does it take to become an anesthesiologist in South Africa?
Specialist training consists of a four-year structured clinical programme in anaesthesia, with tuition in preparation for the Part 1 and Part 2 examinations for the Fellowship of the College of Anaesthetists (FCA).
Where can I study anesthesiologist in South Africa?
In addition to training and research, clinical anaesthesia services are provided at the following venues in the Free State and Northern Cape.
Universitas Hospital.
National Hospital.
Pelonomi Hospital.
Oranje Hospital.
Our satellite departments at Kimberley Hospital and.
lll Military Hospital.
What do anesthesiologist earn in South Africa?
R2,420,673 (ZAR)/yr.
How long does it take to study anesthesiology in South Africa ?
It typically takes 12-14 years to become a licensed anesthesiologist: four years of undergraduate study, four years of medical school, and four years of residency, followed by one year in a fellowship program or two years in private practice.
Do you have to go to med school to be an anesthesiologist in South Africa ?
A physician anesthesiologist is the director of the Anesthesia Care Team. Like other medical doctors, they must follow undergraduate education with four years of medical school. After medical school, a physician specializing in anesthesiology completes a four-year anesthesiology residency program.
What does a anesthesiologists do in South Africa ?
Physician anesthesiologists evaluate, monitor, and supervise patient care before, during, and after surgery, delivering anesthesia, leading the Anesthesia Care Team, and ensuring optimal patient safety. Physician anesthesiologists specialize in anesthesia care, pain management, and critical care medicine.