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Going from medical school to junior doctor

Dr. Vicky Donkin gives her firsthand advice on how to handle the pressure – and the paperwork – during this big leap in your medical career.

Nearly a full year before I was due to graduate I was given a list of five questions to answer in 200 words. The questions were designed to help us reflect on the duties of a doctor and our clinical experiences. Most marks are awarded according to how well you fulfil strict criteria, and further marks are added according to rank in the year and other achievements (such as additional degrees or papers published). At the time of submission we were asked to rank the 25 deaneries. A deanery is responsible for postgraduate medical education; there are about 25 in the UK and are important because they determine where you will live and work.

From this a mark out of 100 was generated and I was assigned a deanery. Obviously not everyone gets their first choice and some areas (particularly London) are more competitive than others. You then go on to rank jobs. Currently you rank two years worth of jobs making up foundation year one (F1) and two (F2).

  • F1is your pre-registration year; you are not fully registered as a doctor and must fulfil certain competencies to be granted full registration and become a foundation year two doctor (F2). F1 doctors work in core areas such as medicine and surgery on a rota with other F1s.
  • F2 doctors are generally given more responsibility and work in a wider range of areas than F1 doctors. F2 doctors work on a rota with other SHOs (senior house officers) and with a range of doctors in training including GP trainees and speciality trainees. After F2 doctors go on to apply for speciality training.

Having been through the process as a Sheffield graduate I was given a two week shadowing period in early June after passing my finals. I spent two weeks in Exeter (my new deanery) doing colorectal (bowel) surgery shadowing the F1s currently in the job. There was so much to learn. The big shock was that the majority of the job was administrative rather than practical and academic. I learnt where the blood forms were kept, and how to send bloods I had taken, how to work the pager system, how to edit our inpatient list and when I needed to see our pre-op patients. This really helped prepare me and make me feel confident for August when I would be taking up my new job.

August came quickly and I had a few days more shadowing and time to learn how to work computer systems before starting on the wards. The first few weeks passed and felt like a fairly smooth transition, my senior house officer (a surgeon in training) and the consultants were very supportive.  However I could feel that there had been a shift in responsibility, I was no longer the medical student following behind a ‘real doctor’ and it was up to me to make the decisions and sign the prescriptions.

My first real challenge was a weekend on call. As an F1 while my seniors were in theatre I was responsible for looking after the patients on the wards and all of the new admissions. This is a massive job and with the bleep going off every few minutes with a different job or another patient to prioritise everything I had learnt in medical school had to be put into practice. Organisation and prioritisation were essential. That first weekend was a real shock and I had never been so happy to see the night team as I was by Sunday. Of course, I was back again on Monday as we sometimes work 12 days running.

Things got easier as my experience grew. I can’t say the transition was an easy one for any of us and the shift in responsibility leaves you feeling scared and vulnerable but there are massive bonuses. I felt like a key part of the team, the patients know me as their doctor and the friends I made in those first four months carried on looking out for me for the next 12.

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