It is common for FY1s to feel anxious & feel like they’re not ready to start. We expect you to feel like this & hence are ready to support you. You will have SHOs who should directly support you with every task you need help with. We want you to regularly check in for everything you do initially. You should never hesitate to ask us even a hundred times if you don’t understand something as the patient comes first, always!
That said, most of your tasks are administrative. The way to success is being organised & being reliable. For unwell patients, you are usually under close supervision.
If you have any questions, just comment below!
Check out: Essential articles for FY1s
- Essential equipment
- Familiarise yourself with the job
- Employment Checklist
- Consider your CV & future career
- Final Tip: Be nice to everyone!
- Further Reading
Essentials: Stethoscope, Pens & Powerbank
Useful: Clipboard Box, Oxford Handbook for Foundation Programme, NHS Name stamp
Familiarise yourself with the job
The final year is your opportunity to get used to common tasks under close supervision by FY1s. Then the shadowing period and/or induction can help you get familiar with the systems at the hospital you’ll be working.
Learn how to survive a ward round
- Develop your own set proforma to preparing notes. Ensure you do this without coming in earlier than your start time!
- Learn how to document efficiently. Try to gain confidence clarifying if you haven’t heard or know something
- You could also review the drug chart & check the treatment ceiling has been set (this is for seniors to decide)
- Practice prescribing common drugs (anticoagulation, IV fluids, laxatives, antiemetics & analgesia) & learn how to avoid common prescribing errors
- Don’t forget to review & request bloods before you leave
- These tend to be your busiest & most stressful shifts. Ensure you keep your jobs list organised & prioritised.
- Managing deteriorating patients, ordering scans & referrals are usually done first
- Essential apps & our referral cheat sheet will help you with this
- You are expected to escalate unwell patients immediately whilst doing an ABCDE. Ensure you put a medical emergency call out if you ever feel worried about a patient or overwhelmed
- Check out our emergency section for information on specific emergencies
- Common scenarios you will encounter include: abnormal observations, verifying deaths, hyperglycaemia, abnormal electrolytes, falls, AKI
Learn how to write discharge summaries
- FY1s often prioritise discharge medications (TTAs) as they take time to order up from pharmacy (particularly dosette boxes)
- Keep it simple: key events, results, investigations & discharge advice (e.g. when to seek help/follow up plans)
- Avoid copying the entire clerking or scan reports
- Avoid giving the GP tasks that need to be done within 2 weeks. It can sometimes take longer than this for a discharge summary to reach the GP
- Ask for feedback (use it as a CBD for your e-portfolio!)
Familiarise yourself with the hospital during shadowing week
- Know where to find & how to prepare the list
- Use the bleep system
- Learn how to refer to different specialties
- How to use the computer systems to request investigations & complete discharge summaries
- Pet peeves consultants may have
- Who & how to call for help
- Learn where the best food & bars can be found (easiest way to make friends!)
This advice is for closer to the time when you are starting FY1 to help you understand how rotas, pay & other things work. These essential employment topics are covered in our free video series!
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. If you work beyond these hours, you will be informed how to file an exception report to ensure you’re paid or given time off in lieu.
On average, FY1s earn between £28,000 to £35,000 per year (before tax) depending on how many hours you’re working & night/weekend frequency. After tax, that works out approximately £1,700-£2,100 per month. The exact amount is defined in your work schedule. Once you’re working you can also claim tax relief on GMC, BMA, membership exams and other fees (essentially you get 20% of the cost back).
Consider your CV & future career
Specialty applications favour those who have prizes, publications, presentations, started membership exams, teaching experience or training, attended courses, quality improvement projects & leadership roles.
Final Tip: Be nice to everyone!
This is easily the most important advice anyone can give you. You should aim to be nice 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.
- Patients & relatives as poor communication is the source of most complaints. Ensure you understand how to deal with complaints & communicate with relatives
- And finally yourself! There are 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.
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