Being an FY1 is what this entire website is dedicated to, however, this is a collation of the most salient points. Links are included for dedicated articles in case you want to do further reading. Please comment below with any questions & I'll update this post regularly with answers to your questions!

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Making the most of the shadowing week

It is important that you take this week to learn how to do common tasks regularly. Try to observe and look out for how FY1s structure their day getting involved as heavily as you can. Get involved with as many types of jobs as you can. These should include:
  • Finding and preparing the list
  • Using the bleep system
  • Referring to different specialties (this can vary significantly & finding out how to refer takes a huge amount of your time when you're a junior doctor!)
  • How to order & review investigations (and what investigations teams will expect you to do)
  • How to handover to the evening & weekend teams
  • Pet peeves consultants may have
  • Who & how to call for help
  • Checkout DrToolbox for a guide on your hospital
  • Going to the best food & bars to hang out after work (knowing these places is an easy way to make friends!)

Buy the right equipment (For more detail & links)
  • Essentials: Stethoscope, Pens Powerbank 
  • Non-essentials: Clipboard Box, Oxford Handbook for Foundation, NHS Name stamp

Check your rota
You should receive a generic work schedule which details the rota pattern 8 weeks prior to starting your job. By 6 weeks, you should be told exactly which shifts you'll be working. You should check the rota doesn't breach any safety limits. The BMA has a rota checker for members. Final year medical students get free membership until October. Ensure you exception report if you find yourself working beyond these hours!

Check your pay
Your pay for the year varies between around £28,000-£35,000 before tax depending on how many hours you're working. After tax, that works out approximately £1,700-£2,100 per month.

The exact figure should be in your work schedule (see above) but note this reflects the figure you would earn for the entire year doing that number of on-call shifts & nights rather than the few months you'll be working that job. If you're curious how pay is calculated here's a hypothetical calculation for an FY1. If you want to calculate your actual pay, you can use the junior doctor pay calculator.

For more detailed information check out this post. I also describe how to claim tax relief on GMC, BMA, membership exams and other fees (essentially you get 20% of the cost back).

I'm worried about being a doctor
When you're starting FY1 it is normal to be anxious & feel you won't be able to manage. Your seniors expect this and your SHO should directly support you with every task you need help with. We expect and want you to check in for everything you do, with direct support for every job initially. Therefore please ask us a hundred times if you don't understand the rationale for any job.

Remember that most of your jobs are administrative! If you are good at these we are usually very impressed! If you're worried about using the system, don't fret! There is mandatory training from the trust on this (and as it is mandatory, you should be paid or get time off in lieu for this!).

Ward rounds
  • Try to prepare in advance with a set proforma, but don't come in earlier than your start time!
  • Ensure you document well, ask seniors to give you clear plans, clarifying if you don't hear or know something
  • Always review the drug chart (specifically VTE) & the treatment ceiling (for seniors to decide)
  • Avoid common prescribing errors
Jobs lists
Discharge summaries
  • Prepare the medications early (particularly dosette boxes)
  • Keep it simple with key events, results & investigations
  • Don't copy the clerking or entire scan reports
  • Include discharge advice (e.g. when to seek help or how long to avoid driving)
  • Avoid giving the GP tasks that need to be done within 2 weeks. It can take a week sometimes for the GP to receive a discharge summary
  • Ask for feedback (use it as a CBD for your e-portfolio!)
Managing unwell patients
  • We expect you to escalate almost immediately for every emergency whilst doing the basic ABCDE
  • If you ever consider "Do I need to put a medical emergency call out?" - put it out!
  • Hypoxia, hypotension & Reduced GCS are common

What's your most important advice?
Be nice to everyone!
  • To nurses & your other colleagues, who will go out of their way to help those who are nice. As you will spend most of your time with them, it is important they become your friends so they can be a source of constant support & advice. 
  • To patients & relatives as poor communication is the source of most complaints. Ensure you understand how to deal with complaints & communicate with relatives
  • And to yourself! There's plenty of tips on how to manage on-calls, but being on time, ensuring you don't miss breaks & keeping up with activities, friends and family will ensure a good work-life balance and prevent burnout. If you're struggling, inform your supervisor!
  • Some people will be difficult to work with but remember that bullying is completely unacceptable! Please see advice & support on dealing with difficult colleagues & bullying is completely unacceptable (& how to deal with it). 

What about the next steps? Planning my career?
There's lots of time in FY1 to start working on your career aspirations. Specialties favour those who have prizes, publications, presentations, started membership exams, teaching experience, attended courses (in particularly training for teachers), quality improvement projects & leadership roles. Read more if you're interested.

Written by Dr Akash Doshi CT2