Teaching: ST. Teaching: Non-medical. Teaching: Med Student. Teaching: Novice. Four supervision categories that exist nowhere in the standard training logbook formats but that describe a substantial portion of a consultant's working day once they reach that level.
This logbook is the Aga version of the anaesthetic clinical record, and the supervision taxonomy is its most distinctive feature. Most trainee logbooks track what supervision you received. This one tracks what supervision you provided — and that distinction matters when you are building a CESR portfolio, applying for a consultant post, or submitting evidence for a teaching qualification where you need documented evidence of supervision activity, not just a claim that you teach.
The Regional Anaesthesia Taxonomy in Anaesthetic 2
Thirty named regional techniques in the second anaesthetic field: Spinal, Epidural Lumbar, Epidural Thoracic, CSE, Caudal, Cervical Plexus Superficial, Cervical Plexus Deep, Cervical Plexus Combined, Brachial Plexus Interscalene, Brachial Plexus Supraclavicular, Brachial Plexus Infraclavicular, Brachial Plexus Axillary, Femoral, Sciatic, Femoral/Sciatic, Lumbar Plexus, 3 in 1, Ilioinguinal, Popliteal, Ankle, IVRA, and four ophthalmic blocks plus Penile.
This is a complete clinical map of the regional anaesthesia competency spectrum. A trainee who wants to demonstrate breadth in peripheral nerve blocks needs this granularity — logging "nerve block" is not a portfolio entry, logging "Brachial Plexus Infraclavicular" with a specific technique note is. The Infraclavicular approach has a different complication profile from the Axillary approach for the same brachial plexus, and a CESR assessor who sees 30 Axillary blocks and zero Infraclavicular blocks is looking at a training gap, not a complete peripheral nerve block curriculum.
CSE — Combined Spinal-Epidural — is listed as a distinct technique because the catheter placement and the sequential assessment of subarachnoid spread before epidural bolusing is a different procedural skill from either spinal or epidural alone. Three separate log entries for spinal, epidural, and CSE cases tell a more accurate story about neuraxial competency than a combined "spinal/epidural" category would.
High-Risk Procedures and the Three-Incident Architecture
Procedure 1, 2, and 3 capture the ancillary procedural work within each anaesthetic: Fibreoptic awake, CP Bypass, PA Catheter, Percutaneous tracheostomy, RSI, TIVA, TCI, Double lumen tube. These are the procedures with specific competency requirements and specific risk profiles.
Fibreoptic awake intubation is one of the core difficult airway procedures. Each one logged in Procedure 1 is a case count toward competency. After ten awake fibreoptic intubations, the portfolio claim is no longer asserted — it is documented in ten individual case records with the patient's ASA status, the surgical specialty, the supervision level, and the reason for choosing the technique captured in Notes.
RSI with a documented indication and ASA status is a different log entry from RSI as a routine choice. The Notes field is where that distinction goes: "ASA 4, full stomach, emergency laparotomy, 02:15 AM, GA ETT IPPV, RSI."
Three independent incident fields — Incidents 1, 2, and 3 — handle the case where multiple things went wrong or required documentation. This is unusual and therefore important. Most cases have zero incidents. The occasional case has one. The rare high-complexity emergency has two or three distinct events that each need independent documentation. Having three free-text fields instead of one means the second and third incidents do not get compressed into a single paragraph that obscures what happened first and what happened as a consequence.
The Speciality Distribution at CESR Level
Twenty surgical specialties: General, Urology, Obstetrics, ENT, Orthopaedics, Trauma, Gynae, Thoracic, Vascular, Cardiac, Dental, Maxillo-facial, Neuro, Neonates, Ophthalmics, Plastics, Paediatrics, Radiology, Resuscitation, Misc.
The CESR assessor examining a consultant-level portfolio is looking for breadth across high-acuity specialties. Neonates, Cardiac, and Thoracic represent three of the most clinically demanding anaesthetic environments. Resuscitation entries represent real resuscitation events — pediatric cardiac arrests, trauma activations — where the anaesthetist's role was documented and the outcome is recorded in the Notes field.
A logbook that captures all twenty specialties over a consultant career, filterable by speciality and sortable by ASA and Priority, is the kind of self-assessment tool that becomes an intraoperative aide-mémoire: before an unfamiliar surgical specialty, the consultant can pull their last ten cases in that specialty and review what regional technique choices they made and what incidents were documented.