Preparedness for Anaesthesia Internship in Ireland: A National Cross-Sectional Evaluation of Undergraduate Anaesthesia Education

Every modern hospital relies on a quiet, critical foundation: the ability to keep a patient safe while their body is temporarily unable to protect itself. This is the domain of anaesthesia, a field that does far more than simply put people to sleep for surgery. It involves managing the airway, monitoring vital signs, and responding instantly when a patient's condition changes. These are not just skills for specialists; they are fundamental capabilities for any doctor working in an emergency room, an intensive care unit, or a surgical theater. In Ireland, as the population ages and medical procedures become more complex, the demand for these services is rising. Yet, the training that future doctors receive before they even enter the workforce has historically been inconsistent. While medical schools teach the basics of many subjects, the preparation for the specific, high-stakes reality of anaesthesia has often been brief, variable, and rarely tested in a way that matters to the student.

A team of researchers from Cork University Hospital, Mercy University Hospital, and University College Cork set out to understand exactly how well Irish medical graduates were prepared for their first year of work in anaesthesia. They focused on the transition from student to junior doctor, a period known as the internship, where new graduates are expected to handle real patients under supervision. The researchers wanted to know if the time students spent learning about anaesthesia during their medical school years was enough to make them feel confident and capable. To find out, they conducted a national survey of doctors who had recently completed an anaesthesia rotation during their internship. These individuals were the perfect group to ask because they had just finished their undergraduate training and were now living the reality of the job. The survey was anonymous, allowing the doctors to speak freely about their experiences without fear of judgment or professional consequence.

The results painted a clear and concerning picture. Out of the twenty-nine doctors who responded, representing graduates from five different Irish medical schools, the vast majority reported that their exposure to anaesthesia during medical school was extremely short. Twenty-five of them, which is more than four out of every five, said they had spent two weeks or less on the subject throughout their entire medical education. When it came to actually being in a theater, the place where anaesthesia happens, the experience was even more limited. Twenty-one of the respondents said they had spent five days or fewer in a theater-based anaesthesia role. While almost all of them had attended some form of teaching, such as online lectures or small group tutorials, very few had experienced simulation-based training. This is a method where students practice skills on mannequins or in simulated scenarios, allowing them to make mistakes and learn from them without risking a real patient's life. Only seven of the twenty-nine doctors reported having this kind of practical, hands-on simulation experience.

The gap between the training received and the confidence felt was stark. When asked how prepared they felt to start their internship, twenty-one of the twenty-nine doctors said they felt either not at all prepared or only slightly prepared. Only two doctors felt well or very well prepared. The areas where they felt least ready were the most practical and urgent tasks: setting up the equipment needed for anaesthesia, helping to manage a patient's airway, and dealing with common problems that arise during surgery. Interestingly, the doctors noted that they were more confident with theoretical knowledge, such as understanding how to read monitoring machines, but they struggled with the physical act of doing the job. The survey also revealed that the way students were tested played a huge role in how much they engaged with the subject. More than half of the respondents said that the weight of the exams influenced how seriously they took the anaesthesia curriculum. When a subject is not heavily tested, students naturally focus their energy elsewhere, even if that subject is critical for their future safety and the safety of their patients.

Through written comments, the doctors shared what they wished had been different. They valued the few moments they had to actively participate in patient care rather than just watching from the sidelines. They called for longer, more structured placements where they could practice skills repeatedly. They emphasized that simulation training was incredibly useful for building confidence before touching a real patient, yet it was rarely available. The researchers concluded that the current system of short, observational rotations is not enough to produce doctors who feel ready for the demands of the job. The study suggests that to fix this, medical schools need to integrate more structured clinical time, expand the use of simulation to teach practical skills, and ensure that anaesthesia is assessed in a meaningful way. By doing so, they could ensure that every new doctor, regardless of whether they eventually become an anaesthetist, leaves medical school with the essential skills to handle acute care situations safely and effectively.