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Mind The Medic

Hey. I'm Zed and I blog at Mind The Medic. I write about being a junior doctor and everything else that comes my way.

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Reply 1
My surgical team consists of consultants, a registrar, a core trainee (CT) and a couple of foundation doctors. Because of the varying on call rotas, we aren’t all on at the same time. Like any rota, if there’s bad coordination then it may cause a rota gap, where there isn’t a sufficient number to cover the ward. This was Week 4 and it was already happening. To make matters worse, it felt like it was my responsibility to fix it.

Why was it my responsibility? I didn’t understand it either. It seems it was on me to find someone else to fill the gap. Which I’d tried to do. I’d asked other F1s, multiple times, whether they would be willing to cross cover for at least one of those days: and I got subpar responses. How hard should I have pushed? If someone said no, what else could I say? I didn’t feel it was my place to coerce people. It wasn’t an easy position to be in. I ended up feeling really sorry for me, in dramatic fashion silently screaming ‘why is it always me?’

What made it worse was getting flack from the core trainee and then by the registrar which I didn’t appreciate. (At this point it was just me as the other foundation doctor was now on zero days, so I was the only visible one if that makes sense). The rotas are online. You can see your own rota and everyone else’s on the surgical firm. So, I really didn’t appreciate the CT making it my fault that he wasn’t enlightened earlier. Excuse me?

Where else in this country would it be the employee’s responsibility to make up for the rota co-ordinators mistake? Where else would the responsibility lie on the most junior member of the team to sort out. It’s the kind of additional stress that I don’t need. And it’s the kind of thing that makes me feel resentful.

I think I just assumed that the rota that had been provided would be right. I appreciate I could have escalated earlier, but in that time, I was trying to get cover. Anyway, the issue was resolved by me offering to come in and cover those couple of days even though I was supposed to be off (but I can take those at a later date).

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Reply 2
Original post by MedicZd
Hey. I'm Zed and I blog at Mind The Medic. I write about being a junior doctor and everything else that comes my way.


What Med School did you go to and where did you do your houseplant stuff?
Reply 3
Driving Home - Mind The Medic
I open my eyes and sit up in my car seat a little. A minute later, I start the engine and continue my drive home.

I’d just finished a busy night shift. Non-stop, constant running from ward to ward for most of the 12 hours. I’d come on the shift with more than 10 jobs already waiting for me. The F1 on call was apologetic as she handed over a few more. What can you do? Some days are just busier than others. Add that to the patient that was deteriorating before our eyes and it’s easy to see why there was a back log.

I spent a lot of my time on this patient, his blood pressure kept dropping despite giving him 4 L of fluid. By the end of the shift he was taken to HDU for more support.

When the day team arrived, I was relieved to shrug off all responsibility and head home. I couldn’t be happier to get into my car and hit the pedal.
The tiredness never hits me in the beginning. I’m usually fully awake and smiling as I head towards home. It’s towards the end when the monotony of driving in a straight line without having to change lanes or stop or think plus the steady soothing hum of the engine starts to gently carry me away. I’m on autopilot. Ever so slowly the road markings start to blur, it feels like I’m drifting a little bit to the left, my lids feel really heavy…

This doesn’t always happen; I can often make it home without stopping. But there have been times I’ve come off the motorway, stopped at the side of the road or once at a local Tesco, switched off the engine and just closed my eyes.

Time passes, I open my eyes, turn the key and away I go.

It’s scary what tiredness can do. I had a colleague tell me that she thought she’d nodded off on her way home and was jolted awake by a horn from the car whose lane she’d started to drift into. The fear and the adrenaline spike kept her awake all the way home.
(edited 6 years ago)
Reply 4
It’s July 2016 and the realisation that there’s only a few weeks before I walk the hospital corridors as a doctor for the first time. I’m filled with terror and excitement, but mostly terror. A year later, and here I am, older and hopefully a little wiser. A year has gone by very quickly but not without some lessons learnt. Here is some of the things I wished I knew before I started F1.

1.

Lower your expectations. This is so crucial. You’ll save a lot of pain and heartache knowing now that the idea you may have in your head is so different from reality. I struggled with this, and to some respect I still do. I hoped I’d be learning more, building on all the things I’d learnt for finals. Realistically, you learn how to document faster, recite blood results without looking and pre-empt what the consultants want even before they know they want it. All the things you revised for at med school go out the window.

2.

Think it through. There were times, especially in the beginning where I’d be in a situation and I just didn’t know what to do. A patient was unwell and I didn’t know why or what to do next or who to tell. My mind would start racing and I would feel myself start to panic. Don’t do that. Don’t panic. Unless it’s a crash call where you have to act really quickly, then you can take a few seconds to order your thoughts. The time you spend running around not really doing anything is time wasted. Take it back to basics if you don’t know what to do: ABCDE.

3.

There were so many times in the first month I would be paralysed by indecision. Some situations I just didn’t know what to do, even if it was a relatively simple query. But with time I got quicker at making those smaller decisions. It’s the same for everyone else. What helped me was looking up trust guidelines, having a quick Google, asking one of the F2s.

4.

Don’t take everything to heart. Consultant’s might question you, registrar’s might tell you off unfairly, other colleagues might seem unreasonable and then take it out on you. It might not even be about you, so don’t let it get to you.

5.

Take care of yourself. You’re working in a system that is under a lot of strain and pressure and some of that will filter down onto you. It’s not your burden to bear all of it. Working 24 hours a day for 7 days a week, won’t save the situation. Just be mindful and do what you can.

6.

Prepare to work hard. You’ll miss lunch, you’ll work when you’re sick and you have to give some stuff up. It’s a hard balance to strike but I always make sure I’ve eaten or I’ve at least had a break. Missing the odd one might not count. But doing this repeatedly will start to affect you and you deserve more than that. I don’t believe being a doctor means you provide a service all the while breaking yourself down. You can’t work in a team, be a good colleague or a good doctor if you don’t look after yourself. You are you first, before you’re a doctor.

7.

There are so many embarrassing moments and mistakes. I’ve had too many cringe-worthy moments, but I learnt from them to make sure they didn’t happen again. (They did, just less frequently)

8.

Don’t expect a lot of praise. When you do get some, it will feel amazing. To actually have someone else applaud your hard work is a great feeling. But don’t hang your hopes on waiting for it, that’s an easy way to be disappointed.

9.

There’ll probably be a not so great placement. I’ve had my share. Don’t let it get to you, not all rotations can’t be the same. You’ll love some more than others. In the ones that you love, enjoy those moments. In the ones you don’t, just focus on working through. They’re four months long, they will always come to an end. Take what you need from them in order to grow and brush the rest off.

10.

Be prepared to laugh and cry. You’ll be working with so many clever, insightful people. You’ll bond over hard shifts and difficult patients. Some of the stuff I’ve gone through I’ve been able to vent to colleagues about, and they get it. It’s important to have a support system that understands. A lot of the times I come home and vent even more, to my mum and on here. You’ll be dealing with a lot, don’t keep it all to yourself.


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Reply 5
A Year In Review (Full Post)

For me, it has been without a doubt, the hardest year of my life. Challenging beyond belief. There have been so many moments where I’ve felt lost and unsure what to do. I’ve had times where I’ve been incredibly unhappy and more so recently where I’ve felt really close to resigning. I’ve been blamed for issues that haven’t been my fault, I’ve had difficulties with senior colleagues and I’ve found it hard to know who to turn to.

I know I could have been better and I could have taken care of myself more. Overall, I've learnt a lot of hard lessons.

Have I enjoyed F1? No. I’m glad I’ll soon be able to close the door on those experiences and move on. And part of me wonders whether F2 will be any different. Will being an SHO mean I get to do more medicine and less rubbish? Who knows?

I never thought it would be easy, I just never imagined it would be so hard.
Reply 6
The Last Day of F1 Full Post

The last day was a mix of emotions. Overwhelming gratitude and relief that I’d finished a difficult placement but also a slight melancholy that I was leaving. I was happy, don’t get me wrong, I’d started a countdown midway through the four months. But while I was working through the final jobs, I kept thinking of how everything was coming to an end. Not only was this the end of a placement but it was also the end of the academic year, the majority of doctors would be moving on to new hospitals. The people I’d worked with over the last months, the relationships I’d built, the camaraderie, it all felt like it was coming to an end.

We had a small get together at lunch with cakes and drinks and it felt like the end of an era.
The hospital can be really sociable. Just walking down the corridor, I’m bound to run into someone I used to work with. I enjoy that aspect of working in hospital.

My next placement is in GP which will be a massive change of environment. It’s always been the one thing that’s bugged me about general practice: the fact that there isn’t that community of peers around you. But I’m still looking forward to the change of scenery. I’m hoping GP will give me some of the learning experiences I’ve felt like I’ve been missing. Plus, surrendering my bleep for the next four months feels like a huge bonus. Not having the constant paranoia/palpitations every time I hear that beep anywhere around me. Immediately looking down at my bleep to see if it’s me that’s being summoned to some unknown problem. I just want to actually learn and do some medicine. Listen to a problem, take my time, explore the issues and be guided and taught as well. All whilst being sat down. I’m really hopeful.

I had the new foundation doctors shadow me on Tuesday and I honestly tried to be as positive as possible. I tried to give them all the necessary information they needed but I know they’ll learn it all as they go along. Luckily, the consultants are lovely so they should be fine.
(edited 6 years ago)
Reply 7
General Practice - Mind The Medic

We had a lot of exposure to general practice (GP) during medical school. Usually, I'd have one day a week based at a practice and sometimes a couple of four week blocks would be allocated for general practice alone. So I’ve seen a fair share of different practices, some were better than others. But overall, I felt like I had a better appreciation of what it would be like to be a GP.

Throughout medical school we were told that at least half of us would be GPs. On its own, the statement doesn’t sound bad, but in context, a lot of the time it felt like we didn't have much choice in the matter. 50% of us would be GPs regardless of whether or not we wanted to. Some people took offense, I didn’t particularly, even though at the time I thought wanted to be a paediatrician.

A few years later, now a F2 on my GP placement, I can see the appeal. 9 to 5 every day plus one afternoon off every week. I don’t have any night shifts or weekend shifts. There's 30 minutes to see each patient, all the while sat down in a room with plenty of opportunities for tea/coffee breaks. I know this isn't fully representative of an actual GP but it's generally a much better working environment than what I’ve experienced so far working in hospital.

So part of me wants this to be it for me. Do GP, have a great work life balance and be financially stable. I really wish I could fall in love with it. At the moment, it just doesn’t excite me. Some of it does. I hear a lot about GPs who have more unusual working patterns, that go beyond seeing patients in a clinic. But if I go for general practice, I want to be really for it, not just the good bits. It's like buying a cake with icing but only being excited for the icing. And then throwing the cake away when all the icing has been eaten.
Reply 8
Last week was a series of lows.

I can't even describe it. It was a case of the proverbial faeces hitting the proverbial fan. Multiple times.

I started the week feeling incredibly tired from the weekend. Nothing unusual, just a tad more Monday blues than normal. But I didn't think anything of it.

I ran a few errands on Monday and Tuesday. I was slowly beginning to feel a bit overwhelmed with all the things I was juggling. And to top it all off, it felt like I was coming down with something. And instead of really tackling those issues, I found solace in lying in bed watching Youtube videos, just something to take my mind off everything.

Then came Wednesday. I had my morning clinic and then went on a home visit to review an elderly man with back pain. The symptoms had resolved by the time I got there so I made my way to the hospital for the weekly afternoon teaching. I grabbed a Subway on the way, even though I'd been avoiding buying lunches because I am trying to save. But I'd been so tired, I hadn't prepared anything to bring in to work and eat, I must.

My supervisor grabbed me as soon as I arrived, so that we could have our mandatory introductory session (which we have for the start of each placement). She asked me how I was and all of a sudden I just offload a tsunami of emotions, mostly about how deflated I felt etc, etc. She gave me a funny look: concern/surprise/worry and told me she wanted to see me again in two weeks. I caught her off guard but to be honest, she caught me off guard as well. Saying it out loud made it all seem a bit more real. I’m not sure why it all came spilling out like that and I kept thinking about it, all the way through teaching. I had some idea in my head that the medical postgraduate team were going to put me on red alert or something and start watching my every move.

By 8, I was fast asleep, I was just too tired and achy to fight it any longer.

I got to work Thursday morning. Settled into my clinic. First patient didn't arrive and I'd left my GP bag in the car (the one I use on house visits and that I had taken home with me the day before). I quickly went out to get it before the next patient arrived. I couldn't find it. Weird. I called home and asked if someone had taken it out of the car. No one had.

I looked all around the car, panic rising. Where could it have gone? Eventually, I ran out of places to look and I had to walk back to my supervisor and let her know. I felt so responsible and stupid. I'd only been there (at the GP practice) for 2 weeks, and this really wasn't the way I wanted to form an impression. I felt like I let them all down.

I went to the police station later on that day. My expectations were low; I knew it'd be unlikely they would find an unmarked generic black bag, but I needed to report it. The policewoman I met made me feel 10 times worse. She had a really accusing tone. One of the questions she asked me: “how do you know the bag was stolen” left me dumbfounded. I stared at her confused, I looked at my mum, and then back at her. I didn’t understand what she wanted me to say. There were other things she said that again made me feel like she was judging me or making assumptions about me. The whole experience was uncomfortable and unnecessarily so.

So, all in all, not a great week.
Reply 9
Liking It? Mind The Medic

Since the beginning of F2, I’ve felt tired. Not the kind of tiredness that goes away with sleep, the kind of tiredness that requires two weeks in the sunshine. That’s the issue with being in a training programme, you just keep ploughing on and on and savour the few days that you get off.

I appreciate being on GP right now and I'm liking the slower pace. But it’s still really hard to get up in the morning. I feel like I have to emotionally psyche myself up and then drag myself to work.

But weirdly, as I start settling into afternoon clinic and I’m between patients, I start thinking that it's actually not that bad. And it’s happened more than once that I’ve caught myself thinking that.

No one is more shocked than I am. As a student, I found GP placements boring. Sitting in the corner and staring, as people come in and out. Not fun. Now, I see my own patients. I have to think on my feet, but at the same time I feel supported and I feel like I’m learning. And I feel like I’m helping. I have time to talk things through with people.

Before we get carried away, I’m still only a few weeks in. Even though it wasn’t my plan, I'm happy I had this placement first. I'm looking at my A&E rota for my next placement and it looks dire to say the least. 10 hour days, 8 in a row. Eugh.


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(edited 6 years ago)
Reply 10
Medicine - An Art? Mind The Medic

I recently had a long consultation with a patient. He was struggling with a variety of symptoms which he’d been investigated for and despite multiple scans he hadn’t received the answers he’d hoped for. This had started to affect his mood.

He talked about his career briefly and how much he enjoyed his work as a mathematician. He felt it suited his personality as he found comfort in knowing that there were set outcomes for every question. A complex equation could be brought to a definitive answer. Unlike medicine, where often symptoms were left unexplained and the only option was to learn how to cope. All the while wondering: will it worsen? Will it ever improve? Will it become something else?

He said something else that caught my attention, ‘I guess that’s why they say medicine is more an art than a science’. I’ve come across that phrase a few times and I’ve never stopped to actually think what it meant. But after he said it, I felt this dawning realisation. Like the feeling of suddenly working out the answer to an exam question the day after. Just talking to the patient in front of me, and watching him almost crumble under the weight of several uncertainties, it reminded me yet again how important it is to have these open conversations.

Treating a condition goes beyond just treating a part of the body. Every time we try to help, and we dive in with good intentions sometimes we cause more issues. Some therapies don’t work and sometimes there are side effects. So, we trial different treatments and hope for the best. But there has to be a balance, an awareness of the impact that this might have on an individual. I think good doctors are the ones who truly put their patients at the centre of decision making and try to maintain that balance whilst juggling the multiple other issues each patient brings (family, job, finances). That is the art.

Do you want more?? More blog posts here @MindTheMedic
(edited 6 years ago)
Reply 11
The Phone Interview - Mind The Medic

I recently applied to be a volunteer at an upcoming ACW event. I had the interview and I got the role. I’m not sure exactly what I’ll be doing, but I’m just excited that I’m going to be a part of it.

Lately, I’ve been thinking about my options which means spending my time Googling. I’ve found myself on the Medic Footprints site quite a bit, especially their blog section. Sometimes, in between patients, I take a quick break and just read through some of the articles. I like reading about doctors who’ve forged new careers for themselves or who’ve adapted their careers in some way to suit their lifestyle.

I find it difficult to openly talk about the possibility of leaving medicine behind. For some reason, it feels like a taboo subject. I know medics are a dedicated bunch with a strong sense of duty, but I sometimes wonder when this starts to become our weakness as well as our strength. It’s still a bit unusual to hear about doctors leaving. I can’t really speak for everyone else, but I do feel obligated to not tread the beaten path, to find a lifestyle that suits me. I'm looking forward to being around other like-minded people who share some of the same internal struggles that I’ve been facing.

I’ll probably be limited to how much I can see and do because I’ll be helping out. But it’s better than nothing. The event takes place in London, over the course of two days. I’ll have to get there a day before, to help prepare.

It’s weird, I knew this was a yearly event so I’d been waiting a while for the event details to be released and then when they were, I was initially hesitant: a) it was in London which meant I’d have to travel down and stay overnight, which is costly b) the ticket prices were more than I was expecting. On its own, I could probably have bit the bullet and paid for them but adding accommodation and travel and no doubt all the other costs along the way meant that I was going way over what I was prepared to spend. Just as I'd made up my mind not to go, I came across a small ‘volunteers’ sign.

I had to do a quick interview over the phone, which I tried to fit into my lunch break. And halfway through morning clinic my phone just turned itself off. Cue: mini frantic crisis. Literally, no warning. Just turned itself off and wouldn’t come back on again. The battery wasn’t low either. I wouldn’t have minded if this had happened on any other day, but seriously, a couple of hours before I’m waiting for a call. Sacré bleu! Long story short, after a lot of troubleshooting, panicking and Googling, I was able to have the interview, wow them and start afternoon clinic on time.

The idea of networking makes me nervous, but I guess that’s not necessarily a bad thing. It’s a skill I don’t have, might be useful to get out of my comfort zone and learn it. If anyone is interested in the event have a look at the Medic Footprints site and I’m also helping to sell some tickets as well here. I'll probably write a piece afterwards as well to let you all know how it went.

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(edited 6 years ago)
Reply 12
Stop - Mind The Medic

Sometimes, I see patients and for whatever reason I get flustered. There might be a few complicating issues, the symptoms aren't clear, my mind is thinking of possibilities A, B, F, K, and Z, the clock is ticking and the floor is on fire. I feel under pressure and I can’t think straight. And when this happens and I don't know what to do, I realise that I need to just stop, take a breath and start from the top.

Last Thursday, I had a difficult morning. I started the day with a complicated patient which set the tone for the rest of that morning clinic. My first appointment was a lady with known mental health issues. Midway through, she suddenly flipped and demanded I stop asking questions. She'd been getting more and more agitated and I think she'd just had enough. It put me in a bit of a bind. I examined her but I felt the safest thing I could do was refer her to be seen to rule out a blood clot. This was another mission. By the time I saw the next patient I was just all over the place. Add that with a complicated, slow computer program, that knows exactly when to act up and I started to jet steam from my ears.

Stop, breathe and start from the top.

I get like that occasionally, more than I’d care to admit. More often than not, I know what to do if I just slow down and take a minute to process everything. I know I add on a lot of pressure on myself and I get frustrated. I worry I might be judged by others. Judged by my colleagues or judged by patients for taking too long. I can't control what other people think of me, but it seems like my own self esteem relies heavily on it. It's a work in progress.

I was recently listening to an interview by the author of The Subtle Art Of Not Giving A F*ck. I've not read it yet, but that book sounds like it was made for me.

But until then:

Stop.

Breathe.

Start from the top.

Read more HERE
(edited 6 years ago)
Reply 13
Outside The Box - Mind The Medic

From recent posts, it’s clear I’ve become more unsure about my path in medicine. But as of yet, I have no plan, or really any solid direction. What I do know is that the idea of taking a break has become more and more appealing to me.

The journey to where I am now has been linear. I went from high school, to sixth form (college), to university, to working without taking any gaps. I’m really grateful I didn’t have to reapply to medical school and that I got the grades I needed. It's been a steady trajectory to where I am now. And there’s the opportunity to just keep going. I could potentially apply for another training programme after F2, become a trainee, become a registrar and then become a consultant or a GP. Do the necessary exams along the way, jump through the necessary hoops. Knowing at each point what my next step is going to be. And there’s safety in that, having a plan for the next 10 years. But right now, it just doesn’t appeal to me...

Read the rest on my blog Mind The Medic
Reply 14
Miserable Budgeting - Mind The Medic

Money is a constant source of worry for me. I’ve always seen it as a form of security and so I make a conscious effort to save and put some aside. I just think it's a good habit to have. I wrote a post about it here.

I’m not sure what’s in store for me in the next few years; I don’t have any concrete plans in terms of what I’ll do at the end of F2. But I do know that one way I can prepare is having money saved up so that whatever I decide, I will have more control over my options. I don’t want to know how much of my salary in F1 went on carbohyrdrate-loaded canteen lunches. Avoiding things like that in F2 should make it a bit easier for me to save money.

Since the end of July, I’ve made myself a target goal of how much I want to save by the end of January 2018. And another goal for August 2018 (I love goals). It’s an ambitious amount, but I’m determined. I feel if I aim high and fall short of it, there’ll still be a good sum of money saved up.
The difficult part of budgeting, is the odd bill that pops up that you don’t expect. Like my exhaust pipe breaking off as I come off the motorway. Inconvenient, expensive and annoying as hell. I actually had to take an Uber to work to avoid being late.

Another thing I’ve found difficult is saying no to meals out and cinema etc. I love food. And most of my socialising revolves around food. It’s hard for me to think of fun things to do with friends that a) don’t involve eating out or b) that are inexpensive. So, it meant for a while, I ended up turning down a few invitations to do things, which was making me miserable. I was missing out on all the fun.

It felt like it was a cycle of work, home, work, home and then work again. All the while being starved off all of life's joys. Confining myself to back-to-back Youtube videos of other people enjoying themselves instead. I was reading Solitary Diner's post on the same issue.

I realise I need a balance. I’m not prepared to make myself miserable, I have enough stresses without adding some more. I just need to figure out a way to be a bit more tactical with what and how I spend. But so far so good.



Interested in other posts? Read them HERE
Reply 15
Applications - Mind The Medic

It’s around this time of year that F2s start to really consider what they plan to do after the year is over, especially as it's also the time when specialty applications are submitted. Those that are lucky enough to have known exactly what they wanted to do since they were 12 don’t have any difficulties with choosing and applying for their specialties. For me, it’s never been that clear.

There were specialties that were a No from the get-go. There were specialties that I felt more drawn to like paediatrics but upon completing a placement I’d realise that they weren’t for me. So, by a process of elimination, I subconsciously and consciously whittled it down to a few options. A&E being one of the few, which is fortunate as I have this placement coming up.

To be honest, it’s beginning to feel like I’ve been holding out for A&E, like a sort of saving grace. I’m hoping for that eureka moment, the dawning realisation that I’ve found what I want from life, that missing puzzle piece that will sustain me until retirement. Obviously, the clouds will part, allowing a beam of sunshine to hit me like a spotlight. Unfortunately, I don't think that’s going to happen. I think I'll do the placement, I may even enjoy certain aspects of it, but eventually the mounting exhaustion of irregular shift patterns, manoeuvring the complicated bureaucracy of the four hour wait plus the incoming strain that winter always seems to surprise us with, will eventually tire me. I might be wrong. I’m just sceptical that any joy will be enough to squash the growing level of doubt and cynicism.

But now I’m at a crossroad and a decision needs to be made. Do I put an application forward or do I sit on my hands, allow the deadline to pass and ultimately choose to not go onto a training programme? A few people have suggested another option, option C, to put in an application, experience the process and then back out. I’m not keen on that idea.

I doubt I’ll be applying for specialty training as it stands, A&E or otherwise. And though initially that made me feel slightly nervous, I feel differently about it now. I'm feeling really hopeful for life after F2. The realisation that if I choose to not apply then I can pretty much do what I want.

It sounds a lot like Freedom.
Reply 16
A message to F1s - Mind The Medic

Suddenly, somehow we're in the run down to the end of the first placement.

And at this point you've come accustomed to how your ward works, you've formed bonds with your teams and maybe even your consultants. But now it’s time to move on and remember a whole new set of names and door codes.

If you're anything like I was, you’ve gotten used to the 9 to 5 grind mixed in with the night shifts and weekends. You're still feeling tired all the time, but at this point it's your new norm. You just get on with it.

Now, you don't shake as visibly when you get called to see a sick patient, and if all else fails, you know taking bloods and giving fluids is nearly always OK.

Maybe you’ve started to have some niggling doubts crop up in those moments when you feel out of your depth. Your thrust head first into a bad situation but somehow you always muddle through.

You can't remember exactly when in the past few months, your ideas of what it would be like to be a doctor were shattered. The rose tinted glasses have come off and you can see it all a bit more clearly. The disorganisation, the strain, none of it pretty.

Sometimes, you wish someone would tell you how you’re doing. Just a little word of encouragement or recognition, just so you know you’re doing OK. It’s nice to hear. But it can be few and far between. You’ve made it to four months, so well done.

I wrote this for anyone who’s finding the reality a little difficult, who feels constantly overwhelmed by the expectations being placed on them. If you've enjoyed your first placement, that's great. If you haven't that's OK too. Either way it's coming to an end. If you’ve found the last few months difficult, it’s because being a doctor is difficult. Plain and simple.

But it’ll start to feel a little easier.
Reply 17
A Bitter Pill To Swallow - Mind The Medic

One of the good things about GP was that I could call my patients back for a review. For the most part, they were easily contactable and happy to come back to see me especially if I’d started treatment. It meant that I could build on previous consultations, I got to know the patient better and they weren’t lost to the wilderness the moment they left my room.

One particular patient I saw a few times over the course of the four months. She had depression and was currently taking antidepressants. In one of our consultations she told me she was fed up: she felt the medication wasn’t doing much, she was going through a particular bad patch and she felt like no one was helping. She told me she had given up on the GPs and preferred to see me because she felt like I listened. This immediately made me feel more important and it made me want to give her even better care.

But, the last time she came to see me, it left me feeling a little frustrated. She was still in a rough patch. We had a really long talk about her life and she talked about all the things that were going wrong. She felt stuck and trapped in her own life. I tried my best to offer advice, but how much could I really do? I felt like I could at least try to tackle her depression. But she resisted all my suggestions. She didn’t want to change the antidepressants to a different type. She wasn’t willing to increase the dose of the one she was already taking and she wasn’t willing to try CBT or counselling. Essentially, we were stuck.

I became a bit discouraged and talked about it with a friend of mine. She said, that though I’m trying to help, I’m her doctor, I’m there in a professional capacity. I can help her by providing medical advice. It isn’t my place to take responsibility for her; she had to take responsibility for her own life.

And it made me realise why I was frustrated. As much as I wanted to help, her issues were mostly social and family-related made more complicated by her depression. The depression was the part that I could help with, but she refused all my suggestions. I thought I could make a difference and help ‘fix’ her issues. But I couldn’t help her, if she didn’t allow me to. And that made me feel stuck. So, what did I do? I left it up to her. She has the resources, the advice, the information she needs to allow her to make her decisions. It's up to her now.

It made me realise that I needed to step back a bit and realise the boundaries of my professional capacity. I’m not a life coach. Or a friend.

It’s a bitter pill to swallow to realise that I can’t help as much as I’d like to.
this is really cool
Reply 19
Less Than 1% - Mind The Medic

So, last month was the time for applications. I spoke about it before here. The end of November was the deadline for all applications to be submitted. All anyone was talking about were exams or applications. I got swept up in the sense of urgency and with all that energy, I started feeling a little unsettled. It felt like I was standing on the outside watching everyone else running around and making decisions, like I was missing out on something.

Some of the other F2s encouraged me to apply, and then defer a place later on. And that's when I realised that not even 1% of me wanted to. Will I regret it later? I don't know. But I know I’ve made the right decision based on how I feel at this point in time.

I think what made me anxious, is not having any sort of plan or direction for the next year. And I love direction. It’ll be the first time that I’ll be free to choose, without the constraints of time or any other pressures.

There are some ideas, but at present, it's all disjointed. I want to travel, I want to write, I want to move to a different area in the country, but I also want to move to a different country. How do I make it all fit?

It's all unclear. I just need some clarity to figure out what it is that I want and I'm just wary of wasting time. I don't want to be 5 months into my F3* and be watching reruns of friends on the sofa.

Although, that actually doesn't sound all that bad.

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