Anaesthesia takes wellbeing and fatigue more seriously than most specialties, because the consequences of a tired or struggling anaesthetist are immediate, and selection panels ask about it directly. They also ask about the ANZCA professional documents, the college's statements on standards of practice, because they are the framework a trainee works within from the first day. This guide covers both sets of questions and how to answer them with substance.
The wellbeing questions
- How do fatigue and wellbeing affect safety in anaesthesia, and what does the college expect of you?
- How do you look after yourself during training, and how will you know when you need help?
- Anaesthesia has periods of intense pressure. How do you manage them?
- A colleague tells you they have been diverting opioids. What do you do?
What the college expects
ANZCA has a professional document on fatigue and on the welfare of anaesthetists, and the expectations are specific: that anaesthetists recognise the effects of fatigue on performance, that they do not work when unsafe to do so, that departments roster to limit fatigue, and that colleagues look out for each other. The college also runs wellbeing support and expects trainees to use it. Know that these documents exist and what they say in a sentence each; the panel is scoring whether you have read them.
Answering with your own strategies
The panel wants more than "I exercise and sleep well". A structure that scores:
Your warning signs. What you notice in yourself when you are fatigued or struggling: irritability, cutting corners, difficulty concentrating, withdrawing. Say that you know them.
Your routine. Sleep protection around nights, exercise, relationships outside medicine, saying no when overloaded, time away from the hospital.
Your escalation. Who you would tell: a supervisor, a mentor, the college's support service, your own GP. Say that you would, and that asking for help is expected rather than a weakness.
The system. What you would do if a roster was unsafe: raise it with the supervisor of training or the head of department, because the college expects departments to act.
One example of a time you recognised you were not at your best and did something about it lands this answer.
The opioid diversion question
This is a safety and professionalism question. Patient safety first: the colleague must not have access to drugs or patients until it is dealt with. Then compassion: they are unwell, not criminal, and they have told you, which took courage. Then the obligations: you tell the head of department or the director of medical services, because you cannot manage this alone and the hospital's process must start; mandatory notification to AHPRA applies where a practitioner's impairment risks public safety, and you say so. Then support: you stay in contact with the colleague and make sure they are connected to help. Say what you would do if they asked you to keep it secret. The answer that fails is the one that keeps the secret.
The professional documents
- What is the role of the ANZCA professional documents in day to day practice?
- Which professional documents most affect how a department runs?
The professional documents are the college's statements on standards of practice: the minimum facilities for safe anaesthesia, the monitoring during anaesthesia, the pre anaesthesia consultation, the recovery room, the handover, fatigue, sedation, and many more. They set the standard a department is accredited against and the standard a trainee is expected to meet. In an answer, say what they are, name two or three that affect daily practice (monitoring, pre anaesthesia assessment, fatigue), and give one example of using one: checking a remote site against the minimum facilities statement, or applying the sedation guideline outside theatre. The panel is scoring whether you know they exist and treat them as the framework rather than as paperwork.
Perioperative medicine
Expect one question on perioperative medicine, the college's developing programme and the anaesthetist's role in assessing and optimising patients before surgery, shared decision making, and care after the operation. Say what it is, what you have seen of it, and why it matters for patients and the specialty.
The common failures
A wellbeing answer with no strategy and no escalation. A fatigue answer that implies you would push through. An opioid answer that keeps the secret. And not knowing what the professional documents are. All four are easy to fix with an hour's reading of the college's material.
Preparing
Read the fatigue and welfare documents and the list of professional documents on the college's site. Write your warning signs, your routine and your escalation. Prepare the diversion scenario with its next step. Then practise each answer against a four minute clock, because these questions are often delivered in the monologue format and need the full structure.