The growth in anaesthesia speciality has been contemporaneous with the advancement in surgical techniques. Although various anaesthesia subspecialities have developed over the years, the value of a general speciality anaesthesiologist cannot be undermined as skills and techniques acquired during basic anaesthesia training are major determinants of efficiency of an anaesthesiologist. A general speciality anaesthesiologist performs multiple roles: that of a perioperative physician, intensivist and acute pain management expert. Anaesthesia also offers a multitude of avenues in teaching and research. A successful anaesthesiologist not only requires having good clinical skills but also needs to adhere to basic medical ethics principles. Anaesthesiologists have also been in the forefront in the management of the current COVID pandemic.

Cardiac anaesthesia is a demanding, but fulfilling speciality which challenges the skills, knowledge, professional and personal competence of cardiac anaesthesiologists on a daily basis. This article outlines the brief history of the subspecialty of cardiac anaesthesia in India, its growth and progress over the decades, reasons for choosing it as a career option, variations in practice standards and how the speciality has been affected by the coronavirus 2019 pan?demic.

Paediatric anaesthesia is an upcoming speciality which is gaining wide interest and can be a career choice for the new trainees. The need to develop paediatric anaesthesia as a speciality was realised with the progress in the field of paediatric surgery. The profile of the 'patient' encountered by a paediatric anaesthesiologist spans from an extremely premature neonate on the fringes of survival, to a full-grown adolescent equivalent to an adult. Perioperative morbidity and mortality are 2-3 times higher in infants and neonates compared to adults particularly in middle and low-income countries. The anatomical, physiological, pharmacological variations and presence of congenital cardiac, pulmonary and metabolic diseases in young children make perioperative management challenging. Special expertise and training are required for anaesthetic management of these preverbal children. In India, 3-years DM and 1-year Fellowship courses in paediatric anaesthesia are now available for specialisation. An ideal paediatric anaesthesia training centre should have substantial paediatric and neonatal patient load with exclusive intensive care facility. Paediatric anaesthesiologists, having knowledge of several facets of paediatrics and anaesthesia are capable of coordinating with health care professionals performing procedures outside the operating room. Paediatric anaesthesia, as a career thus offers a great opportunity to enhance quality and safety of anaesthesia in this high-risk surgical population. Persistent coordinated team efforts improve patient outcomes, reduce stress at work and increase job satisfaction.

Unlike previous years, Anaesthesiology today is a major speciality encompassing many areas of modern medicine. Advent of various surgical sub-specialities resulted into the emergence of anaesthesia sub-specialities, as every group of surgery has specific need. Choosing the best-suited speciality is a complex matter. For that, one needs to have an idea about each one of them. A postgraduate anaesthesiology student does not have adequate exposure to choose the speciality. This article will give an overview of two important sub-specialities i.e., Organ Transplant Anaesthesia and Bariatric Anaesthesia.

Global cancer burden is on the rise and many more patients present for surgery or other oncological diagnostic or therapeutic interventions requiring anaesthesia. Oncology therapy is unique as it requires a multidisciplinary team of surgical, medical and radiation oncologists apart from palliative medicine (PM) specialists, and anaesthesiologists. Anaesthetic management can affect the outcome of oncology treatment both by ensuring early return to oncology treatment and some anaesthetic techniques being innately associated with recurrence. Hence, the time has come for a separate super-speciality of onco-anaesthesiology to cater to the complex unmet needs of cancer patients. PM is the fourth dimension of oncology care and so mandatory education and training should be included in the undergraduate curriculum.

Anaesthesiology is an ever-changing science and amongst its sub-specialities, the field of neuroanaesthesia is making rapid strides. The fragility of the brain and spinal cord and the multitude of complexities involved in neurosurgery and interventional neuroradiological procedures demand dedicated training in neuroanaesthesia. With rapid advancement in other neuroscience specialties, neuroanaesthesia too has made outstanding progress, owing to establishment of structured training, publication of high-quality scientific research, and invention of novel medications and monitoring modalities. The opportunities for training in India and abroad and resources to broaden knowledge in neuroanaesthesia have increased over the last two decades. A career in neuroanaesthesia offers a great future for budding anaesthesiologists.

Obstetric anaesthesia is emerging as one of the most demanding subspecialities of anaesthesia. Obstetric anaesthesiologists are now an integral part of the multidisciplinary team managing the high-risk obstetrics. It has been recognised that targeted training in obstetric anaesthesia helps to recognise the mothers who need special care and formulate specific plan for delivery. Among the subspecialties of anaesthesia, obstetric anaesthesia has the potential to get established early. Obstetric anaesthesiologists have the prospect of choosing either a team or an independent practice. Group practice with a multidisciplinary team can mitigate some of the constraints and allows professional fulfilment and enough time for personal, family and societal commitments. Obstetric anaesthesia is a well-paid and sought-after speciality, and a dynamic field that demands excellent clinical and interpretative skills in a rapidly changing environment.

Anaesthesiologists by virtue of their understanding of physiology, pharmacology and resuscitation skills are best suited to manage critical care units. Armed with this varied knowledge, the anaesthesiologist is 'physician to the surgeon and a surgeon to the physician'. Specialised training helps them to provide extended postoperative and critical care. During the past few months in the battle with coronavirus disease (COVID)-19, anaesthesiologists have stood up to the challenge of caring for critically ill patients, compromising on their operating room responsibilities. The fact from a growing body of literature suggests that an anaesthesiologist as a critical care specialist provides efficient care and better outcomes. With an increasing awareness and need for critical care, government support is going to increase with an increase in avenues for training and research leading to better professional development and earning potential.

Extant legislation, professional and societal ethics provide fundamental guidance to professionals in practising their profession. Legal rules are enforced by courts of law whereas rules of ethics are enforced by professional bodies like the Medical Council of India (now National Medical Commission). In this article, we explore some of the principal guidelines that regulate medical ethics. The role of informed written consent is vital in safeguarding the patient as well the doctor's interests; the approach for getting consent will differ depending on patient and procedure. Medical records document every aspect of the patient's history and details of the procedure and are the only means to settle disputes as they provide legitimate, real-time and accurate details of events that have occurred in the past. Although not explicitly listed as a 'service' in the Consumer Protection Act (CPA), healthcare-related complaints can be filed under the Consumer court and the precedent has been established that it is a service. CPA of 2019 provides detailed regulations for performing scrutiny of cases, fines that can be levied, the directives for seeking compensation, etc., Every anaesthesiologist must have some knowledge of law and ethics in order to protect himself/herself from avoidable litigation or disciplinary action.

Emergency Medicine (EM) is a fast upcoming medical speciality wherein patients presenting with emergent life-saving medical and surgical problems are managed. Emergency physicians are first-line providers of emergency care. They diagnose important clinical conditions even before completing patient assessment, order investigations, interventions, resuscitation and treatment for life-threatening acute conditions. There are several interesting sub-specialisations of EM like trauma care, disaster medicine, toxicology, ultrasonography, critical care medicine, hyperbaric medicine, etc. In some countries, the speciality of EM is a popular choice among medical students; whereas in some other countries, the speciality is now evolving. In India, the speciality is growing fast; Nonetheless, the National Medical Commission has made the existence of the department of EM compulsory in all medical colleges in India from the session of 2022-23. Anaesthesiologists suit the speciality of EM because they have quick decision making skills and swift reflexes as well as diverse knowledge and skills in the fields of critical care, resuscitation and pain management. This article written by anaesthesiologists working in the field of EM, attempts to guide the postgraduate students wanting to take up a career in EM.

The idea of a 'private practising anaesthesiologist'is generally that of a busy practitioner running from case to case, from one nursing home to the other, at all times of the day and night with no time for academics, teaching and family life.But is that really so? Is taking up a career in private practice going to be so full of hardships?There are several advantages of choosing private practice in anaesthesia. To survive in private practice, you need to be very confident in your work, skilful, punctual and good in communication. You can be your own master as a private practitioner. Private practice in anaesthesia is both challenging and interesting. This article, written by private practitioners in anaesthesia who have gone through the exciting and mundane phases of private practice examines the pro and cons of private practice; this can possibly help postgraduate students contemplating to take up private practice as a career.

Pain is one of the most common causes of seeking medical care. In the day to day clinical practice, incidence of pain of some origin is next only to common cold. The average life span of an Indian has also increased and this population is vulnerable to chronic and cancer pain. Anaesthesiologists are well-versed with the art and science of treating pain and their role as pain physician is a natural extension of the professional work. ‘Pain Medicine’ is growing as a speciality. Last two decades have seen an explosive growth in the scientific study of pain and anaesthesiologists taking up pain medicine as a career. Postgraduate students can certainly adopt this super speciality. This article highlights the merits and depicts various aspects of ‘pain medicine’ as a career.