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    These are some of the things I learnt during F1 that might be helpful for those starting F1 in August.

    1. Lower your expectations.
    2. Everything you learnt at medical school goes out the window because you rarely use it
    3. Don't know what to do: ABCDE.
    4. Still don't know what to do: trust guidelines, have a quick Google, ask someone else.
    5. Don’t take everything to heart. People get stressed and take it out on you
    6. Take care of yourself. Do what you can.
    7. Prepare to work hard. You’ll miss lunch, you’ll work when you’re sick and you have to give some stuff up.
    8. There are so many embarrassing moments and mistakes ahead.
    9. Don’t expect a lot of praise.
    10. There’ll probably be not so great placements.
    11. Be prepared to laugh and cry.
    12. Don’t do things just because you feel pressured.
    13. Don’t be afraid to say no.
    14. Book annual leave EARLY. Don’t just rely on emailing the coordinator to warn them, a lot of the time that doesn’t work.
    15. You’ll be under a lot of stress. Expect a lot of pressure to do several things at once
    16. Nurses can be super useful and also unhelpful
    17. Document everything.
    18. ASK. Ask. Ask.
    19. Question everything. If someone asks you to do something, ask why. Apparently ‘because my consultant wants it’ isn’t a good enough reason.

    I could go on. If anyone can think of more please add some points below.

    Good luck F1s
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    I thought you meant Formula 1 and got hyped and then i saw 'everything you know from medical school is thrown out the window'
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    Number 17 applies to absolutely everything. Great list.
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    Here are my disorganised thoughts as I prepare for my final week as a houseplant:

    Take 15 minutes to pee, drink and eat. It's incredible how much more effective you will be after taking just 15 minutes to do those things.

    Bring food and drink on nights - vending machines are overpriced and rarely have nice options.

    The jobs list is everything, be flexible with your colleagues and work efficiently so that you're not duplicating eachother's work, or (worse) things don't get missed.

    Stay on top of the ePortfolio, it's **** but it has to be done. ARCP comes quicker than you think.

    Don't dump on the on call/weekend team. It's not okay to leave discharge summaries and TTOs for other doctors to do out of hours. Same goes for writing up fluids/drugs/leaving out blood forms/vanc or gent levels - all these things can be planned for in advance.

    Take the long view - it's the first year of what is going to be a decades long career. You'll probably be doing specialties you have relatively little experience in or may even dislike - house jobs aren't a predictor of what you'll be like in a few years once you've found what you want to do and are being properly educated in it.

    Write please and thank you on radiology requests - they do notice and it does make a difference.

    The O sign and Q sign are both bad news but you won't have read about them in Macleod's. Sweating is also a bad sign. ABGs and VBGs are super useful. Hypoglycaemia is also more common than you think. Learn about paracetamol overdose.

    Remember people's names and use them, it helps to break down barriers. Go out with the other juniors and grumble lots - everyone's in the same boat, it'll make you feel better.

    SHOs who you've never met before and who you'll never see again after this year may see that you're stressed or upset and will offer to jobs for you or give you impromptu counselling, despite having their own work/personal crap to deal with. You can't do much except say thank you and resolve to do the same yourself one day.

    Be nice, but don't be a doormat. If someone deliberately tries to blame you for something which was categorically not your fault, stand up for yourself. Chances are they were looking to take advantage of your naivety.

    If you have the time, discuss referrals or requests in person. People can be surprisingly flexible and helpful face to face vs on the phone.

    And for that matter, accept that you'll be spending much of your day on the phone or at a computer. The infrastructure sucks and you'll be on hold for ages. The discharge summary/radiology request you spent ages writing will spontaneously decide to delete itself. It's not your fault, you didn't design the system. Become stoic and accept that lots of things are out of your hands.

    Marvel at how much shorter your discharge summaries become over the course of the year.

    Get involved in teaching, it'll stop you from de-skilling, it's good ePortfolio fodder and it's fun too.

    When making phone calls, introduce yourself as "Hi, it's Dr [surname] calling from ward X" rather than "Hi, it's [first name], one of the ward X doctors". Sound authoritative and official, it stops people from fobbing you off.

    They can always hurt you more but they can't stop the clock from ticking - a year goes by quickly and before you know it you'll be fully registered.

    Never resent patients for being ill or scared. If you feel like you're losing your humanity, it's time to talk to someone.
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    The above is all spot on - heed it well.

    I second the advice on taking time to eat and drink. Even if your jobs list looks overwhelming, there are few tasks that will be so urgent that they can't wait 20 minutes whilst you eat something. I used to keep a stock of bananas and rice krispie marshmallow bars for urgent sustenance when things were really going tits up (especially on nights), but you WILL be more effective after you've stopped and eaten / drunk.
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    These are some excellent lists.

    I'd definitely second:
    - Recognising that you are there to be a secretary not a medic and those are the only skills you will learn this year. And that's why teaching others is important - it motivates you to actually retain some of your medical knowledge for when you do need it later.
    - That some seniors are ********s who will shout at you and that is not your fault.
    - That saying no sometimes and politely questioning seniors does not make people hate you. On the contrary - they tend to respect you more.
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    1. If you didn't document it - it didn't happen.
    2. Never label and send off blood bottles that you haven't personally taken yourself, that's a datix waiting to happen.
    3. Socialise, maintain your life outside of medicine.
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    1. GOMERS don't die.
    2. GOMERS go to ground.
    3. At a cardiac arrest, the first procedure is to take your own pulse.
    4. The patient is the one with the disease.
    5. Placement comes first.
    6. There is no body cavity that cannot be reached with a #14G needle and a good strong arm.
    7. Age + BUN = Lasix dose.
    8. They can always hurt you more.
    9. The only good admission is a dead admission.
    10. If you don't take a temperature, you can't find a fever.
    11. Show me a BMS (Best Medical Student, a student at The Best Medical School) who only triples my work and i will kiss his feet.
    12. If the radiology resident and the medical student both see a lesion on the chest x-ray, there can be no lesion there.
    13. The delivery of good medical care is to do as much nothing as possible.
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    (Original post by Etomidate)
    1. GOMERS don't die.
    2. GOMERS go to ground.
    3. At a cardiac arrest, the first procedure is to take your own pulse.
    4. The patient is the one with the disease.
    5. Placement comes first.
    6. There is no body cavity that cannot be reached with a #14G needle and a good strong arm.
    7. Age + BUN = Lasix dose.
    8. They can always hurt you more.
    9. The only good admission is a dead admission.
    10. If you don't take a temperature, you can't find a fever.
    11. Show me a BMS (Best Medical Student, a student at The Best Medical School) who only triples my work and i will kiss his feet.
    12. If the radiology resident and the medical student both see a lesion on the chest x-ray, there can be no lesion there.
    13. The delivery of good medical care is to do as much nothing as possible.
    Feel as though I recognise this! Is it from 'In Stitches' or 'Scrubs'? Haha

    Edit: ah, the house of god
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    I think most of the clinical stuff has been covered.

    I would say most important is to be kind to yourself. Make sure that you eat and drink. But more than that try to have something that you are doing outside of work. Work can become all consuming if you let it.

    Also a plea from a GP. Think what you put on the discharge summary. Especially when it comes to jobs you are handing over. Is there any reason that the referral/test can't be done or requested by someone on your team? Writing a referral letter for you with knowledge of the patients stay and all the tests and their results will be much more straight forward than it will be for the GP trying to glean all the information from the discharge summary and a patient who often doesn't know what really happened. If you are needing something done within a week of discharge writing it on the discharge summary might not be a quick enough option so either asking the patient to book in with their GP for a blood test/urgent appointment if they are reliable enough to do it or if you really need it done a quick ring to the receptionist at their surgery will ensure it gets done soon enough.
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    A lot of really valid points.

    (Original post by randdom)
    If you are needing something done within a week of discharge writing it on the discharge summary might not be a quick enough option so either asking the patient to book in with their GP for a blood test/urgent appointment if they are reliable enough to do it or if you really need it done a quick ring to the receptionist at their surgery will ensure it gets done soon enough.
    Wow, never even thought about it like that, that's a really helpful tip

    (Original post by nexttime)
    These are some excellent lists.
    - Recognising that you are there to be a secretary not a medic and those are the only skills you will learn this year. And that's why teaching others is important - it motivates you to actually retain some of your medical knowledge for when you do need it later.
    Wish I realised this sooner. I've always found teaching uncomfortable because I feel like I don't know enough to teach, when actually I could have learnt more by doing so

    (Original post by Democracy)

    Be nice, but don't be a doormat. If someone deliberately tries to blame you for something which was categorically not your fault, stand up for yourself. Chances are they were looking to take advantage of your naivety.

    They can always hurt you more but they can't stop the clock from ticking - a year goes by quickly and before you know it you'll be fully registered.
    YEP
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    (Original post by MedicZd)
    Wow, never even thought about it like that, that's a really helpful tip
    You should always think about the receiving GP when writing a TTO. Do they care that your patient with 'IECOPD' had 4 days of wheeze and cough and sputum that started white then changed to ... no of course not. You've said IECOPD of course they had that stuff. There's also no need to copy and paste every single blood result from the entire admission making the discharge summary 11 pages long as i see frequently done - GPs do have access to the blood results of their local hospital, unsurprisingly.

    But the plan should be precise and any chronic conditions that have been reassessed e.g. a neurological condition - that is going to need effort put into it. If the senior's plan was vague then clarify it - don't just pass the buck to the poor GP!
 
 
 
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