I am an ex-Manchester Access Programme (MAP) student which is the University of Manchester’s flagship widening participation programme. In 2018 I qualified from the University of Manchester as a doctor. My time there included a 5 year medical degree and 1 year of intercalated Masters in Oncology. Then I stepped my foot in the working world, and although daunting at the start, I soon started to love my job.
Currently, I am working in York as a Foundation Year 2 doctor. Personally, I have really enjoyed my placement in acute medicine working on the acute medical unit; why? Because it offered me a wide range of intellectual and practical skills that made me much more confident as a doctor.
So here’s my typical day at work; starting at 8am I arrive on the acute medical ward. Along with the consultant, I join the handover from the night doctors. I make a note of any sick patients as well as any issues raised by the night team. Soon after, the consultant and I begin the ward round starting with the sickest patients first, then work through each patient steadily. We work as a team with a consultant leading the round. As a junior in my team, I take charge of the computer to bring up scans, test results etc. I also document the patients’ notes and make a list of all the jobs that will need to be performed during the day.
The ward round finishes (or aims to…) between 12:00pm and 1:00pm, followed by a quick ‘board round’ where all health care and admin staff meet to discuss the medical, social, physiotherapy and occupational therapy plans. This allows all team members to communicate effectively regarding patients and to work as a team delivering safe medical care.
After board round I proceed with urgent ward jobs. These often include requesting scans, blood taking or discussions/referrals to other medical specialities.
Now that all urgent jobs are done, it’s time to head down for lunch. Once my taste buds are satisfied, the rest of the day includes working through the remaining ward jobs. These include the jobs mentioned above as well as carrying out further patient reviews, medication reviews, discharge summaries, prescribing, discussion with families, reviewing blood results and scan results. Often an enjoyable part of my day includes carrying out practical procedures such as cannulation, inserting NG tubes, ascitic taps and lumbar punctures.
These wide range of ‘jobs’ that I carry out working in acute medicine has made me a well-rounded junior doctor. I have become more confident in my job, and can review patients on my own and make management plans. I then discuss the plans with my seniors to ensure safe patient care and additionally to provide me with feedback on my decision-making skills and give ad-hoc teaching.
As the day comes to an end at 4pm, I skim through the job list again to ensure all the jobs are completed. I collate a list of jobs and sick patients that I need to hand over to the evening team. The evening handover is carried out one-to-one to the evening ‘on-call’ junior doctor.
Now the handover is done, I swiftly collect my belongings and drive home, relax, re-energise and be ready for a fresh start the next day.
Top Tips for FY1
1. We have all been an FY1 at one point so don’t feel like you are alone, because you are not, there is plenty of help and guidance around you.
2. Make SHOs and nurses your best friends as they almost always know the answers!
3. Ask, ask and ask. Make sure you run everything by your seniors. It WILL save you making errors due to lack of experience.
4. Make sure to get involved with all healthcare teams, such as nurses, HCAs, physiotherapist etc. Listen to them and respect them. Help them and they will help you!
5. Similarly, get to know the pharmacist really well (professionally of course), believe me they will prevent you making prescribing errors. Thus you can learn a lot from them.
6. Practice safely and stick to the basics. Always assess a patient using the ABCDE approach no matter what clinical problem is - you can not go wrong with this method.
7. Take opportunities to learn additional practical skills. Sometimes you may have to fight for it a little but thats not a bad thing, it shows your enthusiasm to learn.
8. Learn to prioritise patients by NEWS score and jobs by level of urgency. Again if unsure then ask seniors to assist you in prioritising the tasks. It's a skill that can only come with experience and exposure.
9. Learn about how the system works early on, such as where the handover takes place. Become organised and ensure you hand over patients and jobs thoroughly and hence leave on time!
10. It's very easy to neglect your own health in a busy ward environment. Please ensure you have your breaks. Take care to look after your physical and mental health - no one else will!
11. If you feel exhausted or see yourself heading towards burnout then seek help early. There are support groups within and outside the hospital who can help ensure your wellbeing. These can include occupational health (great resource), samaritans etc.
Dr Muhammed Anss
FY2
Thank you Anss for sharing this fantastic piece! Lots of these tips are also relevant for those starting clinical years. The team surrounding you is what makes your job easier and even more enjoyable. A big thank you to the nurses who have kept me going through the tough shifts!
Just want to add to Top Tip 8 - never assume NEWS:0 equals a 'well' patient. Assess the trend and get a concise history/handover to help you prioritise. I've seen a patient with a tension pneumothorax with NEWS:0. Like Anss said, prioritising is a skill and that comes with practise - always ask for help if you need it!