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Written by Dr Michael Monteith

Five great tips for starting your foundation year

the-next-step
doctor
FY1
tips
career
4 min read
Female medical professional standing in corridor

About to start FY1? It's understandable to feel nervous, but you’ll be better prepared once you’ve read Dr Michael Monteith’s top five tips to make your foundation year a success.

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, your clinical experience is likely to be limited. If you're called to see a patient, try to gain the opinions of other medical staff. 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 nearby doctors for help or use the crash team to get assistance 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're 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, and sharing jobs with nurses/clinical support 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-call shifts

Your first on-call shift is terrifying, but the important thing to remember is that 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.

You'll find that you may run a lot of clinical decisions past your seniors at the start, but this usually decreases as your experience improves. When you first start working on-call shifts, remember the following:

  • 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've finished your current job (i.e. don't leave half way through your cannula or history/drug chart).
  • It's also important to be polite. Nurses may not know how busy you are, and that you've been bleeped 15 times in 20 minutes.
  • Always make time for scheduled breaks. You are no use to your patients if you're dehydrated and hungry. You'll also be more likely to make mistakes. Carry a bottle of water to stay hydrated and take regular breaks unless the clinical need is high.
  • It's okay to hand jobs over. Sometimes, it's impossible to get through your workload. Often the next shift will be much quieter, and your colleagues may be able to complete the work that you can't. Try to be flexible though, as work may be handed over to you too.

4. Preparing for nights

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

  • Stay up late the night before your shift, but get up at your usual time. A light snooze in the afternoon for one to two hours before you start should help you create a better pattern.
  • 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've finished the shift. Following nights, a small nap in the morning (limited to a maximum of four hours) with plenty of exercise afterwards 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 your seniors, physiotherapists, occupational therapists and nursing staff.

If someone is pressured and your workload is light, offer a cup of tea or to take jobs off them. It will be remembered, and you never know when you may be in a similar situation.