Practical Tips for New Doctors

Starting your first job as a doctor can be extremely overwhelming. I still remember my first proper day on the wards after a few days spent shadowing my predecessor. I was almost out of the ward when I heard a Nurse shouting “Doctor, doctor!” I kept walking for a few seconds before realising, with a significant degree of trepidation, that she was calling after me!

Here are some quick tips for surviving your first few weeks / months on the wards.

Clinical management: 

⚠️ Know how to manage SEPSIS – look at UK Sepsis Trust guidance

📄Locate clinical guidelines for your trust –  download important ones as PDFs & study them 

👩🏻‍⚕️ You don’t need to have all the answers – just remember to assess from top to bottom (ABCDEFG – Don’t ever forget glucose) ➡️ Oxygen & IV access!

☎️ Call Critical Care Outreach team if you’re in trouble but can’t get hold of your immediate seniors (registrar / consultant) 

Practical procedures: 

Be aware of your limitations but don’t be afraid to try. If a senior asks you to do something you don’t feel confident in – state this up front & ask for the support you need e.g. “I am not very confident at doing that. Would it be alright if …”

📞 “I tried once / twice & call you if I need help?”

🖐 “You came with me to watch / assess me on Direct Observation of Practical Skills (DOPS – a type of work based assessment completed by doctors in the UK) and correct me/ assist me if I can’t do it?”

👀 “I watched you do it once & try the next one?” 

Mentors:

📝 When you meet other doctors, keep a note of attributes you admire and ones you would rather avoid.

🗣 If you meet a senior doctor you aspire to be like, ask them if they would be willing to mentor you. This can be as good for them as it is for you – senior doctors need to show evidence of leadership and management skills.

❓ Find out if there are any local mentoring schemes based on specialty in your hospital. 

Contacts: 

📱 Keep a list of useful contacts in a note on your phone e.g. ward number, Critical Care Outreach, Registrar, Consultant, Ultrasound, MRI, CT, portable X-ray etc.

📞 After the handover make sure you know how to reach your team. 

Portfolio:

📆 Get started EARLY.

👨‍⚕️ Take every opportunity to assess a patient in front of your seniors for feedback & work based assessments including (in the UK) Clinical Evaluation Exercises (CEXs) and Case Based Discussions (CBDs).

🖊 Did something particularly difficult/ interesting/ challenging happen on your shift? Enter a reflection in your e-portfolio as soon as you get home.

Teamwork:

😊 Get to know everybody and be polite.

✊ Respect your team members and treat them equally – doctors, nurses, pharmacists, radiographers, OT, physio, porters, admin staff, catering staff etc etc etc.

✏️ Keep a note of their names. 

Legal: 

💵 Check your payslips

⏰ Exception report any overtime. This isn’t just about you, it’s about those who will do this job after you’re gone as well. If no one exception reports overtime then an understaffed ward will remain understaffed. 

🇬🇧 Get membership to your trade union – in the UK this is the British Medical Association (BMA)

🗓Ask your trade union to check that your rota is compliant (the BMA has free tools to help you with this)

👩‍⚖️Make sure you have medical indemnity e.g. Medical Defence Union in the UK

Useful Apps: 

✨BNF (British National Formulary) – switch between adult and child versions

✨Induction app – for extensions/ bleep numbers etc

✨MicroGuide – antibiotics and when to use them 

✨Arrow EZ-IO – how to get intraosseous vascular access 

✨Mersey Burns – fluid requirements for treating burns 

✨Blood Components – Transfusion guidelines

✨Paediatric Emergencies – emergency algorithms including medication doses based on age/ weight 

✨The Royal Children’s Hospital Melbourne Clinical Practice Guidelines – paediatric clinical guidelines including NHS ones

It’s normal to feel overwhelmed at first – even those final year medical students who are excited to move on to the next chapter tend to be overwhelmed. No one expects you to have all the answers right out the gate. Ask lots of questions, keep learning and be kind to yourself.

Good luck out there newbies!