The Letter I Wish I’d Received as a 5th Year Medical Student

Dear 5th Year Medical Student, 

Nothing will prepare you for foundation training. You can read all the textbooks under the sun, in fact, you probably have better textbook knowledge than most foundation doctors. However, the reality is that you’re going to feel way out of depth on day 1 of being a qualified doctor. You are going to be overwhelmed with jobs, colleagues are going to look to you for really big decisions and you are probably going to cry. Lots. That being said, for every 10 challenging situations, you’ll have one that’ll have a significant impact on you and be a welcome reminder of what made you choose this path in the first place. Being a doctor is a huge privilege and a career that opens doors to so many opportunities around the world whilst constantly challenging you to continue learning both as a clinician and as an individual.  

What I aim to do here is to highlight my 3 main pieces of advice that might make navigating this new chapter a little more manageable.  

Firstly, freedom to speak up. As a medical student there’s this ancient hierarchical expectation that you conform to your role and don’t speak unless asked a complex physiology question. Forget that. You’re an adult, you work for the country’s biggest employer and have worked hard for several years to be where you are. Your voice is just as important as the consultant of 30 years. If you see something unsafe, if someone is rude to you because you can’t remember the third branch of the aortic arch or if you can’t attend mandatory teaching because you’re the only doctor on the ward of 40 patients, tell someone and tell them again.  

The MDT are your friends and your ticket to an easier day at work. Simple things like introducing yourself to the ward team at the start of every shift (tell them your name not just that you’re the doctor; even better, try and remember theirs) and communicating to the team that you’re making significant changes to medication or management go a long way. Most importantly, if a nurse tells you they’re worried, chances are they’ve been doing this an awful lot longer than you and you should prioritise seeing that patient as soon as possible.  

Don’t be afraid to talk about death and don’t be afraid to recognise and accept that that process is happening (read “With The End In Mind” – Kathryn Mannix for a beautiful perspective). It’s inevitable for all of us yet modern day culture seems to have created a sense of fear around it and something that we don’t discuss until it’s too late. The reality is that the majority of patients and their families want to hear you speak bluntly about prognosis regardless of what that might sound like. For me, a dignified death is one of the most peaceful and meaningful processes I’ve been lucky enough to be a part of.  

I know I said 3 pieces of advice but the last thing I’d like you to take away is that there might be a time you question your career choice and whether this is for you. This is absolutely ok, give yourself permission to explore other options. Just remember that if you can get through your foundation training, a whole host of opportunities open up and you can start to make your own choices about the way you want things to go. Putting to the side the clinical knowledge that you will inevitably develop, foundation training will teach you an awful lot about yourself and what you want from a career. 

Hannah Morton, F2

Trent Foundation School