Edward Hyde
Name : Edward Hyde
Employer : Gloucestershire Royal Hospital
University : University of Bristol
Subject : MB ChB
Graduated : 2004
I was on the Bristol University matching scheme for my pre-registration house officer (PRHO) job. Having heard about the foundation programme, I was keen to be a part of it because I felt Gloucester had clearly put a lot of effort into analysing what a doctor needs during their PRHO year. It sounded very exciting to be at the cutting edge of medical education.
Finding support
Support has come from a variety of sources. We have an educational supervisor, the first consultant we work for, who is responsible for us for the whole year and is always there for any problems or worries we have, be they clinical or otherwise. We also have a clinical supervisor, who is one of the consultants we work for on each of the rotations and is responsible for us for the three months we are with them. There is also an F1–F2 buddy system. Each F1 is assigned an F2 who they can informally have as a friend, contact or drinking partner. This provides a point of contact for worries and questions that might seem too silly or insignificant to bother anyone else with. There are also separate F1 and F2 leads, both consultants, and a foundation programme director.
Progress monitoring
My progress has been formally reviewed twice every rotation, at the start by the clinical supervisor and at the end, more extensively, by the educational supervisor. The F1 lead and foundation director have both frequently informally checked up on us too, as well as our F2 buddies – mostly in the pub!
The advantages and the challenges
The foundation programme is generally a brilliant step forward in postgraduate medical education. It provides an improved educational content with an increased variety of jobs, which leads to more experience in different areas of medicine. The main problems at Gloucester have arisen from the F1 being a pilot, so there have been teething problems. Despite all the publicity in the medical press, still not enough doctors understand the foundation programme and most other healthcare professionals still do not have a clue about it at all!
The biggest challenge I have faced during the F1 year has been making the transition from medical student to autonomous medical practitioner: learning to problem solve; staying sane when your bleep just won’t stop; and learning the art of being efficient in potentially one of the least efficient workplaces imaginable! I got through it by talking through problems with friends and colleagues, especially the other F1s and by learning when to call on seniors for help. However, sometimes there is no one else about and I’ve simply had to get on with the job in hand.
My next step
My long-term career plan is to be an obstetrician, but the F1 year has inspired in me a love of medicine, so I am going to do the F2 year to get more general medical experience, which is something that I hadn’t expected at all.
My working week
The working week has been different on the different rotations: Medicine was 9.00 am to 5.00 pm, with no take (there is an elective/emergency split at Gloucester with a separate acute admissions unit) with roughly one evening a week spent on ward cover from 5.00 pm to 9.00 pm. One in every three and a half weekends was spent working, either on ward cover or in the admissions unit, from 9.00 am to 9.00 pm. There were no nights!
The acute admissions unit (AAU) involved clerking and reviewing the medical admissions to the hospital, on either an early (8.00 am to 4.00 pm), day (9.00 am to 5.00 pm) or late (1.00 pm to 9.00 pm) shift, with nights every two weeks in runs of three to five nights, at an F1 level doing either medical or surgical ward cover. Weekends were covered by the medical on-call team.
Surgery involved 8.00 am to 5.00 pm days (though these frequently ran much later!). We did a week of take at a time, from 8.00 am to 9.00 pm, once every five weeks. Finally, general practice involved 9.00 am to 6.00 pm days, but were at a much slower pace. I started off sitting in with the GPs and was gradually given my own patients to see – though there was always a GP close at hand to help!
The European working time directive (EWTD) has impacted the job. The shift pattern on AAU was partially due to having to compress all our nights into a short period so that on average we didn’t work too many hours. We frequently had hours monitoring and got the trust to up-band the surgical rotation.
My unforgettable experience
The most unforgettable experience for me so far was watching a patient die slowly over a course of three months. She was almost exactly my father’s age and one of the loveliest people I have ever met. Watching her slowly deteriorate was awful, yet she was a total inspiration because every day she had a smile on her face for everyone, despite knowing that the end was not very far away.