FY1: Baptism By Bleep

Three Weeks In

It's extremely exciting to have finally started work as a doctor. It's been three weeks, and I'm already feeling out of my depth in many ways, but I've loved every second of it so far. I'm excited for what's to come.

We had a couple of induction days at the start to prepare us for the wards. Honestly, they were a nice way to welcome us into the hospital, but they did very little to prepare us for what we'd actually experience. Still, it was an important step, and it was nice to meet each other, meet other doctors, and get to know people before we started. Nothing really prepares you for your first day though, when you're suddenly thrown into prescribing, carrying out procedures, prepping discharge summaries, going on a ward round, and for some people, starting their very first on call shift.

Learning On The Job

I've had three on call shifts so far, and they've all been very different. I'm still getting to grips with the terminology, post night, post take, the take, and plenty of others, but it's all exciting. People told me there was a steep learning curve, and I can already sense it. I've learnt so much in such a short time.

That said, the day to day jobs really do outweigh your ability to find learning opportunities. Sometimes a question that comes from wanting to learn can come across as pushing back on how a patient's being managed. You just have to accept that and not let it put you off asking questions and taking ownership of what you're learning.

I'm currently on acute internal medicine, so I've seen a wide range of presentations, from alcohol withdrawal and psychiatric problems to surgical problems (I'm still not entirely sure why those end up on our ward, but they do) and subarachnoid haemorrhages. I even attempted my first lumbar puncture. When it was suggested I could do it, I was genuinely shocked. I didn't realise that was even an option this early on.

If there's one thing I've taken from this, it's that whenever a procedure or a learning opportunity comes up, you should put yourself forward for it. It's early days, so who knows if the enthusiasm will hold, but I hope it does. Going into work every day with that mindset feels like the right way to get as much as possible out of these placements.

Feeling Out Of My Depth

I mentioned feeling out of my depth, and I do think that's true. I've never prescribed this much. I've never done this many procedures in one day. I've never managed this many patients with this many different complications at once. Medicine really isn't as neat as you'd expect. It's nothing like doing Passmedicine questions. It takes time to see whether a treatment is actually working. It takes time to get the investigations you want done. And it takes a lot of communication, a lot of going back and forth with other specialties, just to get to the point where you can do what your patient actually needs.

Understanding the system is probably the biggest lesson of all, and learning to navigate it properly is what I want to focus on over the coming weeks. I'm already more confident with it than I was, but I've still got a way to go. I've asked a lot of questions, and I know I've probably been annoying at times, but I'm not willing to risk anything when it comes to my patients.

Where I'm At

I know I've rambled a bit and jumped around in this one. In the coming weeks I'll probably write something more specific to certain situations, but right now I'm just loving what I'm doing and loving where I am. I'm looking forward to whatever comes next and to becoming a better doctor along the way.

Each day so far has been harder than the last. I've had to break bad news, and I've seen how some of the treatments we give can end up causing problems of their own. It's always a balancing act, always weighing up whether what we're doing will help more than it might hurt. That's part of medicine. It happens, and I know it will keep happening, but I'm looking forward to the next two years all the same.

I'm looking forward to feeling more confident day by day, and to taking on more responsibility as I go. I'm two weeks away from my first full weekend of on calls, so that'll probably give me plenty more to write about. For now though, this is where I'm at. It's early, I know, but it feels right to be here and it feels right to be doing this. I worked a long time to get to this position, so my plan now is simple: enjoy every day, take at least one thing from it, and try to be a little better the next.