It’s now a little over a month since I started my FY1 post in a large teaching hospital in Wales. I began my rotation on Urology, where I’m one of five ‘juniors’ (ranging from F1 to CT).
We work in the old-fashioned system of ‘firms’, with two consultants whose patients I principally care for, although we cover each other’s patients when another junior is away. Most of our patients are on the one ward, but with outliers elsewhere.
On average, each junior has one in four days on-call, in which we’re responsible for clerking patients referred from A&E and GP admissions. We also cover the occasional weekend, and the occasional block of nights, in which we fall under General Surgery.
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It’s fair to say that before starting this job as an FY1 I knew very little Urology, having had a few lectures early in medical school and one week’s placement in Year Three. The good news is that once you start you learn like never before. My catheter-handling is next-level, I can classify urine like a connoisseur (“this one puts me in mind of a light Riesling”), and I can prescribe PR Diclofenac faster than you can say “kidney stone”.
I’m also learning a variety of non-Urology skills that I’ll be able to carry forward. These include the usual cannulas and ABGs, but more important are the communication skills I’m picking up, and I don’t mean with patients.
Getting things done in a hospital as an FY1 involves a delicate dance of asking questions and making requests of a large number of very smart people, and I’m still very new at the game.
Information is power, and the key is to gather as much information as possible before making any requests of anyone, because they will ask you questions. If you don’t know the answers, at best you feel like an idiot, and at worst they’ll straight-up tell you that you are.
The FY1 reputation for working long hours is well-known, and it’s justified for the most part. I’ve found it is possible to leave at the time you stop being paid, but that either requires a big list of handover jobs to the next shift, which never feels great, or absolute dedication to working at peak efficiency all day.
I’m hoping I get quicker as time goes on, but at the moment I’ve come to accept leaving between one and two hours late fairly routinely, especially if it means I can work at a reasonable pace during the day. I don’t know if this will be sustainable long-term.
Similarly, the stress of starting the job as an FY1 was expected, as I’ve gone from the fairly relaxed schedule of medical school to the long hours with a lot of responsibility. Apart from one breakdown six days in, the stress hasn’t really affected me when I’m at work, but seems to manifest a lot in my dreams.
I often dream myself in the role of a patient, and have to fend off an army of medical students trying to catheterise me. I also get those odd half-waking dreams, where I wake up convinced there’s been a cardiac arrest on the ward, or that I’ve accidentally prescribed something at a thousand times the dose, and it takes a few minutes to convince myself I’m still in my bedroom, far from the hospital.
The end result of all this is I still haven’t found the time to look after myself properly – I’ve stopped exercising and my diet has suffered, especially when I’m on nights, when I am fuelled pretty much entirely by biscuits. Oddly despite this I’ve lost a bit of weight, probably because I don’t have the motivation to cook much of a large meal in the evenings.
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