My first month as a doctor – Andrew

Andrew Whitehead FY1

Our Junior Doctor Panel are a small group of medical students and junior doctors working in different roles who share their experiences with us and with you via blog-posts and webcasts that we include on our website and social media accounts. In return, we support them with their development. Click here to read more about the panel.

Here is a written reflection by our Panel Member Andrew on his first month working as an FY1 doctor.

Andrew’s reflections

Medical school does an excellent job of causing you to doubt yourself. The root cause of this doubt is a bit of a mystery, but an educated guess would be that it lies in the comparison of yourself to the lofty ideals expected of the profession. These ideals are perpetuated throughout medical school – perhaps even before, when you are sat in your med school interview and your very character, personality and beliefs are scrutinised for suitability to enter the profession. It does not help that topics such as doubt and imposter syndrome are typically given only a cursory glance (perhaps relegated to a lecture on wellness that has been shoehorned somewhere into the curriculum). In medicine, one might argue that a degree of doubt is not only healthy but recommended: it encourages doctors to act safely, to seek advice when needed, and to escalate early. But, at what point does this doubt verge on neediness, inconveniencing others, or downright incompetence? Medical school does not prepare you sufficiently to answer this question, so for much of it I assumed that you would only discover the answer when you are finally introducing yourself to patients as doctor and taking responsibility for them.

This notion of independence was on my mind almost daily during my first few weeks as a doctor. Everything felt new: from navigating the many counterintuitive IT systems to locating the most basic pieces of equipment in the ward store cupboard (and enduring the subsequent embarrassment when someone has to show you how to find what you were looking for and it was in front of you the whole time). I didn’t keep count of the number of questions I asked each day, but it felt like the number could have been in the hundreds. (This also includes needing to ask the same questions multiple times, as my headspace was often at peak saturation and retaining even the simplest of information was sometimes a challenge.) Despite this, I felt like time was always found to help me; even when other doctors, nurses and other staff were busy, they would talk me through my queries and offer advice and tips. Nevertheless, there were also times when I had to force myself to ask for help, as the lurking self-doubt and all-too-familiar feeling of imposter syndrome could have convinced me to suffer in silence instead. However, in these moments, I found it useful to ask myself: “Who benefits from not asking for help?” The answer would always be no-one, so reframing the need to ask questions as choosing to become a responsible member of the team was my way forward.

Thankfully, the 4-6 years of medical school learning does kick in at some point! Even though it’s not always at the forefront of your mind, I’ve found that important knowledge and skills often reveal themselves when you need them to: this can be as simple as knowing how to draw blood from the trickiest of veins to more ‘cerebral’ skills such as interpreting results and understanding the significance of abnormal findings. Even when you aren’t quite sure about what you need to do next, or you are struggling to summon this knowledge from the deepest recesses of your memory, half the battle is identifying the abnormal and coming to a decision about what you need to do with this information. After a month of work, I can now appreciate an analogy that I heard during a talk to mentally prepare incoming doctors for the job…

Being a doctor is like fixing a broken printer: the F1 can identify that the printer isn’t working; the core trainee can tell you that it’s a printer jam; the registrar can fix the paper jam; however, only the consultant can get a new printer.

This isn’t 100% accurate, as I have occasionally found myself – as an F1 doctor – having to fix literal broken printers. (You soon come to the realisation that it’s often quicker to figure it out for yourself than waiting for IT to save you.) Despite this, the analogy rings true for much of medicine. Although there are times when I can’t figure out what’s going on with a patient, I’ve realised that you can still be valuable to the rest of the team by understanding the patient well, providing a high-quality patient summary (good ol’ SBAR), and taking the initiative to request tests/imaging and start some basic management.

With all of that said, I’ve put together some advice and tips that will hopefully come in handy during your first month as a doctor. Good luck!

  • Leave the ego at the door. Be prepared to feel lost, dependent, and even dumb at times; the only cure is to ask plenty of questions!
  • Be prepared for some degree of exhaustion. Learning so much in such a short amount of time is both mentally and physically taxing; it’s normal to go home feeling drained and like you don’t have energy to do anything. Be patient with yourself during this time: eat healthy yet comforting food and relax in your downtime – don’t plan anything too ambitious during your first month!
  • The majority of your problems will be procedural, not medical. Figuring out where X is, how to order Y, who you need to speak to about Z etc. will take up much of your working day. Your other F1 colleagues will be amazingly helpful as they may have already worked through the same issues and can save you the time. (You can even bond over your shared confusion at some of the workplace’s absurdities!)
  • Your phone is your closest ally (literally). Use your notes app to record tips you get from staff, door codes, IT logins, photos of useful policies and so on. Soon enough, it will be your turn to induct the next batch of F1s, so think of this as forward planning!