The Fellowship of the Ring (of Anaesthesia)

The Fellowship of the College of Anaesthetists (FCA) is, for many of us, the mountain at the end of a very long climb. It is consuming, and at times …. unfair. Basically, it demands from you to be a jack of all trades and a master of none.

Anyone who has prepared for it can attest to the iatrogenic fatigue that slowly creeps in your bones. Registrar training is relentless: nights blur into days, days blur into calls, and somewhere in between you try to revise ethics, laws, protocols, newest guidelines, and remember to eat something other than coffee. Yet even in the exhaustion, there is purpose. Each shift teaches you something the textbooks can't. The training is demanding, but it transforms you — slowly, quietly, and permanently.

Registrar life becomes the reason for your Stockholm syndrome.

And yet, I often say, life is not only about exams and training.

This message is especially for those who did not pass this sitting- your worth, your intelligence, your compassion and your capability as a clinician are not defined by 12 OSCEs with a 10-minute Q&A prepared by someone you’ve never met.

As the one and only Gandalf reminds us:
“All we have to decide is what to do with the time that is given to us.”

Your life is not defined by an exam date, though your timeline is.

For months, the FCA becomes a universe: every conversation, every late-night panic, every study group meltdown. But once the dust settles, you will remember that the world is bigger(and better) than the Miller, Morgan textbooks or the BJA journals.

It’s a line that carries unusual weight when you’re a registrar. Our time never feels like it belongs to us. It’s divided into calls, lists, crises, academic days, family obligations, and whatever fragments remain for studying. During exam preparation, that sense of lost time becomes even sharper. Every hour feels like it must be “productive.” Every weekend feels like an exam countdown. Every moment spent not studying feels like sabotage.

But Gandalf’s wisdom reminds us that time is more than an exam timetable.

You can choose rest without guilt.

You can choose boundaries.

The FCA is a waypoint, not your final destination. Your life continues beyond the exam room, beyond the results, beyond this particular moment. You are still moving forward, still becoming the doctor you are meant to be.

Tyrion Lannister also reminds us, with his particular head-butting clarity:
“Never forget what you are. The world will not. Wear it like armour, and it can never be used to hurt you.”

It’s a powerful message..

Because failure has a way of trying to rewrite your identity. It whispers that you are not good enough, not smart enough or not capable enough. Yet the dwarf’s words cut through that illusion. You are more than a result. You are more than a mark sheet. You are more than someone who “didn’t pass this time.”

Your compassion, your skill, your clinical instincts, your integrity — those are yours. FCA doesn’t define them. An exam cannot take them away.

Wear who you are like armour:
Your hard work.
Your growth.
Your resilience.
Your ability to show up for patients even when your heart is heavy.
Your courage to try again.

Once you recognise that your value is intrinsic — not conditional — the result loses its power to wound you.

Your story is still being written, and you are still the protagonist.

And in the words of the same Tyrion Lannister — a man who survived more trials than any exam could ever simulate:
“I try to know as many people as I can. You never know which one you’ll need.”

It’s a reminder that your strength isn’t only in what you know, but in who walks beside you. FCA prep often feels isolating, but the truth is that you’ve built a quiet army around you — colleagues who quiz you in coffee rooms, consultants who encourage you after a rough list, friends who listen to your meltdown at 23:00 the night before the exams, partners who carry the emotional weight you can’t speak aloud.

You are not doing this alone, even when it feels that way.

The FCA tests your knowledge, but life tests your resilience.
And resilience is rarely built alone.

You have people.
You have support.
You have a community — and that is a far greater asset than any exam score.

 

In the words of Hannibal Lecter (the most unsettling but surprisingly applicable):
“We begin by coveting what we see every day.”

When you watch seniors who have passed, it’s natural to covet the calm, the letters, the finish line. But your journey is unfolding on its own course — and that’s allowed.

Lecter’s quote points to a deeper truth:

We covet not because we are greedy, but because we are human.

We long for what feels close enough to touch but not yet ours. When you sit in theatre watching a consultant discuss a difficult airway with quiet authority, or when you see a colleague who passed walk out of the department smiling with relief — the desire isn’t envy. It is aspiration wrapped in exhaustion.

And here’s the part we often forget:
Their journey was once exactly where you are now.

Registrar training is one of the hardest chapters of a medical career. It stretches you until you forget who you were before it started. But it also builds friendships, resilience, dark humour, and a kind of professional courage that no exam can measure.

There is life beyond the FCA. There is joy beyond the pass list. And your story — like all great stories — is not defined by a single chapter, but by the arc of the entire journey.

Every FCA-holder has sat on that cold chair outside a viva room.

Every consultant has tasted the disappointment of not passing something they worked for.

Every voice that sounds confident today once shook under pressure.

Your journey is not supposed to look like someone else’s.
Some people sprint. Some stumble. Some crawl.
Some sail through the exam on the first attempt; others transform themselves on the second.
Both stories are valid. Both produce excellent anaesthetists.

So yes — covet if you must. It’s natural. It means the goal matters.
But do not let that longing crush you. Let it sharpen you.
Let it remind you that the finish line is still there, waiting, not running away.

And remember:
Your story is still unfolding, and it does not need to mirror anyone else’s to be meaningful, successful, or worthy.

 

In the end, the FCA is just one chapter… another obstacle in a very long story- your life story. It feels enormous while you’re inside it, but life stretches much further than any exam hall or results email. The path of becoming an anaesthetist is not linear, not predictable, and certainly not defined by one outcome.

Failure is uncomfortable. It stings. It bruises the ego. It makes you doubt things you once felt sure about. But it does not break you — unless you let it.

So move on.
Even if it feels heavy.
Even if the disappointment sits in your chest like a weight you can’t quite shift.
Move on one step at a time.

Rest.
Regroup.
Recover.
And when you’re ready — not when anyone else tells you to be ready — stand up again.

The mountain is still climbable.
And you are still capable.

One step at a time — that’s all it ever takes.

You are still becoming the anaesthetist you are meant to be.
The exam will come again. And when you are ready, you will meet it again — stronger.

Until then, breathe. Rest. Live.
And remember that even Frodo didn’t walk to Mordor in one go.

 And if you do not trust yourself right now, remember-

“For I know the plans I have for you… plans to prosper you and not to harm you, plans to give you hope and a future.” — Jeremiah 29:11