Practical observations from four years of anaesthesia and ICU practice. Written for residents and colleagues, not for general audiences.
FCPS Preparation
The three topics FCPS Part I examiners return to in almost every sitting
After sitting Part I and working with residents preparing for it, a pattern becomes clear. Three areas appear with enough consistency that you can bank on being tested on them in some form. Pharmacokinetics of volatile anaesthetic agents, the mechanism and reversal of neuromuscular blockade, and the physiology of spinal anaesthesia including cardiovascular effects and determinants of block height.
None of these are obscure. But candidates routinely lose marks on them because they learn them superficially. The examiner is not asking for a definition. They are asking for the clinical implication, the exception, or the management decision that follows from the physiology. If you can answer any question on these three areas at that level, you are ahead of the majority of Part I candidates.
Here is how I would structure preparation for each one, including the question angles that are most likely to come up.
Dr. Sidra Rehman
April 2024
5 min read
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Residency
What the first solo night call actually teaches you
My first solo night at Jinnah I had a crash C-section, a child with intestinal obstruction, and a polytrauma case arrive within three hours. No senior in the building. What got me through had nothing to do with knowing more. It was having clear mental checklists and the habit of thinking one step ahead during the quiet moments earlier in the shift. Nobody teaches you to build those habits explicitly. Here is what I wish I had been told...
Dr. Sidra Rehman
March 2024
4 min read
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Clinical Decision-Making
When I choose spinal over general for C-sections and when I do not
The default answer in most teaching is that spinal is preferred for obstetric cases. That is correct in most situations. But there are specific clinical scenarios where I would move to general without hesitation, and others where the decision is genuinely a judgment call based on what is in front of you. I want to lay out the actual framework I use in the room, not the textbook answer, because the two are not always the same...
Dr. Sidra Rehman
February 2024
6 min read
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ICU
Understanding ventilator settings without memorising them
When I started ICU rotations, I was adjusting settings based on what the consultant had set the day before, not from understanding. The shift came when I stopped thinking about each parameter in isolation and started thinking about the physiology I was trying to support. Tidal volume, PEEP, FiO2 and pressure support all follow the same logic once you frame it correctly. Here is the framework that made it click for me...
Dr. Sidra Rehman
January 2024
7 min read
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Career
What Pakistani anaesthesiologists actually need to work abroad
The Gulf, UK, and Australia each have different licensing pathways. The honest answer to whether FCPS is enough is: sometimes, and it depends where you are going and what grade you are applying for. I have looked into this seriously and spoken to colleagues who have gone through different routes. Here is a practical breakdown based on what the actual requirements are, not what people assume they are...
Dr. Sidra Rehman
December 2023
5 min read
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FCPS Preparation
Studying for FCPS Part II when you are running on 5 hours of sleep
Most FCPS preparation advice assumes you have dedicated study time. Most residents do not. The question is not how to study well. It is how to study in 25-minute gaps between cases, during handovers, and on the commute home when you are already exhausted. I passed Part II while working full shifts. Here is the specific approach that made that possible, and what I would do differently if I were starting again...
Dr. Sidra Rehman
November 2023
4 min read
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Life & Medicine
Having a baby during residency. What I found out and what nobody warned me about
I found out I was pregnant while still in the middle of my post-graduate residency at Jinnah. My first thought was not about the pregnancy. It was about the program. I had put years into getting there and I was not prepared to walk away from it.
What followed was genuinely difficult in ways I had not anticipated. Not clinically. The work itself was manageable. The hard part was the absence of any clear structure around what a pregnant resident should expect, what adjustments were reasonable to ask for, and what the actual policy was. Nobody had a clear answer. I figured it out one conversation at a time.
The first trimester in theatre is its own challenge. You are managing fatigue that sleep does not fix, nausea that arrives without warning, and the professional decision of when to disclose and to whom. I kept working through it. I told my consultant when I felt the timing was right and the response was more practical than I expected.
What I want other female residents to know is that the difficulty is real but it is manageable. There will be shifts where you feel you are not doing either role properly. That feeling is not evidence that you are failing. It is evidence that you are doing two demanding things at the same time, which is genuinely hard.
There is also something worth saying to departments and programs. A female doctor who continues her training through a pregnancy and returns to clinical work is not a disruption to a department. She is someone who has demonstrated exactly the kind of sustained commitment under pressure that makes a good clinician. The support a department offers during that period directly determines whether they retain someone with years of investment in her training.
I got through it. My clinical performance did not drop. I completed the program. And the experience shaped how I think about supporting the people I teach now, particularly the ones who are quietly managing more than their clinical supervisors know.
Dr. Sidra Rehman
October 2023
6 min read
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