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Written by Dr Rachel Khaw

10 top tips for starting FY1

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8 min read
Dr Rachel Khaw

FY1 can be a daunting time for those new to working life, so we thought we would help you on your way. In this blog, you can read the top tips picked up by Dr Rachel Khaw throughout her FY1 year.

1. Organisation is key

As with medical school, staying organised will help your day-to-day job run much smoother as an FY1. Keeping an up-to-date jobs list will allow you to prioritise easily, particularly when working on an on-call or busy ward job.

Following a ward round, identifying urgent jobs first will streamline your work. For example, starting with discharge medications which will take a while to be processed, then ordering scans and doing blood tests and then later, when the previous jobs are in process, writing discharge summaries.

Departments will often also ask for eight weeks’ notice for annual leave requests. Looking at when you want to take your annual leave early maximises your chance of getting it, and potentially allows you to request desired dates before others.

Each new place, hospital or department you work in will come with its own door codes, places where specific items can be found, instructions on how to order labels and ways to use the printer. Note down access codes and useful tips for yourself on your phone - they will come in useful when you don’t have the brain-processing capacity in the middle of a busy nightshift.

2. Look after yourself

You are the only one who can look after yourself. You are looking after other people all day, and a run-down, tired, hungry, burnt-out doctor isn’t useful for colleagues or patient safety.

Taking breaks when there’s a quiet moment, and making sure you take time to feed yourself, go to the toilet and rehydrate all sound like straight-forward measures - however, they can often fall by the wayside on a busy shift.

Leaving work on time feels difficult, particularly when you first start working. Getting the last few jobs done, then documenting them, adds up if you’re doing it regularly. Working in shifts should mean your able to handover pending (but semi-urgent, requiring completion out-of-hours) jobs to others. If you’re unable to do this, consider submitting an exception report.

Make sure you have something outside of work to look forward to – whether this is a hobby, sport or social activity, it’ll be useful to take your mind away from work and relax.

3. Always ask questions

No question is a stupid question - whether it’s regarding systems or you don’t understand a clinical picture or result. Help can come from other colleagues, and not only is it good for your own learning, it also shows interest. Don’t forget that others were in your shoes at one point.

Identify your areas of weakness or areas that you feel less confident about – face these and find out how to do them with support from others. This way, when you need to do it on your own it will feel much more manageable.

For example, if you feel less confident about doing ABGs, volunteer to do one during the daytime when someone else can accompany you and give you tips and support where needed, so that when there is an acutely dyspnoeic patient overnight who requires an ABG, you feel happier and more confident carrying out the procedure.

4. Try to not take everything to heart and speak out when you're uncomfortable

The very nature of the job means that you will come across several people of varying attitudes and personas. This can be both a perk and a downside. Many people will be polite and kind, however some people that you will encounter will be emotionally charged due to the context of your meeting, and this can often come across as aggression or shouting. Try not to take it personally. It’s often a reflection of how they’re feeling, rather than anything you've done.

Equally, don’t let people (whether patients or colleagues) walk all over you. It’s hard to do, but if you feel that something is wrong, speak out. Your years of training will have given you a good foundation of knowledge and recognition of when things aren’t right. Don’t feel that you need to do things that make you feel uncomfortable – your name and GMC number goes into your own actions and often, if you can discuss and communicate your rationale, others will understand. In these situations, ask a colleague or senior for support.

5. Look at the bigger picture

Take a step back and look at the bigger picture. Often, finishing a particularly bad shift, it is easy to feel that your personal contribution has been minimal. However, if you take a step back to look at each patient’s journey, your actions will have influenced their treatment along the way. There will be a fair amount of bad days in the job, however the good days will make it all feel worth it. Take time at the end of a day to reflect on the experiences you have. It will allow you to switch off from a busy day.

6. Get to know everyone

Working in an MDT becomes a lot easier if you know the members of the team well. Make a conscious effort to get to know all the different ward and team members that you will be working with, particularly those you work with regularly. This not only will make your working life easier, it will also make it much more enjoyable.

Everyone will be able to provide you with valuable tips from their own experiences, which will no doubt be helpful at some point. Generally, people are very receptive to food offerings – you will be everyone’s new favourite person for the day. If there are opportunities to socialise with your colleagues, take these where possible as some of the people you meet during FY1 will become your long-term friends, and a friendly face at work on a bad day can make all the difference.

7. Download handy apps for quick reference

Find a selection of quick reference apps that you can open easily on your phone to check information. Commonly used apps include:

  • The BNF – quick reference for drug doses
  • MDCalc – scoring systems and risk scores
  • Induction – pocket directory to save going via switchboard, with the ability to add in custom information; e.g., door codes
  • Useful local protocols – save these either to your work computer account or to your phone for easy reference

8. Complete your portfolio contemporaneously

Try to keep on top of your portfolio as you go through each placement. If you’ve looked through your requirements early in the year and know what you need, it will allow you to ask other members of the team to sign you off for assessments and discussions that you’re already doing. This will mean that you can tailor the assessments later in the year to fulfil the criteria that are left. It’s typically the main part of the foundation programme that stops progression, so despite it being not particularly exciting, it’s best to crack on with it.

9. Think about your long-term plans early

Think about your career plans early and try to combine the work you do for portfolio to make it applicable for your career applications. This will allow you to make your work more efficient and avoid doubling up on workload.

Foundation years fly by. Start thinking about what you want to do post-FY2 - whether that’s FY3, higher training or travelling. There will be a number of aspects to organise, and often they need to be started well in advance, so it's worth thinking about early on. Specialty applications open shortly into FY2, which will come around sooner than you think.

If you’re considering specialty training, look at application points and maximise the projects you do to get the best output. You can also consider taster weeks, which can be planned any time in FY1/FY2 in any specialty to help explore your career aspirations.

10. Work collaboratively with your colleagues

Support your colleagues where possible, and they will do the same for you when you need it. Whether this is sharing out jobs on the list after ward rounds or making a well-needed cup of tea, helping others will for the most part only serve in your favour. This can also apply to working collaboratively on research projects, audits, learning opportunities and flexibility.