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Summary

Join us for this on-demand teaching session focused on providing advice for F one medical professionals beginning to work in Accident and Emergency (A&E). You will learn about the typical responsibilities and hours in the role, and hear about the rapid learning curve experienced due to the diverse experiences A&E offers. There will also be discussion around the benefits of operating within this supernumerary job, and advice around practicing key skills. In addition, you'll receive recommendations for several helpful apps used within a hospital setting with a detailed explanation of their uses and features. Those thinking of a surgical rotation in F1 can also get an insider view of what to expect and the skills and knowledge required. This session will also address other concerns like time management and revision for exams while working. This insightful session promises to be particularly useful for medical professionals wanting to learn more about what it's like to step into the F one role within an A&E or surgical position.
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Description

Join us for this session for a chance to learn about any outstanding topics and ask any unanswered questions! Please let us know about anything that you would like us to cover by answering the following questions using the registration form ahead of the session:

  1. Are there any other topics that you would like us to cover?
  2. Are there any other questions that you would like to ask?
  3. Do you have any other worries or concerns about starting work as an F1 doctor?

Learning objectives

1. Gain a basic understanding of the role and responsibilities of an F1 doctor in an A&E setting, including understanding the hours, workload, and importance of constant supervision. 2. Acquire skills in taking patient history, conducting physical examinations, and presenting findings to senior health care providers, focusing on the importance of practicing these skills in an A&E setting. 3. Learn the importance of, and develop skills for, handling a variety of medical situations, ranging from dealing with pregnant women, children, to medical surgeries. 4. Understand the significance of continuing professional development through adopting self-initiated learning activities, such as practicing Cannulas, gaining access to research, immersing oneself in challenging scenarios, etc. 5. Familiarize oneself with different medical apps and resources available for use during rotations, and understand how to effectively use them for better patient assessment and management. This includes learning how to interpret various guidelines and medical measurements.
Generated by MedBot

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Computer generated transcript

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

Um So I've just seen the question about um advice for F one starting a um I would say kind of so II didn't start an AE. So it's hard to um to know exactly what to say. But I would say um A&E is a kind of a very supernumerary job, isn't F one. So I wouldn't be worried about it. Um Obviously, as an F two, it's known for being quite a big job in terms of the hours are pretty horrible. Um And it's, you learn a lot very quickly um because of the different things that you see, um my friends that have had jobs in A&E um as F one have actually really, really enjoyed it in the hospital that I work at. Um They found it super supportive that they work like nine till six. I think most days don't have to do nights or, or kind of unsociable hours cos it's all supernumerary and I really just found it useful in that you see so many different things you see kind of pregnant women, Children, medicine surgeries, see all of it. So you get really confident quite quickly um with lots of different things. So I think it's a really good job in F one. it's obviously you won't get as much responsibility. Um, so it might feel quite, um, yeah, su supervised. But I think that's kind of a good thing in your first job when you're still a bit anxious about things. Um, so I would just try and kind of in terms of advice, I would just try and really take those opportunities and, and go with it. Um Everything that you do will hopefully be supervised by someone else. So I wouldn't be worried about making mistakes. Um But practicing, taking history, examining and presenting your history to a senior um is a super useful scale and being able to do that in A&E uh you'll be able to do that. That's kind of what we do all the time. So I imagine it'll be a really good job, isn't it fun? And yeah, I'm sure you'll learn loads. Um I don't know if that was useful. Um Sorry, II can't give any specific advice, I'd say try and practice Cannulas if you're in a, a lot. Um I don't know what access to research you'll get, but even just watching kind of how people do a to es and acute and while patients in research can be helpful. Um And yeah, just try and, and get yourself in, in situations um where you learn lots, even if that makes you a bit uncomfortable getting, if you're in a supervised role. Um Then hopefully that should just mean you learn lots um in terms of covering nights in AM UI think um you'll still be really supervised if you're in A&E overnight and if you're in AM U overnight, I think. Um So lots of F ones do, am U on calls at my hospital and they're quite different. So there's a med that's always there um kind of normally based in AM U. Um There's lots of sho clinical fellows, it's a very well staffed area um of the hospital. Um And so you're again, quite supportive in that role. Um So I wouldn't be worried. It's a really good job to start. You'll be super confident after that job and there's always jobs that scare you a bit more. And um I think at the end of the day that those jobs are probably the ones you learn the most and you, you just get really good very quickly. Um So I think it'll be a really good job to start on. Um And you, yeah, and hopefully you'll enjoy it in terms of apps. Um So I have quite a few apps I use regularly. So the induction app I'll send these into the chat is the one that I enjoy, uh that you kind of, you have to have to get leak numbers. Um I think it's now called to switch. I don't know why it's called that. Um But this is the app that you get. Um you can search kind of if you just search in like med Reg or whatever the bleep number will come up and it's the same app for every hospital. Um You just say when you log in what hospital you're at and it'll give you the numbers. So that's just super practical um as an app. Um The B NF um is really helpful to have on your, on your phone. Really ready eye research is one that I've got downloaded. Um And that one just has kind of the adult guidelines, pediatric guidelines. And sometimes if you're kind of um if your cardiograph ble goes off and you're running to the other side of the hospital, it take you while not running. I would always walk, by the way, I feel like that's one piece of advice, walk to the walk to situations um because you'll see all the other ridges and everyone doing that as well. Um And it just makes you feel calmer when you get there. Um So if you look at irises on the way, sometimes you can just remind yourself of like, I think like um what you need to do and even though it's kind of inherent in your brain, you, you should know kind of the steps often when you're stressed, it often leaves your brain. So having that is quite helpful and there's also things like Bradycardia and Tachycardia um guidelines on that app as well. Um other one I have is the Foundation app, uh, foundation handbook Foundation. I think this might have been like 5 lbs as a one off payment. And that's really helpful just in terms of it has, um, kind of four different sections. So assessment management reference and calculators, um, under assessment, it'll have lots of, um, lots of different pages on like how to assess chest pain. So there's things like reminders about what to talk about in the history, what to talk about in the exam, what to talk about, um, what investigations to order on differentials. So if your mind just goes like completely blank when you go and see someone, um, you can just have a look at that and make sure you've not missed anything. Um It's got lots of different ones. So like confusion, hematemesis, leg, swelling, stroke, rectal bleeding, like confirming death. It's got lots of different assessments, um, and remind us on that and then it's got management as well, things like management of AFA CS, just like summary pages that are no longer than kind of two scrolls on your phone. Um, and they're really helpful to look at and then, um, the reference one is, it just tells you things to look out on certain investigations. Um, like chest X rays. I don't really tend to use that one as much, but, um, there's things like ng tube placement, um, how to interpret an X ray of that. Um And then there's a calculator section that has things like your Chads Curb 65 Cr. Um Also the one that I use the most is probably G CS because I always forget what components is. So, if I'm trying to figure out G CS, I'll use the calculator from that. Um So that's a really helpful app. Um What else do I have micro guide is really helpful. Usually you can get that on the, the internet, but having it on your phone is also helpful and then I have booku medicine as well actually, which is really helpful. Um It only has certain specialties, I think it's actually a hematology app. Um But it also has things on endocrine and stuff and it has some guidelines on um like hematology, renal endocrine, um and some other stuff. Um but I've used it quite a lot for things like hyponatremia. It has like a really good guideline on that. And um yeah, I would recommend that one, has lots of good guidelines. Um I think those are all the ones I have, I'm sure there's lots more out there, but they're the main ones. Um, in terms of the PSA, I think that's quite realistic to be able to revise for it. Um It's a busy job and I think in the first few weeks it takes a while to kind of adjust and you're often quite shattered when you get home. But I also think it's a, it's, you adapt quite quickly, I think. Um, I think after the first two or three weeks you sort of settle in, you know, what you're doing every day. Obviously, it depends on the job and the number of on call shifts and nights and stuff you do cos they can be quite disruptive. Um, but I would say there's always time that I have after work, um, or even during night shifts and stuff where you feel just a loose end and you can revise. So I think it'd be quite realistic. I also think you'll probably, because you'll be prescribing, it'll probably, um, sorry, you won't be prescribing will. So, um, but I think kind of being immersed in that environment, um where you see things being prescribed every day will also make it easier to provide for it. Um because you'll, you'll pick up on things on a daily basis. But I think it, in terms of time after work, you actually have more time than you think. And I think it's, it's kind of wild in the first few weeks. So you feel like you can go home from work and you don't have to, I don't know, have the guilt that you, oh, should I be revising, what should I be doing work? Um For uni it's quite a refreshing time at the beginning because you're not constantly feeling like you should, there's something that you could be doing. Like I feel like that was sort of always underlying in uni, but, um, once you start work, there's your free time is completely your free time and you can do what you like with it. So, I think when you get home from work, you do have quite a lot of time. I hope that's helpful. I think there was a question about, um, tips for surgical F one starting on surgery. Um, and in terms of stuff I said, so I didn't start on surgery. I started on medicine. Um, but for my friends that started on surgery, um, they really enjoyed starting that. It's a really social job. Um, I think as an F one, I actually preferred my surgery job to, um, to my medicine job, even though I'm definitely a medic at heart. Um, it's just a very fun environment. I think everyone's, um, everyone I met was really friendly. Um, I know it, it's not always the case but, um, it's a very fun job. Everything's a bit kind of more simple than medicine, I think in terms of what you as an F one are dealing with. Um, when surgical patients tend to get sick, I found that often it was more straightforward to know the next steps in terms of investigation and treatment. Um, sort of like if a, if a surgical patient becomes short of breath, there's kind of only a few things you're thinking of sort of infection, um, pe or, um, heart failure or something like that. When with complicated medical patients who already have a Brazilian medical conditions, that can be a bit more confusing to get your head around and they're like thousands of drugs and stuff. So I think surgery is a good one in terms of really building up your skills of assessing patients. Um because often it's a bit more straightforward and a bit more like what we've learned in med school where you do your at e and you kind of have a kind of two or three differentials that you can go through. Um in terms of practical tips, I would say try to learn early on how your surgeons or like the ward round. Um some surgeons will want to know about a patient's CBG S, for example, I was on vascular. So there was a couple who really wanted to know their CBG S for everything. So um I'd make sure that I had that ready if they asked. Um And I'm sure there'll be other kind of little niche things that people like. Um and it just makes things a bit more smoother for you with the F one. It's quite fast, the ward rounds, but um you get quite used to that and you, you don't tend to write very much in surgical ward rounds as opposed to medical ward rounds, um which can turn out to be quite essay like um having lots of things on your handover sheet can be really helpful. So if you print off a handover in the morning, um, you'll get this in your shadowing and I'm sure the f ones will tell you kind of how they've done things and the tips that they'd have for, for you coming in. So, um, it'll vary from kind of hospital to hospital. But in the surgical ward I was on, it was really helpful. We had like columns for most recent blood results, um, kind of the jobs that are outstanding. Their past medical history and their presenting complaint and things like that. So when the surgeon turned around and was like, what's the HB, you just have to look down at your hand over sheet. You didn't have to get a computer system up and have a look and stuff like that. Um We also found it useful that one person was kind of on a, on ac or computer on wheels and one person was writing and we'd have allocated jobs and that made things a lot smoother. So getting into like a learning little tiny things that just make your every day a bit easier on the quick ward round. Um But that'll come easily once you've done, been there for a week or so. Um, when you get bleeps from surgical nurses as well, um My experience is that surgical nurses are very, very competent and can do blood cultures BBg stuff like that. So when you get bleeped by a sick patient, asking them to do as many things as they can before you get there when they're on your way, can be really helpful. So if someone's presenting septic and then you use the spiking, asking the nurses, please, can you take blood of BBg blood culture and do an E CG or something while I'm on my way up, then it means once you're there, half of your sepsis six is already done. Um And you just have to prescribe the other bits. So, um yeah, make the most of your nurses, they're super competent and can do lots of your jobs for you. Um But also obviously they're busy as well. So don't take the piss. Um I hope that's helpful. Um To be honest, I would just enjoy this time you have before you start f one. I think this is such a nice time where you have just completely nothing to do and time off. Um F one can be really busy and I think just enjoy the time off you have. Um If you want to go over anything, I think things like ECG S can be helpful. Um Especially if you're in, I think you said you were in A&E first in A&E, you'll have to look at a bazillion ECG S and by the end of it, it, you'll be so confident with them. Um So you'll learn on the job anyway. But if that's, if you wanted to look over it, that could be something that would be useful. Um, I definitely wouldn't go learning any medicine before. Sort of like facts that you, you learn from finals, even if you feel like you've forgotten them all because I've definitely forgotten all my knowledge from finals. Um, II don't think that particularly helps. Um, it's more the practical stuff when you start off, one that you get your head around and takes a while. Um, and once those things come so, so stuff like, um, uh, knowing the computer systems and stuff like that and knowing how to do a quick referral and being competent with that, once all of those things come a bit quicker, you're much more efficient at your job and things like that. So I would say there's nothing in particular I would recommend going over maybe ECG S and how to invest in things. Um, so like chest x rays, it would be useful. But, um, yeah, just enjoy this time. Oh, my gosh, don't be sorry. I was so anxious before starting F one. I'm a very anxious person and I was literally so scared and it was completely fine and I actually really, really enjoyed it. So, um, I hope that's semi reassuring in terms of resources. Um, I use like in the past la sometimes, to be honest, I don't really, um, look at these things very much, but one thing I was just on a pediatric placement and they told me about this website, um, which I use for the pediatric ECG S but I think it's for adults as well. I think there's bits on it about adults. I'm just trying to have a look but it's in so much detail. Um, but it's far more detailed than you need to know. But, um, sometimes it can be helpful just to make sure you've not forgotten anything if you're looking at a weird E CG and you're really overthinking it if you're worried about an ECG because I'm still terrible at C GS and still get scared and I have to look at them, um, just run it past your senior. I run past every ECG almost if I'm not 100% past the senior. Um, and they really don't mind. Um, and they also will probably be like, oh, I'm not sure, maybe after my judge. Um, so people really don't mind about things like that. Um, and I've had some really nice my judges that have just been like, oh, just whatsapp me a picture of it or whatever. Um, people really don't expect you to be able to interpret difficult ECG S just knowing if it looks weird or looks wrong, um, is the thing they want you to do. So as long as you can do that, um, you'll be absolutely fine. Um, and yeah, as f ones people really don't expect very much from you, um, I would say it's kind of a nice, it, I would try and make the most of it as being your, at the point in your career where you have the least responsibility. Um, and you so really ask for help as much as you need. It's sort of, um, an opportunity for you to learn, um, as much as you can and people will never kind of question you or, um, I don't know, I, at you for asking for help, like that's the responsible thing to do if you don't know and they don't expect you to know because you're just starting out. Um They know you're the most union and they've all been there. So um yeah, you'll be absolutely fine. Um That's a pretty good question. Um I would say as a port of call, don't do anything you feel super uncomfortable with doing. Um So for example, if I was asked to go and see, I don't know, a patient with who was in S VT. Um I've never seen a patient with S VT while I've been in F one. So um I would not be giving them Adenine on my own, that sort of thing. Um because I would just feel really uncomfortable doing that. So I would call the med before I do anything like that. Um The same with like the first time I ever saw hyperkalaemia, I feel the med. Um And sort of even if you just say this is my plan, is this OK? And they say yes, that's fine. Um, um, in terms of specific things I would say, um, in surgery you shouldn't be consenting people. Um, so often you consent people for flexi sick because you've seen flexi sicks. Um, but you shouldn't be consenting anyone for anything you've not seen, I think as a general rule, um, you won't, you shouldn't be discharging patients on your own. Um, so I think, and that just means if they've come into hospital and you're the only person that's seen them, you shouldn't be sending them home before anyone else is see them. So often as F one is kind of in surgery or an SU and A and A and you'll see patients and often none of them, often, a lot of them will be able to go home. Um, but you shouldn't be making that decision. So someone else should be seeing them and say, yeah, they can go home and then you can write this just less and tell them they can leave and stuff. Um, but you shouldn't be making that call on your own. Um Yeah, I think at the beginning, I was really a lot of the questions I had before I started. One was about what is, what is expected of me to do on my own. Like should, II don't know, b initiating the, the major hemorrhage on my own or things like that. And I think the more through one, the more I've come to appreciate it's just that anything that I feel uncomfortable with. I've not done before is totally reasonable to ask for help and phone for advice and escalating it. Um Because if you've not done it before then you don't really know what to do. So I think, um and if you say that to the person you are speaking to like, sorry, I know this is maybe simple, but I've, I've never done it before. Um So I just wanted to double check with you or I just wanted some advice or I just wanted some help with doing this, then there's no way they could be angry with you for that. Um And I think that's the safe thing to do because if you did it wrong then you know, that's on you. So, um I think always escalate or don't do it if you're kind of hesitating about whether you should be doing it or not.