From Medical Student to Foundation Doctor: A Personal Journey and Practical Tips for Success

Donned in my graduation cap and gown, I remember fondly waltzing across the stage of St David’s Hall, tipping my cap gleefully to the Dean of Medicine as my name was read out in front of a hall of friends and families. It seemed that after years of opening curtains for consultants, drilling obscure genetic conditions into my memory and performing cranial nerve exams on my housemates, I had finally done it. I was going to be a doctor. The excitement, however, slowly dissipated as the first Wednesday of August loomed. The terryfying realisation was slowly settling in…I was going to be a doctor! 

Now nearly halfway through my FY2 year, I reflect on how different I feel now compared to last August. There are many misconceptions that I had and have grown both personally and professionally over the last 18 months. Hindsight is a powerful tool so I have distilled some of my most significant ruminations in the hope that anyone reading this might feel more comfortable about their transition from medical school to doctor life. 

The biggest challenge that I (and many of my colleagues) faced when transitioning into FY1 was adjusting to the sudden and sheer level of responsibility. “Mr A is NEWSing a 7, three TTOs need doing and Ms B needs a cannula”. It is not uncommon to face such a scenario on the wards in your morning handover, but doing anything for the first time can be daunting. Adopting a structure for each clinical decision will save your bacon when approaching an unfamiliar task. Above all, remember to be a safe doctor who escalates situations appropriately. The nurse in charge has seen countless doctors pass through the doors of your ward and they will know that you will be doing a lot of things for the first time. Use your colleagues around you, ask your seniors for help and if in doubt, do an A to E assessment. This will help you gather your thoughts and stop you rashly prescribing something without thought. Get familiar with the how to contact your seniors (likely by bleep) from day one so everyone is accessible to you.  

It is essential that you build a support network early on to help. Share stories with your colleagues including the embarrassing ones, (because you will definitely have them!) and don’t forget that everyone is a human with hobbies and interests (yes, even your consultant…).   

Another challenging aspect of FY1 is the need to manage time effectively. It never seems as if there is time to do an entire ward round, see patients, take yet another set of bloods and chase your supervisor to sign a form for you. After your ward round, take a few minutes with your team to hydrate and make a list of jobs for the day, flagging up any jobs that you are unsure how to do. Order them in terms of priority: sick patients first, then time critical things (like requesting scans or bloods) and then patients who are being discharged (as you will be chased for TTOs!). There is no need to rush these jobs; you have the whole of your shift to work through them, so take some time out away from the ward to eat and prevent your own hypoglycaemic episode. Learning when to decline doing something for other priorities is an art, but an art that can be practised.  

As you step on to a new ward for the first time, a familiar voice in your head will whisper derisively “what are you doing here?”. This is an all too familiar feeling to doctors at every level of training (including your consultants). Recognise that self-doubt is normal but acknowledge the fact that you have earned your place and there is a steep learning curve ahead of you. Not everything will make sense and it is helpful to become accustomed to the unknown, as this is a fantastic learning opportunity – you can only go up from zero. Take a moment to celebrate the small wins as well – making that patient laugh or being complimented by a patient’s relative.  

There is no doubt that you will be stretched at some point and feel helpless (picture me at 3am on-call, hungry and running around the hospital) . You need only speak to a trusted colleague (be that your supervisor or a registrar you  gel with) and they will  help remind you why you set out on this path in the first place. People are generally very friendly if you are nice to them! 

Finally, seize opportunities around you. A handy tip is to (actually) read through your emails, as opportunities to learn new things or get skills are constantly being circulated. This can help you identify your own interests and mentors that will help guide your career interests.  

Transitioning into foundation training can be an overwhelming experience, but it’s also an exciting time of growth. By acknowledging the challenges, developing strategies to overcome them and embracing the learning process, I learned to navigate the complexities of being a Foundation Doctor with more confidence and resilience. My advice to those about to embark on this journey is simple: trust the process, ask for help when needed, and remember that you are not alone in this. By doing this, you can say to yourself “I am going to be a great doctor”.  

Sunil Patel

F2, West Midlands Central Foundation School