First week as an F1 doctor
The following has been written by Dr
Anirban Pal, a doctor who is just finishing his F1
year:
My first week as a foundation doctor
was better than I had expected. I had a supportive team of
seniors and nursing staff; they made the transition to what was my
first ‘real’ job so much easier. Understanding that you are
going from what is essentially a self-driven environment in medical
school to a team-based working environment is one of the key
differences and leaps you have to make when you start work this
year. Remember always, that respect makes a team tick, and if
you show respect you will soon become a favorite amongst
equals.
Sometimes, even though it is exceedingly
rare, your team may not be very supportive of you or your fledgling
status – there are always other forms of support that you can
access. Speak to your educational supervisor, speak to the
ward sister or matron, or even a member of your family.
Remember that you should never suffer in silence.
We had numerous induction sessions during
the first week. These sessions whilst mind-numbing at times, are a
must. There are people there who have been working at the
hospital for far longer than you have and they will have some gems
of advice for the coming year. A lot of the time, they also
hand out some useful kit at these sessions – I remember an
antibiotic guideline card which I still carry with me. In all
likelihood you’ll have to fill out a number of forms and sign just
as many; get used to it as your signature will become a
hotly contested thing in this coming year. Dealing with the
administrative machinery is one of the less pleasant experiences of
the first week, but it is also absolutely necessary to ensure that
the rest of your year goes smoothly. Make sure all your
documents are correctly filled in and that occupational health has
your correct address! You’ll have to jump through a lot of
hoops this coming year so get used to it and accept the suffering
as part of the experience.
Back on the wards, you may feel nervous
dealing with acutely ill patients in a foreign environment.
Always know that you are not alone. Get help whenever you
can. You’ll learn best from watching expert seniors at
work. Your skills at assessing patients, practical skills etc
will naturally improve during the year but always get senior help
when you feel overwhelmed.
Your principal job as a houseman are the
‘house-keeping jobs’ (blood rounds) I spent my first days just
getting comfortable with the computerized systems in use at the
hospital so that I could access results, order investigations, and
look at x-rays without needing any help. Also, learn the
layout of your ward – where the essential equipment and crash
trolley are kept, where the stationery is kept, and where the
tea/coffee is kept.
On-calls
You may be asked to perform on-call duties
during the first week, and almost certainly in the first
month. Key to being successful during an on-call is to be
organized. Getting a good hand-over is useful but may not
always happen. Most of the time, you will be covering the
wards. Understand which wards you’ll cover and map a rough
geography of their layout so that you can do your own rounds during
the on-call. Do one round of all the wards when you’re free
(from having done a consultant ward round on weekends, or when
handover is finished on nights) picking up any jobs that are
there. A good time to go on your own round is always after a
nursing drug round (usually 8am, 2pm, 6pm, 10pm)!
Carrying the crash bleep is an unpleasant
experience for most people. You have to be prepared and know
your ILS guidelines by heart and have some familiarity with the
crash trolleys in the hospital. At a scene of cardiac arrest,
you should always have seniors present to direct affairs. If
you’re the first one, just get on and do A-B-C and try to get
others around you organized until senior help is on the
scene. Remember that your cannulation, venepuncture and ABG
skills need to be sharp to be successful in this stressful
environment.
Equally important during these first few
weeks is to get to know your fellow foundation trainees. Be
sociable and open. A good beginning will win you a lot of
friends for the rest of the year. You will need all the
friends you can get to swap on-calls, cover shifts, and just
generally to ‘discuss’ the frustrations of work
What makes a good foundation trainee, my
consultant told me, is not a genius but a person who is honest,
reliable and trustworthy. Aim to be all of these things
during this year and you will make the right impression on the
right people.
Written by Dr Anirban Pal (an
F1 doctor)
Please note the content and opinions expressed in all
case studies are those of the writer and do not necessarily reflect
the views of NHS Medical Careers.