It’s that time of year again. For most people, August is a quiet month – a restful summer break without urgency, stress or systemic upheaval.
But not for us.
August means a new influx of junior doctors, many of whom will be finding their feet for the very first time on the Acute Medical Unit. I really like changeover – as corny as it sounds, it’s actually kind of cool to meet people at this strange crossroads, before they go on to have amazing, varied and impressive careers. It’s one of the things I love about AMU actually.
For those of you nervously navigating the start of your first medical job, I hope you receive as warm a welcome as I did ten years ago. Better yet, I hope you catch the bug and start thinking seriously about acute medicine as a career.
So what advice would I give to a brand new FY1 starting out on AMU?
Firstly – and probably most importantly – make use of the big and supportive team to build that crucial work-life balance. FY1 is intellectually exhausting. We want you to take your breaks and go home on time wherever possible. Many AMUs will have someone specifically rostered to a long day – if you’re due to finish at 5pm, you shouldn’t feel guilty about handing over jobs to the person covering the later shift. We are an acute specialty and work always spills over into the evening. That doesn’t mean you have to sacrifice your rest time.
Make use of your take shifts. Every FY1 I speak to tells me these are the educational highlight of the job. On take, you’ll have the opportunity to clerk a new admission from scratch, before they are reviewed by an on-call consultant. The best thing you can do to learn and develop is to commit to an impression and a plan. What do you think is going on and what are you going to do about it? Your plan will be reviewed almost immediately by a senior, but you should always put your own thoughts down first.
While the day job is often very admin-heavy, there’s usually a procedure or two to do on the unit, most often an ascitic drain or a lumbar puncture. Ideally I’d like every FY1 to have done a few procedures before the end of the placement, even if they don’t yet feel comfortable performing them unsupervised. If something comes up on the ward round, ask your registrar if they’ll supervise you. The only way to learn this stuff is to get your hands dirty.
The same goes for point-of-care ultrasound. POCUS is a big noise in acute medicine at the moment and chances are there will be someone weirdly into it in your department. If you happen to work at a certain hospital in Twickenham, this person is me. I’ll wax lyrics about the merits of ultrasound in a separate blog, but AMU is the perfect place to pick up a probe and learn the basics.
Finally, don’t get too downhearted if you’re struggling, either with the workload or with the more emotionally draining parts of the job. Dealing with this many new things is absolutely exhausting. I remember going home most days during the early part of FY1 unable to do anything but stare at the TV. It’ll get easier, and you may even find yourself enjoying it after the first three months are in the rear view mirror.
And then you get to rotate round to a whole new job! The circle of life.
If you find yourself thinking “hey, this is actually really good fun, I wonder whether this is the specialty for me”, then congratulations! You are a smart person. Take a look at our website, come along to one of our events, or drop us a line. We’d love to hear from you.
Good luck. We’re all rooting for you.