Brutal hours, mental stress, extra portfolio work, exams to study for and yet the beauty of a career I still love

Transitioning from medical school into Foundation training is one of the biggest changes I have experienced. As a medical student, although the workload could be intense, there was always a sense that the ultimate responsibility belonged to someone else. You could make a mistake, ask a question, or simply say, “I’m not sure,” and there was always a doctor nearby who would take over. Then, almost overnight, you become the doctor.

Suddenly, there are patients who depend on your decisions. You are the person being bleeped when something changes, the person expected to review an unwell patient, prescribe medication, request investigations and make decisions. It can be exciting, but it can also be terrifying.

The working hours can be brutal. On ward cover shifts, there have been times when the nurses seemed to be bleeping every two minutes. Just as you finish reviewing one patient, another bleep comes through. Then another. Then another. Somewhere in between, you are trying to deal with an emergency, prescribe medications, answer questions and complete the endless jobs that seem to multiply rather than disappear.

The most stressful moments are often the emergencies. As an FY1, you can find yourself standing next to a deteriorating patient, trying desperately to remain calm while your mind is racing. You know that you need to act, but you are also aware that you are still relatively inexperienced. There is something incredibly reassuring about hearing the medical registrar arrive and take charge. Suddenly, the situation feels more manageable. You realise you are not alone, and you can focus on doing your part.

Night shifts are a different type of challenge altogether. After several nights of broken sleep, your ability to think clearly can feel completely different. At 3am, a nurse might call you because an 85-year-old gentleman has a resting heart rate of 55 bpm. You find yourself thinking, “Is this a sign that he is deteriorating, or is he simply an 85-year-old man who is fast asleep at 3am?” These may sound like small decisions, but when you are responsible for a patient, every decision feels important.

That responsibility is probably one of the hardest parts of becoming a doctor. As a medical student, you learn about diseases, investigations and treatments. As a doctor, you have to apply that knowledge to a real person in front of you. You start to understand that the decisions you make can genuinely change someone’s life. That can be an incredible privilege, but it also brings a huge amount of pressure.

There are sacrifices outside of the hospital too. I have missed birthdays, family gatherings and weddings because I was on call and could not find anyone to swap with me. Sometimes you watch your friends and family enjoying important moments while you are sitting in a hospital trying to keep up with jobs. There are days when you leave the hospital exhausted, realise you have barely eaten properly, and then remember that you have to come back the next morning.

There are also the quieter stresses: worrying that you have forgotten something after leaving the hospital, wondering whether you made the right decision about a patient, dealing with difficult conversations, feeling guilty when you cannot give every patient as much time as you would like, and trying to study for exams while working full-time. On top of that, there is portfolio work, teaching, audits, applications and the constant pressure of thinking about what comes next in your career.
Yet, somehow, despite all of this, I still think medicine is a beautiful career.
One patient in particular made me realise this.

During my time working in gynaecology, I looked after a 50-year-old woman who had undergone a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Her postoperative course became complicated by an intra-abdominal collection. I was the first doctor to assess her when she became unwell, and I arranged a CT scan which identified the problem.

She was subsequently admitted to the ward for treatment. What followed was a brutal 75-day hospital admission. The collection led to further bowel complications, including an obstruction. She experienced vomiting, required an NG tube and went through numerous investigations and interventions. There were days when she was incredibly unwell and other days when she seemed to be improving, only to deteriorate again. I was not always allocated to her ward round, but I found myself going to see her anyway. I genuinely cared about how she was doing. Almost every day, I would spend a few minutes with her, explain the plan, answer her questions and simply encourage her. I felt a personal responsibility towards her because I had been the doctor who first recognised the problem and diagnosed her. Eventually, after 75 long days, she recovered. She was able to eat and drink without vomiting, her bowels and bladder were working normally, and the infections and collections had resolved. I remember walking onto the ward on the final day and seeing her sitting there with the biggest smile. She had tears in her eyes. She thanked me genuinely and gave me a hug. It was a simple moment, but it meant more to me than I can properly put into words. In that moment, I realised that this is why I do this job. Medicine can take a lot from you. It takes your time, your sleep, your weekends and sometimes your ability to be present for the people you love. It can make you question yourself and leave you exhausted. But occasionally, you get the opportunity to make a real difference in someone’s life. Sometimes that difference might be something as simple as taking five minutes to explain what is happening to a frightened patient. Those moments make everything else feel worth it. The transition into Foundation training has not been easy, and there have been plenty of moments where I have wondered what I had signed myself up for. But when I look back at the difficult days, the long nights and the sacrifices, I also think about the patients I have helped. Despite all the brutal hours, the stress, the exams, the portfolio work and the sacrifices, I have absolutely no regrets. If anything, these experiences have made me realise even more strongly that medicine is where I want to be. It is exhausting, demanding and sometimes overwhelming, but it is also incredibly meaningful. And for me, that makes it a beautiful career.

Dr Sujjanv S Yogesan

F2, Yorkshire and Humber Foundation School

October, 2026

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