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So, You’re Starting FY1… Now What?

By Freya Baxter

5th Year Medical Student


First of all, congratulations on passing medical school! This is a huge milestone after years of hard work. Now, you’re stepping into the next chapter of your journey as a doctor.


Starting FY1 is very often described as a steep learning curve, and it certainly is. But not just clinically. Alongside Medicine, there are a lot of practical and administrative challenges that are not always explained. From figuring out how the hospital systems work, to potentially moving to a new city or understanding what you’re financially entitled to, it is a major transition.


For students from widening participation (WP) backgrounds, these aspects may feel especially unfamiliar. If you do not have any insight into these things, it can feel like you’re simply just expected to pick it up as you go.


This guide focuses on those less talked about aspects of starting FY1, the ones that make a difference in how supported and prepared you feel as you begin this new chapter.


Understanding the Finances


A major factor to consider when starting FY1 is the financial side of things.


There are several upfront costs that arise often all at once e.g., arranging indemnity cover, paying a deposit and rent or relocating to a new city. These expenses can quickly add up and are often taken out before you first paycheck arrives. Having just completed five years at uni, many are not in the best financial situation so this can be extremely daunting.


It is also worth being aware that your first salary is not always straight forward. Pay delays and payroll errors can be relatively common at the start of FY1. While these issues are easily resolved, they can still be stressful especially if you are relying on the income to cover essential costs.


Where possible, it is important to plan for this transition period. It is not always possible to have some extra funds able to act as a buffer but even just being aware that these delays can happen helps reduce some of that uncertainty if you find yourself in this situation.


Relocation Reimbursement: What am I entitled to?


Following UKFPO allocations, many FY1s find themselves relocating as they start work. If you are moving for FY1, you may be eligible for relocation expense reimbursement. These funds can be quite substantial so are definitely worth looking into for some additional financial support. Relocation reimbursement is offered by many foundation schools but is not always clearly advertised. Typically, this funding can contribute towards:


  • Moving costs

  • Travel to your new area

  • Short-term accommodation


However, it is important to be aware that there are usually strict rules about what can be claimed so make sure to contact your foundation school early on. Usually, foundation schools require you to apply yourself and provide receipts for all expenses, so these are important things to keep in mind. These details vary depending on your region but, guidance is often linked through the UKFPO or the individual trusts. For those with financial pressure, this funding can make a meaningful difference but, only if you are proactive and enquire whether it is available and how to access it.


Travel Costs and Claims


Leading on from relocation reimbursement, another area that is often overlooked is excess travel reimbursement. If your commute is longer than a baseline distance or you are travelling for parts of your work, you may be able to claim back for some of those costs.


Unfortunately, the process can feel quite complicated, and as a new FY1 adjusting to the role, it can be easy to deprioritise submitting claims. However, if applicable, it is worth making the most of this entitlement. Setting aside some regular admin time or a monthly reminder can make the process more manageable and help ensure you do not miss out.


Finding Somewhere to Live


Relocating for FY1 often comes with lots of pressure, therefore finding accommodation can easily be deemed one of the more stressful parts of the transition.


Hospital accommodation is sometimes available and can be used as a short-term option, particularly if you are moving to a new area and need time to explore before you jump into a contract. However, availability is often limited and varies between the trusts, so it is important to contact your trust early on if this is something you are considering.


Private renting can involve upfront costs such as deposits and bonds as well as organising a guarantor, all of which can be difficult to arrange at relatively short notice.


Some FY1s choose to arrange temporary accommodation initially, giving themselves some flexibility before committing to a longer contract and costs. Whilst this is not always ideal, it can ease some of the pressure around having to make quick decisions and spending lots of money prior to earning.


Making the Most of Shadowing and Induction


The transition into FY1 is supported by both your final year assistantship and the shadowing period at the start of the role but, it is not always clear how to make the most of these opportunities.


As a requirement set by the GMC, medical students complete an assistantship during their final year. Assistantships are designed to help you prepare by working alongside the clinical team and gradually taking on responsibilities under supervision. Where possible, use this time to build confidence with documentation systems, prescribing, reviewing unwell patients and communicating with different members of the multidisciplinary team.


During shadowing, focus on the practical essentials such as how the ward runs, important phone numbers and how to use local systems. It can also be helpful to gain some exposure to on call or out of hours work to understand how the role differs and when to escalate to a senior. Importantly, this is a supported environment where you are allowed to make mistakes and learn, you are not expected to get everything right.


Induction itself may feel overwhelming and it is normal to not retain everything. It is important to focus on the practical essentials e.g., how to access system, who to contact for certain issues and how to escalate concerns. These areas are the most important. It is important that you are a safe practitioner, the rest will come with time and experience on the job.


Support, Mentorship and Progression


Some hospital trusts offer a “buddy scheme” where FY1s are paired with an FY2, often someone who has previously completed the same rotations. This can be a valuable source of support for both practical advice and career guidance.


If a formal scheme is not available, it is worth seeking out mentorship independently, potentially in your area of interest through organisations such as WPMN or BUSOG. Also, any seniors you meet during your rotations may also be happy to offer guidance. With specialty training becoming increasingly competitive, accessing advice early can be particularly helpful if you are ready to start thinking about your steps following foundation training.


Aim to keep your ePortfolio up to date and link your assessments as you go along to ensure you're prepared for ARCP. It can be useful to perform mini-cexs at the start of each rotation. The seniors are aware that you're new to the department, so they'll try to make time to observe and assess you. You'll be expected to be more independent near the end of your rotation. However, always remember to escalate whenever you're unsure. 


Handy Apps


There are a number of resources available that can make your working life as an FY1 a little easier, particularly when you are getting used to new systems and environments. Many trusts also have their own local apps, for example for hospital directories or bleep systems, so it is important to become familiar with these during your induction and shadowing period.


Below is a list of useful apps/resources to download prior to starting:


A quick reference tool that provides concise guidance on common clinical scenarios. It can be particularly helpful when you need to make safe decisions in a short space of time.

  • MicroGuide

    An antimicrobial prescribing app that provides access to local hospital guidelines. As antibiotic policies vary between trusts, this is especially useful when prescribing or reviewing patients with suspected infections.

  • EOLAS

    A platform that brings together local guidelines, hospital information and educational resources in one place, helping you access key information more efficiently.

  • ToxBase

The UK’s primary clinical toxicology database, providing guidance on the management of overdoses and poisoning. This is commonly used in both emergency and ward-based settings.

  • BNF (British National Formulary)

    A key resource for prescribing that most medical students will already be familiar with. The app allows for quick access on the ward, making it easier to check doses, contraindications, drug interactions and necessary adjustments. It will likely become one of the most frequently used resources during FY1.

  • MDCalc

    A collection of clinical calculators and scoring systems that are commonly used in practice. While many students are already aware of this resource, it becomes increasingly useful when making and documenting clinical decisions, helping to ensure accuracy and consistency.

  • OrthoFlow

    An app designed to help you diagnose and manage orthopaedic trauma with simple and easy to understand information and diagrams. A must-have if you find yourself on a T&O or A&E rotation!

  • BurnsPlastics

    A useful app for assessing and managing burns and plastic surgery presentations, with clear guidance and diagrams. Particularly helpful if you are working in A&E or on a plastics rotation.


Preparing for the Transition


Starting FY1 is a big step and a lot of what makes it challenging isn’t always obvious at first. Alongside the clinical work, there are new systems to get used to, responsibilities to take on and practical things to figure out, It’s worth remembering that you’re not expected to have everything sorted from day one, A lot of it is learnt as you go, and things will become more manageable over time.


The people around you make a big difference. Your fellow FY1s are in the exact same position and will quickly become a key source of support. Putting yourself out there and getting involved in things like the Doctors’ Mess or social events can help you feel less alone in a new setting.


At the same time, try to keep in touch with friends and family outside of Medicine and make sure you’re able to keep up with new and old hobbies. It is especially important that you are able to have bits of downtime.


Overall, FY1 is a year of learning in every sense. You’ve worked hard to get here, and you’re more than capable of being a great doctor! It might feel overwhelming at first, but with time you’ll find your feet, grow in confidence and start to enjoy the role you’ve worked so hard for.



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