2020-2021, F2, Wales Foundation School
Looking back, it’s been quite a year. From working on the frontline during a global pandemic, to completing my first year as a doctor, I can confidently say that I have learnt to swim in the deep end.
Before I started as a foundation doctor, I had taken a 2 year break from clinical practice to pursue a masters in Public Health and work as a lecturer. This led me to feel very apprehensive about returning to clinical practice as a foundation doctor. However, these anxieties were soon relieved by an incredibly supportive team and great fellow FY1s who eased the transition.
On our first day we attended numerous induction talks. One talk was by an FY2 doctor about “Being a FY1 doctor”. She explained how nervous she was when she first started but reassured us that help will always be given to those who ask for it. Alongside parting some gems of wisdom for FY1, she joked about how we would no longer be able to use the excuse “I’m a medical student” as we were all now “doctors”.
Challenges
My first couple of weeks was a great introduction to being a doctor as I worked as an Anaesthetics FY1. I attended numerous crash calls from the offset in my job, which although daunting at the time gave me the opportunity to develop my skills in IV access, resuscitation and to learn to remain calm under pressure. These skills have laid strong foundations for the rest of my rotations.
Some difficult moments included a paediatric death, failing to cannulate a very sick patient or dealing with hostile patients or colleagues. Whilst the first couple of weeks as a doctor felt like a steep learning curve, I always felt incredibly supported and it helped to talk through scenarios with fellow foundation doctors as “a problem shared is a problem halved”. There were also many positive moments such as seeing a patient improve from a critical condition, and cannulating a patient with “no veins”.
My next rotation was stroke medicine. Good organisation, excellent communication and prioritisation were essential to this job. I really appreciated having done my Anaesthetics rotations beforehand, this really helped me with difficult cannulations and allowed me to think systematically through acute scenarios.
The most daunting part of FY1 for me was being the on-call doctor, providing medical cover for all the hospital wards. You would undertake a range of jobs such as taking bloods, ordering X-rays, prescribing medications and reviewing acutely unwell patients. Although these on calls could be incredibly busy, I always knew that a senior doctor was just a bleep away if I needed help. A key lesson I learnt is there is always more jobs to do than time allows, therefore prioritisation of tasks is key to success. Also the motto “do something sensible” is key, if you are debating whether to run something past your senior, it’s best to run it past and be safe than to leave it.
With each new rotation, you will feel out of your depth and this is completely normal. I can remember at the start of my FY2 Paediatrics rotation, during handover, saying one of the babies had “Atrial Fibrillation”, however, “AF” is shorthand for “Anterior Fontanelle” in Paediatrics. This gave the Paeds consultant a chuckle. Despite what you may initially think, by the end of the four months rotation you will become more confident and independent in that specialty.
Job Allocation
I was lucky enough to secure my top choice Foundation Programme rotations. I decided to work in a friendly district general hospital in South Wales doing Anaesthetics, Stroke Medicine and Surgery for FY1 followed by Emergency Medicine, Paediatrics and Respiratory Medicine for FY2. Unfortunately, at the end of my FY1 Stroke Medicine block the Coronavirus pandemic hit. This resulted in me being redeployed to Coronavirus ITU. Whilst it was an incredibly emotionally challenging time, the camaraderie between my colleagues made me incredibly proud to be part of the NHS.
I believe the most important piece of advice I can give you is a good foundation doctor isn’t someone who knows everything, it’s someone who is organised, approachable, honest and knows when to ask for help.
Final Note
If anyone tells you that being a doctor is an easy job, they are not being entirely truthful. What I will say is it is an incredibly fulfilling job and one which I feel privileged to do. With the added pressures of COVID on top of starting as a doctor it is even more important than ever that you look after yourself. If you ever feel like you are struggling, I would encourage you to speak to a colleague, educational supervisor or someone you trust. Lots of doctors go through difficult periods and getting support is the best thing.