You don’t need to see the finish line

A few weeks ago, I stood on the start line of a marathon in the Brecon Beacons. It felt slightly ridiculous.

The race began at 5:30 pm. By the time I reached the halfway point, the sun was beginning to set, and the rest of the marathon would be run in darkness. Just a few months earlier, I had been recovering from injury and questioning whether I would be able to run at all. Now I was preparing to spend the next several hours running with nothing but a headtorch to guide the way.

As darkness fell, the beam from my headtorch illuminated only a small section of the trail ahead. The finish line was still hours away and completely invisible. There was no way to see the whole route.  The only option was to focus on the next step, then the next, trusting that if I kept moving forward, I would eventually get there.

Reflecting on my time in the Foundation Programme, I have realised that my time as a doctor has felt surprisingly similar.

When I was a final-year medical student, I worried about all the things I didn’t know. How would I manage my first night shift?  What if I was asked a question I couldn’t answer? How would I cope with making decisions independently? Looking back, I think I assumed that starting Foundation Training required me to have the whole route mapped out in advance, but the reality was very different.

Like most new doctors, I arrived on my first day feeling excited but uncertain. I had learned the theory at medical school, but putting it into practice felt daunting. There were moments when I felt overwhelmed, moments when I questioned myself, and moments when I worried that everyone else seemed more confident than I did.

What I didn’t appreciate at the time was that nobody starts Foundation Training feeling completely ready.

The reality is that confidence and competence develop gradually, often without you noticing. It grows each time you independently review a patient, answer a bleep, make a referral, discuss a management plan, or support a patient and their family through a difficult situation. The transition from medical student to doctor is not defined by a single moment; it is shaped by thousands of small steps taken over time. Progress happens quietly, and it is only when you look back that you realise how far you have travelled.

Running has taught me the same lesson.

Training for endurance events can be frustrating because improvement is rarely obvious from one day to the next. Some runs feel effortless, while others leave you questioning whether you have made any progress at all. Recovery from injury taught me this even more clearly. There were weeks when every step felt difficult, and it was tempting to focus on how far I still had to go rather than how far I had already come.

Foundation Training has been no different. There have been difficult shifts and challenging rotations, but there have also been countless opportunities to learn and grow. The doctors I admired most as a new F1 were not the ones who knew every answer; they were the ones who remained calm, asked for help when needed, and continued learning every day. Over time, I realised that becoming a good doctor is less about reaching a destination and more about committing to the process of continual improvement.

Perhaps the biggest lesson from both endurance sport and medicine is learning to be comfortable with uncertainty.

As medical students approach the start of Foundation Training, many will understandably feel pressure to know exactly where their careers are heading. Specialty applications, future training pathways, and long-term career plans can feel daunting. Yet some of the most valuable experiences I have had during Foundation Training were opportunities I never could have predicted when I graduated from medical school.

If I could give one piece of advice to my final-year medical student self, it would be this: you do not need to see the whole route ahead before you start. On that marathon course, my headtorch only showed me a few metres at a time. I never saw the finish line until I was almost there. Yet step by step, checkpoint by checkpoint, I made progress. Foundation Training has felt much the same. You do not need to know everything on your first day. You do not need to have every career decision mapped out. You simply need to take the next step, ask for support when you need it, and trust that your confidence and competence will grow with experience.

Looking back, some of the most rewarding parts of Foundation Training have come from the journey itself rather than the milestones along the way. The path ahead may not always be visible, but that should not stop you from moving forward. Sometimes, all you need is enough light to take the next step.

Sophie Booth

F2, Wessex Foundation School

September 2026

All previous HOFP articles can be found on on our HOFP webpage

The views expressed in this article are those of the author’s, and do not necessarily reflect the official stance of the UKFPO.