Saturday, 2 August 2014

The End of An Era

After 9 years in the city where I studied for my BSc, went to medical school and then did my foundation training, I will be moving on next week. Just a weekend of night shifts and 350 miles stand between me and the next chapter in the Learnaholic Chronicles.

In particular, I'd like to take this opportunity to reflect on the crazy, stressful, interesting, exciting years that are foundation training. A year ago, I wrote this post as a sort of FY1 survival guide for all the new doctors starting their training. This year, #tipsfornewdocs (started by people much wiser than me, I must point out) seems to have gone viral and everyone from the highly entertaining Medical Registrar on facebook to the British Medical Journal keen to impart their words of wisdom onto the fresh faced new graduates about to be let loose on the wards. With that in mind, this isn't going to be a list of tips - there are loads of them out there. It's just my thoughts on what the last 2 years have meant and what I've learnt.

Setting foot on the wards 2 years ago was the start of a huge learning curve. As I've mentioned before, I had a bit of a difficult time outside of work in the first month of the job, so in particular the first few weeks were pretty tough. Slowly, though, I think I've managed to find my feet.

There are some things that I think I will always remember. There are a lot of firsts for junior doctors, and those tend to be pretty memorable. From the first death I confirmed or the first time I told a relative their loved one had passed away to the first time I did a lumbar puncture or correctly interpreted a CT scan, those "first" encounters tend to be pretty memorable. Some of the memories make me cringe, others I think I dealt with pretty well.

Then there are the people you just won't forget. I'm not sure why certain stories stick with me more, certain patients are more memorable than others. Often it's about timing; a particularly memorable patient is often one who I've spent more time with and got to know properly. Other times, it's been a particularly intense encounter, or a patient who has reminded me of someone I've known personally. From the lady who hugged me and thanked me after I told her her brother was dying to the patient with terrible venous access who I'd have a daily giggle with whilst attempting to get his morning bloods, some people are just etched on my brain.

I've attempted before to try to express how I feel about the encounters we have in medicine. I still haven't worked out exactly the way to say it. I suppose the key thing I've learnt over these past two years is just how much of medicine is about people. I love the detective work involved in working out a new diagnosis. I love the science which helps me to understand why condition x produces symptom y and is treated by drug z. But a doctor who gets every diagnosis right and knows the molecular mechanism behind everything he does will only get so far. I'll admit to having rolled my eyes at the "fluffy" bits at medical school, but if these couple of years have taught me anything, it's that without the fluffy stuff, we're not much use at all.