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A day in the life of a junior doctor

Over a year after graduating from medical school, Dr. Vicky Donkin talks about the realities of working as a junior doctor.

August 2nd 2010 was the day I walked onto a ward in my scrubs with a Dr. before my name. I spent my F1 year (foundation year one, also known as preregistration year) working in Exeter. Then, after becoming fully registered with the General Medical Council (GMC), I moved to Torbay hospital in South Devon. 

It’s been a whirlwind, and nothing you learn at medical school really prepares you for the transition. However, it’s not all bright lights and dramatic operations as shows like Casualty would have you believe. The vast majority of your job for the first year or two will be paperwork and practical procedures such as taking blood and inserting cannulas (drips). But you play a key part in the running of your team and it is usually you that knows the patients best. 

Throughout the winter I worked on a ward caring for the elderly, one of the busiest departments given bed pressures and winter outbreaks of flu, pneumonia and vomiting bugs. Much of our work was centred on rehabilitation and ensuring safe discharge for vulnerable elderly patients.

A day as an F1 doctor in care of the elderly would often run like this:

08:30 Arrive at work to add new patients to the list and discuss any issues that have arisen over night with the nurses.

09:15 Board round led by myself and an F2 (foundation year two doctor) taking it in turns to discuss each patient with the rest of the ward team (made up of nurses, occupational therapists, physiotherapists and pharmacists) and make plans for the day. Board round is a key time to allow everyone to have an opportunity to speak and to prioritise particularly unwell patients and urgent jobs.

09:30 Ward round: twice weekly consultant led rounds where it was my job to tell the consultant about each patient, to ensure unwell patients were seen first and no one missed. Hopefully the round would be finished by midday to give time for lunch. On days with no consultant the F2 and I conducted our own ward round ensuring that all patients - especially new patients – were seen. This gave us the opportunity to develop clinical assessment and decision-making skills.

13:00 Catching up with jobs from the ward round, writing discharge letters to GPs and prescriptions for patients.

14:30 Visiting time, mostly spent speaking to patients and relatives about their condition, care and discharge planning.

16:30 End of visiting time, review of job lists to ensure all jobs done, update list and home by 17:30. However, I may be called to review a sick patient at any time, making the day unpredictable and variable.

Although this is how a ward works during a normal day, weekends and nights have much less staff on duty and patients are only seen when required and only urgent jobs are done. This is the time when skills in triage, prioritisation and efficiency are important.