Your opportunity to learn

Everything you need is at your fingertips to help you in your first year as a doctor, writes BMA Welsh junior doctors committee member Andrea Cordaro

Location: Wales
Published: Friday 15 May 2020
Andrea Cordaro

Dear interim foundation doctors,

You will now start working earlier than expected in the profession you have spent so much time and effort working towards. First of all, congratulations on becoming doctors. Medical school prepares you for difficult scenarios but I certainly do not remember being warned of a looming viral pandemic that would turn our hospitals and workforce upside down. This is a highly challenging, new, and unusual set-up for all of you. I want to give you some insight into what to expect during your foundation year, tips for managing the short-term, and resources for your long-term development.

As IFYs (interim foundation doctors) the work you are doing is essential to patients and staff. Take this as an opportunity to learn as you work, too. Foundation year is about putting lots of the skills and knowledge you gained in medical school into practice. Perfecting cannulation, negotiating radiology scans, handing over patient information efficiently but thoroughly are some of the skills that you will be exercising now. When this pandemic eases and we revert to our usual working patterns, you will still use these skills, so ask questions, get involved with your teams and gain as much experience as you can.

Provisional licence to full licence

During this year, to convert your provisional licence into a full licence, you will need to complete a set of criteria to mark your competency. Be familiar with the GMC’s Outcomes for Provisionally Registered Doctors and contact your local medical education team to clarify what needs to be achieved to ensure you obtain full registration by the end of foundation year 1.

Assistance

Have the confidence to ask for assistance or clarity whenever you are unsure about a task. People will help if you ask them. You should never feel on your own. 

Emergencies

Update yourself with the presentation and management of common medical emergencies. These will present all the time, whether on a COVID-19 or non-COVID-19 ward, and it’s these management plans you want to have at the tips of your fingers.

Organisation

Keeping organised is one of the main challenges for foundation doctors. Prioritising tasks, time-management, and having a job and patient list helps to keep the day under control. The more organised you can be, the less tasks you will have to handover at the end of the day (but don’t rush if you can’t finish everything!).

Documentation

Learn how to document. This is an art and some doctors will write a few lines while others will spend time sitting and writing detailed notes. The more patients you see the more you will understand what requires detailed documentation (eg, discussion with family members) and what can be written concisely (eg, radiology request).

Comfort

Stay comfortable. I won’t steer you to a particular brand of shoes, but any plain trainers should do. You will be running around a lot or may have bodily fluids spill on your shoes one day – you want to be as comfortable as possible! Also, take time to have lunch (it sounds silly, but you need to eat!). Contractually, you should be getting 30-minute break every four hours.

Nurses

Make friends with the nurses. In medical school, we don’t spend much time with nursing colleagues, but when you start on the wards you work together constantly. They are an extremely valuable learning source too!

Educational and clinical supervisors

During your interim placements, you may already know who your educational supervisor for year one will be. This is the consultant who will oversee your year. Clinical supervisors only oversee your current four-month rotation. Make sure you keep in regular contact with both of them and raise any concerns you have early on. They are extremely busy. If it’s urgent and you don’t get an immediate reply, try again or try their secretaries. They are there to support you.

COVID-19

You will most certainly be talking about COVID-19 more than any other disease at this time. Hospital guidelines are being updated very frequently and may change as more information about the disease is uncovered. Find your intranet COVID-resource hub and keep up to date with the guidelines (eg, thromboprophylaxis, calling the intubation team, antibiotics, oxygenation plans). Make sure you wear the appropriate PPE (personal protective equipment) when and where specified and keep yourself informed on any updated guidance from Public Health Wales.

Induction

You should have a comprehensive induction before starting your interim placements and have adequate supervision at all times. If you have any concerns, raise them early with your educational/clinical supervisor and contact the BMA’s First Point of Contact Service. We want to know where appropriate induction has not taken place so this can be addressed.

Indemnity

Make sure you sign up with a medical defence organisation and enrol in the pension scheme as soon as possible.

Useful information

Finally, I wanted to highlight some resources that may be helpful to you during this interim period, but also throughout the rest of the year:

  • For more information on what the BMA in Wales can do for you, information about your contractual rights and COVID19 resources you may find useful during this period, please refer to the ‘Welcome to the profession’ blog from the BMA Welsh junior doctors committee.
  • WJDC developed the Take Control Cymru campaign, which helps junior doctors understand their workplace entitlements and training rights.
  • For tips about a good handover, please view this post by Stephanie Rees, another WJDC member: Importance of a good handover
  •  The BMA has a PPE hotline for doctors to report PPE shortages in their workplace. You can call the hotline 24/7 on 0300 123 1233 or contact an adviser using webchat
  • For any queries about your Annual Review of Competence Progression, contact HEIW[email protected] and your medical education department to clarify any doubts you may have.
  • Ask your colleagues or medical education department for any apps they recommend. The local hospital antibiotic policy app and the BNF/BNFC are useful. There are many hospital-specific apps too that you can download.
  • The BMA has a range of services they advise for wellbeing and support. It is OK to not feel OK during this period. You may be worried, have second thoughts about your career, or have had a difficult day. This is normal and it is important to talk about your worries and seek advice. Visit the BMA wellbeing page  
  • The BMA is waiving the remainder of membership subscriptions for 2019-20. Until 1 October 2020, IFYs will receive free BMA membership! Find out more, here.

Entering the world of hospital medicine earlier than expected is exciting but can be unnerving. Remember that confidence takes time. People are always there to support you during this interim period, your F1 year, and beyond. You have started your medical career in the most unique way – you’ll do great!