Down The Rabbit Hole

Today, every foundation doctor in the country changes jobs.

It isn’t like Black Wednesday — we’ve all been here for eight months, at least, and are slightly less terrified than we were on the first day of our first jobs, back in August, and mostly know at least where the toilets are by now, and it’ll be another four months before the next set of newly minted doctors start work. It’s still weird, though, because no two wards ever keep blood forms or radiology requests in the same place and you keep writing down your old pager number and the consultants are all different and you don’t actually remember the first thing about gastroenterology.

It’s a curse and a blessing at the same time that, in my job, I’m almost always on the move to somewhere new. It keeps things interesting. It means that I get a lot of experience in a lot of different kinds of medicine. But just as I’ve learned all of the nurses’ names and started to sound as if I might vaguely know what I’m talking about, I’m gone.

I loved my first job.

And then not only did I change jobs but I changed from a ward-based specialty to four solid months in medical receiving, which is absolutely crazy and like no other job in the hospital. I spent the first fortnight of my new job wandering around and muttering oh-my-god-I-want-to-go-home.

A few weeks ago, I talked about feeling as if I was getting burned out on receiving. It’s a fast pace and a high turnover and a constant string of long days punctuated by the occasional day off, and unless, I suppose, you’re an acute physician by temperament, which I’m not, it’s difficult to keep that level of energy up for four months all in a row. I would like, just occasionally, to finish work before bedtime. I would far rather have done a second general medical job and had both of them punctuated by receiving weeks and receiving weekends, which is the way my SHOs and the F1s in a lot of other hospitals do.  Anyway, a lot of it is because this isn’t the job that I want to do — among the best parts of medicine for me are having my ward and having my patients and getting to the end of the story, and that’s not what this has been about.

So, yes, I did get burned out on it.

But that isn’t the whole story.

Because once I conquered the oh-my-god-I-want-to-go-home feeling of once again not having a clue what I was doing, I learned a lot and I worked with some cracking people and I had fun. I learned how to make a management plan for real and how to take responsibility, and, oh, so much about the kind of doctor I want to be and also the kind of doctor I don’t want to be. I’ve been right and I’ve been wrong, and the times I was right were important but I’ve learned more from the times I was wrong. The most crucial thing I’ve learned, I think, is that there are ways to make a difference to people even in an environment like that, and that an environment like that is maybe one of the places where it’s most important to do it.

I’ve been on nights this week and I worked last night, the very last night of this rotation. Thus, why I’m at home writing about my old job instead of at work doing my new one, but it meant that I hadn’t left yet when the F1s who are about to start there came crowding into the office for their induction, all two-thirds of the way through their F1 year, just like me, and every one of them looking like Sputnik had crashed down on their heads. The best way to deal with that is to just jump into the chaos and not think too closely about the way nothing really makes any sense and trust that it will, eventually, come to make its own kind of sense, somehow.

It’s just how this year goes.

Looking like Sputnik has crashed down on my head is after all precisely the way I looked in August and again in December and precisely the way I’ll look again on Friday when I realise that I have to work with surgeons now.



  1. …well, you certainly seem to be learning something, but WOW, how stressful. Still. I kept thinking this would be all over post-commencement, and that they’d let you settle in!

    • It’s the same hospital, so I guess to a certain extent I have settled in — more than I ever did as a student, at any rate, when I was getting punted to somewhere new every few weeks. I know my colleagues and the important phone numbers and how to get investigations done in the middle of the night and the fastest route to Starbucks. You know, the important things. Sadly, I’m on the move in August and I’m going to miss the hell out of my hospital.

  2. The idea of sputnik crashing down on your head has a totally different slant for me. In my line of work, SPUTNIK is the acronym for one of the clinical trials… (I am frequently convinced that whoever dreams up these acronyms probably has too much time on their hands)

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