'Sometimes I'm Proud. Other Times I'm Ashamed': A Letter To New Junior Doctors

I’ve loved my first year as a junior doctor, despite the emotional turmoil. Here’s my advice for those about to start the journey



To my new junior doctor colleagues just starting out,

A year ago I was standing in a packed lift, going up and heading into the unknown. Hospitals are full of worried people – those waiting for test results, those going to see their unwell relatives, the recently bereaved. People whose lives are spiralling out of control. But as I stood in this lift full of the emotions of others I was preoccupied by my own anxieties, waiting to start my first day as a doctor.

I entered the ward where I would spend a large proportion of my waking hours for the next four months, stethoscope clutched in my sweaty hand. It seemed appropriate to introduce myself to the consultant, so I navigated through the hustle and bustle to the nearest person wearing scrubs with a sense of authority and told him I was the new foundation year one (FY1) doctor. He told me he was the porter taking out the bins but it was very nice to meet me.

When I introduced myself to the first patient I saw that morning, the words came out as a question: “Hello, I am one of the doctors?” The first few weeks were full of constant firsts – from the first time I prescribed paracetamol (double-checking that the dose is indeed 1,000mg four times a day, despite having taken paracetamol myself plenty of times) to managing critically unwell patients with sepsis, heart attacks, seizures and strokes.

I have seen approximately 3,000 patients, each with their own story to tell. I have found myself crying in a toilet because I was so blown away by the care and compassion that the younger brothers of Nora showed her in the end-stages of dementia and organ failure. I chatted to lonely Simon about his far-away family every day for two months before he died and became the first of many deaths I have confirmed.

When Michael’s wife thanked me for always making time to reassure her husband after his accident, I was touched beyond words. Abdul confided in me that he hated hospitals and wanted to die. When he became more unwell and was unable to communicate, I advocated for his doctors to step back and let him die in peace, rather than persevering with invasive treatments unlikely to be successful.

On the flipside, I am privileged to have multiple opportunities every day to make a positive difference, to learn more about our fascinating bodies, and to work alongside the fantastically diverse mass of humans who make up our NHS. I have observed my colleagues deliver outstanding care – from the senior nurses who slickly and apparently effortlessly run the show, to the cleaners, ward support workers and volunteers who work tirelessly to make sure our hospitals keep going, and can make a patient feel infinitely better with a cup of tea and a smile.

You will laugh and you will cry, sometimes about the same situation. Know that you are never the most scared person in the room, and things are always worse at the cold end of the stethoscope. Keep your principles and call out the injustices you see.

No matter what anyone tries to tell you, writing that “urgent” discharge summary is not the most important thing you will do today. Scribing for your seniors on ward rounds probably isn’t either. Sometimes the most helpful thing you can do for someone is kneel down, hold their hand and be with them in their most vulnerable hour.

Make friends with your colleagues. When you feel like no one else can understand how lost and overwhelmed you feel, those working under the same roof probably will.

Being a junior doctor is amazing, rewarding, and exciting. I love my job, and am happy to go work most days. I hope that in between the challenges, the stresses and the emotional turmoil, you will be able to love it too. Looking back, it is hard to believe how far I have come in just 12 months: tasks that once baffled me can now be done on autopilot, and the bleep of my pager no longer makes me jump. There is still a lot to learn and so much I don’t even realise I don’t know yet, but that’s part of the fun.

Have a great year, look after yourselves, and ask for help when you need it.

Yours,

An FY1 (soon to be FY2) doctor.

Names have been changed

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