It was March 2020 and I was preparing for part two of my medical school finals. Late nights in the library, endless practice revision questions online and frantic OSCE practice on each other. News of the first coronavirus cases in the UK trickled into our everyday reality, but no one could have predicted how events would unfold in the weeks and months to come.
Within a space of a week, our clinical placements were ended, finals were cancelled, and we were informed we were now officially doctoring; starting on the wards within a few weeks. I felt anxious at the prospect of being thrown onto the wards, let alone during a global pandemic. The hospital environment was rapidly evolving and having not completed an assistantship meant I felt under prepared and overwhelmed.
Straight in: joining the NHS as an interim FY1
I was based on a cardiology ward at Barnsley Hospital for my interim foundation post prior to starting my academic foundation job in the East Midlands in August. I was extremely lucky to have been paired with a fantastic FY1 who I learnt an incredible amount from.
Familiarising myself with PPE, management of positive COVID-19 cases, learning how to use the electronic systems and the daily routine of the ward. There was a lot to absorb during the first couple of weeks, but with the support of my team, I started to ease into the role.
Learning on the job
Unexpectedly, my interim role held far less responsibility than that of an FY1, and in hindsight was the perfect environment to make mistakes and learn from them under supervision. I didn’t feel intimidated to ask obvious questions, and I was able to practise my clinical skills, writing discharge letters, note taking and prescribing medications. I never realised the importance of efficiency and organisation of a junior doctor until I had to work with large workloads under time pressures during my interim role.
I felt incredibly lucky to be contributing to the workforce during a time of national crisis, and I cherished the personal satisfaction I gained from making a difference to patients on an individual level while they were at their most vulnerable.
Without a doubt this meant I seamlessly transitioned into working as an FY1 in August. While the responsibility has increased, starting work as a doctor earlier than expected was the best experience I could have had to prepare me for life as an FY1.
Top tips from a newly qualified doctor
I found these top tips useful at the start of my interim job. Now as an FY1, I use them every day.
Refresh your clinical skills
Follow the phlebotomist round so you can observe and practise as much as possible. Identify skills you’re shying away from as it’s better to learn early rather than later under pressure. Spend time becoming an expert on the basics, such as ABGs, bloods, cannulas and catheters.
Memorise doses of commonly prescribed medications
Try doing this for analgesia, fluids, antiemetics, laxatives, antibiotics, anticoagulants. It’s also worth becoming familiar with your trust’s antimicrobial guidelines. That said, if you’re ever unsure, it’s better to check.
Learn to keep an organised jobs list
The best way to excel in your FY1 role is to be very organised. The FY1 I shadowed during my interim foundation role was efficient and I learned from her how to keep a good jobs list. I write my notes in an ordered fashion. My list is split into clinical skills, prescribing jobs, discharges and imaging. Here’s a mock example of my jobs list.
Photo credit: Ayesha Girach
Print enough copies of the handover list
My top tip is to give yourself more time than you anticipate as printers always break when you least want them to! And print enough copies for the team. You are responsible for keeping the list up to date, so updating it throughout the day makes it much less overwhelming at the end.
Download useful apps on your phone
There are a number of great apps available to download. Check to see if your trust have any apps they use for messaging internally or for contact information and follow the trust’s guidance on confidentiality. Useful apps include ones for prescribing, for checking in emergencies and working out calculations.
Wear sensible work attire
I’d recommend investing in comfortable shoes, like a good pair of trainers. Scrubs are great because you can wash them each day at a high temperature and there’s no need to iron or worry about them getting dirty! Also, scrub tops with a pocket are great for your phone, snack, job list and a pen.
If you’re working on a COVID-19 ward, don’t forget to get fit-tested for the correct masks prior to starting work. Carry goggles on you at all times and label them with your name. Consider shoes you can wash easily and a change of clothes at the end of the day.
Keep a note of key door codes and contact numbers
Doors have codes to treatment rooms, doctors’ offices and the mess, so keep them noted in a safe place. Keep a few useful contact numbers handy too.
Keep watered and fed
Hospital canteens during the COVID-19 pandemic may run reduced hours, have less stock or even be closed. So plan ahead and pack a nice lunch to look forward to. I always carry a snack with me in my scrub pocket and have a water bottle on me at all times, labelled with my name.
Work on your portfolio from the start
Stay on top of your portfolio and update as you go with teaching sessions, MiniCEX, case-based discussions, core procedures and reflections. It might also be a good idea to consider organising a clinical supervisor and educational supervisor meeting early into your first job.
Try and give 100% always
Your energy is infectious – the more enthusiastic you are, the more motivated everyone around you will feel. If you can, offer to help your colleagues if you have finished jobs. It can boost team morale and creates a more friendly working environment.
Dr Ayesha Girach
Ayesha completed her medical degree at the University of Sheffield with an intercalated MSc in Clinical Neurology. She graduated early during the COVID-19 pandemic and undertook an interim foundation role in the cardiology department at Barnsley Hospital. Ayesha commenced an academic foundation post in research at the University Hospitals of Leicester Trust in August 2020.
Ayesha has an interest in medical research, medical education and ophthalmology. She hopes to pursue a career which combines all of these. Ayesha has been awarded two research scholarships during her time at university and has published and presented her research on a national and international level.
See more by Dr Ayesha Girach