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Surviving your first month as a Foundation Doctor

By Dr James Glasbey

Surviving your first month as a Foundation Doctor

Did you start your FY1 this August?

Dr James Glasbey, Academic Clinical Fellow in the West Midlands Deanery and Wesleyan Junior Advisory Board member, shares his tips and advice for new trainees.

Starting Foundation Year 1 can be daunting. Suddenly you move from the supported environment of medical school, to holding responsibility for patients' care.

A few moments stuck with me from my first month of FY1, and these tips continue to help me out in my most pressured moments. Hopefully they will do the same for you - good luck!

Get organized

Ward rounds (particularly surgical ward rounds) are hectic. You barely get a chance to finish writing in the notes, let alone complete scan requests, or blood forms. This leaves you with a catalogue of jobs to complete after the round, which can take up much of your day.

A good tip is to have a number of forms with you, with the generic information pre-filled (consultant name, hospital name, ward, date). This will allow you to complete these requests at the bedside and immediately reduce your workload.

Some FY1s choose to hold a clip board on the ward. Whilst this is not essential, the principal; safe storage of your list, and quick access to necessary forms is. Be a good secretary, get things organised in advance.

Drink a coffee!

In life, in lectures, at home, if I don't eat enough during the day, I can barely concentrate. However suddenly when I started FY1 I didn't eat or drink anything for 13 hours, because I had too many jobs and too many patients. I remember one really busy day on the ward when the registrar asked whether I'd like to come for a coffee.

I was shocked; with so many TTHs (To Take Home Medication) to do, how could we take 10 minutes to have a coffee? She said, 'you will not be able to look after patients properly if you do not look after yourself'. This stuck with me.

However urgent things seem; booking transport, writing a TTH, rewriting a drug chart, you can afford to take 10 minutes to drink a coffee, recharge and hit the ground running for the afternoon. Don't let people pressure you into thinking otherwise. (Disclaimer: The exception is, sick patients can't wait!).

Don't worry, ask!

A consultant once said to me, 'I know more about the job of being a doctor not because I'm more intelligent than you, not because you've not studied enough, but because I've been doing it longer!'.

Nobody expects you as a new FY1 to know everything about creating a management plan. The team just want to see that you're safe, sensible and willing to work hard to get ward jobs done.

If you don't know what to do, why you're doing something or when to do it - ask! A registrar would rather re-explain to you why a CT (computerised tomography) scan is required than have to go and ask a consultant radiologist to re-report it when the clinical information is wrong.

Get stuck in

I hadn't considered wanting to do cardiology during medical school (my first FY1 job). On my first day of FY1, a core trainee said to me, 'treat every job as if it's what you want to do'.

That didn't mean pretending to my team that I'd always wanted to be a cardiologist, but did mean keeping an open mind and recognizing the broad transferable technical and non-technical skills I could gain from the rotation, whichever career path I would eventually follow.

By being enthusiastic, turning up to voluntary teaching, and reading around topics that had arisen on ward rounds, I gained the trust of the registrars and consultants on the team. They took opportunities to teach me where they may otherwise have not. By the end of the job I had learned how to do focused echocardiography, performed DC (Direct Current) cardioversions, and inserted central venous lines.

Often if you step forwards and ask if you can learn a procedure, under strict supervision, people will be very obliging to support you.

Squash

I didn't get a chance to play squash in my first week as an FY1. I enjoy playing squash, as it gives me a chance to exercise, meet with friends and blow off steam.

When you are doing long-days and runs of on-call it is very easy to get into bad habits of neglecting your hobbies. Book sporting commitments, make plans with friends, arrange trips away - and stick to them.

Medicine can be stressful, and you need to actively make time to stay happy and healthy.

Play nice

In a hospital, every member of the team is equally as important. A life-changing heart transplant operation cannot happen if there was not a cleaner to clean the theatre, or a caterer to provide nutrition to the postoperative patient.

Treat every member of the team with respect, and the ward environment will be a nicer place for everyone, especially you!

This guide was written by Dr Michael Monteith, a member of Wesleyan's Junior Advisory Board. The views expressed in this article are the personal opinions of the author.

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