A day in the life of an FY1 on Care of the Elderly (COTE)

Starting your first job as a doctor can feel like stepping into the unknown. The early mornings, the fast pace, the responsibility – it’s a lot to take in. That’s why we’ve invited current F1, Dr. Charlie Pearson, to share a glimpse of his working day on Care of the Elderly (COTE).

Whether you’re preparing to start work in August or you’re simply curious about what life on the wards is really like, Charlie’s honest and insightful account will help demystify the experience. From ward rounds to multidisciplinary teamwork and navigating tough conversations, here’s what a typical day looks like on the front line of patient care.

Morning meetings

My day typically starts around 6:30am – if I can resist hitting the snooze button a couple of times!

I cycle into work for 8am, where we meet in the doctors’ office. Here we print off the patient list and ward round sheets before ensuring that all wards across Care of the Elderly (COTE) are evenly staffed.

We then begin seeing patients. On days when we have a consultant, they usually join us around 8:30am to review particularly unwell or newly admitted patients.

At 9:30am, we have the Multidisciplinary Team (MDT) handover. The MDT is especially important in COTE, as frail patients often have complex needs regarding mobility, living arrangements, care support and eventual discharge planning. This meeting ensures that everyone is aware of the different elements of each patient’s care.

Ward rounds

The length of ward rounds varies. On a good day, with enough doctors in the team, we might each review around ten patients.

If most are stable or medically optimised for discharge (which is common in COTE), we can be done by 12pm. When patients are more unwell or staffing levels are lower, the ward rounds tend to take longer.

Ward rounds involve reviewing patients clinically, chasing investigations and planning next steps. It’s always satisfying when you feel like you’re making a difference – whether that’s progressing a patient’s care or seeing them make improvements.

One of the most rewarding aspects of COTE is getting to know your patients and advocating in their best interests. Since settling into this rotation, I’ve realised how much I value continuity of care.

Follow-up jobs

After the ward round, we meet with the nurse in charge to run through the patient list, discuss any outstanding tasks and provide updates. Then, after a quick lunch, the rest of the day is spent following up on jobs from the ward round.

A big part of working in COTE is communicating with families and discussing treatment escalation plans. Unlike in younger, fitter patients, certain investigations or treatments may not be appropriate for frail, elderly individuals.

Recognising when comfort should be prioritised is an important skill, and being able to have these conversations sensitively with both families and the wider team is invaluable.

Other jobs throughout the day range from requesting and following up on investigations to making referrals to specialist teams and writing discharge summaries. Occasionally, acutely unwell patients may require urgent clinical input.

Handing over

By 5pm, any outstanding urgent tasks are handed over to the on-call doctor covering the evening shift. The patient list is updated to reflect the day’s progress before the night team take over.

Overall, there’s a lot of variety day-to-day, as well as work between teams and communication with patients and their families. It requires quite a lot of thinking and energy, so often the day will end at home with a cup of tea in front of the TV.

Thanks for sharing your experiences, Charlie. No two days are ever quite the same, but one thing is certain—being an F1 is a steep learning curve filled with growth, challenge and purpose.

If you’re feeling nervous about starting your own journey, know that you’re not alone—and that with time, support and experience, you’ll find your rhythm too. Stay curious, stay kind and take it one day at a time.