Welcome to the second edition of The Clinical Anaesthesia Viva Book. We are extremely grateful for all the positive feedback that we received for the first edition, both from candidates for the FRCA and from examiners and consultant colleagues. We actually set about writing a ‘Book 2’ several months ago and two things became apparent. Firstly, was the fact that the first book needed some updating, especially with regard to some aspects of peri-operative care; examples of this are investigation of high-risk patients for non-cardiac surgery and the recommendations for peri-operative beta-blockade. Secondly, after questioning the current batch of trainees about what they had been asked in their clinical vivas, it became clear that while there were some new questions, they weren't in abundance. This is good news if you are about to take the exam and reaffirms a point we made in the first edition – there aren't many ‘new’ diseases, just patients still suffering from bad hearts, bad chests and difficult airways that need anaesthesia! The clinical problems remain very much the same, and this explains why it can't be an easy job to write new questions for the exam! For these reasons we decided to add to, and update, the first book.

Having been consultants for 5 years or so now, the three of us felt a bit more distanced from the exam than we did when we wrote the first edition.