Dr K – 2020 graduate experience
Dr K was due to graduate from medical school on July 7 2020; instead he graduated on April 1, and was given GMC registration 48 hours later. Shortly afterwards he was working in an acute care hospital as a 2020 UK graduate on a three-month placement.
Departmental teaching for foundation doctors was cancelled at the hospital and core teaching went virtual. Instead Dr K described how he had the ‘steepest of learning curves’ on a COVID-19 admissions medical ward, clerking patients.
Despite the lack of formal tuition, he said the hands-on teaching, coupled with support from F1 doctors to consultants, meant that he had the best learning experience possible.
He says, ‘I think we are probably the best prepared cohort of F1's there has ever been. I'm going to be a very strong advocate for this role continuing in years to come, even if there isn't a pandemic.
‘I felt supported in that learning, not just dumped in at the deep end and get on with the job.’
He says every patient he saw was then reviewed by a more experienced doctor. ‘That is the best learning experience you can have, because you've just seen a patient, you've gone through a series of thought processes in your head, and then you're with a consultant or a registrar, who's perhaps got a little bit more time, who can go through the same thought process as you've had and pick out perhaps where they might have thought something different or changed something.’
Three months on, he has just begun his Foundation 1 placement within the same NHS health board. ‘It meant that starting day one on Wednesday, it was just like another day in the office. And that's how I think it should feel after six years of medical school.’
He found that because of the coronavirus (COVID-19) pandemic, there were actually more ‘hands on deck’ – the registrars who had been doing lab/research work came back to clinical duties; the consultants were doing more telephone clinics and so had more time.
The F1 doctors were particularly helpful to him, answering questions when he got stuck, and preventing him feel out of his depth – which he understood was not the norm.
‘We had this amazing safety blanket of having the people who had just done that job for eight months around us, which you don't normally get when you start on day one in August, because they have then moved on to a different job. Although I've never done it the other way around, from my experience speaking to other people, the level of support, even though we were in the middle of a pandemic, was so much greater than it normally is.’
Consultants were supportive, both clinically - with an acute medical consultant on 24 hours a day, seven days a week – and in terms of trainees’ welfare. A pre-ward round chat was established, not to discuss clinical matters or handover but to ask how everyone was doing. Some consultants were better than others but the fact that they made that effort was appreciated and novel.
This empathy for trainees may have been generated in part because consultants were having to make decisions on little evidence in stressful situations, bringing back memories of feeling a little out of their depth as trainees themselves. This brought them closer together.
He says, ‘I think they were aware of how strange a time it was, and even for them, they were feeling stresses that they perhaps hadn't felt in their careers for a while. Not having clear guidelines on how to make quite important decisions, and actually, some things being a case of, "I've read a few papers that said this has worked, so we're going to try that."
‘But perhaps, that made them feel a little bit close to us, maybe, because a lot of the time, we're making decisions that, even though they might be guideline driven, we haven't actually implemented them before, we haven't seen the results, that we feel very out of our depth a lot of the time.’
He felt part of the medical team, being rota'd, paid and relied upon by the other doctors rather than just a medical student on an apprenticeship on the periphery. The wider team of nurses and allied health professionals worked well with them and everyone looked out for each other.
Dr K, who gone straight from A levels to medical school without travelling, intends to take a pause in his training after Foundation stage 2 because opportunities to travel were cut when his elective was cancelled due to the pandemic.
But his career plans – to become an ENT surgeon - have not changed. He admits that he was considering not going into medicine after medical school because he assumed it was going to be ‘very scary and very unsupported’ to the point where he was very close to doing a PhD. The reality has been very different. ‘I've had a fantastic experience.’