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Hi guys. Thank you for joining. We'll just give it five more minutes to let more people join. So we'll start at 635. Yeah, we can see and hear you. Ok. Kidding. Yeah. Yeah. It's like we'll start in five minutes. Yeah. Yeah. Yeah, we'll start in five to just let other people join. I'll share the slides and then we'll start at 635. Ok. Um Yeah. And then are you gonna press like next, each time? Yeah. Yeah. Just let me know when you want the next slide. Do you know how to blow the background? Can't, no, I can't do it. I mean, it's fine but. Ok. Ok. Ok, guys. So I think we'll, I think we'll start. Um So, hi, everyone. My name is Pre I'm an F one currently at Kingston Hospital and today our talk will be on looking specifically at the F one role and I've got my friend Far, that's also an F one at Kingston with me who will be giving the talk. So I'll hand it over to her if you've got any questions, just put it in the chat and we'll try to answer it as we go along, if not, we'll just answer it at the end. Um So yeah, any queries just put in chat. So we'll get going. Um Var let me just share this. Yep. OK. So, hey guys, I'm Tara, like Pria said, I'm one of the F ones we work together in Kingston Hospital at the moment. So I'm just going to be giving you an insight into what it's like to be an F one. the kind of key things that you should be aware of and things that I had no idea of before I went in. So I hope this helps some stuff you may already know because um I think Pria did a session a few weeks back where some of these things were touched, but I'm just going to sort of go into details into what it's like to be a medical and a surgical F one and also the sort of things that you will hopefully find useful in your job. So we're going to speak about the normal working day on a medical award and then normal, a working day on a surgical ward, what to expect on your, on calls and sort of tips and tips and tricks that nobody told us before we started that hopefully, can we can sort of relay back to you um if any of you guys are in London or even if not some of the apps that I've got at the moment, which are really useful um uh when, when you do your job um as well as E portfolio, which is really important because, you know, you need to pass your ACP. Um And then also just a little bit about planning for life after F one and F two, even though I know it might seem like it's a bit too early but just some thoughts to have in the background whilst you're doing your jobs. Ok. So, um on my rotor, so I started off with elderly. Um So at the medical ward and I had two rotations um on a medical ward. So usually you've got your 9 to 5 normal working day. Um or, and then you've got your long days, which is with the on call. So on a 9 to 5 working day, um obviously every hospital starts slightly at a different time, but we start at nine. So we've got our morning huddle, which is just, you know, just before nine around nine o'clock, which I'm sure you all know, office or from placement and things like that. This basically this is well, the senior sister and then the doctors meet in the morning and they highlight sick patients overnight and also any potential discharges. Then we've based on how many patients we have, they get allocated to the doctors. And also this is sort of depends on how many doctors you have on the day. So if you've got five doctors, then you're looking at a good day. If you've only got like three doctors, then you know, you're going to have quite a few patients and then you go on after getting your patients allocated to you, you go on to prepare the ward round notes, which I'll go into a bit of detail in a second. Then you do your ward round which way you load up the scans, do the documentations, highlight any new issues and then around twelveish. So ideally, every ward round should be done by sort of midday. It doesn't always happen, but ideally it should. And then because at 12 o'clock, you have a rag meeting. So it's an MDT meeting with your therapists and nurses and they just sort of discuss every patient to help alongside with discharge planning. And then you've got your ward round jobs, which after two, which also includes updating relatives. So just kind of going back. I'm just going to speak to you a little bit about in detail what you kind of need to know the morning huddle. That's fine. Your sick patients are highlighted one thing when you get your patient list, always take notes of your potential discharges because in the morning, the discharge work ideally has to be done sort of before 12 o'clock. And the thing is if it's not done, it just adds work on to you because the sister in charge and the nurse will be bleeping you about discharge summaries and TT S which I'll go into detail a bit later, but it's just for you to have an organized day. It's ideal to get the discharges done earlier on so that you can carry on with your day stress free because the last thing you want is when you're busy getting like a million bleeps. Um and then when it comes to preparing your ward rounds, you want to make sure obviously doing it quickly is quite important. So the best way is I always look for each of the patients, you need the vitals. So the new score, if it's zero stable, that's perfect. Um If for example, they're a bit hypotensive or tachycardic, just highlight that um to to the doctor because that's to your consultant. Sorry. So they, so they, they're aware um blood blood results from the morning, particularly if you, if you're looking for any trends. So if someone is admitted with an infection and you're looking to see that the inflammatory markers are coming down, things like that, which are very important. So the CRP you got white cells and cells electrolytes. These are the important things because I remember back when I, before I started working, I didn't know what was important, what wasn't important. So it really depends on the patient and then your issues list. So always make sure when you do your ward round notes that your issues list right at the top is up to date. So um and any issues that are resolved. So for example, if someone has an AK I and it's resolved, then just resolved next to it. So that's quite important. Um And then your treatment escalation plan and VTE. So just to sort of summarize the ward round how I notes, you've got your patient notes right at the top, you write the consultant that you're grounding with um or the sho or the registrar in your first month, try not to go see patients alone because you need to be supervised. So you will be ward driving with someone. So their name at the top, then the treatment escalation plan. So are they for C CPR or are they for um are they do not resuscitate? Um or what are they for, what's their plan? Because if they, if a patient per arrests, the notes will be the first thing they look at to see the plans going forward then BT. So are they on low molecular weight Heparin? Are they on Apixaban? Because you know, this is a complication that can happen. PS and DVTs can happen if you're an inpatient for a long time. So that's quite an important thing. And then obviously, the things that you're going to document on the day. Um OK, so we can move on to the next and also feel free to ask me any questions throughout. Shout out or I'm monitoring the chat as well, so we can help you as we go along. Um So surgical working day. So, well, my current job at the moment is a surgical one very similar, except obviously you start a lot more earlier. So we start at 730 finish at five. The slight difference is that we have to come in quite early to prepare our surgical list and prepare the notes. So even though everything sort of starts after eight o'clock that whole time, we're trying to get the patient list. And in our hospital, I know every hospital is different. Um Maybe if you're going to a hospital where the lists are done by, I don't know the admin team, that's great. But in, in our hospital we have to do and and it's quite important because anyone that you don't add in the list, they get missed. So you just want to make sure that you give yourself enough time. So we come in around 7, 10 past seven, some 715 just to give us a head start to double check everything and then prepare the notes, then you have your morning meeting around eight o'clock. So that's when the consultant comes in and all the rest of the team and um the post take patients are highlighted um and any operations that need to be done on the day gets highlighted as well. They review scans, particularly CT as a big group together, you know, more eyes to spot anything that has been missed before. Um And obviously like highlighting sick patients from the ward. So after that, we all get allocated patients. So I'm on general surgery. So we've got emergency surgery, upper gi and colorectal all in our team. So we come in the morning and anybody who's on call will be on the emergency side of things, anyone who's not on call can decide between upper gi and colorectal. So you get to see a bit of everything. So if you, if any of you have any general surgery jobs, it's a good way for you to learn, then we have our ward rounds. We, we go with our registrars. Um, you don't really see patients alone in surgery if you're an F one. So you see them with the sh or the, or the registrar and here you sort of load up the scans, uh highlighting your acute issues. Yep. And then after you've done your ward round, which by the way, you probably know from med school, it's, the surgical ward rounds are so quick. So they go so quickly. So you have to give yourself some time to sort everything out and sort the notes out and then you've got your afternoon jobs which that you need to do for your patients. And then if you have time, um you can assist in theaters. So this is kind of like, it depends. So I wasn't, surgery is not something I wanted to go into. So I wasn't too worried about not getting theater opportunities, but I know any of you who are budding surgeons, you need those hours for future training. So if you do have a surgical job, try and get your theater time, get your assistance, get your sign offs. So that's something to sort of think ahead if that's your interest. Yep. And then around fourish, um, our registrars and consultants want updates has the jobs been done a bit, a bit like a, you know, chase. Um And then, yeah, and after that, yeah, next and then, yeah, and then after you're done around five o'clock, you hand over to the on call team if needed, if there is anything to chase and then try and finish on time to the best of your ability. So the sort of jobs that you'll be expected to do as an F one procedures. So taking bloods, um inserting Cannulas catheters and sort of other trained procedures. So for example, if you've watched an Ascitic tap and you've done a few ascitic tap under supervision, if your sho registrars are happy for you to carry some out independently, you can do those. So it's kind of, it's about how proactive you are in some hospitals, the nurses are really trained. So in our hospital they do all the bloods and Cannulas. But I know in up north, for example, f ones have to do all the procedures. So procedures was kind of one of the, one of the main jobs, then it's requesting bloods. So for the next morning, um or even if they need bleeding that day, requesting these radiology requests and then also vetting them. So things like chest x-rays CTAP or pelvis um requesting them and then also calling on call radiology to vet them. Um Every department is different. It's quite difficult for us to speak to our radiologist on call um in our hospital. So whenever you do any vetting, just make sure that you have your information about the patient. So the key things like who's the patient? How old are they? What is their current acute issue? So like a one liner, why do they need the scan? Why you're vetting it? How urgent is it? And then it's about how well you push your case, the radiologist will be like, ok, fine, I'll do this kind of thing. So it's quite important that you really know um why you're requesting the scans when you communicate with the relevant team um Clar in and documentation. So this is actually a very, very important thing because um you know, as an F one, you're documenting basically everything and what you're documenting it. It's a legal document, isn't it? So if consultants sometimes or registrars, they will just do the ward on really quickly and then they'll go. But then if something goes wrong from the documentation, they'll be like, oh, why didn't you document this? So if you have any doubts, whether it's impressions, if you're not sure about what we're treating. So, you know, a post state patient and you don't know what the impression is. Double check. The consultant put in an impression and a very clear plan because they might be busy. They may not double check. But then God forbid, if something goes wrong, your documentation is what, what will be taken to the court. So documentation is quite key. I'm not trying to scare you, but it's just very important that what you write down is clear, succinct and checked with your senior. Other things are obviously answering your bleeps. We'll go into that in a bit in detail in a second and then specialty referrals. So if there is um if you're on a surgical ward, for example, and there's an elderly patient who needs a lot of medical input, they'll ask you to do a medical referral or a care of the elderly referral. So these are the jobs you'll be doing. So you need to, you need to know exactly why you're referring the patient. What is your specific question you're asking to the specialty and give them as much detail as possible so that they can give you that review or give you the necessary advice needed, then you want um then you'll be doing discharge summaries and TT Os, which is your bread and butter as an F one and the and then managing acutely unwell patients. So just to kind of go a little bit into discharge summaries and TT OS. So the main thing about discharge summaries is that it's a short succinct summary. So you're not expected to write a big essay. Nobody wants to read an essay because at the end of the day, if you're the GP, you're going to be reading about over 10 discharge summaries a day. So you just want a short succinct summary. Um It has to be to the point and it's written in prose. So we don't actually abbreviate or do anything like that. So the main thing is that you don't want any jargon, you don't want any abbreviations you start with like who's the patient? So, so and so aged 25 came to XY Hospital for this many days. They were treated for a particular condition. These were the investigation results that um that they underwent during their stay. This is the treatment that we provided. This is the follow up that they will need. That's it. It's as simple as that. You don't need to overcomplicate yourself. Keep it simple because you'll be doing so many of these a day. And if you have like six discharge summaries all to be done by 12 o'clock, if you write big essays, it's not going to be helpful for anyone and it also keeps your job quite easy. So, so that, that's the key thing. So here I've written a bit of an example just for you to understand. So this is a patient who came in with um a made up patient who came in with pneumonia. So day doctor this so and so was admitted to this hospital on this day. They came in with shortness of breath. This is, this was the diagnosis. So it was pneumonia. She was treated with antibiotics. She made a good recovery and is now discharged with the remaining course of anti biotics. Please. So I always put at the bottom like all the results like x-ray results or CT results or whatever. And I'll write, please find her most recent blood test and chest X ray findings below. There will be no outpatient follow up for this patient and she's been discharged with safety netting and then just like it's just a short letter. And in this section, the follow up is quite important because if it's a patient, a surgical patient, they may need some follow up. So we put that in that hospital bit if it's um there's also a GP follow up segment. So there you write what you want the GP to do. So whether it's reviewing meds, if it's um I don't know organizing. So in our hospital, we don't have drugs and lia on alcohol services as an inpatient. So if we have any patients who have substance abuse problems, then I write in the GP referral, please. Could you refer to? So you know, things that we couldn't do because we don't have the facilities. If the GP can organize. So that's quite important. The follow ups are quite important when you do your discharge, summaries next, then TT OS. So TT Os stands for, to take out medication. And a lot of people get quite confused and kind of stressed out in the beginning. You know, I was just thinking to myself back like a year ago, I was really stressed out to do the summary and TT S but it's actually quite simple. So with the TT O, you just have to think any of the patients regular medication that they're already on, they can take it. So unless you've made some changes. So if a patient is on antihypertensives, for example, and they've always been on it. Um But then during your hospital admission stay, their BP has been absolutely fine without needing the antihypertensive, then you can just, you don't have to drag across that medication. You can just write at the bottom for, to review so you can um drag it if you want, but you can just put um Right, right. Like click review and then um the GP and then you can write on the GP follow up bit. Um Please review antihypertensives if clinically indicated. And I know that all of the systems will be different so that I'm the system we use, which is CRS is quite different to whatever other systems you will you may use, but they'll train you. Uh But it's essentially the same thing you know, is it some, uh, medications do, do they need to be reviewed? What will they be, um, taking what has been stopped? So, the regular medications, if you're ever confused, they can stay, um, unless, like I said, if you made a change so you can drag those across and their TT S and then medications for which the course is not yet completed. So, for example, if your patient came in with pneumonia and they're getting better, um, and they're sorry, medically fit for discharge, but they still have to finish the remaining course of Doxycycline or amoxicillin or whatever antibiotics you put them on you, then just ok, they've had two courses, give them the remaining full course. So then you just kind of go through the drop chart, see why, why are they on this medication? Do they need it? And then you drag it across. Um, other things like analgesia, if they're in pain, um, they need, you know, those are safe to drive across. Just be careful. Some things like paracetamol, um, safer than, um, like Dihydrocodeine, for example. But if you are giving someone dihydrocodeine, just make sure that you give them laxatives to go with it because then you don't want them to be constipated. So things like that when you do your tt just make sure that you think about it. And if you're, especially in the first week when you're a bit confused, always ask your senior. I ask my sho like a million questions each day for the first couple of week and then you sort of pick it up. Um, and then, like I said, any medications that require reviewing must be highlighted. So you can already highlight it on your TT, but if you want to be extra cautious, you could at the bottom where it says GP follow up just be like, could you review the following medications? And then the other thing is if any of you guys are on the care of the elderly wards, um, there's a lot of polypharmacy that you'll come across with care of the elderly wards. So if you, if you think that there's a patient on too many medications, like, I don't know, a 90 or on Ramipril and you're like, is this really indicated, speak to your consultant, speak to your registrar. Um, you know, any changes because as the junior doctor, as the F one, you are the one who's going to be looking at, looking at these medications a lot more than your seniors, they, they, they will look at it, but I think you'll know more because you're with the patient seeing the notes all the time. So if there's anything you're worried about, you know, you passed your med school exams, you know how to be a doctor, um, just flag it up with them and then you can go through it together and it also is kind of good for you to be independent and start making decisions alone to prepare you for sho um and as f ones remember, you can't prescribe methotrexate or any other chemo drugs or any other biologics. And sometimes when you have, when you're doing your tt it's so easy to just drag across the methotrexate because you're just doing it, but just make sure because we still have the preregistration and methotrexate requires full, full registration, just double check when you drive across. And if you can't drag these sort of medications across, then ask your sho be like right, I can't do this. Are you ok to do this for me? So just protect yourself in that sense. Yeah. So I also wanted to go through some common prescription errors. So prescription is something you'll be doing a lot and sometimes you'll have to do it so quickly, especially in the ward round. If the patient needs it then and there. So always, always double check because you know, you are the one prescribing, you are the one who will get into trouble if something goes wrong. So you want to be careful and check everything over. So common errors that can happen are dosing errors. So for example, um if you're giving somebody gentamicin, um you just make sure that you calculate the doses. So there should be a gent calculator link with your trust or if you're in a different hospital, there's always, you can Google the calculator and it comes up. So patients weight, height, creatinine and age. So these are the important things that you need for calculation. Um If sometimes when the patient comes into A&E and they don't get weighed, I would ask the nurses to kind of weigh them erly so that you can do your calculation. Um when you prescribe analgesia, just make sure that you double check the how much morphine you're giving them the grams and everything so that you don't overdose them. That's quite important. Um Other things like warfarin dosing. So that's another important thing. So you don't want to make errors with Warfarin because obviously Warfarin is one of their sensitive drugs and a change in a Warfarin dose, it will take about 2 to 3 days for it to take effect. So if you think that somebody's over, so if their inr is a bit too high or a bit too low and you have an idea of what dose to give them, just run it by your senior or your pharmacist, especially in the early weeks of F one and then dose them accordingly. Um And then the other things is frequency errors that you can come across. So make sure that if a patient is getting medication once daily, it's OD if it's twice, you know, just check how many times they need that medication because you don't want to give them too much or too little other things that I've actually seen on the ward transcription errors. So just one of my consultants around the strike period, wanted to, wanted to practice prescribing himself because, you know, the Juniors do it so much. So when they're striking, um they wanted to kind of do it to be prepared for the strikes and he told me to give metroNIDAZOLE but he selected metacide instead. So it's things like that. They sound so similar, but they're two different drugs. So you want to make sure that you select the right thing or if you're hearing wrong, if you don't know, did they say metoprol or metroNIDAZOLE? Just double check? Because you know, they're two different drugs. So common mistakes that can happen, especially if you're under pressure, doing so much, so quickly. So just take care of those things. Route of administration is another error that can happen. So make sure if someone is subcutaneous, then it's ac if it's oral, it's, or if it's intravenous, like just double check all of that. And then allergies, of course, this seems like a very common thing like, oh, you know, why would I give someone who's pen allergic tazocin? But it can happen because like I said, you're busy, we're human at the end of the day. So just always double check. I don't always trust the system even though it comes up with the allergy in bi always ask the patient as well just to protect yourself and them. Um And then of course, contraindications. So you don't want to give beta blockers for an asthmatic, for example. So just take care of those things and check those. Um And now I'm going to go into to talk about medical and surgical on course and the common things that you encounter. Um Sorry, just before I proceed, anyone have any questions that they want to ask me right now, we can wait until the end, but I'm happy to answer any right now. Ok? If not just we can put it on the chat. So with on calls, medical, medical, on calls, you always attend the resource huddle in the morning. So around nine o'clock, you assign yourself to a role. So if you want to be scribe or taking bloods or abgs, um and then throughout the day for medical and surgical on call, you'll be attending peri arrests and cardiac arrests for the for the day. Um And then from 5 to 9 is when you actually do the on call, this can change between trusts, it might be 6 to 10 for some hospitals. Um So the jobs that you would do from 5 to 9 as well as attending peri arrest and cardiac arrest is any handovers from the day team. So any things that you need to change. So chase and then next, you'll be assessing acutely unwell patients. So with this one, I know it's quite scary in the beginning, but always take your A two E approach. So if you don't know what's going on. Have a quick read about the patient before you go and review them because you should have access to a computer, get a basic idea of their past medical history, their current issues and then also what drugs they're on because you want to rule out things like morphine toxicity and morphine, things like that. So just have a quick idea. Have a bit of a read before you go up there, then assess your patients with A two E and then, and then if you're confused, you can ask your sho but usually a whole team will come when there is a Perret. Um and then there will be prescriptions as well that you will have to do on out of hours. So usually action handovers from the day team is things like if they did a set of bloods and um they want you to chase the inflammatory markers, whether it's coming down or coming. If it's going up and not doing its job, you want, you want to escalate antibiotics. So those could be some potential jobs. Other things are like warfarin um prescription. So patients who are on Warfarin, if their clotting had not been done during the day and they decided to clot uh do clotting on a patient at three and then the, the blood tests haven't come back. It will be your job. Well, they should hand it over to you to chase and then dose the dose the Warfarin for which there will be guidelines and things like that. Um Other jobs again, like I said, will be prescriptions. So if patient needs fluid prescriptions, you'll be doing those procedures. So Bloods Cannulas um catheters, um like I mentioned a few seconds ago, chasing bloods and action, any plans. Um and, and also anything that you're acutely worried about, you can hand over to the night team after you're on call. So that's your main sort of jobs as an on call doctor. This is quite important because no one really told us this when we started working and especially in the first couple of weeks, people were giving handovers which were just not realistic or people were looking at me like why are you giving me this handover? So it's really important that you know what a good handover is. So a good handover is something where a management is required. So, and something that will change the patient's management for that duration of time. So, like I said, if they've got rising inflammatory markers, ok? Should we escalate and escalate the antibiotics or if they need warfarin prescription, wait for the inr check and then, you know, dose accordingly. Or if you're worried about a patient's potassium because it's been up and down and you want to, if they are hypokalemic, you want to wait for those blood results check and then prescribe potassium or you are worried about a patient's heart and they've had chest pain and whatnot. And you want to check if the troponin has gone up. So these things which will acutely change management is what you should hand over. Anything that can wait till the next morning or it's not going to make any difference at all. There's no need to hand it over. So, a good handover also means not just saying, oh, can you review the patient or can you check their bloods? What do you exactly give, give one line of what is this? Who is this patient? What, what, what are they in for? What has already been done? What are you waiting for? So if someone, let's just say someone came and had chest pain at 3 p.m. So the doctor would have done an ECG reviewed the ECG sent off some bloods to check the troponin and then you know, it's five o'clock troponin isn't back. You can hand that over be like, oh, they, they had some chest pain, did an ECG no significant changes, but we need to chase the troponin. Are you ok to do that? And then could you do troponin in four hours time? So they should give you a plan that you can action because you're going to be quite busy on an on call. So you want to give clear succinct information, instructions on what to do and will this change management overnight. So that's quite important. A bad handover if someone asks you or if you ask someone to update next of kin unless they're dying, unless they're acutely dying. And there's been a sudden change and deterioration. They need an update. Fine. But if it's just about daily or how are they on it today, then you don't, that's not an out of hours job. Also. Vetting scans because vetting scans after five for an F one in our hospital is quite hard because sometimes radiologists don't work after five or we have or they may not want to speak to a junior. So if, if you're able to get scans before five o'clock, that'd be great to make it easier for the out of hours team. So just check it, whichever hospital you go to just double check what, what the sort of logistics are, so you can act accordingly. Um And also a bad handover is, is, is not giving someone clear instructions on management and just kind of telling them review and then going. So make sure you take that few minutes to explain. So just a few tips and tricks that we, we kind of learned over the over the past year. Documentation is key. So like I said, it's a legal document. Um sometimes especially in surgery, the ward rounds are like rapid fire. You can't document really quickly. So make a few bullet points, then double check it later in your own time before submitting it just so you don't make any errors if you're unsure, always check with the consultant and they would appreciate you for checking because it's their legal document, which you're, you know. So technically, you are the most important person on the ward round with the documentation and everything. Um Always ask and escalate if unsure if you're a bit worried, you're nervous, don't make decisions on your own. Just check with a senior sho and make combined decisions especially in the first month of being an F one when referring to other specialties, just be very clear, concise, ask them direct and specific questions because a lot of the time referrals will get rejected or they might say it's not enough information. What do you exactly want from me? So just double check those and give them good information and instructions if you're referring with specific questions. Yep, and then working on your E portfolio. So this is quite important. So um you want to start early with your E portfolio, um know what you have to do. So in per rotation, we needed two mini texts, minimum two dos and two CBD s like this is the minimum requirement as well as two reflections each. So try and get those opportunities early. So don't wait until the end of your rotation and chase the doctors around, try try early because you're gonna be doing so much work. It's not like med school where you have to go fish for them, you are working. So there should be someone to always sign you off. So make sure that you start on those early. And so it just helps with organization as well prioritize your protected teaching. So as a France, you will be getting protected teaching, which is also important to pass your ACP. So there are days when we get really busy on the ward and we can't attend teaching, but just try and make sure that you prioritize your protected learning time because that is your protected learning time and I know it can get a bit difficult. So try and make sure you attend your teaching. Um, do your discharge paperwork as I explained earlier before 12 pm to avoid getting bleed, unnecessarily because the nurses also have to arrange transport and get the medications from the TT. So TT S are very important in the beginning discharge summaries, try and do them all by 12 p.m. because you're going to get busy. And then one other thing I thought helped was having like a to do list or a jobs list. Um, we all of us always have it and you've probably seen doctors have one. it just really helps with organizations. So you don't miss anything and always just go through each of your patients again before the end of the day to see you haven't missed anything. And the main thing is look after yourself. Um, so many days, me and Priya have been on call, haven't had any water. So, you know, you, you want to make sure you drink regularly, you have a snack with, you take that time, even if it's 20 minutes, quickly eat something. You're going to have busy days, but you're also going to have quite chill days, especially around the summer. So try and utilize those timings and like you can only look after patients if you're well hydrated and if you've looked after yourself. So that's really important. Um So these are some apps, I hope you guys might find this helpful, but I find this helpful. So we use induction app in London to get contact numbers for hospitals and specialties, et et cetera. So if you're in any London hospitals, induction is a very useful app. Um Other thing, especially in the first month of F one smart doctor, I think is like three or 4 lbs is really helpful because if you don't know what analgesia to give or what laxatives to give or what, how to acutely manage a patient, the app has really good, like for each presentation, it tells you what to do. So if it's I know chest pain, it will tell you potential differentials what to order. So you will, if there's anything you missed, you can always go back and check with smart doctor. So it's really, I find it really help, especially on calls. Um Then I have ATN O job next year for F two. So this black, yeah, that one also, so that's called Also Flow that's a really good app for, if you have any TN job, I haven't used it yet, but I've got it at the moment. The other one is FC. So it's Fracture Classification again. Any of you guys with an author job, haven't used it yet but had a look. And it's really good. B NF. So BNF is your best friend. Any, any medication queries? Contraindications, just go on the BN FMD CALC. Another really good one. Just scoring patients, whether it's just G CS scoring or any other scoring for like this is perfect. You don't have to stress about going Googling things, everything is on MD CALC and then we also use Pando, which is just you can send pictures to dermatology specialties to get their input. So in our hospital, that's how we communicate with the Derm team. You can send them pictures of the rash, ask them, it's really quick and it's really effective and it's your referral. So any of you guys, if you find those useful, go for it. This is just so as I explained earlier, your E portfolio is really important. So I already explained earlier, you have two CBD S, we had a minimum of two CBD S, two minix two dos per rotation and one developing the clinical teacher. So it's like where you teach, you need one, no teaching to be done for the whole year and someone a reg has to sign you off. Um minimum of two reflections per rotation more is advisable because you'll be reflecting on a lot, especially in the beginning of your f one career. Um We, so obviously, this may change a little bit, but it shouldn't be different for different trusts. So you would still need 60 hours of teaching by May. Uh and 30 hours of that is core teaching. So this will be scheduled and the other 30 you can um you can attend sort of bedside teachings or other sort of trust um given teachings to, to help with your hours. And one thing you should remember is I know the F one year goes on until August, but the Horace Epo Prolia stuff needs to be done by May. So try and give yourself enough time because you know, your deadline is May, we had to do an audit, which was given to us. Um I know some people for F one don't need to do an audit. So just very trust dependent. Uh one P PDA, personal professional development plan per rotation and then your clinical educational and education supervisor sign offs and, and you have to map all of these to the curriculum to be able to pass. Um I know when you go to your trust, they will go in depth with this. But basically, once you do all of these, there will be a set of curriculums and you just have to map all of your work against these curriculum to say you've done it. So if you're a good communicator or you've clinically assessed patients, your CVD S mini kicks and stops are basically evidence to say that you've met those. And then once you've mapped everything you're done. So just start these early because you will get busy. So yeah, just, just for you to pass. And this is a slide that I added in because um I know you're starting F one soon, but F one goes so quickly and then you'll be in sho and if you want to go straight into training, this whole process happens like early F two. So you should ideally have your evidences. That's if you want to go into training, like straight away, you need to have your portfolio ready. So if any of you haven't got anything at the moment, um F one is the best place for you to get involved with projects. So whether it's um getting into quality improvement projects or teaching opportunities for points um audits or just gaining experience like taster weeks, et cetera, this is your year. Um And you know, like as an F one, you will be busy but you will have time to be able to do these things. So if there's a specialty you really want to get into and you want to apply for training, um get all of those, well, like start it early because you don't want to get at the end of F one and think Oh no, I haven't. My portfolio isn't as great. So if you have quite a few things that you want to get done, do it start early in F one, find links, find opportunities, speak to consultants, ask them if there's any projects you can get involved in just really at work in the hospital. And then lastly, just enjoy F one. It, it's actually really fun. Me and Priya really enjoyed it. You grow so much in a short space of time and you forget how well you become at the end of it, that me back in August versus me. Now, there's such a big difference and it is definitely enjoyable. So yeah, enjoy your time as an F one as well. I think I've spoken quite a lot uh without a break. So if you have any questions, just fire them at. OK? Looks like no one has any questions. Um If yeah, I mean, if you do have any questions um um before me, before you guys go, please also fill out the feedback link that I've put in the chat. Um All sessions are recorded. Um So it should be available in a couple of days and thank you very much. Thank you. I hope you guys enjoyed it and I spoke quite a lot, but hopefully it was useful and yeah, please do the feedback form. Um And if you have any questions, just email, email us um or just watch the talk again. Yeah, thank you very much.