Final Year, Finished

In August I wrote a post called Final Year, sitting at the start of it, full of fire about what was ahead. I'm now writing the bookend. I've finished. I've passed. In a few months I'll be a doctor.

It still feels strange to type that.

Looking back through the blog the other day, I could see how much the tone has shifted over the last five years, from the loose, slightly chaotic first post in 2021 to whatever this is now. The voice has grown up because the writer has had to. Fifth year did most of that work.

I won't pretend it was easy. This year carried losses that were close to me, and that has a way of rearranging how you see the rest of your life. I won't go into it here. Some things don't need to be on a blog. But I'll say this: loss has a way of becoming a roadblock if you let it, and the work of the year, alongside the medicine itself, was learning not to let it. Not to bury it either. Just to carry it without letting it stop you. I think I've come out of this year more resilient. I don't say that lightly.

The year started with everything stacked on top of each other. Job applications. The PSA. The MLA AKT. The OSCE. Portfolio sign-offs. And underneath all of it, the strange knowledge that a computer would generate a number that decided where I'd live and work for the next two years. It is a peculiar kind of pressure. You're being assessed constantly, but the most important variable in your life is being decided by an algorithm you can't influence. I'll write about the exams properly in a follow-up post, because they each deserve a little more than a sentence, but the short version is: I started early, I kept going, and I passed.

The placement that mattered most to me this year was ENT. I've written about ENT before, and I keep coming back to it because it keeps being the answer. Joining clinics for head and neck cancer patients, taking histories, sitting in counselling appointments where the news being delivered was not good. Scrubbing into neck dissections, abscess drainages, watching robots resect tongues. Assisting on an emergency tracheostomy. Going on call with the SHO and registrar, seeing acute presentations in A&E, compromised airways, quinsy drainage. I had the chance to use a nasoendoscope properly for the first time, to start closing up at the end of cases, to actually feel my hands becoming useful in a theatre rather than just being the extra body at the table. ENT remains, very much, the answer for me. Five years in, that still feels right.

The other thing that shifted this year was death. I've seen it now, in the hospital, more than once. I'm not going to claim I'm comfortable with it. I don't think you should be. But I'm aware of it in a way I wasn't a year ago. What I want, and what I'm still figuring out, is how to be present for patients and their families in those moments without being overbearing. I'll get it wrong before I get it right. That's fine. It's the kind of thing you're meant to spend a career learning.

I had my final on-campus contact day at the School of Medicine recently. The last time I'll see most of those faces. I thought I'd feel sentimental about it and, honestly, I didn't. Not because of my friends; the people I've actually built something with these five years are coming with me. But there's a wider crowd that you spend five years next to without ever really being close to, and a fair few of them I'm quietly glad to be walking away from. Five years is long enough to see who people are. The chapter wants to close. I'm ready.

A couple of things I want to put on the record before I do.

The first is that my first first-author paper was published in the Journal of Plastic, Reconstructive and Aesthetic Surgery this year. I want to mention that properly rather than sliding it in as an aside, because it took a long time, it took a lot of work, and it's the first piece of academic work with my name at the top of it. That matters to me. I'm proud of it. It's the start of a body of academic work I want to build over the rest of my career, not the end of one.

The second is that I would not be writing this post without the people around me. The friendships I've built over these five years are some of the strongest I'll carry into the rest of my life, and the support from my family has been the thing underneath all of it. None of this happens without them. I don't want that to be the throwaway line at the end of a blog post. It's the actual answer to how I got here.

So: a few months from now, I start as an FY1 in Acute Internal Medicine in London. Final Year is finished. I'm about to be a doctor.

It feels good to write that.