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Ideas, Concerns & Expectations of a Baby Junior Doctor

Medical school teaches you a lot of things... but not how to survive out there in the 'wild' of the wards. In the first of a new series of blogs, Aidan Whitehead, a new FY1 doctor reflects on his first impressions of surviving on the job. It's a jungle out there...

Medical school teaches you a lot of things.

It teaches you about G-coupled receptors and how steroid hormones work. Ion channels, and how different drugs exert their effects – remember that time when you finally learned the difference between an antagonist and an inverse agonist?

It teaches you to appreciate the patient’s ideas, concerns and expectations, why they actually came to the doctor in the first place (i.e. because their wife told them to), and the theory behind how people should behave when they’re sick (i.e. take the drugs the doctor tells you to) and why sometimes they don’t.

Eventually you learn how to interpret liver function tests (and use phrases like ‘looks like an obstructive picture’ even when you haven’t got a clue.) Medical school has already taught you the anatomy of the thorax so then it will go on to teach you to differentiate between consolidation and effusion on a chest X-ray – or at least how to have a good guess.

But that’s all well and good.

It doesn’t teach you how to figure out why a nurse appears ‘grumpy’ with you when you don’t think you’ve done anything wrong, or why the printer isn’t working, or how to figure out what to say to a husband who knows his wife is suddenly dying,after 50 years of marriage.

You might well end up completely lost when a midwife phones the ward asking for advice on a 7 week pregnant patient with a PV bleed – but there’s no-one to ask and you are definitely not qualified to triage the call. Which are the consultants that will gladly fill in e-portfolio tickets? Which registrars will make soothing noises down the phone even if you’re asking the most inane questions because you can’t remember how to prescribe cyclizine? And how do you come to grips with the brutal reality that really horrible things will just happen to absolutely lovely people?

Medical school won’t teach you that, because that’s not their job. They place us on the wards knowing that only experience is of use in those situations. Med school is just the beginning; and within my first week I’ve become acutely aware that my knowledge of different types of epithelium is useless when faced with a fiendishly complex computer system in the way of finishing your discharge letters; and being able to name all 12 cranial nerves in 10 seconds doesn’t help when the nurses are asking you to sign 12 (twelve) controlled drug prescriptions and the diabetes nurse is trying to give you a plan for the patient with BMs in triple figures.

The ideas, concerns and expectations I had of F1 were not entirely out of proportion with reality. I knew that I would have to manage multiple incoming tasks. I knew that I would have to work hard at professional relationships. But when you are physically placed in front of a task, or when that ‘grumpy’ nurse has shouted *your* name because a patient is unresponsive – it’s you that has to respond. And it’s you that has to know how to assess that patient who is down and out. And medical school does teach you, at least, how to do that.

Guest Blog: Aidan Whitehead, 22.10.2016


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