The Student Room Group

do you learn much in F1?

Hey guys IMG here . about to apply for a stand alone FY1 position and am just wondering if I'm making the wrong decision. Some other people have told me that applying directly to FY2 is better, which we can do since my 6th year here provides us with full GMC registration

Some people on this forum have also mentioned that you don't really learn much during FY1. The main reason i want to do FY1 Is because 1. I don't know how the UK hospital system works and 2. practica skills (blood taking , canula ect) are poor because we don't get the opportunity to do that much.

But if what others have said is true , that you don't learn that much , is it better to apply straight for FY2, even if the first few months will be really rough , is it worth it in the long run to skip an entire year of brutal work hours in which you don't actually gain much in terms of knowledge.

does anyone feel like FY1 was a valuable experience for them , or would they rather just have skipped it?
Reply 1
You should do F1 training before moving onto F2. Ive never heard of this scheme you’re talking about?
I personally would not have wanted to do f2 without f1. There is more responsibility as f2 and I feel the f1 learning experience was useful.
Original post by HateOCR
You should do F1 training before moving onto F2. Ive never heard of this scheme you’re talking about?


some EU graduates do an internship year in their home country and they are allowed to apply for fy2 posts if they want. However, many prefer to do fy1 regardless, in order to get experience with the UK system.
F1 was a very valuable experience for me, I probably learnt more as an F1 than as an F2. Yes, a lot of the day job is admin but you do learn a lot of medicine out of hours. Being part of the crash team is also a valuable experience - in some DGHs F2s are expected to lead cardiac arrests out of hours and you need to have been to at least a few of these to know what to do (AS is not all that representative of how these situations go IRL...)
Reply 5
I think the real answer is... it's up to you. You are legally qualified to be an F2, so you could cut a year out of your life, earn some extra money. But yes, you will definitely be in for a bumpy start.

Everyone knows that new F1s are pretty clueless, and people are usually nice to them. Usually by F2 people are familiar with their local systems and how hospitals work broadly in general. You may be expected to hold the bleep for referrals, advice, and as above even for crash calls potentially, That could be quite intimidating.

All of that said, there are also IMGs who come to the UK at all levels of training and this is also something that's recognised within the system. Sometimes even people transferring from within the country may be surprised by how different local policy and ways of doing things can be. Generally, if you have a good medical basic knowledge, common sense, and decent support within your department, it will all even out. (This is of course a gamble because there is always the chance that you won't have a supportive department)

Sooo.. you could definitely apply for F2, but it's a risk that it could be pretty sucky for weeks-months. But hey, that's decently likely with F1 anyway! What's your risk appetite? :tongue:
(edited 6 years ago)
You know i think it is not very useful and that what you learn during it about how the system works can be just as easily learned during FY2. But i will just reiterate that for anyone else reading and for sake of debate!

Original post by Anonymous
Being part of the crash team is also a valuable experience - in some DGHs F2s are expected to lead cardiac arrests out of hours and you need to have been to at least a few of these to know what to do (AS is not all that representative of how these situations go IRL...)


No guarantee that will happen during FY1 though - i know multiple CT1s who have never been to a crash call in their life. If you want to get experience of crash calls/acute resuscitation, just spend a day in A&E resus, not a whole year as an FY1!
Reply 7
Thanks for the replies. I have to admit I'm already worried about starting foundation and don't think its worth taking the risk going straight to F2 , especially since i am really not confident in my abilities to practice , so definitely need support. And i guess also as someone else mentioned , being clueless in FY1 isn't as bad , but if you don;t know atleast the basics of the job as an FY2 aren;t people gonna get really pissed?. Also can you be demoted for f2 to f1 you aren't good enough??
Original post by nexttime

No guarantee that will happen during FY1 though - i know multiple CT1s who have never been to a crash call in their life. If you want to get experience of crash calls/acute resuscitation, just spend a day in A&E resus, not a whole year as an FY1!


Seriously??? How does someone go through foundation having never attended a crash call? :eek:
Original post by Anonymous
...but if you don;t know atleast the basics of the job as an FY2 aren;t people gonna get really pissed?.


You are still supported when you ask for help though. To give you examples: my first FY2 job was ortho. When walking onto the ortho ward the FY1s literally let out a sigh of relief and said 'thank god you are here'. Ok... but FY1s are a year closer to orthopedic teaching in med school. None of the FY2s had touched on ortho for a year and had forgotten the vast majority of what we knew for med school finals. In terms of knowledge, the FY1s were the better ones! But the difference is that as an FY2 you've had a year of seeing people who are medically fine just sit on wards waiting for carers, and so when it comes to seeing (95% of) orthopedic patients you would just confidently state 'no new problems, continue discharge planning'. They FY1s were saying exactly the same thing, but getting really anxious about it and taking twice as long to get there. But when actual orthopedic problems happened - wound infection, problems with x-rays etc - you just call the reg. Or when medical problems happened you can just call the med reg. Doesn't matter whether FY1 or FY2 - you phone for help when you need it. The difference was superficial confidence, not actual knowledge. And you definitely can ask for help as an FY2 (or CT2 or ST8...).

On AMU the patients were more complex but had a consultant ward round every morning to make plans. The FY2s were doing the same job as FY1s on that rotation.

O&G - little bit of decision-making on postnates, but that was not very often and again you could just phone the reg with no one getting annoyed. The other parts of the job - labour ward, gynae ward, assisting in theatre, admission unit - they would expect every patient you see to be discussed with a reg or cons, so no decision making there really.

Honestly don't mind what you do, but just contributing my experience. You very much can ask for help as an FY2 and people will be understanding in terms of people being new FY2s, especially someone new to the country.

Also can you be demoted for f2 to f1 you aren't good enough??


As discussed in the other thread, unusual but not impossible. The example given was someone who didn't know what a neuro exam was being 'demoted' (you aren't really promoted to FY2 so that's the wrong term) to FY1.

Original post by Anonymous
Seriously??? How does someone go through foundation having never attended a crash call? :eek:


IKR.

Thinking about it, i don't think i attended an adult crash call during FY1. Paeds yes, but they put out crash calls at the drop of a hat. Adults no.

Went to loads during FY2 though.

I moved regions recently and one interesting thing i've learned is that the number of crash calls can vary wildly from hospital to hospital. The big acute hospital near me put out 650ish genuine crash calls last year. That compared to about 100 at my previous hospital, which was about 50% bigger with more acute admissions. Seems there are cultural differences dependant on local hospital in terms of how many people have DNRs and under what circumstances people put out crash calls!
(edited 6 years ago)
Original post by nexttime


IKR.

Thinking about it, i don't think i attended an adult crash call during FY1. Paeds yes, but they put out crash calls at the drop of a hat. Adults no.

Went to loads during FY2 though.

I moved regions recently and one interesting thing i've learned is that the number of crash calls can vary wildly from hospital to hospital. The big acute hospital near me put out 650ish genuine crash calls last year. That compared to about 100 at my previous hospital, which was about 50% bigger with more acute admissions. Seems there are cultural differences dependant on local hospital in terms of how many people have DNRs and under what circumstances people put out crash calls!


That's really interesting. The crash calls I have been to have mostly been either arrests or peri-arrests. I can think of only 3 that were not (2 haematemeses and a seizure). Would you say that they are sometimes put out unnecessarily were you work?
Original post by nexttime



IKR.

Thinking about it, i don't think i attended an adult crash call during FY1. Paeds yes, but they put out crash calls at the drop of a hat. Adults no.

Went to loads during FY2 though.

I moved regions recently and one interesting thing i've learned is that the number of crash calls can vary wildly from hospital to hospital. The big acute hospital near me put out 650ish genuine crash calls last year. That compared to about 100 at my previous hospital, which was about 50% bigger with more acute admissions. Seems there are cultural differences dependant on local hospital in terms of how many people have DNRs and under what circumstances people put out crash calls!


Thats interesting.

I went to loads of arrests as a FY1, attended 2-3 proper arrests a week. Even got involved in a resus thoracotomy on CCU with a cardiothoracic SpR during one of those arrests

It really set me up for FY2 and subsequent ED/ITU jobs
(edited 6 years ago)
Original post by Magendie
Thats interesting.

I went to loads of arrests as a FY1, attended 2-3 proper arrests a week. Even got involved in a resus thoracotomy on CCU with a cardiothoracic SpR during one of those arrests


... how?! As mentioned, at my old hospital they averaged 2 arrests per week so that would be physically impossible. At the current one with almost 2 per day you'd still be going to 1 in 4 arrests. Are there only about 10 doctors in your hospital lol?

When I said I went to loads as an FY2 I meant about 8 lol, not >100!

It really set me up for FY2 and subsequent ED/ITU jobs

Actual training, like a handful of FY1 jobs can be, sets you up really well for the responsibility later on. But I don't feel that standard FY1 posts even counts as 'training', one aspect illustrated by total lack of emergency experience among some medical CT1s!
Original post by Anonymous
Hey guys IMG here . about to apply for a stand alone FY1 position and am just wondering if I'm making the wrong decision. Some other people have told me that applying directly to FY2 is better, which we can do since my 6th year here provides us with full GMC registration

Some people on this forum have also mentioned that you don't really learn much during FY1. The main reason i want to do FY1 Is because 1. I don't know how the UK hospital system works and 2. practica skills (blood taking , canula ect) are poor because we don't get the opportunity to do that much.

But if what others have said is true , that you don't learn that much , is it better to apply straight for FY2, even if the first few months will be really rough , is it worth it in the long run to skip an entire year of brutal work hours in which you don't actually gain much in terms of knowledge.

does anyone feel like FY1 was a valuable experience for them , or would they rather just have skipped it?


I think you should go straight to F2. Yes it will be a bit more of a rocky start, but you will save a year of your life; I highly doubt you will need an entire 12 months to get used to the system and practise procedural skills.

If anyone expresses major frustration at how an F2 can be so clueless (I'm sure you aren't), then you just explain that you have not been working in the NHS for very long. They will understand. And F2's are still allowed to ask for help, as has been mentioned above.

It may also be worth enquiring as to whether you can shadow the F2 who is doing the job you will be starting, before you actually start yourself. 1 week, 2 weeks, 1 month, to be honest I don't think they will mind and you may be able to reduce their workload whilst getting to grips with the system in a less stressful way.
(edited 6 years ago)
Original post by nexttime
... how?! As mentioned, at my old hospital they averaged 2 arrests per week so that would be physically impossible. At the current one with almost 2 per day you'd still be going to 1 in 4 arrests. Are there only about 10 doctors in your hospital lol?

When I said I went to loads as an FY2 I meant about 8 lol, not >100!



Actual training, like a handful of FY1 jobs can be, sets you up really well for the responsibility later on. But I don't feel that standard FY1 posts even counts as 'training', one aspect illustrated by total lack of emergency experience among some medical CT1s!


Back when I was an FY1, there was only one crash team in this v big teaching hospital. Every acute team would have one person carry an "FY crash bleep". I had three acute jobs, and worked with colleagues who hated going to crashes, I didn't mind, so I almost always ended up going to crash calls.

Not near a 100, EWTD meant I had a bunch of leave forced on me when I was an FY1 working long ass hours.

N.B. by "proper arrest" i actually mean "proper crash call" Which was anything from a medical emergency call to a full blown arrest.
(edited 6 years ago)

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