Dr Kathryn Leask
Your early days on the Foundation programme might be challenging but that doesn't mean they have to be a chore, says Dr Kathryn Leask.
I'm not sure that anyone feels completely ready for their first FY1 job. I knew it was going to be hard work, that I was going to be constantly tired and that I'd have very little time to do other things outside work. It's a big step up from medical school, but with a bit of preparation and thinking ahead your first weeks can be an enjoyable and enlightening experience.
Before starting my new role I spent some time in the unit I knew I'd be working in. This allowed me to get to know the nursing staff and also get a feel for how the unit ran. I learned where the notes and clinical supplies were kept, and was able to practice my venepuncture skills and spend some time looking at drug charts and other documents I would be responsible for filling in.
This was really useful for me. Other than helping me feel more prepared, the sister on the ward was impressed by my enthusiasm and I think it made the staff warm to me a bit more quickly!
You will hopefully be in a hospital that you're already familiar with and know your way around. If not, I'd suggest having a map and making sure you know the quickest routes – even if this means going outside and around the hospital, rather than through it. Among other things, you are likely to be on the cardiac arrest team and it never looks good to be the last one to arrive all the time.
It's important to get acquainted with procedures as well as places, so familiarise yourself with the drug charts and how to prescribe regularly used medications. I vividly remember being bleeped in the middle of the night and being asked to prescribe paracetamol. I had no idea what the dose was, even for something so frequently used, so it's worth getting to know commonly-used drugs and intravenous fluids.
Strong verbal and written communication skills are essential if you're going to be a good doctor, and proper documentation is essential. I found it was worth spending a bit of extra time making sure my note-keeping was accurate and complete. Patients and their relatives are much more likely to complain if communication is poor.
It is important that your colleagues become your friends, as you will spend most of your time with them and they can be a constant source of support.
In view of the amount of patient contact that takes place, clinical incidents are bound to happen. They can't always be avoided but I would stress that what is important is that you learn from them in order to continually improve your practice. If something does go wrong, let someone know straight away and reflect on what has happened to prevent it happening again. Keep accurate, reflective notes of any incidents so that you can discuss them at your annual appraisal.
One of the best pieces of advice I can offer is to make sure you get on well with the nursing staff – you can learn a lot from them. It is important that your colleagues become your friends, as you will spend most of your time with them and they can be a constant source of support.
Being thrown in the deep end can have its benefits.
FY1 doctors who don't accept that nurses might have more experience than they do are unlikely to make many friends, as are those who leave the nurses to clean up after them following a procedure. But remember that you are responsible for your decisions. Don't feel pressured into doing something you're unsure about, and if in doubt always ask a senior.
The early days of your new job are likely to be taken up with admin and induction, but you might discover that you are working out of hours during your first weeks as well. It can feel pretty daunting, but just remember that no one expects you to be perfect from the outset. Being thrown in at the deep end can have its benefits, with the steep learning curve forcing you to become more self-sufficient.
My three top tips for surviving your FY1 year:
- Make friends with the nurses
- Always clear up after yourself. Don't leave it for anyone else!
- Keep good, detailed medical records.
Dr Kathryn Leask
BSc (Hons) MBChB (Hons) LLB MA MRCPCH FFFLM DMedEth
Kathryn has been a medico-legal adviser with the MDU since 2007 and is a team leader, trainer and mentor in the medical advisory department. Before joining the MDU, she worked in paediatrics gaining her MRCPCH in 2002 and did her specialty training in clinical genetics. She has an MA in Health Care Ethics and Law, a Bachelor of Law and a Professional Doctorate in Medical Ethics. She is also a fellow of the Faculty of Forensic and Legal Medicine and has previously been an examiner and Deputy Chief Examiner for the faculty exam. Kathryn is currently a member of the faculty's Training and Education Subcommittee.
See more by Dr Kathryn Leask