As I come to the end of FY2, I’ve been thinking a lot about my experiences over the last the two years since I qualified as a doctor & what (hopefully, helpful and honest) advice I’d give to brand new medics on the cusp of a career in the NHS. Here’s what I’ve learned:
1. Being a doctor is the best job in the world. Some days it will feel like the worst, but 95% of the time it’s the best and most rewarding career. I adore the NHS. Be proud of yourself, you’ve worked damn hard to get here.
2. Remembering to say “thank you” on a busy ward at 2pm can earn you a cup of tea at 4am. A sincere “thank you” with eye contact might even get you a cup of tea *and* some magical NHS biscuits on your night shift (the holy grail is NHS toast). Nurses are all-seeing superheroes.
3. You won’t believe what you have to do with your hands. Some days I get home and look at my fingers and just think “man, the places you guys have been today”. Always keep a pair of gloves in your pocket on call & always grab some on your way into a crash call.
4. Working in the NHS teaches you what true love is. True love is the foster parents of babies born addicted to heroin, the spouses of fifty years negotiating the hurdles of early stage dementia together and the sisters who shave their heads to support each other through chemotherapy.
5. Crying at work isn’t great, but it’s normal and it’s ok. Our job is stressful and we care and we see more upsetting things than most of our peers. I’ve had a secret cry a few times – once when I cared for an unpleasant patient who openly identified as a Nazi, lavishly decorated in swastikas and another time after a horrific night shift when I was so tired I knew I couldn’t drive home safely and I wanted to be at home so much I just burst into tears. Reading @DrMikeFarquhar’s sleep and night shift research was enlightening.
6. Insider info: you can hide at least a cereal bar, 2 satsumas & a freddo in your scrubs pocket with your bleep, list & phone – the BNF, MedCalc & @ResusCouncilUK apps are good. If you’re hardcore, you can fit a 12oz coffee cup in there too. I love my @KeepCup with all my heart and it has seen me through some very painful, prolonged phone calls on hold with microbiology/blood bank/pathology/radiology.
7. Some people are sh*t and you’ll find yourself caught up in a safeguarding case & completely despair for humanity. Remember that for the small number of perpetrators, there is a vast army of amazing healthcare staff, emergency services, social workers, lawyers etc. Remember these people.
8. Sildenafil is the chemical name for Viagra. Clerking tip – if it’s prescribed on someone’s GP record, it’s probably for erectile dysfunction rather than for its alternative, smaller print indication of pulmonary artery hypertension. Just check before prescribing it as a regular hospital drug; insisting sildenafil is taken on the 8am ward drug round can be a bit awkward.
9. Try not to let your ePortfolio become the bane of your life because it will, easily. You don’t know something well enough until you can teach it to someone else so find ways to make med student teaching fun e (baking is a good, failsafe bribe) and fill gaps in your own knowledge. Always ask for written feedback. Broach stupid questions politely. #FOAMEd is great.
10. You’ll dispense life advice like “just because it says “fit for human consumption” doesn’t mean it can go in any orifice” & “I’m not sure competitive speed skating is the best sport to take up just after your knee replacement”. Educate your patients but respect that people make their own choices of their own accord and have every right to do so.
11. Natural death shouldn’t be feared. Bereavement and grief are sad but dying is a normal part of life and we need to talk about it. Lots of things are frustratingly out of our control in medicine but allowing your patients to die well shouldn’t be one of them. Read @AtulGawande & @DrKathrynMannix’s books.
12. Trust your gut instinct. It doesn’t kick in overnight but your “uhhh this is not good” feeling gets pretty good after a few on-calls. Check observations, blood results & then call someone using SBAR. Call your colleagues by their names, not their specialty – e.g. please can you review this chest drain, Dr Jones? Using someone’s name make a world of difference (and makes it that little bit harder for someone to say no, especially if you know their first name).
13. Therapy dog visit day is the greatest day of all.
14. Reading books about other doctors’ experiences can seem somewhat unappealing after long days of *actually living it* but there are warm, fuzzy feelings of solidarity on those pages after a stint of nights, missed birthday parties and a monstrous laundry situation (CC @amateuradam’s This Is Going To Hurt).
15. If you’re a female doctor in scrubs, you will inevitably get called “nurse”. My personal record is 6 times in one shift. It’s annoying, but the best way to handle it is to politely smile & correct the misconception. Stereotypes only stop being stereotypes as a result of education and awareness. Also, a big badge saying “DOCTOR” helps. There are a whole host of wonderful, smart, sassy and inspirational female doctors floating around in the Twittersphere – @choo_ek , @DrJenGunter, @_NMay, @sbattrawden, @jkwillettmd, @medicalwomenUK, @feminemtweets, @coffeeheadaches & @HannahPopsy to name a few – the medical sisterhood is strong.
16. Listening is the most important skill we have in our doctor toolboxes. But just as importantly, find someone to listen to you talk at length about whatever you’ve recently watched on Netflix (I highly recommend Queer Eye, both seasons) because good conversations after work unrelated to work are vital. Cook unnecessarily ostentatious dinners for your friends, run far, get outdoors, wholly immerse yourself in good books or interesting podcasts and somehow find your way to process.
17. I like the Grandpa test – if the patient was your Grandad, would you be happy with the care they’re getting? If not, why not? Food for thought.
18. Lastly, always be kind. You have to be kind to yourself to be kind to others. Very few people will remember the name of antibiotic they were on, but people will always remember kindness shown to them when they were poorly.
Dr Sarah Simons undertook her foundation years in the East Midlands. She has a particular interest in Emergency Medicine with an academic focus on global and refugee health and from August is taking time out of training to work part-time alongside an MSc in Global Child Health. You can hear more from her on the “2 Paeds in a Pod” podcasts aimed at junior doctors new to working in paediatrics and she occasionally tweets at
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