Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Hi, next we have Gita Lingham who's going to talk about how to succeed in foundation year one surgical jobs. Oh, thanks Michael for the introduction. Uh Yeah, my name is Gita Lingham. I'm a surgical reg in east of England. Um, and I'm going to tell you how to succeed in your F one. Uh, so basically could summarize this talk in one slide, which is be good at your job. Sounds really silly. But people think of F one perhaps in a slightly more complicated fashion. But essentially if you do the job that you're meant to do as an F one, people will like you, you'll get opportunities and you'll get to do more. So focus on that. Don't take too much on. Uh So what is being good at your job? What does it mean? Uh, a few key points came to my head when I think about F ones so efficient, keen to learn team player caring. These are all good attributes of an F one um, organization. Ok. So if you guys know anyone that's in F one now or has done F one, they'll tell you that actually the medical knowledge side of things is not actually that extreme. Um We don't expect F ones to have a vast amount of medical knowledge, but actually organizational skills are far more key um being efficient time management. All those words that you hear during medical school all apply during F one. So don't stress too much. I assume the majority of you listening to this are medical students about to start F one. Maybe even some people are part way through F one. But don't stress about the amount of medical knowledge you need. Um It's actually more about how you manage tasks. And a lot of F one is about watching essentially other people do more doctoring and then you then act on those jobs. So it's all about organizational skills. Um So this slide, there's a lot of words on it, apologies. But essentially, I just wanted to highlight some of the key roles that you might have as an F one. So ward rounds nights, not all I know not or do nights as an F one on calls. And then you might be asked to present uh maybe an audit meeting or an M and M morbidity and mortality meeting. Um The key thing that I wanted to get across here was actually how much repetition there is during F one. we all had to go through it, but essentially F one is a lot of documentation. It's a lot of walking around behind someone often and writing down what they have to say. Um It is useful, it is part of the learning curve. Um So, although it can seem repetitive and boring, um it is a necessary evil and actually, there's an art to documentation when you first start F one you're gonna hear your seniors explaining things to patients in layman's terms. And then you have to be able to translate that into a nice succinct way in the documentation. Um So instead of writing, patient feels sick, you would write, patient feels nauseous. So if it's things like that, it's that translational skills that you develop during F one. But documentation is key again, very much from an organizational point of view. A lot of documentation is about just making sure it's all very accurate uh date, time, name of person on ward round and making sure you've documented all the plans very clearly. Um jobs. So again, that's something that appears in three out of those four things is doing jobs. Um A lot of F one will be having a little jobs list that I'm sure you guys will see in people like a handwritten list with a little check box to color in or tick off. Um But that is a big part of your role seeing unwell patients. Um So I think that's potentially what people think of more when they think about starting F one. Um But yes, you do still have to go review patients uh communicating with other teams, nurses, patients, that's all part of it. Um And then the M and M or audit meeting is just a slightly different role that you might have in terms of presenting stuff. Uh Yes. So this is the point that I was trying to make f one can be really repetitive. Uh But it's there for a reason, it's important to learn the basics before you progress. So don't be disheartened if you feel like you're just on a ward round all the time. Uh I've done some common translations for you. This is based off actually the most recent f one cohort that I have at my hospital and things that they don't know, this is a little bit um surgery specific. Uh but a lot of the stuff will also happen in medicine, but just in general terms. So free fluids. So a lot of surgeries about whether patients can eat or not eat. Um So nil by mouth, I've got there. So it's two hours for clear fluids, six hours for anything with milk or any food, free fluids basically means you can have any fluids whatsoever. Uh clear fluids, there's no milk so you can have black tea, black coffee water. Uh If your boss says to get a CT, this is very general surgery specific. But if your boss says to get CT, it's a CT abdomen and pelvis. With contrast, when you hear the words prep for theater, your brain should be translating that to, I need to keep the patient, I by mouth, I need to do group and saves, you might have to book the patient for theater. You shouldn't have to consent them because that should be done by someone who knows about the procedure. But you should be thinking of something. Uh, that is something that needs to be done. VT, uh, you'll hear this a lot in any specialty that you do. But again, that's all about what prophylaxis you're putting in place. So Ted Stockings and then whatever um form of inox and flex, that type of thing, your hospital uses pain ladder. I've put is a classic in F one. You learn it in medical school, but I'm not sure you really take it in until you start F one and you will be asked at least once a day to prescribe pain relief if not 10 plus times a day. Uh Use the pain ladder. It's there for a reason. It exists for a reason. Um Build it up, start with the regular paracetamol and build it up. Um A point for an F one is to know the difference between when you prescribe something on the regular side and when you prescribe it on the PRN side, uh regular is far more likely to be given P RN is very difficult on patients and nurses. Um So it is literally if they need that extra bit, not as a, not as a, um, a given. So my pet peeve is paracetamol on APR side. Um, there is no surgical patient that should have paracetamol on APR side. Um, they should have it regularly. It's far easier for the nurses. It provides better pain relief and the patients will be a lot happier. So I've done again, general surgery specific, but I've done, I've done little sort of plans for each common presentation. Um, it's not something that you necessarily need to remember. It's something that again, the repetition when you're on your surgical placement will naturally come to you. But it's just to highlight some of the things you may be asked to do. So, any inflammatory condition, you need to be thinking, does this patient need to be on antibiotics? That'll be your job to prescribe and check with the boss. So that's what they want. IV, fluids, analgesia, keeping patients know by mouth. We've talked about their group and saves prepping them for theater and making sure they have their VT assessment. Again, cholecystitis, very similar. Um making sure that they've got the appropriate imaging as well, additional small bowel obstruction. So again, a very common pathology that you'll see in F one, NG tubes that comes into the practical side of things with F one, you will be asked to do a lot of practical skills in F one and they're often very enjoyable and they can often be the best part of the day really. Um but get stuck in with these. Um, it's important to practice them. It's a good time in your career to practice them as well to make sure that you're on point for later on. Uh, skip through these, uh, top tip for F one, especially on surgery. Is that when a boss says that they want something done, uh, the cliches they wanted it done yesterday. Um, so if we want a scan on our patient, bloods on our patient, it means now, um as an F one, you'll essentially be judged on how quickly you can get stuff done. So if somebody asks you to do bloods on a patient, they don't mean do them tomorrow. They mean that minute. Um So again, it's just coming back to being efficient time management and getting things done, that's essentially the, the motto of F one. OK. So, so far I've talked about doing the actual job and I cannot emphasize how much uh you should focus on that. First and foremost, is doing your job, doing it well, if you do it well, bosses will remember you as that good F one. And in the future when you bump into them again, uh you will get opportunities and they will um write references for you. They will offer you up for other opportunities, other jobs, et cetera. So doing your job is by far, the most important thing is an F one. But there are other things that you can potentially look at as an F one. But again, this is secondary to, once you've nailed the job, do not feel like you have to do any of these things during F one, you can just focus on the job and that is more than ok. Um So please don't stress yourself out by these other things, but the other things could include things like theater time, audits, exams, applications. Um Again, this is, it's free time. Um, but don't, like I said, please don't stress about doing this and F one, if there's any FS listening, it becomes a little bit more, um, relevant, but definitely not something you need to worry about as an F one. Ah, yeah. Here we go. So, first rotation, F one, I wouldn't bother with anything other than doing your job. I have never felt more tired in my life than my first week as an F one, even now as a surgical reg when I do a week of on calls and then nights I don't feel nearly as tired as I did as my first week as an F one. Um, there's something about going from medical school where you're in for two hours in the middle of the day and then you go home for lunch, um, versus actually working all day. It, it will knock you out. So first rotation, please just focus on learning the job, doing the job, making friends, making good support network. Don't stress second rotation, so December onwards, start to think about the other things. Um Have you liked anything so far? Have you done anything towards your ACP or portfolio? Have you done an audit? And then third rotation is when you should actually uh get something. Um So uh general tip. So theater time, um we're more than happy for you guys to come at any point that you're free. Please come to theater. We like to see F ones in theater. Um, it's not a scary place. It can often seem a scary place when you first come. But the more times you go to theater, the more you get used to it and actually the more people know you and the more opportunities you'll get, um, audits papers, there's always people doing stuff in the hospital. You just have to find them, chat to your seniors often sh os that are applying for registrar roles, um, or registrars that have got lots of different projects on just chat to them, get involved with something presentations. So my advice, look up some conference deadlines, um, and then work towards those so that you don't miss them and you can present taste a week. So they recently brought back Taste a weeks in the, uh CT applications. You now get um, maximum points in the commitment for surgery section if you've done a taste a week. Um So again, a very simple thing to organize, you just contact the specialty that you think you want to try out and you say I want to do a taste a week. Um As part of F one, you are entitled to get a week of study leave for that taste a week. Um So again, it's just about planning and organization plan it in advance to make sure um that you can get it done exams. My advice, not during F one. You will all have colleagues that do exams during F one and it's not that you definitely can't do them during F one. I just personally wouldn't stress yourself out. There's enough to do an F one. It's just my, it's a very personal advice, very personal preference. You can do it, but I honestly wouldn't stress about doing them during F one um, portfolio requirements. So have, if you know what specialty you want to do, obviously, the ones I've got up here are surgery but any, whatever specialty you want to do if you know already, that's great. If you don't, that's ok. At this point during F one, I did not know what I wanted to do and that's absolutely fine. But if you do know, have a look at the portfolio requirements, now, you don't need to necessarily do anything about it, but just have them in the back of your head to sort of guide how you spend your free time. The other half of F one, the more miserable part of F one is just being exhausted. Uh The repetition will get to you. You will probably be told off at some point during F one and you will have a stressful day. You will have a shift where patients die, you will get attached to patients, you will get attached to their relatives. Uh, sad events will happen. These are sadly, uh things that are all part of the job. Um, but it's normal. OK? And that's, that's the key point to get across is that it's not meant to be every day is an incredible day. I think the phrase and Grey's anatomy is, it's a great day to save lives. Um And it is, and you will have some incredibly high moments and you will really enjoy it, but you will have some lows and they are ok. Um The key to getting over that, um, is a good support network. This is a quote from Miranda Bailey, one of my favorite TV characters. Um Rest is not a dirty word. Rest is not laziness no matter what you're told or how many times you're told it. Rest is love. Rest is peace. Rest is a beautiful model for your Children. Um So again, know yourself, know your personality, know what you're more tended towards, but please don't tire yourself out. That again comes back to the fact that doing your job and doing it well is absolutely more than enough. Ok, I'm sure you guys have felt it during medical school, there's always somebody out there that's doing more. Um And you're always gonna have that feeling. We all have that sense of imposter syndrome. We all have that sense of feeling behind, but actually doing your job and doing it well, puts you well ahead of the game. Um So don't take on too much and please rest throughout, obviously, not too much. Um So again, this is a bit of a sort of like mum slide uh stroke hr type thing, but regular meals, sleep, friends and prioritized tasks. Uh The tip I have for meals is, um I was told this is an F one, if you're doing night shifts as an F one, keep your meals the same. Uh It helps with the recovery from nights to days. So obviously you're sleeping in the day. But actually, if you keep the three times a day eating and you don't eat overnight, it helps you get back to your regular pattern. So keep your meals the same sleep. It's important to get a good rest. Like I say, um, you will feel tired during F one. It's just the idea of working that will make you feel tired, but it's important to get a good night's rest. Um Even this weekend in a lot of the Registrar talks, they've talked about the importance of getting a good night's sleep. Friendship team work. Um F one is really enjoyable. From this point of view, you'll make some really good friends. You work as a team. It's a little bit like when you bond during initiations at medical school and freshers week, it's sort of a because you're a little bit miserable and stressed together, you bond and you make good friends, but don't underestimate the importance of that. So use your team, use your friends um value your support network prioritize. So again, that's just a note to say that you've now you're now an adult. When you're an F one, you're now a fully functioning working human being. And yes, you have a full time job, but you will also have to juggle all sorts of other things, friends, family, exercise, uh diet, you know, um all those sorts of things. So just, just think about what's important to you and prioritize appropriately. ACP um Not really too much to say on this ACP and F one. Again, it will come around to the deadline and everybody's like, oh my gosh, have you, you know, got all your CBD S and S and have you done your tab assessment and this and that um take a deep breath. It's not that difficult. Um Have a look at the checklist beforehand, know what you need to sign off. The key part to this is getting to know your supervisor. Um They are often the hardest people to track down. So figure out where your supervisor works, know what they look like, know which department they're in. Um and the easiest way to get things signed off is for you to go and find them. Um endless emails are a little bit pointless. So by all means, send an initial email. Hello, I'm so and so I'm your um supervisee. Um I work in this department, blah, blah, blah. And there are some supervisor that are absolutely brilliant and will respond straight away and they'll say, yeah, we'll meet tomorrow for your initial assessment, but just by the nature of it, lots of supervisors are incredibly difficult and that email will get missed. Don't leave it until the end of your placement to get signed off. Go find them if you know that they are in the seven on a Wednesday, then go hang around the to seven on a Wednesday. Um And they actually like that initiative. So don't feel scared to do that. They would rather you come and find them and they can always tell you that there today is not a good day, maybe tomorrow, but they would much rather that than you just send 20 emails, none of which they respond to. Um This again is just a bit of a slide just to say that it, I know it. I'm making it sound really depressing f one but it's not all sunshine and roses. Um There will be bad days but they are ok and they are normal. Um And like I said, just use the team around you and your support network to help. Uh OK. So we're very fortunate to be sponsored by Teach me surgery. Um So I've just got a very quick question um for you guys, uh just as a practice question might be something you get faced with as an F one. So 69 year old patient underwent an Lewis Esophagectomy for esophageal cancer three days ago. He has since developed af and his pyrexial white cells are 23 CRP 300. What investigation would you obtain for this patient? So these are the options. Have a think in your head. Which one you think you will do? Luckily it's virtual. So I can't actually pick on anybody and there's only one person in the audience. Oh I'm looking at the uh responses. There aren't any yet. Oh OK. Just go for it. Yeah. Alright. So um oh why did it not work? It should have gone bold. OK. Essentially the answer is ct I don't know why that didn't work on my slides. Um The answer. CT no, no real prizes for guessing ct in a surgical question. Uh Yes, we do like CT, the stereotype is real, er but essentially multiple causes for patient sepsis, but the most life threatening complication um is potentially an anastomotic leak which is best picked up using CT. So to summarize uh focus on your job, don't beat yourself up, doing your job is excellent and the other stuff is extra um work hard and opportunities will come. If you're a good f one people will like you. People will take you under their wing, they'll mentor you, mentor you um and offer you projects and things like that. Um Support networks. I've said I've harped on about, but they are very important and look after yourself. Um It's, it's an enjoyable experience. Um And II do hope those you are in it are enjoying it already and the ones I have it next year. Good luck. I'm sure you'll all be fine. Any question is there? Questions? No questions. No. Ok. All right. I will hand you over to Jared. He's going to teach you something.