#but I'm an adult! i can assume the personal risk necessary to take my meds 2nite

[tiddykittylikesskittles]

My coworker, having gotten stuck in the main building on a pee run due to weather: 😰

Me, has to take meds, not needed to supervise children: 🤠🚶☔

[dxmedstudent]

Hi! I have a question, as a female junior doctor, white coats aren't allowed but how do you keep your oxford handbook on you? Or your phone, bleep, bottle of water? And are they allowed non-ripped loose jeans? And can one wear black nondescript trainers if they have foot problems and need arch support? Thank you! I'm worried about starting F1...

Hello! You’re right. They were outlawed for infection control reasons a long time ago (around 2003?) so I only have the most vague distant memory of doctors wearing white coats. It was before I was even in med school!  Personally, I kind of feel white coats would be too warm for most people; after all, we’d still have to wear smart clothes underneath. And hospitals are warmed so that patients wearing nothing more than a gown don’t feel chilly. I’m someone who always feels cold, but even I’m not sure I’d want a white coat. My ‘little ward bag’ is juust big enough to fit my handbook, pens, money, and assorted other items. I’ve actually drawn it in a comic here. It fits a surprising amount, it turns out. I only take it off when I have to for procedures, or if I’m having a rest on nights. Otherwise, it’s become almost a physical part of me.  And the stuff that goes on my lanyard or gets carried around has been featured in the follow up comic here. I don’t carry a bottle of water with me, though I’m thinking of bringing a flask to work to get myself to drink more water. So I definitely recommend that, but there’s the challenge of not losing it if you’re on call. In terms of how we dress as doctors, I try to draw my comics as close to real life as possible. We all have our own styles and comfort zones on the smart/scruffy continuum, so there’s no one answer that fits everyone. But in general, most junior doctors tend on the smarter end of smart-casual. I’ve explained it in this post here, because coincidentally I’ve had a few asks about shoes and dress codes recently. I also recommend this post on shoes for tips. The NHS dress code as it stands, specifically forbids jeans and trainers. This means that your employers, and your seniors would be within their rights to ask you to dress differently if you turn up wearing either of these. Because it’s in the rules, and they can start citing vague but old-fashioned GMC guidance on ‘dressing like doctors’ and the like. I have complex feelings about dress codes, and feel that we as doctors are sometimes our own worst enemies when it comes to imposing old-fashioned rules on our peer group. Do I feel a doctor having blue hair or tattoos makes them less professional? No. I feel that we are too quick to assume what our patients would or would not accept to be appropriate dress for doctors. But although I support my more outlandish colleagues, I personally dress smartly.  Because I’m a short woman who keeps getting asked if she’s a med student or a nurse (If I’m lucky), and I need to look like an experienced, reasoned adult that patients and their relatives feel is competent. And because it’s a kind of uniform that makes me feel more confident to be assertive. I feel it’s like a costume that helps us to take on the doctor persona, and it’s a visual signifier to our patients and our fellow colleagues that we are at work and we mean business. I would suggest that erring on the side of smart is sometimes a necessary evil in order to be taken seriously.  When you start as an FY1, you’re the lowest in the pecking order, and you’re working with doctors and nurses who are decades older than you. It’s hard not to feel like a bumbling kid, in some ways. Most of your patients are elderly, and many will tell you that you look far too young to be a doctor. There’s another risk, If you wear trainers or jeans on the wards, your seniors might take you aside and tell you it’s inappropriate. It’s the kind of thing that people can remark on. I used to think nobody would be that petty, then one of the surgical consultants gave one of my fellow FY1s a public dressing down for wearing scrubs outside of theatre. Because apparently surgeons should always dress smartly +++ outside of theatre. I think that’s an overreaction, but I personally don’t want to risk extra grief at work from colleagues or patients. Bearing in mind that we rely on feedback from colleagues and seniors to pass every year, and rely on their assessing our competence. However, plenty of people wear trainers when they are on nights, or if they are on placements like ITU or paeds or A&E where they are expected to wear scrubs every day. That said, if you are on the wards or in clinic, then the expectation remains to wear smart shoes and smart clothes. I’ve seen ladies get away with fitted dark ‘jeans’ that basically look like fitted trousers, but proper denim would definitely be noted.  Unfortunately, my advice would be: dress down at your risk. Perhaps if you have medical problems, they might let you get away with the trainers. I hope so, personally. I had to wear canvas trainers to clinical rotations in med school for a few months due to foot problems, because everything else was agony. Then again, I was probably limping around everywhere, so perhaps they just felt it best not to comment. However, the rules are a little stricter if we are working, so I wonder if they would be as lenient. We’d have no excuse to wear jeans, though, because there are plenty of options for comfortable smart-looking clothes (as opposed to shoes). As for shoes, I can empathise with your struggles. I’ve had chronic foot problems since med school, and it’s been a real struggle to find shoes that don’t cause me agony. I’ve bought (then had to get rid of) so many shoes that seemed comfortable only to cause agony after a few hours. Many of my friends can wear just about any shoe. I’m so envious, I’d give anything to be able to do that, even just for a night. Unfortunately, I’m stuck with torture feet. Even with problem feet, it’s not impossible to find smart shoes that are comfortable; you can and will find ones that work for you eventually. It’s just hard, and it takes a long time because what works for each of us is a little different. I now have brogues that I genuinely love to wear on 13h on-calls, that feel comfier than my canvas trainers. Comfy smart shoes do exist. And we have to seek them out, because as a professional doctor it probably won’t be possible to wear trainers the whole time. My Advice would be:

explore stores and ranges that offer half sizes or wide/narrow fit. sometimes that makes all the difference.

Look at orthopaedic ranges. Yes, I know some of them are designed for grannies. Not all of them are; I have some pretty nice shoes from the footglove range from M&S, and I love Clarks. Both are perhaps more expensive than I’d like, but hardly in ‘designer shoe’ range.

Oxfords, brogues and loafers can all be really comfy when you have worn them in.

Plimsolls, Toms and shoes that don’t look like trainers but still offer support.

Consider trainers that don’t obviously look like trainers? Maybe some of the nicer ones from Sketchers or something?

Stay away from pumps. Nobody gets out of them without bloody feet. Pumps are a trap.

Consider insoles, if they have helped in the past. That might help to adapt

Podiatrists may be able to help advise what kind of insoles you might need if you have high arches or need special support.

Google shoe recommendations by nurses and other doctors. Nurses are on their feet a lot and know all the best shoes.I’m personally collecting recommendations to try out. 

Good luck in FY1, and let me know how you get on. At the end of the day, what we do when we are at work is far more important than how we dress. So this shouldn’t have to be a massive source of stress for you. You absolutely don’t have to be dressed like the smartest, fanciest person out there, just look vaguely presentable and you’ll be OK.