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The Unofficial Guide to FY1

By Dr Michael Monteith

The Unofficial Guide to FY1

Dr Monteith is a member of Wesleyan's Junior Advisory Board and has pulled together ten top tips for those about to begin FY1.

1. Professional communication and relationships are key!

It can't be emphasised enough how communication underpins your early success when you start FY1. Your clinical knowledge tends to be at its peak, however on the whole, clinical experience tends to be limited. If you are called to see a patient, try to gain the opinions of other medical staff as nurses tend to be specialist in their own right and can quickly summarise their care.

Most medical staff are prepped for your arrival and the majority are willing and happy to help if you ask for it! If you find yourself in an emergency situation and unable to contact your direct seniors, ask any other doctors for help nearby or use the crash team to get help quickly.

2. Organisation

You will quickly find that some of the best doctors are those that can organise effectively. Busy wards and on-call shifts can be stressful and it can feel like you are drowning in work.

Having a systematic approach to jobs can relieve a lot of pressure. Simple things such as arriving early for shifts, printing handovers, keeping a jobs list/folder (with a system for booking and reviewing), prioritising jobs in order of clinical need, sharing jobs with nurses/clinical support etc can really help.

Having a system and sticking to it is the best way to ensure you don't miss anything important. Outgoing FY1's are also useful as they may give you additional tips on how to survive!

3. On Calls

Your first on-call is terrifying! The first thing to remember is you aren't alone! Everyone is scared of such responsibility so early on, but remember there are seniors above you and ward staff to assist you. Don't be afraid to ring your seniors!

You will find that you may run a lot of clinical decisions past your seniors at the start but this usually decreases as your experience improves.

The dreaded bleep will acoustically pound your ears with more work when you already have enough to keep you going for a week. Unless you are fast bleeped or on the crash team, bleeps can wait until you have finished your current job (i.e. don't leave half way through your cannula) or history/drug chart etc.

Always be polite, the nurse may not know how busy you are and that you have been bleeped 15 times in 20 mins.

Always…ALWAYS make time for scheduled breaks! You are no use to your patients dehydrated and hungry as you will make mistakes. Carry a bottle of water to stay hydrated and take regular breaks unless the clinical need is high.

IT IS OK TO HAND JOBS OVER! It can be impossible to get through the workload and often the next shift will be much quieter and so able to complete the work that you can't. There is also a flipside however, so try to be flexible, as colleagues may hand work over to you someday.

4. Prepping for nights!

If you are about to start nights you will likely have very little time to prepare or recover.
Changing your body clock can be difficult, with two main approaches adopted by FY1's:

1. Stay up late the night prior to your shift but get up at your usual time. A light snooze in the afternoon for 1-2 hours before you start should help shift you into a better pattern.

2. Get a full night's sleep the night before your shift and have a lazy day before you start. Utilise caffeine to stay awake on your first night and go straight to sleep once you have finished the shift.

Following nights, a small nap in the morning (limit to a max of 4 hours) with plenty of exercise after should see you get back into your normal rhythm again.

5. Don't take things personally

Whether it's the patient that's just urinated on your shoe or the consultant microbiologist shouting at you for bothering them with hardly any information, do not take it to heart! You will quickly see how pressurised all of your colleagues are - including seniors, physios, occupational therapists, nursing staff etc.

If someone is pressured and your workload is light, offer a cup of tea or to take jobs off them (including nurses!)... IT WILL BE REMEMBERED and you never know when you may be in a similar situation.

6. Organise annual leave early

Obtain your rota before you start, as many trusts ask for 6 weeks notice before approving leave. Swaps can often be arranged with fellow FY1's although you should try to repay the favour if others need time off. Work with your team, consultants and rota managers closely as they will be more likely to work with you.

7. Befriend your rota co-ordinator

A friendly manner and the odd packet of biscuits will work wonders with the person that approves your leave and offers extra shifts!

8. Shadow your out-going successor if possible

Nobody likes to work extra shifts, but shadowing your outgoing FY1, especially if they are on-call, will assist you no end. Having an idea where handover is, how to print out lists, where theatres/wards are located etc, takes that extra bit of stress off you before you begin.

9. Start your educational portfolio early

Every year there are a handful of naughty FY1's that don't keep up to date with their portfolios. It differs according to each Health Education area, but it's best to keep on top of this as you go along.

Nobody wants to fail and some tutors are stricter than others. If you have legitimate reasons as to why you are not achieving your educational goals, speak to your clinical or educational supervisor early.

10. Enjoy your year/Don't burn out!

In every clichéd 'Top 10 Tips' article, there is always something cringeworthy about enjoying your job... But it really is a vital point in medicine!

Being bottom of the ladder is never an exciting prospect, and at times it can seem like you are the administration dump... However, it does get better!

The year passes very quickly so start to think about what you would like to do with your career early on so that you can prep your CV for applications in FY2.

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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