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Prescribing IV Fluids

There are certain situations where you need to prescribe IV fluids which vary from fluid resuscitation to maintenance fluids if

ABG Interpretation

In this article, we will look at more practical aspects of how to read an ABG and treatment following your

Passing the Prescribing Safety Assessment (PSA)

The PSA is aimed at final year medical students and those graduating overseas to assess their competency at prescribing as

Applying to Anaesthetics

Anaesthetics is a very hands-on specialty. Day-to-day work will have a mix of practical procedures and other clinical work such

Applying to Radiology

Radiology is a very exciting and innovative field of medicine. Radiologists have such an important role in the investigation of

Abdominal X-rays

The advantages of AXRs are far less radiation to patients & that they’re logistically easy to organise out of hours.

On Call Tips

FY1s are usually most apprehensive about being on call, but it is also the shift you will usually learn the

Fluid Balance

Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this,

Surviving Ward Rounds

It takes time to get used to the ward round. Particularly, when patients are being seen so fast it seems

ePortfolio

Your eportfolio is a tool to store and record evidence that demonstrates your progress, clinical competencies and reflections. Try to

Reduced GCS

As a doctor, you will frequently be called for a drowsy patient. They can vary from confused to completely unconscious.

Ranking Foundation Jobs

If you’re worried about not getting your top choice, you shouldn’t worry. It doesn’t affect your future career and wherever

Leave

As an FY1 doctor, there are different types of leave you will come across during the year and the rest

Junior Doctor Pay Calculator

We’ve created a junior doctor pay calculator to help you better understand your salary, tax, student loans and NHS pensions.

Referral Cheat Sheet

Our referral cheat sheet is our most popular resource having been downloaded thousands of times! It has key information to

Audits & Quality Improvement Projects (QIPs)

Audits & QIPs are a way to identify issues, drive changes and assess the effects they have. It is your

Coronavirus and your wellbeing

Covid-19 is taking a huge emotional toll on everyone. The usual work-life balance tips don’t work as well when you can’t go

Leadership

Although it can be scary to take on a leadership role, it is an essential role of junior doctors and

Coping with illness

ContentsImportant things to rememberOccupational healthThe legal stuffFurther reading Important things to remember You will get sick. That is life. You’re

Paediatric Chest Pain

Most of the time, chest pain in children originates from a benign cause. However, paediatric chest pain can be a

Postnatal Patients

The management and review of postnatal women are usually straightforward. There are a few points specific to postnatal women that

Paediatrics: Prescribing

As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like

Psychotropic medication

Psychotropic medication includes some of the most commonly prescribed medication in the the world. This article will cover the types

Common Dental Issues

A very quick guide to common issues prompting referrals to maxillofacial surgery (aka MaxFax and OMFS) This is a surgical

Anxiety disorders

Anxiety is a commonly experienced symptom as part of the body’s reaction to stress. It becomes a mental health disorder

PEG Tubes

PEG tubes are used as long term feeding options (and medication administration) for those in whom NG tubes are unsuitable

Applying to Rehabilitation Medicine

Rehabilitation medicine is a holistic specialty in which you spend a great deal of time with patients. There are many

Paediatrics: Communication & Consent

As an FY1 you will likely manage paediatric patients during their admission, often in other specialties like general surgery. Difficult

Communicating with Relatives

We commonly find ourselves needing to communicate with the next of kin & relatives. In this article, we cover the

Savings Accounts

In this article, I will be discussing the different types of savings accounts and key points about each. For more

Thyroid Disease

As a junior, you will frequently see patients who potentially have thyroid dysfunction. The problem is these patients often present

Diarrhoea

Diarrhoea is a very common complaint and may be the reason for a patient’s admission, or develop as a new

Arthralgia

There are three joint pain calls you might receive whilst you’re on call or on the wards. We have split

Performing Arterial Blood Gases (ABGs)

Thanks to Geeky Medics for an excellent video demonstration Equipment Gloves Alcohol wipe Cotton wool/ gauze ABG syringe (ensure it

Mood (affective) disorders

In this article, we cover depressive disorders, bipolar affective disorder and schizoaffective disorder with an overview of the epidemiology, diagnostic

Consenting Children and Adolescents

The rules on consenting children and adolescents can seem a complex business. Putting the theory learned in medical school into

Morbidity & Mortality Meetings

M&M meetings discuss the outcomes of patients and mortality rates, with the view to improving clinical care, quality control and

Chronic Pancreatitis

Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads to the destruction of pancreatic tissue leading to irreversible loss

Sharps Injuries

Sharps injuries happen when you least expect them. You can’t always prevent them but you can do a lot to

Benign Anorectal Pathology

In this article, we cover common benign anorectal pathologies including haemorrhoids, fissures & fistulas with a quick overview of their

Risk assessment

Determining the risk of harm to the patient, and sometimes to others, is an essential part of a psychiatric assessment.

Superior Vena Cava Syndrome

SVC syndrome is an oncological emergency. There is obstruction of the superior vena cava resulting in stagnating blood and a

Vertigo

Vertigo is described as an “abnormal sensation of motion. It can occur in the absence of motion or when motion

Medical Podcasts that are worth a listen!

We asked on social media what your favourite podcasts were & these were rated the most popular. Comment below if

Overview of eye drops

Medicines reconciliation is the process of accurately listing a person’s medicines. This often takes place when they’re admitted into a

Dialysis Patients

There is an increasing prevalence of end-stage kidney disease and it is therefore likely that you will be involved in

Gynaecology Assessment & Common Disorders

As gynaecology issues uncommonly present on the ward, many doctors have difficulties with the standard framework for addressing these issues.

Hypophosphataemia

The UK Medicines Information group have provided excellent guidance on how to replace phosphate.

Sudden Visual Loss

Loss of vision can be a scary symptom for patients to experience, and a scary presentation for doctors to manage!

Diplopia

Diplopia, also known as double vision, happens when there is a mismatch in images produced by the two eyes; hence

Nutrition

Nutrition is an important aspect of a patient’s health and is overlooked during medical school as you are learning exciting

Hypomagnesaemia

The UK Medicines Information group have provided excellent guidance on how to replace magnesium.

Hypocalcaemia

Acute hypocalcaemia that is severe (<1.9 mmol/L) or symptomatic can be life-threatening and necessitates urgent treatment. It is often initially

Acutely Swollen Joint

There are three joint pain calls you might receive whilst you’re on call or on the wards. We have split

Working Less Than Full Time

ContentsWorking LTFT in FY1/FY2Eligibility for LTFT trainingCategory 1: Trainees with health conditions and caring responsibilitiesCategory 2: Trainees with unique opportunities

Notifiable Diseases

As a junior doctor, it is your statutory duty as a medical professional to alert the local public health team

Credit Cards

This article will cover the different types of credit cards, the main things to look out for, and the reasons

Eye History & Exam

This is intended for junior doctors on the ward or in ED, covering how to approach the eye history &

Diverticular Disease

Diverticulae can occur throughout the gastrointestinal tract but are more common in the sigmoid & descending colon. Whilst frequently found,

Metastatic Spinal Cord Compression

Spinal cord compression occurs when there is compression of the spinal cord or cauda equina at any level secondary to

Venepuncture

Equipment Gloves Hand sanitiser Alcohol wipe Tourniquet Cotton wool/ gauze Needle Syringe or vacutainer Blood bottles Specimen bag Plaster or

Interpreting CSF Results

Understanding how to do an LP and interpret the results is an essential skill for most doctors, particularly those planning

Abdominal Pain

When you are on call, you will often get a bleep about a patient with abdominal pain. Abdominal pain can

Self Harm

The most common place you will see a patient who has self-harmed is in ED, where they have been referred

CNS Infections

A CNS infection is one that involves the central nervous system in some way. This includes the meninges, cerebellum, ventricular

Applying to Oral and Maxillofacial Surgery (OMFS)

Oral and Maxillofacial Surgery is a mouthful (no pun intended), but you may have heard of it referred to as

Transfusion

In this article, we will go through the three most common scenarios you will encounter. These are: (1) Does this

Dealing with a complaint

Everyone will receive a complaint – this is inevitable. Usually, these are informal, “I’m unhappy with the care delivered” from

Introduction to Dental Traumatology for A&E

This article aims to give basic information on the assessment of dental trauma to enable the reader to both recognise

Suturing

Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In

Urinary Tract Infections

Urinary tract infections (UTIs) in adults are extremely common in both primary and secondary care and it is inevitable that

Bowel Obstruction

Bowel obstruction is a common reason for admission or complication of patients under the surgical team, but doctors don’t frequently

Appendicitis is a one of the most common abdominal emergencies worldwide. Your aim is to be able to diagnose it, distinguish between simple and complex cases and optimise medical management whilst your seniors decide on the timing of surgery.

Mental Capacity

Mental Capacity is the ability to make your own decisions at the time at which the decision needs to be

Clinical recordings and the Correct Consent

In all specialities of medicine patient clinical recordings, whether this is photographs or visual investigations, are imperative1. Not only are

Fever in the Returning Traveller

COVID-19 aside, international travel is easier and more prevalent than ever before, and illness associated with travel is common. Although

Stomas

The word stoma comes from Greek to mean “an opening”. There are many types which are formed for a variety

Managing patients with CKD

In whichever specialty you work, you will encounter large numbers of patients with chronic kidney disease and this will impact

Groin Lumps

The groin, also known as the inguinal region, extends from the anterior superior iliac spine (ASIS) anterolaterally, the thigh inferiorly and the pubic tubercle medially. It is an anatomical region vulnerable to surgical pathology due to a weakening of the abdominal wall occurring during embryology.

Anaphylaxis

Anaphylaxis is a serious, life-threatening allergic reaction. Features include airway compromise, breathing or circulation difficulties and skin changes. Skin changes

Difficult Airway Patients

As a doctor, you may come across patients with complex airways. They should be found on dedicated wards such as

Applying to Geriatric Medicine

Within Geriatric Medicine you are always working as part of a multidisciplinary team and have lots of close interactions with other allied health professionals. In my experience, this means plenty of opportunity for discussion and shared decision making with colleagues, as well as being able to gain knowledge and learn from others’ expertise. This also creates a very supportive environment to work in.

Headache

Acute headache is a common complaint that you’ll see whilst on the wards or in the acute take. Although most

Deep Vein Thrombosis

A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms within a deep vein and

Applying to General Practice

GP training is one of the most popular pathways. In this article, we discuss how to build your portfolio, the

Paediatrics: Clerking & Discharge tips

As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like

Pancreatitis

Pancreatitis is a condition characterised by the inflammation of the pancreas. These patients are usually managed conservatively. Your aim is

Hypernatraemia

Hypernatraemia is defined as a sodium above 145 mmol/L with severe being more than 150 mmol/L.

The Credit Score

In this article, we talk about what the credit score means, how it affects you & tips on how you

Kidney Stones

Given how frequently patients present with renal colic, it is helpful for FY1s to understand the basic management. Specifically, this

Current Accounts

This article summarises some key tips and tricks on how to get the most out of your current accounts. For

Safeguarding History – The Basics

Children are vulnerable. Unfortunately, child abuse does happen, and it has a significant and lifelong impact. You may be one

Cannulation

Demonstration video thanks to Geeky Medics Equipment Gloves Hand sanitiser Tourniquet Appropriate size cannula Alcohol swab Gauze Syringe 0.9% sodium

Infective Endocarditis

Infective endocarditis (IE) is relatively rare in the UK. However, delays in diagnosis and treatment can lead to serious complications,

Refeeding Syndrome

Defined as a collection of electrolyte abnormalities associated with a massive intracellular shift of electrolytes. Associated with aggressive nutritional rehabilitation

Careers Advice

FY1 is a great opportunity to explore new specialties and start to gain an idea of what working in them

Hypothermia

Hypothermia, whilst an infrequently encountered issue during foundation, is a high-risk condition with a need for investigation and often rapid

Consumer Loans

It’s important for healthcare professionals to have an understanding of the different loans which are available – to help them

Opiate Withdrawal

As doctors, you will frequently see patients with opiate dependence. It isn’t uncommon for these patients to be admitted due

Urinary Catheterisation

In this article, we discuss when a catheter might be needed and top tips on male & female catheterisation. Before

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory disorder of the gastrointestinal (GI) tract, which may be

Neutropenic Sepsis

Please read an overview of the management of sepsis before reading this article. Neutropenic sepsis is defined as a temperature

Lumbar Puncture

A lumbar puncture uses a fine needle inserted between the vertebrae in the lower back to take samples of CSF

Clinical Coding

If you’ve ever wondered how hospitals generate income from the work you do – the answer is clinical coding. In

Microbiology Discussions

A lot of your time as an FY1 will be spent on the phone to various other specialities. You’ll come

Choosing your Future Career

What does your future hold? Have you thought of a specialty that you want to pursue? This article discusses the

Discussing Treatment Escalation & DNAR

As an FY1 you should not be expected to make decisions regarding treatment escalation and DNAR, but you may need

How to take a psychiatric history

Psychiatry, as a specialty is unique in that diagnostic methods, rely very heavily on symptomatology, therefore assessment has to be

Acute Asthma

You are unlikely to be expected to make decisions about long term asthma management, therefore focus your efforts on learning

Red Eye

Red eye is one of the most common eye presentations you will encounter. Whilst many will likely be referred to

ENT Emergencies

In this article, we cover the main ENT situations you are likely to encounter either in A&E, during an ENT

Colorectal Cancer and Polyps

Colorectal cancer is one of the most common cancer types seen in the western world. They are adenocarcinomas arising from adenomatous polyps in the colon and rectum, with a majority seen on the left side of the colon.

Gallstone Disease

Patients regularly present under the surgical take with gall stone disease. The aim of this article is to supplement the

Nausea & Vomiting

You will frequently get calls regarding nausea & vomiting: many patients present with it or develop it because of their

Bullying and Undermining – Changing Culture

Welcome to FY1. In your first few months, you will find your learning curve is steep and you may feel

Vaginal Bleeding

One of the most common obstetric/gynaecological presentations in a hospital/GP setting is vaginal bleeding. When women present with per vaginal

Parkinson’s Disease

In this article, we will present several common scenarios involving Parkinson’s disease (PD) that you might face on the ward

Applying to Occupational Medicine

Occupation medicine is a fantastic specialty and one with a huge variety of opportunities. In this article, we discuss this

Hypercalcaemia

Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia is a life-threatening electrolyte emergency requiring prompt recognition and urgent

HIV

Human Immunodeficiency Virus (HIV) is a species of lentivirus that can infect humans and subsequently causes Acquired Immunodeficiency Syndrome (AIDS).

Sore Throat

One of the most common A&E presentations is a sore throat, and while sore throat seems like a pretty straightforward

Dementia

As an FY1 in hospital, you will come across lots of patients with dementia. They often have multiple problems requiring

Frailty Syndromes

What is frailty? In simple terms, frail patients lack physiological reserves, and it takes more for them to bounce back

Dealing with difficult colleagues

This is a tricky area to cover as it can be challenging to us both personally and professionally when things

NHS Pension Scheme (2015)

This article is supplementary to the webinar on the same subject, which you might find extremely useful as we were

Sickle Cell Disease

Sickle cell diseases are a disorder of haemoglobin affecting red blood cells. This autosomal recessive, single gene defect results in

Psychosis

Psychosis refers to patients suffering a loss of contact with reality. It affects 3 out of 100 people in their

Opiate overdose & toxicity

You will likely encounter an opiate overdose due to the prevalence of opiates for recreational use, in those who have

DKA and HHS

You’ve found a patient is hyperglycaemic & either they are ketotic or have significant hyperglycaemia (>30mmol/L) and so you suspect DKA or

Back Pain

In this article, we cover the assessment and management of back pain. This article forms part of a series on

Common Skin Issues

Dermatology is a vast topic that junior doctors often find daunting. Do read our article on describing skin lesions. Fortunately,

PR Bleeding

The first thing when called is to identify whether the bleeding is truly a lower GI bleed or whether it

Alcohol Withdrawal

Suddenly stopping alcohol intake in patients who have been drinking heavily for prolonged periods is dangerous and can lead to

Palliative Care

Dying is a natural process and unfortunately, something that we all come across in our daily jobs, including whilst on

Describing Skin Lesions

It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues or to refer

Chest X-Rays

In this article, we focus on the interpretation of a CXR. Have a low threshold to request one as they

Management of the Aggressive Patient

At times as a junior doctor, you will be faced with the management of patients displaying aggression. There are many

Hypoglycaemia

In this article, we provide a quick overview of how to treat and investigate the cause of patients with hypoglycaemia.

Epistaxis

Epistaxis is a common presentation, especially amongst the young and elderly population. Knowing the basic management, red flags, and when

Referrals

Often one of the scariest things you can do as you will most likely be speaking to a more senior

Hypertension in Hospital

As a junior doctor, you will often be called about patients with raised blood pressure (BP) in secondary care. This

Palpitations

Palpitations can be described as the sensation of an abnormally received heartbeat. It can be rapid, irregular, forceful or just

Pulmonary embolism

A pulmonary embolism (PE) is a blocked blood vessel in your lungs, most often due to a blood clot. It

Gynaecological Examination

If the thought of conducting an intimate examination or attempting to wield (without any embarrassing pitfalls) the contraption that is

Jaundice & Deranged LFTs

As the FY1, you will see patients with liver dysfunction either on the take or deranged LFTs when you are

Upper GI bleed

These patients have the potential to become haemodynamically unstable extremely quickly; try to avoid delays in reviewing them. In-hospital mortality

Death Certification

After a patient has died you may be asked to complete the death certificate. It may be issued by a

Hypokalaemia

As an FY1 you will frequently see hypokalaemia and most trusts have guidelines that should be used in the first

PICC Lines and Midlines

You may well be asked to take blood from a PICC line or be called to see a patient because

Haematuria

You will regularly see patients with blood in their urine, most often picked up incidentally on a urine drip. Your

Breaking Bad News

As a junior doctor, you will have face situations where you have to convey potentially distressing information, whether it is

10 Gifts for your Colleagues

As we all rotate so frequently between departments, many of us like to get our seniors or juniors something nice

Compartment Syndrome

Acute Compartment Syndrome is one of the few orthopaedic emergencies. If missed, it can lead to severe and life-changing consequences

Mental State Examination

The mental state examination (MSE) is an observational assessment of a patient’s appearance, behaviours and cognitive state. It has seven

Orthogeriatrics

Fragility fractures in the elderly As a junior doctor on call, in geriatrics or in orthopaedics – you will frequently

Student Loans – should you repay early?

Student loans are a Government-run scheme in the UK and the most recent plan (Plan 2) has resulted in higher

Paediatrics: Venepuncture & Cannulation

This article will discuss how to take blood and cannulate patients in the paediatric setting.

Hyperkalaemia

Hyperkalaemia can cause life-threatening emergencies particularly cardiac arrhythmias. A widely used definition is extracellular [K+] ion concentration ≥ 5.5 mmol/L.

Work-Life Balance

Work-life balance is a topic that has become increasingly prevalent over the past decade with positive changes being made to

Syncope

From the Greek: Syn: together & kopein: to cut – referring to a block in blood supply from the body to the brain, most often due a drop in systemic blood pressure. It is defined as (1) temporary and transient (2) a form of loss of consciousness…

Pulmonary Oedema

RCEM has published some clear and comprehensive information which is well worth a read. Below we include a very quick summary

Understanding Types of Homes

Patients may live or be discharged to a wide variety of social care settings and understanding these is important for

Sections of the Mental Health Act 1983/2007

What is the MHA? It is legislation that governs patients’ Compulsory detention Treatment Discharge Aftercare It can be used to

Acute Stroke

Whilst on call or in A&E you may be asked to assess somebody who is suspected to have had a

Nasogastric Tubes

NG tubes are passed from the nose to the stomach. Depending on the material, they can stay between 2 to

Sepsis

Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a patient with sepsis is hypotensive despite

Anaemia

Perhaps the most common blood test you will review daily will be the FBC (full blood count). You will commonly

Acute COPD exacerbation

As an FY1, you are unlikely to be expected to make decisions about long term COPD management therefore focus your

Pneumonia

In this article, we will focus on more practical concerns when managing a patient with pneumonia for junior doctors. Covid-19

Constipation

Constipation is one of the most common complaints in hospital, especially on the geriatric wards.Failure to treat constipation can lead

Mortgages for Doctors and NHS Professionals

Getting onto the property ladder is becoming increasingly difficult for first-time buyers due to the difficulty in saving for the

Heart Failure

Heart Failure is not a diagnosis in itself, rather a collection of symptoms that require investigation to find the underlying

Non-Invasive Ventilation

Non-invasive ventilation is a way of providing ventilatory support to patients in respiratory failure without using an invasive airway device

Death Verification

As a new F1 in August, it can feel like quite a daunting task to verify a death, particularly if

Diabetic Foot Ulcers

Introduction: Diabetic foot ulcerations are a significant complication of diabetes and often precede minor (below the ankle) or major (above or below the knee) amputation. At least 2% of people with diabetes experience new foot ulcers annually, and of these, one in 400 undergoes amputation (Kerr, M. 2019)

Preparing for FY1

It is common for FY1s to feel anxious & feel like they’re not ready to start. We expect you to

Anticoagulation

For new doctors, prescribing anticoagulants can be daunting. A few simple rules can make this easier. Ensure you use your

Hypotension

Expect many bleeps about hypotension from concerned nursing staff. It is a useful way to flag up which patients might

Paracetamol Overdose

As an FY1, you will encounter these either during clerking shifts or you may look after them on the ward.

Applying to Paediatrics

On the one hand, you wear a Disney lanyard, with a pocket stuffed with stickers, on the other, you are

Prioritising Jobs

I’m going to try and be as generic as possible so that hopefully these tips work across different specialities and

Reviewing and Requesting Bloods

Here we focus on blood tests requests for a variety of common scenarios you might see in practice and also

Applying to Core Surgical Training (CST)

Surgical training has a variety of work to get involved in as well as having many sub-specialties within it. The

Delirium

Acute confusion, otherwise known as delirium, is very common in hospitals: 20-30% on medical wards, and between 10-50% of those

Pneumothorax

A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e.

Discharge letters: hints & tips

Writing a discharge summary is a task you are likely to carry out every day, and despite the sense of

Seizures

Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic ward who is

Handover

Handover occurs between shifts to ensure everyone is up to speed with patients. The exact nature of how it occurs

Medications in Diabetes

In this article, we’ll cover the treatments used in Diabetes Mellitus. We’ll look at key things you need to know

Urinary Retention

Urinary retention can be acute or chronic. When acute it occurs within a number of hours causing significant pain. In

Acute Kidney Injury

AKI is very common affecting around 20% of inpatients & it is important to recognise promptly and correctly to avoid

Common Prescribing Errors

When I supervise and teach FY1s, prescribing is in the top three things they are most concerned about. Usually, they’re

Interpreting Blood Films

A blood film looks at our three cell types (erythrocytes, leukocytes & platelets) under a microscope to identify any abnormalities

Self-discharge

Frequently patients wish to self-discharge from hospitals. This article pertains to adult patients only (18y+) and these patients can be

Applying to Ophthalmology

Ophthalmology provides a great deal of variety by combining medicine, surgery & A&E. It is predominantly an outpatient specialty with

Junior Doctor Contract explained

In the UK, there are different contracts for each of the different regions: Northern Ireland, Scotland, England & Wales. For

Applying to Obstetrics and Gynaecology

In this article, we discuss why you should apply to O&G training, how to build your portfolio & we detail the application process. O&G is a 7 year run-through programme, incorporating a core curriculum with ultrasound training & there are plenty of opportunities to subspecialise.