A Message To F1s

Suddenly, somehow we’re in the run down to the end of the first placement.

And at this point you’ve come accustomed to how your ward works, you’ve formed bonds with your teams and maybe even your consultants. But now it’s time to move on and remember a whole new set of names and door codes.

If you’re anything like I was, you’ve gotten used to the 9 to 5 grind mixed in with the night shifts and weekends. You’re still feeling tired all the time, but at this point it’s your new norm. You just get on with it.

Now, you don’t shake as visibly when you get called to see a sick patient, and if all else fails, you know taking bloods and giving fluids is nearly always OK.

Maybe you’ve started to have some niggling doubts crop up in those moments when you feel out of your depth. Your thrust head first into a bad situation but somehow you always muddle through.

You can’t remember exactly when in the past few months, your ideas of what it would be like to be a doctor were shattered. The rose tinted glasses have come off and you can see it all a bit more clearly. The disorganisation, the strain, none of it pretty.

Sometimes, you wish someone would tell you how you’re doing. Just a little word of encouragement or recognition, just so you know you’re doing OK. It’s nice to hear. But it can be few and far between. You’ve made it to four months, so well done.

I wrote this for anyone who’s finding the reality a little difficult, who feels constantly overwhelmed by the expectations being placed on them. If you’ve enjoyed your first placement, that’s great. If you haven’t that’s OK too. Either way it’s coming to an end. If you’ve found the last few months difficult, it’s because being a doctor is difficult. Plain and simple.

But it’ll start to feel a little easier.

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The Irony

As part of the two-year foundation programme, I’m based at one hospital site which serves a small town. Anyone who lives in this town and needs hospital care would come to this hospital. However, for the time being, I’m stationed at a GP practice not too far from the hospital.

During one of my morning appointments, I finished typing up the notes of the patient I’d just seen and clicked onto the next patient. How it works is that I have a list of appointments for the day along with the appointment time. When I need to access the patient’s notes, I double-click their name and occasionally a small grey notification box will pop up with some extra information or reminder or some warning. So, when I clicked on the next patient on the list, the helpful grey box popped up letting me know that this was a consultant, who worked at the same hospital I was based at.

To any other normal individual, they would take this information on board and amend their communication style accordingly. I, on the other hand, start to overthink the situation, making it 10 times more complicated than it needs to be.

Two things immediately spring to my mind about why this will be uncomfortable. The first: speaking to another medic. I’ve mentioned a similar situation here. I just find the whole situation weird, whether it’s me that needs to see my GP or when it’s this type of scenario and the dynamic is shifted to me being the one with the responsibility. I can’t help but think of the irony when I’m sat across from someone who has 20 more years of medical experience. It’s like having your head teacher come to you with a math equation they need help with. It’s a different dynamic.

The second conclusion my mind jumps to is the possibility that I might run into this person again, when I eventually get back to the hospital. Very frequently people share deeply personal issues which I try to deal with as sensitively as possible. That comes with the territory but I can compartmentalise it to an extent and leave it at work with the understanding that I’m unlikely to come across that patient outside of GP. However, the stakes are higher when you see someone who works where you work.

Thankfully, it was blood pressure related. I’ve never been so glad for someone to come in with hypertension. I don’t think I had the emotional bandwidth to handle anything more complicated than that.

How did I handle it? I decided to just treat him like a normal patient and not let on that I knew he was a consultant. Might not have been my brightest idea but I went along with it up until the point where he sort of started using medical terms and I just shifted it slightly to accommodate that. I just never asked what he did for work.

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It’s around this time of year that F2s start to really consider what they plan to do after F2. This is also the time in the year when specialty applications are submitted. Those that are lucky enough to have known exactly what they wanted to do since they were 12 don’t have any difficulties with choosing and applying for their specialties. For me, it’s never been that clear.

There were specialties that were a No from the get-go. There were specialties that I felt more drawn to like paediatrics but upon completing a placement I’d realise that they weren’t for me. So, by a process of elimination, I subconsciously and consciously  whittled it down to a few options. A&E being one of the few, which is fortunate as I have this placement coming up.

To be honest, it’s beginning to feel like I’ve been holding out for A&E, like a sort of saving grace. I’m hoping for that eureka moment, the dawning realisation that I’ve found what I want from life, that missing puzzle piece that will sustain me until retirement. Obviously, the clouds will part, allowing a beam of sunshine to hit me like a spotlight. Unfortunately, I don’t think that’s going to happen. I think I’ll do the placement, I may even enjoy certain aspects of it, but eventually the mounting exhaustion of irregular shift patterns, manoeuvring the complicated bureaucracy of the four hour wait plus the incoming strain that winter always seems to surprise us with, will eventually tire me. I might be wrong. I’m just sceptical that any joy will be enough to squash the growing level of doubt and cynicism.

But now I’m at a crossroad and a decision needs to be made. Do I put an application forward or do I sit on my hands, allow the deadline to pass and ultimately choose to not go onto a training programme?  A few people have suggested another option, option C, to put in an application, experience the process and then back out. I’m not keen on that idea.

I doubt I’ll be applying for specialty training as it stands, A&E or otherwise. And though initially that made me feel slightly nervous, attending the ACW 2017 event this past weekend has put me in a different headspace. Speaking to a whole range of medics who were experiencing varying levels of frustration was intense but it was also refreshing to listen to doctors who had created new careers for themselves.

Which makes me feel really hopeful for life after F2. The realisation that if I choose to not apply then I can pretty much do what I want. It sounds a lot like Freedom.

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