Designing a Teaching Programme for Newly Qualified FY1s as an FY2

I recall receiving my first rota as a newly qualified FY1 and discovering I was on ward cover for the very first weekend, just after the notorious Black Wednesday. I was horrified. I was anxious. I felt out of my depth. Not enough words in the world could describe this feeling.

At that point, I remember realising very quickly that medical school had not prepared me for being a foundation doctor. I knew the theory. I knew the guidance. But I knew nothing about answering bleeps, prioritising jobs at 2am, navigating ward-based care or even knowing what to do during on-calls.

No one sat me down and said: this is what to do on your on-call, this is how to respond to bleeps, or this is what to do during emergency situations. Rather, as foundation doctors, you are expected to learn on the job, picking up tips and tricks along the way. Looking back now, it was not a case of ‘I am not fit for this role’ but rather just a lack of guidance.

I recall working in the emergency department during my final rotation in FY1. I participated in an assistantship programme to guide newly qualified doctors into their incoming role as an FY1. I noted they were motivated and capable new doctors who were all understandably anxious regarding this huge leap from medical school to working as a foundation doctor. Many of them asked the same questions: What is expected of me? How do I answer bleeps? How do I complete my portfolio? How do I prioritise? How do I make referrals?

This is when it dawned on me – I absolutely loved sharing my own experience. And this is where the idea for this teaching programme began.

Alongside two other colleagues, I created and co-designed a virtual three-month teaching programme specifically designed for newly qualified FY1s, called The FY1 Starter Pack. This programme was not designed to teach medicine but rather to bridge the gap between medical school and the realities of working in the NHS as a foundation doctor. The programme supported newly qualified doctors transitioning into clinical practice, enhancing their confidence, safety, and competence in their new roles. The teaching covered a broad range of relevant FY1 topics, including what to expect during on-calls, safe-prescribing, responding to common bleeps, efficient documentation, how to escalate and communicate with peers, how to manage the Horus e-portfolio and other general guidance for settling into the FY1 role.

The sessions were created to be practical and honest with advice coming from doctors who had only just recently survived their foundation year 1. We based this on things we had wished someone had explained to us at the start of our foundation journey, using our lived experience to guide our peers.

We talked about uncertainty. We talked about what it feels like to be asked something you don’t know. We talked about how to respond to common bleeps, prioritise and create job lists. We talked about creating boundaries and learning to say no. We did this to normalise the feeling of uncertainty that comes with stepping into new roles and responsibilities, rather than pretending feeling out of your depth is strange or something to be hidden.

What stayed with me the most was the impactful feedback we received. Whether that was during Q&A at the end of each session, through the feedback forms or even private emails. All thanking us for guiding them through their new role, making them feel more at ease with their impending on-calls, knowing what to do for their portfolio and simply reassuring them that we were all in the same boat once upon a time.

The delivery of this programme alongside full-time clinical work was not easy at all. Like other foundation doctors, we were also balancing our rotations, our own professional development as well as our personal lives. But the project reminded me the importance of sharing our experiences, encouraging and supporting one another through a period of significant transition.

Creating this project taught me that support in medicine does not always need to be from senior doctors who have been in their role for years on end. But rather, sometimes, the real support comes from those who may only be one step ahead, reaching back and saying I’ve been through this, and you are not alone. Especially as foundation doctors when we are constantly supporting and learning from each other. The project helped create a space that allowed newly qualified doctors to learn from shared experience, honesty and peer advice to help ease their transition. And sometimes small initiatives like this can make a whole world of a difference for someone feeling out of their depth – just like I was on my very first ward cover weekend.

Dr Fatima Khan

F2, West Midlands South Foundation School

June 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.