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    Hello all,

    I am currently in my Foundation Year 1 post and am hopefully going to FY2 August 2016.

    I have been informed that my jobs have no FY1s so as the FY2 I would be expected to take the role of the FY1?

    This has had me thinking, how is FY2 any different to FY1 (especially in those jobs where the FY2 is the most junior)?

    Thanks guys,
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    Which jobs are you talking about? Perhaps knowing that might make it easier to explain. There are generally some big differences between FY1 and FY2 - FY2s tend to be on the general SHO rota for a given specialty, alongside ST1/2s. And are expected to work at SHO level. Not all specialties will have FY1s, some will only have SHO and above.

    In my specialty, paediatrics, the FY2s are SHOs - they are on the SHO rota, they are expected to go to deliveries for neonatal resus, they help cover the neonatal unit, they do out of hours shifts, and generally more is expected of them. The FY1 in the same department does not do any of that, and basically has a fairly supernumerary role clerking patients and doing some baby checks.

    Not sure what you mean when you say that you would have to 'take the role of the FY1' - should there be an FY1 and the post is empty? Or does your future department never have them? If it's the latter, then what you probably mean is that (alongside all the other SHOs) you'll still be expected to do quite a lot of the work that some might see as being more typically 'FY1' jobs - TTOs, blood forms, cannulas, keeping the list up to date - but it doesn't mean that you would only have the responsibility of an FY1. You would no doubt be expected to have the skills, knowledge and responsibility of an FY2. It's quite common for specialties outside of general medicine and surgery not to have an FY1. And all the SHOs, not just the FY2, just get all of the firm's work done. My general experience is that FY2s are treated the same as all other SHO-grade doctors.
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    (Original post by junior.doctor)
    In my specialty, paediatrics, the FY2s are SHOs - they are on the SHO rota, they are expected to go to deliveries for neonatal resus, they help cover the neonatal unit, they do out of hours shifts, and generally more is expected of them. The FY1 in the same department does not do any of that, and basically has a fairly supernumerary role clerking patients and doing some baby checks.
    When F2s move into jobs like this (especially scary for paeds but for all specialities in general) do they get extra training on how to e.g. manage a neonate in respiratory arrest or is it something you're expected to know from medical school/work? :confused: Even in a less acute situation, if you suddenly start an O&G job not having done a rotation in it since fourth or fifth year, is it kind of professional expectation to have gone over the medical conditions/how do a bimanual etc?
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    (Original post by BakedBeanz)
    When F2s move into jobs like this (especially scary for paeds but for all specialities in general) do they get extra training on how to e.g. manage a neonate in respiratory arrest or is it something you're expected to know from medical school/work? :confused: Even in a less acute situation, if you suddenly start an O&G job not having done a rotation in it since fourth or fifth year, is it kind of professional expectation to have gone over the medical conditions/how do a bimanual etc?
    Paeds SHOs should all get sent on an NLS course as part of induction, and if there is anything remotely scary about a delivery, it's very standard to call the reg early - paeds is very top-heavy.

    For O&G yes, you will be expected to be able to do speculums and bimanual examinations. It makes sense to read up a bit on common conditions and their management. You will also probably have to spend some time on labour ward but that also tends to be reg/consulant led.
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    In my last job of cmt2 I was on a job where I was the most Junior member of the team. It's frustrating at times but in certain specialties understandable and can be a nice learning environment where you're not in a position you're expected to act up and down simultaneously which a lot of Sho jobs can be like.

    Being an fy2 with no fy1 can be good. It depends on the job. I did gerries where I had no f1 and shared a reg and consultant with the half of the ward. Gives you a new sense of responsibility and you get good at doing something other than just a list of jobs given to you.
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    (Original post by BakedBeanz)
    When F2s move into jobs like this (especially scary for paeds but for all specialities in general) do they get extra training on how to e.g. manage a neonate in respiratory arrest or is it something you're expected to know from medical school/work? :confused: Even in a less acute situation, if you suddenly start an O&G job not having done a rotation in it since fourth or fifth year, is it kind of professional expectation to have gone over the medical conditions/how do a bimanual etc?
    Depends where you work. I have found my FY2 job in peads very stressful due to lack of training and support. We were refused access to NLS course and yet expected to go to deliveries and resuscitate babies. The reg was supposed to be available but if they were busy with another emergency (which happened regularly on nights) you were stuck with that blue newborn and had to fix it the best you could.
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    (Original post by Anonymous)
    Depends where you work. I have found my FY2 job in peads very stressful due to lack of training and support. We were refused access to NLS course and yet expected to go to deliveries and resuscitate babies. The reg was supposed to be available but if they were busy with another emergency (which happened regularly on nights) you were stuck with that blue newborn and had to fix it the best you could.
    That's very concerning. Did you raise it with your ES/local trainee reps/mention it on the GMC survey?
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    (Original post by Anonymous)
    Paeds SHOs should all get sent on an NLS course as part of induction, and if there is anything remotely scary about a delivery, it's very standard to call the reg early - paeds is very top-heavy.

    For O&G yes, you will be expected to be able to do speculums and bimanual examinations. It makes sense to read up a bit on common conditions and their management. You will also probably have to spend some time on labour ward but that also tends to be reg/consulant led.
    Thanks I do find this side of Medicine a bit odd- as a student, you roll onto a ward having practiced cannulation once on a model and you have free reign to do it on patients. Whereas nurses could have done cannulas for years and then just moved trust and have to reattend training before being allowed to do it for e.g.. The flipside of it is that the responsibility from day one. Definitely interesting to hear, respect to all you junior doctors out there!

    (Original post by Anonymous)
    Depends where you work. I have found my FY2 job in peads very stressful due to lack of training and support. We were refused access to NLS course and yet expected to go to deliveries and resuscitate babies. The reg was supposed to be available but if they were busy with another emergency (which happened regularly on nights) you were stuck with that blue newborn and had to fix it the best you could.
    That's absolutely shocking, no junior doc or baby should be in that position
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    (Original post by Anonymous)
    That's very concerning. Did you raise it with your ES/local trainee reps/mention it on the GMC survey?
    Yeah. Nothing happened. Told by ES to stop rocking the boat basically.
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    (Original post by Anonymous)
    Yeah. Nothing happened. Told by ES to stop rocking the boat basically.
    That's bull****, frankly. (I am anon #1, no idea why it anoned me). If there was an adverse event because you hadn't been adequately trained and the reg was busy, the hospital (and potentially you) would be in a whole world of trouble.

    I'm getting more stroppy about this sort of crap in my old age.
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    Anon2, I'm sorry you had that experience - both the feeling unsupported in the first place and also the difficulties raising your concerns.

    NLS should happen as part of paeds induction. For a variety of reasons, it often doesn't happen right at the start, but you should book yourself on to one if it doesn't happen. Some Trusts try to organise an in-house one for their trainees, others expect trainees to organise it themselves - but it should happen. The same as ALS, there is a list on the resus council website. Claim it back through study budget etc. There should also be departmental induction that includes neonatal resuscitation and the specifics of local policies / equipment such as how to use the resuscitaire.

    What should happen, is that paeds SHOs who have not done any neonates before (this includes GP trainees as well as FY2s), should be accompanied to all deliveries until they feel comfortable going alone (EVEN if you have done NLS as part of induction). Which as a general rule, should be at least a couple of weeks, more like a month - depending on volume of neonatal calls and how quickly you get some good experience. This could be either a reg or a senior SHO accompanying. Sometimes this is challenging, especially out of hours. The most, most, important thing you need to remember, is call for help early. Many times, by the time people come running in, you will have a crying baby - but we would all much rather come and find that the baby is now doing ok, than to not be called until a few minutes later when things are not going well.

    I would really advise you to put in incident forms each time you have to go alone and you felt unsupported / underqualified, even if the baby came out crying and you didn't have to do anything. It's another objective record of your concerns, and the Trust are obliged to respond to them.

    As a general piece of advice for anyone who has their first paeds job coming up - it is worth checking in advance with the department, what the NLS arrangements are - whether they will organise an in-house one for you or not. Because if you have to book it yourself, they are often booked up several weeks in advance, and it is really useful to be able to do this as early into your job as possible. It can be very frustrating on day 1 to be told that you have to organise this and to then find that the next available course <200 miles away is in 6 weeks' time.
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    guys im not sure what the difference between an ~LAS and LAT is. Im going to be coming for a medical school in europe, so one of those cases where the final year is considered a foundation year.
    do i have to apply directly to hospitals or through something?
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    The on call requirement was the main difference in my experience. Being the only trauma doctor in hospital overnight was definitely not something they'd do to an fy1.

    (Original post by Anonymous)
    Depends where you work. I have found my FY2 job in peads very stressful due to lack of training and support. We were refused access to NLS course and yet expected to go to deliveries and resuscitate babies. The reg was supposed to be available but if they were busy with another emergency (which happened regularly on nights) you were stuck with that blue newborn and had to fix it the best you could.
    Extremely concerning. It sounds like you've left the job now - I genuinely would be anonymously reporting this to an external authority. GMC I guess?
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    (Original post by junior.doctor)
    Anon2, I'm sorry you had that experience - both the feeling unsupported in the first place and also the difficulties raising your concerns.



    What should happen, is that paeds SHOs who have not done any neonates before (this includes GP trainees as well as FY2s), should be accompanied to all deliveries until they feel comfortable going alone (EVEN if you have done NLS as part of induction). Which as a general rule, should be at least a couple of weeks, more like a month - depending on volume of neonatal calls and how quickly you get some good experience. This could be either a reg or a senior SHO accompanying. Sometimes this is challenging, especially out of hours. The most, most, important thing you need to remember, is call for help early. Many times, by the time people come running in, you will have a crying baby - but we would all much rather come and find that the baby is now doing ok, than to not be called until a few minutes later when things are not going well.

    I would really advise you to put in incident forms each time you have to go alone and you felt unsupported / underqualified, even if the baby came out crying and you didn't have to do anything. It's another objective record of your concerns, and the Trust are obliged to respond to them.
    I had similar experiences to the Anon. Despite all the reassurance we had at induction that we will not be expected to menage neonates it was exactly what happened during my first night on call. It was relatively easy to get senior support during the day but on nights it was just one SHO (and FY2s were included in that rota) and reg covering. If the reg was stuck with another emergency you had to manage. We brought the issue to attention of powers to be and eventually some changes were made.

    I agree with advice to find out in advance what training is offered by the department and sort out your own if needed.
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    Hello all,
    I am currently doing FY1. Just wondering if anyone can give me advice on FY2 LAT. I am considering applying, but I am not sure I am eligible.
    I don't fit the criteria for inter-deanery transfers.
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    Hi guys if do an fy1 las this year would I then be eligible to apply for a stand alone fy2 job next year
 
 
 
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