What I wish I knew as a junior doctor
Author: Nikki Stamp
It’s that time of year when our fresh faced and newly minted interns start working as real doctors! Congratulations on making it this far. Medical school is an achievement and you should be very proud of your work thus far.
Being a doctor is such a wonderful privilege and a career that can provide you endless satisfaction. As you embark on your career, it can all seem so overwhelming. Likewise if you’re making another important leap, such as to being a Registrar. It’s exciting and scary all at once.
Here’s some of the things I wish I had known as a junior doctor, or things that have made my life easier over my working life so far.
Keep an open mind
Being open minded is very important as a junior doctor. For your patients, be open to the fact that they may have a reason for skipping clinic, not understanding you or having different world views to you. One of the great things about our profession is that you get to meet people from all walks of life and from every background.
For yourself, be open about what you might experience. The term may not be as bad you think it will. Perhaps you wanted to be a surgeon but would really rather be an emergency physician. Go into every job with eyes wide open because not only will you learn things that will always be useful, you just may stumble upon your passion in medicine.
Plan your life not just your career
Work life balance is not just about family and children. Being a doctor with friends, hobbies and just good old sleep ins will make you a well rounded clinician. You need to be as fit and healthy as you can be to be able to do your best work. Being chronically sleep deprived does not help this.
Having friends is so important. You’ll need a support system and a way to debrief. You need people to have fun with to make you a happy human. Medicine lumps you with some difficult times and it’s important to maintain a human connection.
But plan your career too
Once you work out what you want to do, find out what you need to do to get a training position. Talk to your Registrars and Consultants about what things would be beneficial for a career in surgery for example. You may want to get involved in some research or do courses offered by hospitals and colleges. Don’t forget the importance of clinical work though. All the research in the world won’t replace learning good clinical skills. Be in theatre or cath lab or wherever it is you want to end up.
Besides finding a specialty that you actually enjoy, it’s important to be pragmatic too. Make sure that you factor in things like the lifestyle of a particular specialty. It’s also becoming increasingly important to think abut what your employment prospects are at the end of the road. We may be coming into a time when securing full time employment as a specialist is tricky, so be sure that you’re not getting into an area where there may not be a place for you.
Ask for help and ask early
It’s really easy to think that everyone expects you to know or be able to do everything. That is simply not the case. If you’re in over your head, or you don’t know what’s going on, ask for help. You have so many resources at your fingertips, including nursing staff and other allied health professionals. Don’t be afraid to kick your problems up to someone more senior as they can not only help you, but you’ll learn something too. The doctors who worry me the most are the ones who don’t realise their own limitations and struggle on stubbornly. Don’t be that doctor.
Always be honest
Similar to the above, don’t tell porky pies. You often get found out and it can lead to patient complications. If you’re asked a patient’s creatinine and you don’t know it, say so. Then say you will find out. That is much more professional and safe than making it up.
Likewise with patients, we’re often afraid to admit that we don’t know the answer to their questions. That’s absolutely okay, tell them and again, say that you’ll find out.
On some terms more than others, a ward round will finish and you realise you have dozens of jobs to do. At least half a dozen people will be harassing you to get them done too! Don’t be overwhelmed, just keep a list of things that need doing that works for you. Triage your jobs and work through the most clinically urgent ones first, then head down the list.
Talk to patients
Patients want to talk to the staff who are looking after them. They want to know what’s going on with their condition and if you ask the right questions, they will give you a huge amount of information. That can be used to make the diagnosis, treat the disease and discharge them safely and with great satisfaction.
We don’t always have time to sit down and chat for as long as we like and that’s okay. I’ve said that I don’t have the time to chat right then, but make time to go back and speak to them later. And sometimes they just want to chat about themselves. And that’s okay too.
For patients who don’t speak English as a first language, don’t forget an interpreter. This includes deaf patients who may use Auslan as a first language. Giving information in their own language can make a huge difference to their day.
Dr Kate Granger is a geriatric medicine consultant in the UK who has a terminal cancer. As a patient, she was shocked at how few staff introduced themselves to her during her treatment. She started a campaign called “Hello My Name Is” and aims to encourage health care workers to introduce themselves to patients. Don’t rely on your name badge to do it for you!
Especially as a younger doctor, you will see so many new things. If you see something you haven’t heard of before, have a quick read about it. Our access to technology today means that we can often have a quick flick through something on our smart phones.
If you’re going to an operation, have a read about it the night before. It helps to understand what is going on much more and means you can ask some great questions and learn from the situation.
Enjoy yourself! You have a great opportunity to have a stimulating and fulfilling career. You will get the chance to meet some amazing people and see incredible things. Look after your patients, look after yourselves and most of the rest will fall into place.