FRCAAtlas2027 / 28
STUDY EDITION

THE SCIENCE. THE DECISION. THE PATIENT.

Know why.
Show how.

A learning atlas for the changing FRCA. Connect the science to the patient, then practise explaining your decisions.

Start with oxygen delivery
56 concise lessons56 original SBAs25 clinical exercisesWhat changes in 2027?

LEARNING LIBRARY

Choose a question worth understanding.

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56 lessons · Primary and Final filters include shared lessons

PhysiologyPrimary

Oxygen carriage and delivery

Why a reassuring saturation can coexist with inadequate tissue oxygen delivery.

Explain · Apply · Recall
PhysiologyPrimary

Ventilation, dead space and control

Separate the gas moving at the mouth from the gas reaching exchanging alveoli.

Explain · Apply · Recall
PhysiologyPrimary

Respiratory mechanics

Read pressure and flow together to distinguish resistance from compliance.

Explain · Apply · Recall
PhysiologyPrimary

V/Q mismatch, shunt and diffusion

Explain hypoxaemia using the relationship between ventilation and perfusion.

Explain · Apply · Recall
PhysiologyPrimary

Acid–base interpretation

Identify the primary process, then test whether compensation fits.

Explain · Apply · Recall
PhysiologyPrimary

Cardiac output and perfusion

Connect pressure, flow, preload, afterload and contractility.

Explain · Apply · Recall
PhysiologyPrimary

Renal physiology and fluids

Use filtration and tubular handling to explain fluid and electrolyte changes.

Explain · Apply · Recall
PhysiologyPrimary

Cerebral physiology

Understand why pressure, CO₂ and venous drainage matter to the brain.

Explain · Apply · Recall
PhysiologyPrimary

Metabolism, endocrine function and temperature

Link the surgical stress response to glucose, energy and heat balance.

Explain · Apply · Recall
PhysiologyBoth

Haemostasis and transfusion reasoning

Think about oxygen carriage, clot formation and the cause of bleeding separately.

Explain · Apply · Recall
PharmacologyPrimary

Pharmacokinetics and infusion models

Distinguish the dose needed to fill a distribution volume from the rate needed to replace elimination.

Explain · Apply · Recall
PharmacologyPrimary

Receptors and dose–response curves

Separate potency, efficacy, affinity and the therapeutic window.

Explain · Apply · Recall
PharmacologyPrimary

Intravenous anaesthetic agents

Choose a drug by the physiological trade-offs it creates.

Explain · Apply · Recall
PharmacologyPrimary

Inhalational anaesthesia

Relate uptake, solubility and potency to the changing alveolar concentration.

Explain · Apply · Recall
PharmacologyPrimary

Analgesic pharmacology

Balance analgesia with ventilation, sedation and recovery.

Explain · Apply · Recall
PharmacologyPrimary

Neuromuscular block and recovery

Immobility is not anaesthesia, and visible strength is not complete recovery.

Explain · Apply · Recall
PharmacologyPrimary

Local anaesthetics and toxicity

Use ionisation and sodium-channel binding to explain block and systemic toxicity.

Explain · Apply · Recall
PharmacologyPrimary

Autonomic and vasoactive drugs

Predict cardiovascular effects without reducing a drug to one receptor label.

Explain · Apply · Recall
AnatomyPrimary

Airway anatomy in practice

Connect landmarks and innervation to airway protection and injury.

Explain · Apply · Recall
AnatomyPrimary

Neuraxial and peripheral nerve anatomy

Learn each block as a relationship between nerves, targets and nearby structures.

Explain · Apply · Recall
PhysicsPrimary

Gas laws, flow and resistance

Use equations with their assumptions, not as universal rules.

Explain · Apply · Recall
PhysicsPrimary

Oximetry, capnography and arterial pressure

Know what each monitor measures and what can make it misleading.

Explain · Apply · Recall
PhysicsPrimary

Machines, breathing systems and vaporizers

Follow gas from supply to patient, then follow exhaled gas out.

Explain · Apply · Recall
PhysicsPrimary

Ultrasound and imaging physics

Trade penetration against resolution and interpret artefacts deliberately.

Explain · Apply · Recall
PhysicsPrimary

Electrical safety and heat transfer

Explain hazards through current paths and energy transfer.

Explain · Apply · Recall
EvidenceBoth

Statistics and critical appraisal

Translate a study result into an absolute effect and a judgement about validity.

Explain · Apply · Recall
Clinical practiceBoth

Preoperative assessment and shared planning

Turn a list of diagnoses into a plan for this patient and this operation.

Explain · Apply · Recall
Clinical practiceBoth

Airway strategy and rescue

Plan oxygenation, intubation, rescue and extubation as one sequence.

Explain · Apply · Recall
Clinical practiceBoth

Emergence, recovery and postoperative problems

Explain delayed recovery as a differential diagnosis, not a single drug effect.

Explain · Apply · Recall
Clinical practiceBoth

Regional anaesthesia decisions

Choose a technique around expected benefit, contraindications and rescue.

Explain · Apply · Recall
Clinical practiceBoth

Acute, chronic and neuropathic pain

Assess pain in its functional and personal context.

Explain · Apply · Recall
Clinical practiceBoth

Procedural sedation

Prepare for the level of sedation the patient may reach, not only the level intended.

Explain · Apply · Recall
Specialty practiceFinal

Obstetric anaesthesia

Balance maternal physiology, urgency and fetal considerations.

Explain · Apply · Recall
Specialty practiceFinal

Paediatric anaesthesia

Start with age-specific physiology, then plan with the child and family.

Explain · Apply · Recall
Specialty practiceFinal

Cardiac disease and cardiac surgery

Describe the lesion’s physiology before naming anaesthetic drugs.

Explain · Apply · Recall
Specialty practiceFinal

Thoracic surgery and one-lung ventilation

Predict the consequences of deliberately excluding one lung from ventilation.

Explain · Apply · Recall
Specialty practiceFinal

Neuroanaesthesia and brain injury

Prevent avoidable secondary injury while arranging definitive treatment.

Explain · Apply · Recall
Specialty practiceFinal

Vascular, abdominal and orthopaedic surgery

Anticipate the physiological consequences of the operation itself.

Explain · Apply · Recall
Specialty practiceFinal

Trauma and major haemorrhage

Resuscitate and control the cause in parallel.

Explain · Apply · Recall
Specialty practiceFinal

Sepsis and shock

Identify the cause, support organs and reassess the response.

Explain · Apply · Recall
Specialty practiceFinal

Intensive care and organ support

Explain what support can achieve and how you will know when it is no longer needed.

Explain · Apply · Recall
Clinical practiceBoth

Resuscitation and safe transfer

Treat transport as a period of care with constrained access and resources.

Explain · Apply · Recall
Specialty practiceFinal

Anaesthesia outside theatre

Preserve anaesthetic standards when the environment makes access harder.

Explain · Apply · Recall
Professional practiceBoth

Communication, consent and professional judgement

Make decisions with the patient using information they can use.

Explain · Apply · Recall
Professional practiceBoth

Teamwork, handover and crisis communication

Make priorities and responsibility visible to the whole team.

Explain · Apply · Recall
Professional practiceBoth

Safety, quality improvement and sustainability

Turn an observed problem into a measurable change.

Explain · Apply · Recall
Professional practiceBoth

Safeguarding and vulnerable patients

Recognise concerns, protect immediate safety and escalate through the right route.

Explain · Apply · Recall
Professional practiceBoth

Learning, teaching and reflective practice

Practise retrieval, explanation and decision-making, then use feedback to change the next attempt.

Explain · Apply · Recall
Clinical practiceBoth

Cardiac arrest and peri-arrest reasoning

Recognise arrest, begin effective treatment and search for reversible causes.

Explain · Apply · Recall
Clinical practiceBoth

Perioperative anaphylaxis

Recognise unexplained circulatory or respiratory collapse even without a rash.

Explain · Apply · Recall
Clinical practiceBoth

Malignant hyperthermia

Link a hypermetabolic pattern to triggering exposure and act early.

Explain · Apply · Recall
PhysiologyBoth

Liver, gastrointestinal function and nutrition

Connect hepatic function to drug handling, haemostasis and metabolic reserve.

Explain · Apply · Recall
Clinical practiceBoth

Obesity, sleep apnoea and frailty

Individualise reserve, airway planning and drug response.

Explain · Apply · Recall
Clinical practiceBoth

ECG and investigation interpretation

Use a reproducible sequence, then explain the clinical implication.

Explain · Apply · Recall
Clinical practiceBoth

Infection prevention and antimicrobial reasoning

Prevent contamination and use antimicrobial treatment for a defined purpose.

Explain · Apply · Recall
Specialty practiceFinal

ENT, eye surgery, burns and transplantation

Identify the feature that makes each procedure or population different.

Explain · Apply · Recall

STUDY ROUTES

Build connections, not just a reading list.

01Primary · build the science

Work through mechanisms, calculate with units, then explain the same idea in a patient scenario.

  1. Oxygen carriage and delivery
  2. Ventilation, dead space and control
  3. Respiratory mechanics
  4. V/Q mismatch, shunt and diffusion
  5. Acid–base interpretation
  6. Cardiac output and perfusion
  7. Renal physiology and fluids
  8. Cerebral physiology
  9. Metabolism, endocrine function and temperature
  10. Haemostasis and transfusion reasoning
  11. Pharmacokinetics and infusion models
  12. Receptors and dose–response curves
  13. Intravenous anaesthetic agents
  14. Inhalational anaesthesia
  15. Analgesic pharmacology
  16. Neuromuscular block and recovery
  17. Local anaesthetics and toxicity
  18. Autonomic and vasoactive drugs
02Primary · measure and interpret

Learn what a device measures, how it can fail and what you would do when the reading changes.

  1. Airway anatomy in practice
  2. Neuraxial and peripheral nerve anatomy
  3. Gas laws, flow and resistance
  4. Oximetry, capnography and arterial pressure
  5. Machines, breathing systems and vaporizers
  6. Ultrasound and imaging physics
  7. Electrical safety and heat transfer
  8. Statistics and critical appraisal
  9. ECG and investigation interpretation
03Final · plan around the patient

Start with the patient’s problem. Explain priorities, alternatives, rescue and postoperative care.

  1. Preoperative assessment and shared planning
  2. Airway strategy and rescue
  3. Emergence, recovery and postoperative problems
  4. Regional anaesthesia decisions
  5. Acute, chronic and neuropathic pain
  6. Procedural sedation
  7. Obstetric anaesthesia
  8. Paediatric anaesthesia
  9. Cardiac disease and cardiac surgery
  10. Thoracic surgery and one-lung ventilation
  11. Neuroanaesthesia and brain injury
  12. Vascular, abdominal and orthopaedic surgery
  13. Trauma and major haemorrhage
  14. Sepsis and shock
  15. Intensive care and organ support
  16. Resuscitation and safe transfer
  17. Anaesthesia outside theatre
  18. ENT, eye surgery, burns and transplantation
04Both · practise professional judgement

Use these alongside clinical cases, with a partner acting as a patient, colleague or observer.

  1. Communication, consent and professional judgement
  2. Teamwork, handover and crisis communication
  3. Safety, quality improvement and sustainability
  4. Safeguarding and vulnerable patients
  5. Learning, teaching and reflective practice

A 25-MINUTE STUDY SESSION

Read less at once.
Do more with it.

  1. 5 minRead one mechanism and its assumptions.
  2. 5 minClose the explanation and retrieve it.
  3. 10 minApply it to a question or speak through a case.
  4. 5 minCheck your reasoning and choose a point to revisit.
An independent educational resource for the changing FRCA. See curriculum coverage and depth.