2023-2024, F1, Trent Foundation School
Starting work as a doctor is an overwhelming, exciting and challenging transition from medical school. The hard work has paid off and there is an opportunity to put your knowledge into practice. Being an F1 is challenging and a very steep learning curve, but remember, there are hundreds of other people up and down the country in the same boat, and you absolutely aren’t expected to just slide in and know everything.
Before starting work, you will get an induction period, this is a great opportunity to meet your peers and meet your colleagues on the ward. Introduce yourself to the ward manager/sister and get to know the nurses. It is also a good idea to check your logins work, and learn how to navigate the IT systems, and have a flick through common presentations on the employer guidelines such as antibiotic regime for sepsis/pneumonia/abdominal infections. Employer guidelines will be your lifeline. Nobody, whether F1/F2/core trainee/registrar or consultant will be able to remember the antibiotic choice for each condition and there is absolutely no shame in looking it up so please make use of the employer guidelines for prescribing choice/management – this is good and safe medical practice.
Prepping a ward round
It would be good to have an idea of the sick patients on the ward before the ward round – this will be useful as it will allow you to get advice from seniors early in the day. It will also help you organise and prioritise your day. You can do this by creating a jobs list and communicating with other doctors on the ward too is very useful. I always find it useful to go back through the notes after ward round with my jobs list to make sure I haven’t missed/forgotten anything. Knowing which patients may be discharged that day will allow you to prioritise their TTO’s – communicate this with the nursing staff so they can prioritise this too. There will always be a senior colleague about that you can ask for advice so make sure you use them!
I was so worried about on call shifts. I had this horrible feeling of anxiety and being the only person with a patient having a cardiac arrest/peri-arrest. I took some time shadowing the on-call bleep holder to help give me confidence, and quickly realised that people arrive very quickly to these calls, and they are great to learn from. I found it useful to take on the role of scribe during crash calls, because it was a great opportunity to observe and learn while also being in the action.
For other on call jobs, you may be asked to review a patient with chest pain, or chase blood for hyperkalaemia, or review a high NEWS score. I found it useful to use the app ‘smart doctor’ for these situations, and always approach high NEWS with A to E assessment.
It usually takes a couple of weeks to settle into each job as you rotate, you will learn so quickly. If you are struggling, don’t hesitate to reach out to your supervisor as they can be very helpful in guiding you through the transition to becoming a doctor. Good luck!