Dr Gareth E Hughes, F1 Trainee, Royal Bolton Hospital
Dr Emma Wylie, F1 Trainee, Manchester Royal Infirmary
What does a typical day in the life of an F1 involve?
Emma - Being an F1 in acute medicine at a central teaching hospital generally means that there is no such thing as a 'typical day'. There is a terrific variety from day to day, but I can guarantee there will be some sort of ward round, either with a consultant, registrar, SHO or on occasion by myself. There will be between 25 to 50 patients, admitted with anything from Diabetic Ketoacidosis to stroke, which adds to the challenge and diversity. Ward duties include making notes, ordering and checking investigations, and caring for any especially unwell or unstable patients and attending X-ray meetings, grand round and F1 teaching every week. In addition to these duties I will be on-call once a week, this is most definitely my favourite time, clerking in patients from A&E, and initiating a plan of action, including investigations and initial treatment.
Gareth - Every day in my placement is slightly different depending on whether I'm working in Old Age, Child and Adolescent or Substance Misuse Psychiatry. For instance, on Thursday's I start my day by attending the Substance Misuse ward round where the team reviews patients along with families and other healthcare professionals involved in their care. My role in these reviews is to update my consultant on any new issues that have arisen with the patients on the ward and to enter the ward round notes on the the electronic patient record system. Following this I complete any jobs that arise as a result of the ward round and then have supervision with my consultant where we discuss patients and how I'm finding the placement. Following this it's back to the ward to complete any remaining jobs and then it's on to my administrative tasks, doing discharge summaries or referral letters or audit work.
What is the best thing about being and F1?
Emma - Undoubtedly the best thing about being an F1 is the feeling you are actually part of a team and making a difference to patients' lives. It is a world away from being the unwanted and awkward medical student that I felt I was.
Gareth - I love my job and I think the best part of it is working day to day with patients and seeing the differences you can make in their lives.
What is the worst thing about being an F1?
Emma - When patients die. As a junior doctor you frequently spend a lot of time with patients and at times with their families through their illness. I have not learned to be detached enough for it not to hurt when patients die in spite of everyone's best efforts. I don't know whether that is a good thing or a bad thing.
Gareth - I think the worst thing about being an F1 is that non-medical colleagues sometimes expect you to know everything just because you are a doctor.
What did I learn during the Foundation Programme application process?
Emma - I found the application process a difficult and stressful time. However it taught me to reflect and re-reflect on my experiences and accomplishments throughout medical school. This is now an essential part of being a doctor and of progressing up the ever more competitive career ladder.
Gareth - During the application process for the foundation programme I learnt about how to reflect on my past experiences and make these relevant for my application. This way of thinking has helped me with the reflective practice which is a necessary part of the foundation portfolio.
What issues were important in making decisions about ranking programmes and health economies?
Emma - Given the fact that I am still unsure as to what I would like to specialise in, it was a simple decision. I wanted a large teaching hospital, and a track with both basic medical and surgical rotations, such as A&E, cardiology, general medicine and surgery. My one further preference was obstetrics, a specialty I enjoyed as a student and am considering for a career.
Gareth - The key issues for me in ranking health economies were really location and the tracks offered. I knew that I wanted to stay near to Manchester and based on my experiences as a student I was able to rank the local hospitals in order. The choice of tracks was also very important for me. I wanted a varied job with exposure to as much medicine as possible and there were certain jobs I really wanted to do, namely Paediatrics and A&E. The pay banding for jobs didn't really influence my choice of tracks as these vary year on year and the pay levels one year don't guarantee what you'll end up being paid the next. My advice would be to choose hospitals you've enjoyed working in as a student and if you're not sure look at the choices in tracks to guide your decision.
What surprised me about being a Foundation doctor?
Emma - There were many things that surprised me upon starting my job. My first day was on-call and I felt totally unprepared; I was surprised how sick with nerves you could be upon meeting your first patient. However, what surprised me most was that after just a few hours on my first day, I felt as if I had always been an F1 doctor and from that moment on I have loved almost every second of the job - another surprise.
Gareth - I think I was well prepared for starting my job but I was surprised at how, even with a good induction programme, it did feel like we were being thrown in at the deep end. Having said that, in hindsight this probably was the best way to learn.