Guest blog by Dr Lisa Curran
All over the UK, medical graduates start their first hospital post on the 7th August 2019. What an important day this is. 23 years ago, I was there too.
August 1996 to February 1997, I was Medical House Officer for Dr Gallen at Wycombe General Hospital.
February 1997 to August 1997, Surgical House Officer for Miss Hands, Nuffield Department of Surgery, John Radcliffe Hospital, Oxford.
What do I remember of the first day? Not very much! Some things I do remember.
I was called to the postgraduate medical education centre, on the top floor of the hospital, large windows with views over the Chiltern Hills, where I met the other new House Officers, we had induction all morning. I remember we had a number of speeches from important people, and noticing the consultant microbiologist was very tall, with a beard, didn’t wear socks and had open sandals. We had tea and nicely cut sandwiches for lunch. The medical education centre felt like a peaceful haven on the few occasions I got there over the following months, somewhere quiet, away from the hectic hospital environment.
After induction we were given our bleeps, went to the basement to pick up our white coats and then off we went to the wards. I don’t remember anything bad happening that day, but actually don’t remember very much! I did meet with my Consultant Dr Gallen, who would be responsible for me professionally. I remember him telling me a bit about his schedule, inviting me to join him in outpatient clinic when I could, and that we discussed summer holidays and the English weather!
What do I remember from the first six months?
I remember the feeling of acclimatising to a new, dramatic world. Full of people and intense events. Life with a bleep, the constant bleeping and trying to find a phone to respond, the feeling of always having something to do that still hadn’t been done, while new problems arrived all the time.
I remember getting used to walking the corridors and stairs of the hospital at night, the feeling of entering a ward at night when all except a few nurses were asleep, to find the right patient and make my assessment, hoping I was doing the right thing.
I remember the staff accommodation behind the hospital – up the stairs, stark kitchen with bare essentials and my small room. My next door neighbour was a female house officer, who seemed terribly sophisticated and composed and had a boyfriend with long hair who looked like a rock band member.
I also remember some of my other colleagues very well. My closest working buddy, Dr M, was also in his first house job after six years of medical school at Oxford and knew he wanted to be a Surgeon. I had many interests at that stage, endocrinology, infectious diseases, oncology, hospital medicine of some sort felt the only likelihood. Dr M was very popular with the nurses, I had lots of unnecessary bleeps to check his whereabouts. We were always on call together; one of us would cover the wards while the other covered Accident and Emergency. Dr M was into night ice hockey (was an Oxford Blue) and taking the nurses to TGI Friday High Wycombe. I was into running and visiting London.
What do I remember of the patients?
I remember my first death. Remember it in detail. It was my first weekend on call, we worked a 48 hr shift - 24hrs covering Accident and Emergency and 24hrs ward cover. She died during my second day when I was covering the wards. I had seen her several times during the day, had assessed her each time and prescribed an anti-spasmodic for abdominal pain. A crash call went out on Sunday evening as she was unresponsive, low blood pressure. We later found out she had ruptured a massive aortic aneurysm and died. I was extremely upset, felt as if I’d killed her. I remember the Registrar taking me outside the hospital to try and calm me down as I was in floods of tears. He was very kind. It wasn’t my fault apparently. The aneurysm was known, she wasn’t for surgery, it could have happened at any time.
I remember my first Christmas working in the hospital, my daily familiar ward round to see the patients, including one long stay psychiatric patient who had an electrolyte disturbance, and whose bed area was always surrounded with multiple large bottles of diet coke and water. Our daily chats, the festive period in hospital feels very different, as if none of us should be there, but conversely it’s the most appropriate place for us to be.
House Jobs in the 1990s were different in many ways to Foundation Year jobs now, we had on call rooms between the wards, we worked every other day on call and 48 hour weekend shifts, we knew our patients inside out as it felt as if we lived in the hospital too most of the time.
My tips for your first three months as a doctor?
- Don’t rush! Rome wasn’t built in a day. We all had to start at the beginning. It’s OK to take a bit longer to do something when you start, think things through and ask questions if need be.
- Take time to get to know the team – if a team isn’t obvious, create a temporary one that you feel safe in. It could be a couple of other foundation officers, or a registrar that you like, or some of the nurses on your ward. We all work best in good teams.
- Ask the experts – watch for people you feel comfortable talking to and look like they know what they are doing – most people are delighted to be able to help.
- If you are worried or upset about something – talk to someone, don’t bottle it up, there is nothing worse than worried thoughts going around and around in your head. Talk it out!
- Eat well, exercise and get as much good quality sleep as possible.
- Smile and relax.
- People want you to be a good doctor, to enjoy your good work and progress far in your chosen field. Enjoy the journey.