Author: Dr Rhiannon Jones
What is Foundation Year 2 like?
Extra responsibilities as an FY2 doctor include; the ability to decide which patients can be discharged from hospital, decide who to admit and whilst on-call, you sometimes advise GPs on patient management plans.
My first placement as an FY2 was General Practice. A typical day is included below.
8.30 am-4.30 pm, Monday-Friday, No weekend shifts or night shifts
- 08:25 am: Arrive at the GP practice. Log on to the computer and look at first patients notes.
- 08:30 am: Call the first patient in. Take history, examine patient and make management plan. As an FY2, your appointments start at 30 minutes per patient and this reduces to 20 minutes by the end of the placement. If particularly stuck can ask GP for advice.
- 11 am- 11.30 am: Morning clinic finishes, complete patient referrals.
- 11.30-12 pm: De-brief with GP supervisor. Present each patient to GP for feedback.
- 12-1 pm: Home visits. You normally go on 2 home visits per day. Can contact GP supervisor as needed.
- 1-2 pm: Lunch
- 2 pm-4 pm: Afternoon clinic
- 4-4.30 pm: De-brief with GP supervisor
Trauma and Orthopaedics
My second placement as an FY2 was on Trauma and Orthopaedics. I strongly disliked this placement for many reasons. I worked horrible hours, and had far too much responsibility than I would have liked!
Wednesday and Thursday, On-call, 8pm-9am the night shift
- 8 pm: Meet daytime FY2 on call for evening handover. Hands over sick patients and outstanding jobs, and highlights patients to the clerk. Pick up the on-call phone and bleep.
- 8 pm-6 am: Take referrals (mainly from A+E). Clerk patients and consent patients for operations. Update the theatre lists and trauma board for the morning. Review orthopaedic patients as needed. (Nurses contact you throughout the night)
- You are the only orthopaedic doctor in the hospital however you can phone the on-call registrar as needed
- 6 am: Finalise trauma board and theatre lists
- 6.45 am: On-call registrar arrives. They go through the list of patients who have been admitted overnight. Mini ward round before the trauma meeting with the registrar to review the patients admitted overnight and make sure consent forms have all been signed.
- 7.45-8.30 am: Trauma meeting. You present the meeting and show relevant X-rays to all orthopaedic consultants and doctors on for the day shift.
- 8.30-9 am: Post-take ward round. Full ward round of all patients due for theatre in the day. Also, a review of all patients admitted overnight by the consultant
What I wish I’d known before starting medical school.
Virtual Work Experience Week
This course is a week-long online course covering all the preparation elements a student needs when applying to medical school.
Topic: Do You Have What It Takes To Be A Medical Student?
Date: Wednesday 25th November 2020
Time: 7pm (BST)
Virtual Work Experience Week – get medical work experience from home.
Friday, Zero day
Saturday and Sunday, Off work
Monday, Standard day 7.45am-5pm, Ward 32
- 7.45 am-8.30 am: Trauma meeting. Hear about all patients admitted overnight and patients who are awaiting orthopaedic operations. Take note of patients on your allocated ward and what plans have been discussed.
- 8.30 am: Start ward round with the FY1. Depending on the FY1, normally we would split the ward in half and work independently and then recap at the end.
- 10 am: MDT meeting with all staff to discuss patient plans.
- 10 am-3 pm: Continue ward round, start jobs. Review sick patients allocated to FY1. At around, 2 pm registrar arrives on the ward and also asks if there are any problems that need sorting.
- 3 pm: Another MDT to check the progress of ward jobs.
- 3-5 pm: Complete outstanding jobs. Handover outstanding jobs or sick patients to the on-call doctor. Put out blood cards for the following day and start discharge summaries if there is time.
Tuesday, Standard day 7.45am-5pm, Covering outliers
- 7.45-8.3 0am: Trauma meeting
- 8.30 am: Covering outlying patients. Occasionally 2 doctors cover outliers, sometimes just 1 depending. Obtain a list of outliers and identify which ward they are on. Split patient list if working together. Start independent ward round reviewing each patient.
- Once ward round is completed, consult other FY doctor on outliers to form job list. Complete jobs over the day.
- 2 pm: Registrar arrives to review patients as needed.
- 2-5 pm: Complete jobs, review sick patients as needed.
My final placement as a Foundation Year doctor was on A+E. Each shift was similar, so a typical day is described below. For this rotation, I worked every other weekend with night shifts every 2-3 weeks. I enjoyed the consistency in workday structure with this placement and variety in the patient cases.
A typical day, 4 pm-1 am
- Arrive at A+E, change into scrubs. Introduce self to the on-call consultant. They allocate you to an area: paediatrics, adult majors/minors, resus.
- Start reviewing patients. Aim to review a patient, manage and discharge/refer onwards in 1 hour. Obviously, this depends on patient condition and severity.
- Ask seniors questions as needed. If any jobs remain at the end of the shift, handover to FY2 who is working later.
Life as a Foundation Doctor – Summary
After 5-6 years in medical school, medical students are dying to get stuck in and start working as an official doctor. Your foundation years aim to prepare you for more responsibility gradually with supported teaching throughout.
The rotas can be horrible, night shifts disgusting, and seniors can sometimes look down on you, but you have, arguably, the best and most rewarding moments of your entire career. You remember why you wanted to be a doctor in the first place, and finally, see what the reality of being a doctor actually is.
Further information about the foundation programme can be found on; https://foundationprogramme.nhs.uk/
 Information on junior doctor wages can be found at: https://www.bma.org.uk/pay-and-contracts/pay/junior-doctors-pay-scales/pay-scales-for-junior-doctors-in-england
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