The Hands-on Guide to the Foundation Programme
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The Hands-on Guide to the Foundation Programme
About This Book
About to start the Foundation Programme?
Making the transition from medical school to professional life?
The Hands-on Guide to the Foundation Programme, Fifth Edition is a practical guide for medical students and foundation doctors, dealing with the many challenges of the programme. With hints, tips and realistic advice on various aspects of the course, from self-care to prescribing, this guide provides invaluable support, with up-to-date information on postgraduate training and recruitment, practical management skills and career pathways to help build confidence, enabling you to hit the ground running.
This edition features newly expanded sections on emergencies, psychiatric evaluation, the Situational Judgement Test, and the common calls and conditions you will encounter on a daily basis. The Hands-on Guide to the Foundation Programme is a perfect companion to assist the junior doctor in preparing for the intellectual and emotional challenges of the foundation years. Take the stress out of the Foundation Programme with The Hands-on Guide!
Frequently asked questions
Information
Chapter 1
STARTING UP
Panic?
People to help you
- Nurses who often know a great deal about what needs to be done for each patient. Many are very experienced and have been doing their jobs for years. Their advice can often be invaluable. They often also know individual patients very well. They generally have fewer patients on their lists than the doctors and may have spent considerable time with both the individual patient and their relatives. Every time they take a patientâs observations or administer drugs they are exposed to the subtle signs of disease. This gives them a great âintuitionâ for when patients are developing a problem. If you are unsure about the current issues or plan with a patient then their nurse will hopefully be able to help.
- Patients who want to be treated kindly and properly and with as little pain as possible. Developing an open and honest approach with patients will make your life infinitely easier. If there is an issue you do not know the answer to or cannot fix immediately it is usually best to acknowledge this. A partnership with patients empowers them and also reduces the stress that comes from pretending to be an omniscient doctor.
- Other doctors who love to demonstrate their skill at just about everything. Most people are secretly happy to be asked by a junior doctor for help; it makes them feel useful and gives them a chance to shine. If you ask for help you will almost certainly get it. There is no shame in it, and you will be helping others by developing a culture of honesty and cooperation. If you are unfortunate enough to initially meet with some degree of apparent resistance or negativity do not take it personally. Some doctors (usually the busy ones) wonât always be overjoyed by having another thing added to their list; however, this does not mean that you should not have asked or that they are critical of you. Try not to take any emotional outbursts personally.
- Other members of the multidisciplinary team. These allied healthcare professionals can be really helpful in providing you with useful information about your patient.
- Problems arise when junior doctors do NOT ask for help. This can be a disaster. If you feel panic rising in your throat, please just ask for help. This is counter-intuitive for self-reliant medics, but it saves lives (yours and the patientâs).
- Make sure you attend orientation day for junior doctors if the hospital has one. It is useful for finding out what the hospital can do for you. They can be painful and bureaucratic but they are often sources of important information. Most hospitals now have a mandatory shadowing week when you start your FY1. Use this to your advantage to get acquainted with the hospital.
- If possible contact your predecessors before their last day on the job. They can give you invaluable information about what to expect (the idea for this book originally came from a request for help from a new junior doctor). In particular, ask them for any nuggets of information, for example, what your new consultants do and do not like, how to access the computer systems, if there are any specific specialist investigations you may be required to request and how to do so.
- Most people find that they are physically exhausted during their first week of work. Such fatigue passes as you get used to the hospital and new routines. Plan to be kind to yourself during this time and try to avoid planning too many late nights. Hospital life is always much easier when you are well rested.
Three basic tips
- Take the initiative in hospitals. If things are not working, do something about it. If there is a problem, try to think of a solution for it, and contact the person in charge. You may need more firepower, and this can come from your senior sister on the ward, your consultant or even the general ward managers. Junior doctors can achieve amazing changes when they make the effort to do so.
- Similarly, take initiative in managing patients. Try to know why each patient came to hospital and what their current problem is. This may sound insultingly basic but it is not unusual to see a patient on a ward round when no one has this information to hand. Again, nurses are usually quite good at knowing what a patientâs current problems are. Present seniors with a plan for your patients rather than just asking them what to do. You will learn how to manage problems much more quickly if you think about them yourself first. Donât be afraid to look beyond what is asked of you. If you feel that a patient has a problem that your team is not interested in then donât just ignore it, take the initiative. The fact that a senior doctor has not addressed a problem does not necessarily mean that it is okay to ignore it. Thinking strategically actually makes work more fun and prepares you for more responsibility.
- Prioritize your work. When tasks are being fired at you from all directions, priority setting is really important. Try to learn early on which things are very urgent and which can wait. Despite the hype, in between moments of chaos, there is quite a lot of downtime in your junior doctor year (unless you are very unlucky or disorganized!). Keeping a list of written jobs is essential, especially when you are really busy. If itâs not written down clearly, you will at some point forget it no matter how important you know it is.
Other useful start-up information
Dress
- Changing from student to doctor mode can put grave dents into your early pay cheques. If nothing else, buy good-quality shoes which will look good and will stay comfortable after a hard day on the wards.
- Whilst wearing theatre scrubs (âbluesâ) on the wards can be all the rage, doing so is a theoretical infection risk and frowned on by some hospitals. If you have to wear them outside theatre, remember to change regularly and return them to the hospital laundry to be washed! Wearing them outside hospital grounds is definitely not acceptable.
Table of contents
- Cover
- Title page
- Copyright page
- Dedication
- Introduction
- How to use this book
- Acknowledgements
- Abbreviations
- Chapter 1: STARTING UP
- Chapter 2: GETTING ORGANIZED OR âTHE FOLDERâ
- Chapter 3: PAPERWORK AND ELECTRONIC MEDICAL RECORDS
- Chapter 4: ACCIDENT AND EMERGENCY
- Chapter 5: BECOMING A BETTER DOCTOR
- Chapter 6: EMERGENCIES
- Chapter 7: CARDIAC ARRESTS AND CRASH CALLS
- Chapter 8: COMMON CALLS
- Chapter 9: DEATH AND DYING
- Chapter 10: DRUGS
- Chapter 11: HANDLE WITH CARE
- Chapter 12: APPROACH TO THE MEDICAL PATIENT
- Chapter 13: PRACTICAL PROCEDURES
- Chapter 14: RADIOLOGY
- Chapter 15: APPROACH TO THE SURGICAL PATIENT
- Chapter 16: GENERAL PRACTICE
- Chapter 17: SELF-CARE
- Appendix I: SCORING SYSTEMS
- Appendix II: USEFUL TESTS, NUMBERS AND OTHER INFORMATION
- Further Resources
- Index
- End User License Agreement