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By The Next Step

A guide to preparing for FY1

5 min
Male healthcare worker standing in hospital corridor

This article is written in collaboration with Mind The Bleep – a free education platform designed to help medical students as they prepare for FY1.

It’s common for medical students to feel anxious and like they’re not ready to start FY1. That’s why it’s so important to seek the support you need to ensure the patient always comes first.

This blog delves into all the tips and advice you need to make the transition into Foundation Year that little bit easier, written by those who have been there and experienced it.

Stock up on useful equipment

When it comes to equipment, the most essential items we can recommend are your stethoscope, a supply of pens and a power bank. Other useful equipment to have on hand includes a clipboard box, an NHS name stamp and the Oxford Handbook for the Foundation Programme.

Familiarise yourself with the job

During your final year, you’ll get plenty of opportunity to familiarise yourself with common tasks expected of you in your role. You will be under close supervision by FY1 doctors, so this is your chance to ask any questions you may have.

Shadowing and induction periods can also help you get used to the hospital systems you’ll be using.

Prepare for ward rounds

When it comes to surviving ward rounds, it’s important to develop your own set proforma to preparing notes. It’s good to get into the practice of doing this without needing to start work early.

It’s also important to learn how to document efficiently. Try to gain confidence asking for help if you come across something you haven’t heard of.

During this period, you could also spend time reviewing the drug chart and checking the treatment ceiling has been set (this is decided by your seniors).

Similarly, you could practice prescribing common drugs, including anticoagulation, IV fluids, laxatives, antiemetics and analgesia. This will help you to avoid common prescribing errors.

And don’t forget – review and request bloods before you leave!

Prepare for being on call

On-call shifts can be busy and stressful. That’s why it’s so important to keep your list of jobs organised and in priority order.

Managing deteriorating patients, ordering scans and making referrals are usually carried out first. There are some useful apps and referral cheat sheets that can help you with this task.

In your role, you will be expected to escalate unwell patients immediately, and you should do so by carrying out ABCDE. Ensure you put a medical emergency call out if you ever feel worried about a patient.

Learn how to write discharge summaries

When writing discharge summaries, keep it simple. Focus on key events, results, investigations and discharge advice (for example, follow up plans or information on when to seek help).

Things you should avoid include copying the entire scan report and giving GPs tasks that need to be completed within two weeks. Sometimes it can take longer than this for the task to reach the GP.

It’s also worth noting that FY1s often prioritise discharge medications (TTAs), as they take time to order from a pharmacy (especially those in dosette boxes).

Most importantly, ask for feedback and use it as a CBD for your e-portfolio.

Familiarise yourself with the hospital during your shadowing week

Your shadowing week is the perfect time to get used to your hospital environment – from using the bleep system to learning how to refer to different specialties.

It’s a good opportunity to learn how to use computer systems to request investigations and complete discharge summaries, as well as navigating the pet peeves consultants may have.

It’s also the perfect time to figure out who and how to call for help, alongside learning where all the best food and bars can be found!

Check your rota

You should receive a generic work schedule that details the rota pattern eight weeks prior to starting your job. By the six-week mark, you should be told exactly which shifts you’ll be working.

You should check that the rota doesn’t breach any safety limits. If you work beyond these hours, you will be told how to file an exception report to ensure you’re paid for these hours or given time off in lieu.

Check your pay

On average, FY1s earn between £28,000 and £35,000 before tax, depending on how many hours are worked and the night/weekend frequency.

After tax, that works out to around £1,700 to £2,100 per month. The exact amount is defined in your work schedule.

Once you’re working, you can also claim tax relief on GMC, BMA, membership exams and other fees (essentially, you get 20% of the cost back).

Consider your CV and future career

When it comes to considering your CV and future career, it’s important to remember that specialty applications favour those who have:

  • Won prizes
  • Had work published
  • Presented at conferences
  • Started membership exams
  • Training or teaching experience
  • Completed quality improvement projects
  • Held leadership roles

Be nice to everyone!

This is easily the most important advice anyone can give you.

You should focus on being nice to:

  • Nurses and other colleagues who will go out of their way to help those who are nice. As you will spend most of your time with these people, it’s important they become your friends so that they become a constant source of support and advice.
  • Patients and relatives, as poor communication is the source of most complaints. Ensure you understand how to communicate with relatives and deal with complaints when they arise.
  • And finally, yourself. Being on time, ensuring you don’t miss breaks and keeping up with friends and family will help you to achieve a good work-life balance and prevent burnout.

Some people will be difficult to work with, but please remember that bullying in the workplace is completely unacceptable.

Employment essentials

Check out our series of essential employment topics, including advice on understanding rotas, pay and tax, and how to build your CV.

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