Most F1s struggle with the transition

A new cohort of newly qualified doctors have stepped on the frontline this Wednesday. The transition from medical student to F1 doctor is a huge leap. I still remember my F1 year like it was yesterday. Suddenly, I was handed the responsibility of people’s life in my hands. Despite the inductions and five years of medical school, I felt underprepared. When I started F1 I wish I knew these 7 insights:

  1. Most F1s struggle with the transition

My first post was medicine. It was a stressful job with busy on call duties. There were times when I felt overwhelmed with the intensity of the workload and out of depth. I did not enjoy the work and felt medicine was not for me. F1 was hard as I felt I did not know what I was doing and doubted my capacity. What helped me going through F1 was sharing my struggles with other F1 doctors who also felt nervous and overwhelmed. It was reassuring to know that other people shared similar experience and the feeling we are all in the same boat helped to go through that year. Sometimes, simply talking about a difficulty can be extremely helpful instead of suffering in silence. The experience I had as an F1 was typical given the new environment, having to adapt working with a new team. The demanding nature of the work meant some days the medical team was stretched thinly. Unfortunately, this is common in the system we work with rota gaps. No wonder, doctors feel overwhelmed, stressed and some suffer burnout. This leads to my next point

  1. Put your oxygen mask on first

As doctors, we are good at caring for others. When it comes to caring for ourself, we are less good. In medicine, it is hammered in us to proceed with ABC when managing a critically ill patient. Airway, breathing and circulation. A quote that got stuck with me is ‘put your oxygen mask first before helping someone else.’ So often, I see doctors trying to help others first before helping themselves. I have also done it myself. Self-care is something I have previously neglected because I was too busy saving lives. What I failed to realise was that if I do not attend to my own needs first, how could I possibly be of help to others. For instance, I was the only doctor covering all medical wards in the hospital I worked in F1 with 2 pages of jobs to do. Blood tests to take, cannula to insert, patients to review, drug charts to re-write and so on. I felt I had to keep ploughing on through my list of jobs and did not take any break or stopped to have food during a 12-hour shift. I felt hungry, extremely tired and was probably dehydrated from not drinking regularly. In hindsight, I would have been more productive had I stopped for a break. Being aware how vital it is to take good care of myself, I make sure this does not happen again. Taking a 15 minutes break during a long shift means my energy level does not drop to the point I become exhausted. Reminding myself to keep well hydrated and eating my meals are crucial to perform well. In the long run, good self-care makes a lasting impact to our wellbeing.

  1. Life is fragile

As a doctor, I am reminded how fragile life is every day. One of the things we do in medicine is to break bad news. Telling someone they have an incurable disease, they had a miscarriage, or they cannot drive are difficult conversations. This has significant impact in their life. It’s always difficult to predict how the person will react. Some patients become upset and melt down, others are not bothered or less sensitive. An example is a gentleman I saw presented with right sided- weakness which turned out to be a TIA. When I explained what happened to him and the implications on his fitness to drive, it was difficult for him to accept. He was taken aback. I gave him time to process the information and answered his questions. 3 weeks later, I saw him again and had another chat. He seemed to be doing well. We talked about how he was managing, and he graciously thanked me for being completely honest with him and having taken time to listen to him.

During my placement in Obs & Gynae, I worked with a senior colleague who was about to retire in a few months. He was a kind, very approachable gentleman liked by his peers. One day, I learnt from a colleague he had a heart attack and was admitted to hospital. It was unexpected. I later found out he did not survive. It was a tragic loss for the department, his family and friends. This event made me realise how fragile life is, we do not know how long we have on Earth. We may not be here tomorrow. Every day is a gift.

  1. Give a sense of meaning to what you do

A common regret dying patients have is: “I wish I’d had the courage to live a life true to myself, not the life others expected of me.” Having observed people regretting how they lived their life is heartbreaking. It took them a lifetime to realise they wish they had the courage to live a life true to their purpose. Living a purposeful life true to myself is something I value. When I was younger, I worried about pleasing others, I worried what others would think of me. Then I learnt to worry less about pleasing others. Now, I realise other people don’t even care about my life as they are too busy living their own lives. For instance, it took me a lot of courage to start my YouTube channel and talking in front of the camera. I was worried what people would think of me. I’m so glad I did it anyway and most people don’t even care what I’m doing. I know I would have regrets had I not started this channel. In the end, what matters is the conversation you have with your future self. Did I have the courage to live the life that I was meant to live?

  1. Kindness

Being friendly, considerate and generous are important qualities. Although kindness is perceived as a combination of naïveness and weakness to many people, that is far from being the case. Being kind often requires courage and strength. As a doctor being kind to patients and colleagues convey a sense of care and sympathy that goes a long way. People notice when we show kindness because it makes a positive difference in their life. Kindness also includes being kind to yourself. When it comes to ourself, we are much harder on ourself. We rarely think about showing ourselves kindness. When we beat ourself up, we cause unnecessary suffering to ourself. Self-criticism only sabotages us and worsens a situation. To calm my inner critic and replace it with the same kindness, warmth and understanding that I treat others who are struggling, I choose the language that makes my self-talk carefully. Flip the narrative from “poor me”, “I’m not good enough” to “suffering is part of life, may I be kind to myself in this moment”. Self-kindness gives us support when we most need it.

  1. Friends and family are important

The relationships we foster are crucial for our happiness, health and wellbeing. Research has shown the value of having a strong a support network as the most reliable predictor of our wellbeing. I have observed the detrimental effects of loneliness on wellbeing in my practice. So often, we become so caught up in our own lives, we let golden friendships slip by over the years. Having deep regrets about not giving friendships the time and effort that they deserved is common as we grow older. Loneliness is a major problem among young people. Having moved to a new city many times for work, it can be difficult to keep a close supportive network. However, with some organization and planning we meet at least twice a year with old friends who live far apart. The benefits of technology make it so easy to communicate with friends and family nowadays. Reaching out to someone you miss or have not caught up with is a great way to stay in touch.

  1. Have fun

I’ve learnt not to take myself too seriously, have a laugh and cultivate a sense of humor. It’s important to have a creative outlet besides working all the time or constantly chasing a goal. What I like to do is take a step back and remind myself there’s so much to life than pursuing success. If I cannot be happy with what I already have, then having more will not make me happier. I believe injecting fun and excitement in life are important to flourish. Celebrate your success and enjoy your way to where you want to be.

Share this article with a newly qualified doctor you know. I’m sure these 7 insights will help on their journey.