A Strange Start:
When I envisioned the start of my career in medicine, I did not think that it would play out amidst a global pandemic. In February, we were told by our medical school that it would not be possible for our last few months of placement to go ahead. Fast-forward a few months and I am concluding my time as an interim foundation doctor in orthopaedic surgery.
Under normal circumstances, graduating medical students undertake a two year foundation training programme. Having completed our final examinations in January, these last few months would normally be spent participating in apprenticeship type placements and rotations in our areas of interest.
During the COVID-19 pandemic, a new role has been forged to fast-track final year medical students who have met the required competencies. The GMC granted early provisional registration to students satisfying these criteria, allowing us to practise in the newly created role of interim foundation doctor (FiY1). This role was not compulsory but many final year students, including myself, opted to apply for one of these positions. It has been a strange and exciting time to enter the world of medicine.
I undertook an FiY1 post in orthopaedic surgery at a hospital in Greater Manchester. The orthopaedic department was entirely restructured to meet changing demands.
Elective procedures like hip and knee replacements were put on hold, and an emergency orthopaedic hub was created to relieve pressure from A&E. The orthopaedic wards at my hospital were transformed into COVID wards, with their large number of side rooms making them suitable for isolating COVID positive patients. Orthopaedic patients were therefore dispersed throughout the hospital, being cared for outside of the usual ortho unit.
Interim foundation doctors, like myself, were placed in non-COVID areas with a view to freeing up doctors with greater experience to move into COVID wards.
The Role of an FiY1:
My role was similar to that of a foundation doctor, but with greater supervision. Day to day tasks included documentation on ward rounds, ordering investigations, prescribing under supervision, clerking new patients, completing discharge paperwork, and performing procedures such as venepuncture and cannulation. Other junior doctors and allied health professionals were available to oversee our activities. I found this extra help useful as I got to grips with putting what I have learnt into practice in a new environment.
I am grateful that we were integrated well into the surgical team, with weekly opportunities to attend teaching from junior doctors. I was given a consultant supervisor who acted as a point of contact for any questions and who helped me to meet the objectives that we set together. All of this helped me to settle in well and after a nerve-wracking few weeks, I started to feel more comfortable with the role.
From ‘Hi, I’m Becca, one of the medical students’ to ‘Hi, I’m Becca, one of the doctors’:
Introducing myself as one of the doctors rather than as a medical student may take some time to get used to! In these early stages, I have definitely felt a sense of imposter syndrome. Speaking to other interims and junior doctors, this is a feeling that many of us have.
Although we have been preparing for this moment for years, the title comes with an intimidating sense of responsibility and expectation. The hospital environment magnifies the difficulties that many are facing during COVID, with some patients experiencing prolonged periods of isolation and loved ones sadly being lost. Being privy to a person’s fears and feelings in moments of vulnerability, and being able to make someone laugh during a time of loneliness, are great privileges. One of the most important things that I learnt from this interim role is that our humanity is just as important as our knowledge.
As I move on from my interim post, I will cherish the friendships that have formed during this unprecedented time. I am very grateful for all of the support that other junior doctors and interims have given me throughout my orthopaedic job.
Many of us were looking forward to getting dressed up and celebrating what we’ve achieved over the course of half a decade, although this is currently not safe under the circumstances. We have however been invited to attend an online graduation celebration to mark entering this new stage of our lives, while we await the usual face-to-face ceremony. At the moment, we are unsure what this online event will look like, but at least I won’t run the risk of tripping on stage in heels any time soon!
In the meantime, I am excited to start my foundation training in Liverpool in August, hopefully drawing on some of the skills that I have learnt in this interim role.
Next time: Resilience & the Big Problem with Bouncing Back