Moving on from medical school

On my first day I remember feeling a mixture of excitement and fear! I felt proud to be a doctor but scared that suddenly I had so much responsibility. The strangest thing was when a nurse said ‘doctor’ and I looked to see who she was talking to before realising it was me. Nothing can really prepare you for the change between medical school and your first position as a junior doctor because it is such a life-changing experience – your working hours change, you will be on call and most importantly you have a great deal more responsibility. However, there are ways to help you cope with the transition and get the most out of your first year in the job.

Battling those first day nerves

Before I started, I shadowed the person doing my job before me, which really helped me find my bearings on the first day. It made things less daunting as I knew where I was going and who the members of my team were. Shadowing schemes are usually arranged for you but you may have to arrange your own if you go outside your deanery. Making sure you know the basics will make your first day a less scary prospect. You should also think about how you are going to approach a patient so that when the time comes it doesn’t panic you. 

The best way I found to feel confident was to step out with a smile – if you look as if you’re enjoying your job and that you’re happy, it puts the patients at ease. I also introduce myself by my first name to make them feel more comfortable. If you don’t know the answer to one of their questions, be honest and tell them you’ll find out rather than giving them a half-baked answer. Don’t make promises you can’t stick to or you will undermine your position. If you say you’ll come back and see them then make sure you do. 

Don’t worry if you feel out of your depth – just make sure you let someone in your team know so that they can help you. Your team induction will introduce you to the people you will mainly be working with. It will also give you the chance to ask more practical questions such as where you can get coffee, where the toilets are and where the canteen is. Team inductions are vital for getting to know your colleagues and it’ll make things less daunting as you realise how friendly everyone is and that they were in your shoes once too. Hospital inductions are compulsory and inform you about how to make requests, where to go to get things reported and employment-related issues such as joining the pension scheme.

Tips for on-call shifts and working nights

The idea of the first ‘on call’ strikes fear into most medical students but knowing the protocol will help you get through it. In preparation for it, work out what your responsibilities are and which seniors are on that day. The main thing is to get the basics right and your technique will improve with every patient. When working nights, be organised as time can run away very quickly. You will have to take calls from wards who would not normally phone you during the day. Before leaving a ward, let the nurses know where you are going to be and if there’s anything they want you to do before you go. Tackle tasks as they arise because if you put them off you won’t have time for them.

Striking a balance

It’s really important to have interests outside of work but you have to be realistic. You won’t have time to do all the things you did as a student so choose one or two things to do in your spare time. My main sport is netball so I looked for a team in the area before I moved. If you don’t have the opportunity to do your research before moving to a new area then ask your colleagues once you start what’s available, for example which local gyms offer NHS discounts or even where the nearest 24-hour supermarket is. Don’t get involved with too much to start with – it’s best to focus on your training at the beginning and re-introduce your outside interests later on, as sleep comes top of the priority list when you’re getting used to life as a junior doctor.

Building support networks

This job is like no other and you will be affected in ways you didn’t expect. Every interaction with a patient will affect you in some way and coping with the death of a patient can be the hardest thing. The best way to get through this is with the help of your friends and your team. Although some people wouldn’t recommend it, it’s vital when you start out to have someone you can talk to outside of work about your job – maybe even a friend who is a doctor – so you can analyse the way you handle situations and support each other. You will have a clinical support tutor and educational support tutor, whom you can go to with personal or professional issues. The college supervisor in your department can give you pastoral support too if needed. If you have supportive family members and friends from non-medical backgrounds make sure you remember to just talk about ‘normal’ things with them.

The junior doctor’s basic toolkit

Some useful things to carry with you are:

• a pen – without it you will be unable to do your job
• a stethoscope
• an Oxford handbook of your choice.

Other than these essentials, do not carry too much as you should be able to find anything else you need. 

Emma Bryden is a foundation year one doctor (F1) in vascular surgery at the Royal Berkshire Hospital in Reading.