I qualified from University of Southampton School of Medicine in 2022 and started working in a hospital on the south coast as an FY1. My first rotation was in general surgery - specifically colorectal surgery.

I'd heard from friends who'd gone through foundation training that surgical rotations generally tend to be busier and more intense than other specialties, so I was anticipating it to be a hard one to start with.

Nevertheless, I was excited to finally start working as a doctor and was looking forward to the challenges that would come my way.

Learning on the job

I very quickly learnt that my friends were not lying! Colorectal surgery at my hospital had a large volume of patients, which meant a lot more jobs altogether.

It wasn't just a matter of doing the ward round and then updating the board to ensure we knew what jobs to do - we'd also have to factor in clerking patients in pre-op clinics and doing shifts in the surgical high care unit. This is where we'd be looking after post-op patients who needed a bit more monitoring than what was possible in a normal ward-based setting.

We worked with a fabulous bunch of nurse practitioners who knew the job inside out and offered us guidance throughout the rotation. The pharmacists were so helpful with prescribing questions and the ward nurses were also very knowledgeable.

Working well as a team is so important in medicine and I learnt the value of utilising all the different skill sets within the team very early on.

Time management

While the job came with many different aspects to it, my rota was also very intense. We had no night shifts and a mix of normal working days, long days and twilight shifts. We would sometimes have stretches of seven days in a row, or 11 days with one day off in the middle.

In the first few weeks of the job, I found myself overwhelmed with the workload and felt the need to get as much done as possible before taking a break. This was a big mistake (and one that is commonly made by many new doctors) as it would often mean not taking a lunch break until 3/4pm on some days, and then also end up staying late.

Time management was initially a struggle, but eventually I started to recognise what jobs needed to be addressed earlier in the day. There are always jobs that can wait until after you've had the chance to take a proper break.

I also started to realise that handing over jobs to the person on the late shift is reasonable to make sure you're able to leave work on time. Of course, there are situations where you're dealing with a sick patient and need to stay behind, or finish off a job you'd already started to ensure it was done (though this can be a domino effect).

Finding a balance

Sadly, I only learnt these lessons after I'd experienced burnout early on.

It was during a resilience workshop that I realised I was burnt out, when we had the opportunity to talk to our peers and seniors. I was initially slightly embarrassed as I'd only been working for a month and thought it was too soon to feel burnt out, but it can happen at any time.

A lot of things started to make sense to me. I went from waking up each morning being excited for what the day would bring to waking up and dreading coming to work. I felt more and more exhausted both mentally and physically as well as questioning whether I was cut out for this.

I'm so glad the resilience workshop happened sooner rather than later as it helped me realise that I needed to make active changes to improve things.

Having a good work-life balance was important to me as I still wanted to enjoy having a life outside of work. I'm proud of the fact that I still managed to make time to socialise and leave my work city on a regular basis to see friends from outside of my work bubble - especially once I realised I was burnt out.

It's essential to make the best use of your time off and do things unrelated to medicine - or nothing at all! Time off to relax makes you come back to work feeling refreshed and is much needed.

Here's my advice for incoming FY1 doctors.

It's okay to feel overwhelmed when you start. We all felt it and continue to do so from time to time, but always ask for help! Whether it's from senior doctors or allied healthcare professionals, there's so much support and knowledge to gain from all members of the team and everyone understands that you're a new doctor.
Learn how to keep a good list and stay organised. This alone will help you to visualise what needs to be done during the day and allow you to prioritise tasks in order of importance.
Most importantly, make sure you take proper breaks and don't go too long without one. Reach out to your supervisors if you're struggling.

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What I learned during my surgical FY1 rotation

Dr Kithmini Gamage

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