#junior doctorhood

[dxmedstudent]

Dx- I am feeling really really sad right now, can't really stop crying. I sent you an anon a month or so ago (if you remember) on the day of my OSCE and updating you how it went... Long story short, there was a leak and many of the students knew the stations in advance and I was feeling shit about it after (because it was a good half of the year I think) but my OSCE results came back and I got 25 (out of a hundred) and a very clear fail. There are no retakes (it is formative) but I am now in my final year and I can't help but feel like absolute shit. I know I am a good person (the patients I see now at the GP always tell me I will become a lovely doctor) but I feel so stupid... My friends did better and they didn't know about it either- so they're trying to say some hospitals are harsher but I know someone on the exact same circuit as me who also passed. I just feel horrible, my EPM overall is going to be so low and I will have to accept that I can't live in London. Idk. I feel really sad... I'm going to meet my personal tutor and he will provide words of comfort. OSCEs are absolutely the worst.

Hey, I'm so sorry to hear this. It's really unfortunate that the stations were leaked - and therefoe some people got an unfair advantage which then ruined the grading curve for everyone else. It always sucks to do less well on an exam than we hope - expecially when that's at least partly not our fault. It's not fair, and I can see why it really hurts. I'm sorry, I wish we could make it better. I would say that the EPM is only part of it - the SJT matters too! You don't know where you're going to get a place til its done. Now I received this message a while ago and I lose track of time, I'd love to hear where you ended up! Ultimately this only affects your foundation years - remember that it won't be forever, and when you get a clinical fellow job, locum or go into training you'll get another chance to apply whatever you want. Even if you don't get into London, you might get somewhere nearby enough to travel back to see family and friends on the weekend! I should say that as someone who has lived both in and around London for work, it honestly took me less time to get back to see family and friends from some places outside fo London than when I was on the other side of London! I also want to say that whilst it hurts if we get sent further away than we want, sometimes that also ends up being a nice place to work, with the best kind of people. You can find your home, and make friends anywhere! I wish you all the happiness in the world, and as you face your foundation years you always have at least one friend to share things with - whether things are good or bad. Welcome to the team :)

[dxmedicalstudent]

Continuing on the theme of magical items I wish I had on the wards... I’m not going to lie, my own personal ward bag (in real life) fits a surprising amount of stuff, and might as well be a Bag of Holding. 

[dxmedstudent]

I bought this for my sister recently! Yet to read it myself, but I appreciate every medical memoir that comes out and shares a bit more about what it’s really like. Older medblrs may be familiar with Kay’s comedic career through his former medical band Amateur Transplants. He and Suman Biswas provided a sountrack for disgruntled med students and doctors from their student days until well into their medical careers. The band broke up due to the pressures of being doctors and touring round the country, but you can still buy the albums, I think, or find most of the songs on Youtube.  I must note that I didn’t always apprecate the language they used (definitely in problematic fave territory).

• This is Going to Hurt by Adam Kay •

If anyone is thinking of applying to study Medicine, I really recommend reading this book.

This is Going to Hurt chronicles Kay’s experience of being a junior doctor over 6 years, from first arriving on the wards fresh out of medical school, to being a senior registrar with the responsibilities that the role entails. You know from the start that Kay left medicine altogether after those 6 years, and the book doesn’t shy away from explaining why he couldn’t cope any more. From my understanding at least, it is a very realistic portrayal of how medicine impacts the life of its staff, and the ups and downs of a career in this field.

Kay is now a comedian, and it definitely shows - I actually laughed out loud at many points during the book. It’s equally sad and hilarious. I really recommend it!

[dxmedstudent]

How to book annual leave without incuring animosity from your colleagues...

Work with people. Offer to swap, and genuinely check for whether you can swap when other people ask. When we work together, it’s nicer for everyone, and everyone is more likely to get the days off that are meaningful to them.

Be genuine when you’re asking for swaps. Share how much it means to you; people are more likely to swap for your dream holiday or the first time you get to see family than if you’re just trying to get out of a bank holiday weekend.

Try not to take off a whole chunk of leave before you’ve met your colleagues. If possible, it’s nice to be able to discuss plans with colleagues if they might be contentious. It doesn’t mean you shouldn’t put in for that leave, but it feels better when it’s people you know and they’ve at least talked about it. On the ward, you’re a team who have to trust each other with looking after patient’s lives. You get to be friends.

The exception for this is honeymoons or once in a lifetime trips. Just... nobody wants to come and find that someone’s booked the maximum time off right at the start or at some key point of the year before we’ve all even joined.

Yeah, it’s first come first served, but when you are at the start of a placement and have to take scraps and odd days off because everyone’s booked their leave way before they joined, it kind of sucks. It’s understandable if there’s a big holiday that you had to book in advance (or a wedding, given the horror stories of how many people get timetable to be oncall for their wedding), but try not to book all your leave before you’ve even met your peers. Because that will probably leave other people with no dates that they’ll actually want.

Don’t brag about it. I’ve had the pleasure of working with people who brag that they got their leave requests in before you. Which happens, but dude, someone has to be last, and why would you berate your colleagues for letting you take leave first? How is that a friendly way to behave? It’s just going to encourage everyone to apply even sooner, and turn it into an arms race. And the problem isn’t people being slow; it’s staffing being so low that if one person in the department takes leave that’s it, nobody else can. No matter how you do it, people get screwed over if there’s very little slack in the system. 

Don’t do something that could likely screw over your colleagues’ plans without having a friendly chat. Like for example, taking every Friday/Monday off for the next 4 months (great, nobody else in the dept gets to take a weeklong holiday, EVER). I’ve known people who’ve done this just because ‘I couldn’t think what else to do with my days off, so why not’, before they even joined the department, and it was pretty selfish that they never even considered that other people might want to occasionally have a Monday off after a weekend oncall, or take a week off at once. In theory, it’s not bad, as long as you’ve had a chat with your colleagues or would be willing to change if anyone wanted a week off for a holiday etc. Otherwise it’s pretty selfish if you know that your random days off that you don’t even care when they are, are basically always going to stop every single one of your colleagues from running together 7 days for, say a family holiday with their kids etc.

Or booking off half term/Easter/Christmas/etc. Yeah, you have children, but you’re not the only person with family. I’ve known people who’ve done this, and they’ve usally been very nice interpersonally. But the department does tend to resent them a tad before they meet them, because some person you haven’t even met has basically changed how you can take leave for months on end... without so much as saying ‘hi’.

[dxmedstudent]

To you, what does it mean to be a doctor?

It means so many things that I’m not sure I’ll ever explain it. You might get anidea if you go though my #junior doctorhood or #personal tags, but even then, it’s barely a start. It means that when you get to work you put on the stethoscope and you take on the role people need you to play. When you step into a shift, you have to be the person they need you to be. You are calm, you are professional, you are respectful. You are patient with patients and their relatives, and genial when you can be. You are comrades with your nurses, your physios, every single colleague if possible. It helps to have a role; you’re dealing with scary situations, and being able to draw on a template for professional behaviour helps us as well as patients. But we aren’t just a white coat or interchangeable faceless drones. You have to put what happened before or after your shift aside. Even when you’ve had an argument with your mum or got dumped or you’re no longer speaking to a close friend. Even when your gran recently passed away. Your kids might be sick, you might have other worries at home; doctors and nurses are still people with  Even when you’ve had a cancer scare and you’ve got tests and you’re not sure you will be OK. If you’re burning out, if you can’t take up that mantle and put the life stuff out of your head, you will need to address that and you need to take time off. Sometimes all of the above will need you to put yourself first, especiially if you find that you can’t be the doctor. Seek help, look after yourself, and try not to let it get to the stage where you can’t cope. But it’s OK if it gets to that point  - it happens to the most wonderful people. But it also means you take your humanity with you. Because I loved my grandmother, I treat all the elderly as I wish others had treated them. I remember what it was like to be sick, to be scared. When I deal with someone with mental health or a stigmatised illness, I remember the people I love who have been suffered and misunderstood, and I use that to fight frustration or jadedness. As a doc, you’ll meet people from all walks of life, going through all sorts of things. Your heart will break. It will absolutely shatter sometimes. And you’ll have to pick yourself up and deal with the next patient.

[dxmedstudent]

This is me.

I mean, yeah, I also applied for the full 5 days of study leave I am entitled for my exam. But I hate the fact that we all stay late every day on the ward so much that I'm also taking quite a few annual leave days to study.

Because when you have a compulsory exam but also have oncalls (12h + shifts) and have to stay late on your 9-5 days, just when are you gonna get to study?

I'm also probably going to have to use my days off to make up my clinic numbers.

This is probably why so many docs fail their postgrad exams...

You know what’s not a great use of annual leave?

Using it as your only study leave…

[dxmedstudent]

Don’t Become Her.

I’ve noticed that with time I’ve gotten more efficient. I like things done certain ways at work. You have to make order out of chaos somehow, you know? And I like to double-check things, Even with juniors around, I’ll check the blood before I leave work in the evening. Just in case. The outreach nurse spotted that and told me I should join ITU so I could control-freak to my heart’s content. I’ve never been a control freak, but medicine changes you. To deal with the anxiety of missing things, you make a system to get things done (in order of priority and efficiency), and you have a system to avoid things being missed. The thing is: I’m looking down the line. At what some of my registrars are like. And some of them are control freaks to a scary degree. Like, a registrar recently berated me for being 2 whole minutes late to ward round. The previous day, I’d been 5 minutes late. As it happened, I was going through some personal stuff at the time so was a little preoccupied. Previously, I’ve had consultants chew me out for such things as ‘my name wasn’t on every sheet of paper’ in a patient’s fixed notes - in HDU where you think that’d be the least of the concerns. I’ve been bollocked for not arranging outpatient appointments fast enough - for patients who haven’t even left hospital yet.  These episodes hurt my feelings because in each situation I’d been working really hard, dealing with complex patients and going the extra mile. And then someone’s like ‘well, you didn’t do something minor so let’s focus on that and not the many actual things you’ve done’, it makes medicine a lot less rewarding. I’ve gotten to the point where I don’t really expect praise or thanks, any more - it’s nice but it almost makes me feel awkward. I mean, it’s nice but you can live without it, I guess.  I just don’t want it to look like something minor overshadows the tons of work and effort we do. People get so set on the small details of how they want it done - then by the time they become consultants, it becomes entrenched. I find these kinds of people scary; the ones that are more assertive than average, might seem nice enough but will turn on you and snap your head off for something minor that most normal people wouldn’t think was a big deal. No doubt it’s because they are stressed in general, but it doesn’t help.  It saddens me that in a system where people are constantly burning out and finding medicine or nursing not rewarding enough to stay, people allow themselves to demoralise their colleauges over minor things. So I really  don’t want to become that person. I don’t want to get unduly frustrated when someone does something that seems silly or frustrating but is actually pretty minor. I find myself getting more frustrated than I used to - I have more responsibility, and more oversight of juniors, after all. Even in my personal life, it can be hard to avoid thinking like I’m at work. Just because I’m used to managing a 4069 point checklist and  in order of urgency silly timetable and running around, doesn’t mean everyone else is. I have to remind myself that normal peoplearen’t necessarily used to juggling 354 things. When you get punished for making mistakes-  or you worry you will, you have to make a conscious effort not to take in that attitude and iflict it on everyone in your life. You have to let the worse parts of medicine not become your personal norm. And that’s one thing my colleagues are bad at. Some of these people come in hours early to prep things so that they can make things more convenient for the consultant, and leave late sorting things out. No wonder they expect you to know everything - they spend way too much time outside of work being consumed by it. They even come in on days off to do more work - as if getting home every day at 9 isn’t enough of a sacrifice. And I’m just not prepared to let medicine take up that much of my life, and I’m not prepared to be that person, either. It’s just never who I wanted to be, nor the life I wished to lead. And so much of medicine is like that, that I realised I’m really looking for a specialty that will let me keep my humanity and stop me from being That Person.

[dxmedstudent]

How to get annual leave and swaps on a nightmare rota:

You’ve all probably heard that it’s a nightmare to get annual leave when you’re on an oncall rota. Well, it is, but I’m going to share my secrets for swapping and booking leave.

1. Don’t get your hopes up too much.

You might not get the days that you want. It’s crushing if you can’t go on a holiday you want, or spend those days with your friends you were hoping for, or miss a friend’s wedding or something like that. It sucks and I can’t make it better. I can only give you the tools to make it slightly more likely that you’ll get what you want. Based on real life experience.

Warn your loved ones that you might not be able to get the dates that you want, but you’ll try.

No, really, I’m serious. Set realistic expectations. You don’t want them to think it’s because you don’t care about their wedding or your brother’s graduation or your girlfriend’s dream holiday etc. People who don’t work in healthcare may not realise how tricky the process is.

learn to love excel spreadsheets. They are the way forward.

Make sure you’ve got a clear representation of your rota available, that you can send to friends and family when needed.

2. Check early.

This may mean:

email colleagues to find out who the rota coordinator actually is.

This may be before you even work at that hospital so you might have to do it all remotely via phoning and emailing a ton of people who aren’t really sure.

If nobody knows, try switchboard or whoever your contact for your placement there is - someone will eventually cc in someone who knows who the rota coordinator is.

This is easier if you’re already working in the hospital, and more difficult if you’re not.

Once you know who it is, calling the coordinator might be more useful than emailing; they tend to get inundated. A lot of the coordinators I’ve known have been patchy on the email communication front due to sheer volume.

Visiting them is also an option if you’re in the same hospital; this stuff is always easiest to clear face to face with the spreadsheet in front of you.

Bear in mind most people don’t have plans for their weekends months in advance, but when you get into the realm of last minute swaps, people are more likely to have stuff they’d rather do than work your shift.

Remember that the new junior doctor contract stipulates that if you give enough notice, they should try to accommodate life changing days. So get that notice in as early as possible.

3. Cast a targeted net.

Your colleagues want to help, but sending out mass emails or whatsapp messages about swaps often has a low return. People mean to check or reply, but then forget. Don’t rely on a half-assed message on whatsapp to find you any swaps for your precious days.

Look for people who also want to swap; these people will be most motivated to help you both come to an agreement.You’re both highly motivated to make it happen, so it’s more likely to come together.

Consider 3 or 4 way swaps if a bunch of you want to swap but there’s no easy solution. With a lot of excel work, it can be done.

Sitting down together with excel can really help, but it’s possible to organise entirely over email with a few brief chats. 

Strike when the iron is hot; don’t leave it too long between emails and chats, or people will forget what you were all agreeing. Good swaps involve a flurry of targeted activity and being sorted quickly and well in advance.

However, even people who want to swap might not be compatible with you on the rota. That’s where my secret comes in.

Find people who are not oncall when you want to be free, and for whom doing your shifts won’t compromise their own timetable too much. This is important; people are less likely to swap if it’ll make their own lives miserable for a couple of weeks.

Consider the people on the rota in the slots above and below yours, because they’d be working that oncall a week earlier or later, so it pobably won’t bother them too much to swap.

Contact these specific people individually, with a proposed swap plan. Make it as easy for them, and offer to contact the rota coordinators on their behalf and just cc them in to agree. After all, You’re the one who wants this swap, it’s fair that you do most of the work.

Consider asking your wardmates if they will swap before casting a wider net (and the days are possible for them on the rota, which you should check before bothering them); this way you know that your ward will retain minimum staffing and the rota coordinator gods will be happy. They also know you and are therefore slightly more motivated to help you than other juniors who may still be faceless strangers at this point.

2. Do all the work for everyone involved in the swap.

The less other people have to do, the more they will be willing to help you, because it doesn’t inconvenience them. And whilst people want to help, they are also busy, so the easier you make it, the easier it is for them to help you.

Find your slot on the rota. Make sure you’re doing what you think you are.

As mentioned before, find people who are not oncall when you want to be free, and for whom doing your shifts won’t compromise their own timetable too much. This is important; people are less likely to swap if it’ll make their own lives miserable for a couple of weeks.

Make a timetable of what your proposed timetable would look like, and what theirs would look like. Doing it in excel helps because it can really give a visual for things like when you’re proposing zero days to be moved to, and ensuring that there aren’t run-on weekends or too many days in a row. It will also ensure you don’t miss any obvious issues like that which will bite you when you’re actually working that horrible rota you made.

If you’ve identified a horrible situation with a rota swap you’re proposing or agreeing to, own up to it, even if it’s already agreed. This year we spotted one after we’d agreed, and had to change it back again.

Take a look at their ward timetable or ask their ward coordinator whether it’ll mess up their ward’s staffing. You’ll have to do the same for your ward as well, but don’t forget that days swapped might affect both wards.

Take minimum staffing seriously. Your colleagues will not thank you for leaving them understaffed, though occasionally consultants agree to it for things like interviews, weddings etc.

Be courteous to everyone, no matter how frustrating this process is. You’re asking for a favour, after all.

Be willing to help out others in turn. If nobody’s willling to take on minor inconveniences to help their peers, none of us will ever get swaps, so bear that in mind.

Consider empty slots on the rota; people who are on maternity leave, slots that never got filled, part time worker slots that never got filled, and sick leave absences. Most of these won’t get filled, meaning their shifts will go out to locum every week until they do, and their ward position will remain empty every week. Since that person is already not there, and there will be locum shifts out regardless, ask your rota coordinator if you can work their oncalls, and whether they can put your oncalls on the days you need swapped out to locum instead. This often works for rota coordinators as they might get more time to find locums, or at least it puts them in no worseof a position than they already were, staffing wise.

If you’re doing this months in advance, I’d make a spreadsheet of what the proposed timetable would look like in case they find someone later to fill the job. Send this to the rota coordinator as part of your discussion; it will make it easier for them to visualise what they are dealing with. If the new shift pattern isn’t  horrific for their potential employee (for example, just doing a weekend oncall a week earlier or later), there would be no reason not to swap in advance and just give them that new timetable.

Before you’ve locked down on the oncall day swaps, check with your ward that you’ll be able to take annual leave on the days that you want in order to make it all come together. Swapping oncalls doesn’t necessarily mean there will be enough people on the wards so make sure both are adequately covered.

[dxmedstudent]

All Grown Up...

"When I was a child, I spoke as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things."

- 1 Corinthians 13

I think about this quote sometimes, and I have mixed feelings about it. Because, inherently, I don’t think we need to put away childish things, at least, not in the sense of hobbies or interests. I get it, and I’m not about to argue with every Bible scholar about it, except to say the meaning is probably personal for everyone. But that said, life has a way of evolving. It’s funny, I was talking to an old uni friend about things like credit scores and whether we’ll ever get a mortgage the other day. The kinds of thing I’m pretty sre I never once discussed with her in like 8 years of being at university together (yup, some folks were stuck with me for two degrees! can you imagine?)  You spend years talking about all the silliest stuff, homework, uni friends and all sorts of hijinks, then one day you realise you both like to swot up on money savings expert.com for fun. Well, not fun, but because you don’t want to live in a shed forever. Like, don’t get me wrong, talking to uni friends is still silly and fun, but now there’s a lot more talk of houses and who’s getting married and work. It reminds me of when my school friends started getting married and talking about wine tasting classes. I mean. Wine tasting? It’s not that it’s surprising that grown ass women drink wine, it’s just that we’ve been friends since like 13 years old! We used to be the silliest, funniest smart girls that existed. Don’t get me wrong, we’re still hilarious, it’s just interesting how things have evolved. We aren’t quite the same as we used to be. And yet, as my 70 year old cancer patient was telling me, you always feel about 16 inside. I’m sure the fact that most of my medic friends are child-free is due to us being in medicine, if we’re honest. And even then, by my age even medics have started to settle down.  I still feel like the same silly teenager I was before, I just get paid and have a desire to live somewhere more sensible. It’s weird, because I don’t really remember growing up, yet here I am doing a responsible job, handling my own finances, thinking about buying a place and dating seriously like a grown-up. 15 year old me would recognise much of my life - the art and games and anime haven’t changed, natch. The DnD is a good addition. There are many great things I’ve picked up that I love, regardless of whether they are seen as ‘mature’ hobbies or not. But it’s weird to realise that you’ve also grown in many ways. I guess this is what my Guy was talking about when he talks about his friends, sometimes. They are great people - a wonderful, welcoming bunch of men and women with some of the most adorable kids. But he’‘s mentioned that sometimes hanging out with them just isn’t the same now that they’ve all got partners and their kids to look after. They hang out a lot, and it’s still awesome, but it’s different. And they (and my friends) aren’t the kind of couples to leave you out if you’re single, like I hear happens to some people. I genuinely don’t know why people do that. I don’t think my partnered friends ever made me feel less welcome when I was single - if anything they were more attentive to make sure I didn’t feel left out. But even so, I know that bittersweet feeling he was describing, because there are times when I too have felt that life has moved on, and I need to adapt to it. I’ve faced it at turning points in our lives - when everyone goes off to uni, when everyone starts working, when everyone settles down - points at which your lives all change in many ways. I’m still sad sometimes that I’ll never just be able to hang out and play games with some of my friends (because they’ve grown up and moved abroad) or just chill with other friends as easily as I once did. And I feel sad about the people who drifted, or the ones it didn’t work out with. And it’s OK to feel like things are changing a lot, or life looks pretty different to what it used to be. You can’t change how life has evolved, but it’s OK to acknowledge it.

I went out with a schoolfriend for dinner this evening. A bestie of my sister’s from primary school. I’ve known this tall, strapping dude since he was 5, and he’s effectively a little brother to me. We’ve spent countless hours playing games and talking about anime or pokemon or whatever. And he’s just gotten engaged, it’s so awesome because I got to hear all about his love, and their plans together, and the proposal and I’m so excited for them; he’s a wonderful kid and I hope they are so happy together.  But also, he’s like my little brother. Getting married.  Like, I had just never imagined we’d be sitting there talking about work and gushing about SOs like grownups. I mean yeah, we still talk about anime, I gave him some nice recs to watch with his fiancee.  And it’s nice - to share our hopes for the future, and catch up over the past, and be silly whilst occasionally navigating some grown up problems. After our catch up, it felt so fun being grown up. People have so many fears and expectations anout growing up or reaching 30. But if anything, there’s no sudden switch. You don’t magically become old and serious and lose all sense of fun. You’re still silly. It’s just you start to plan a bit further or make plans that are a bit more serious. But you don’t have to give up your past in order to have a future.

[dxmedstudent]

I've done two things this evening: prepare a last minute case presentation for tomorrow (whoops) and try to sort out some swaps and leave for events that are important to me.

And the latter has been the more exhausting by far.

Matching up other people's shifts to look for compatible swaps, emailing them only to find out that a lot of people have truly random things going on planned like 3 months in advance, then doing the same thing again.

I'm tired. I just want to do some nice things with people I care about. Like normal people do. Not look like this:

I may have gotten someone to agree to my swap. I've made sure the ward will be safe and oncalls will be covered. I've even made sure that my timetable and the other person's won't be horrendous. The powers that be had better smile upon this, because I am. So tired.

[dxmedstudent]

In 2016 58% of people applying to medicine and dentistry courses were women. However, according to the Royal College of Surgeons of England, only about 12% of consultant surgeons in 2018 were women. Why? A small survey in the BMJ medical journal points to the level of discrimination. As a general surgical trainee, I have been shocked by the experiences reported by some female colleagues. The discrepancy in the number of women applying to medicine and those going on to become consultant surgeons can partly be explained by the higher dropout rate. Could inherent gender discrimination within surgery itself play a part in that?

Female colleagues with children have struggled to be accepted and are seen as less than full-time surgeons, despite working similar hours in hospital to those surgeons with part-time hospital and research commitments. A female surgeon returning from maternity leave didn’t dare tell colleagues that she had a 10-month-old baby at home, fearing that she would be viewed as lacking “commitment to speciality”. Female surgeons are continually asked about their family plans. I was even asked at an international conference if colorectal surgery would be the correct career path if I plan to have children. These aren’t challenges that are unique to surgery – or to women, with more men taking longer paternity leave – yet the stigma seems more entrenched in surgery than other specialities.

All I can say is, as a woman in medicine, I am not surprised. Surgery is renowned for being a boys’ club, and that is just not on.

[dxmedstudent]

I’m sorry that you died before I got chance to hear your story. While I was fumbling around, trying to get blood from your dehydrated veins, you were trying to tell me about a special day you’d experienced 30 years ago. You were so proud and I promised to return some time later to hear about the day in full.

But I also cruelly cut you off mid-sentence because five other patients on my ward needed blood samples taking. My other 31 patients also needed critical and urgent tasks that I had to perform in order to keep them safe and help them heal. Right before you rapidly deteriorated and died, the last thing you experienced was a harried, overworked doctor interrupting your joyful reminiscence.

It’s so, so hard sometimes to make time for actual meaningful human interaction. It’s something we have to claw back, whilst we’re also desperately rushing around trying to keep everyone safe and alive. Sometimes we all have those shifts where you’ve kept everyone alive and safe, and given good technical care, but felt like you couldn’t be the doctor you wished you could be. And it hurts, because you want to be better. The best times are when we can go that extra mile. When I have the time to spend with patients who are lonely, or anxious, or suffering. When I can make people feel better, rather than just patching things up or fixing problems. But it’s hard to go the extra mile.

[dxmedstudent]

Best laid plans...

Me before Night Shifts: I'm going to go out after my shift! I might be a bit tired but I can totally handle this. I've done it before! I'm a hardworking professional who never lets anything limit her potential!

Me after Night Shifts: I'm a nebulous, exhausted gas vaguely approximating human form. I was rather optimistic to think I'd be functional today.

[dxmedstudent]

I’m not saying my current team are awesome...

...But I get to talk about feminism, liberal politics, interesting new books to read, and the McElroys at lunch, and it’s awesome?! I adore when your seniors tell you stuff about their life or you can actually talk about non-work related things like actual colleagues. So yeah, actually, I am saying they are awesome. I don’t know how I’m going to cope when I eventually rotate back onto some team that treats me like a nameless jobs monkey that they don’t need to bother to get to know. Not now that I feel like an actual valued part of a team.

[dxmedstudent]

Paperwork sucks.

Nothing kills my passion for medicine quite like filling my pre-employment paperwork for my next job and contemplating how to get all the appropriate checks and paperworks done in a timely manner whilst working full time at another site, in another town.  The worst bit is when forms which could easily be filled digitally as word docs or PDFs aren’t set up to allow you to do that, so you have to print them out, fill them in , scan them and then email them back. Why must things be

My least favourite part of moving around every year (apart from moving day) is the flurry of paperwork that gets flung at us around May, and then takes up until July to sort out. Every year.

I’m going to need to reward myself somehow after getting through this lot.

[dxmedstudent]

Record numbers of burnt-out NHS staff in England are quitting because they are fed up with spending too much time at work and not enough at home with their family, research has revealed.

The number of personnel leaving the NHS because of a poor work-life balance has almost trebled in the last seven years, an analysis by the Health Foundation thinktank shows.

Between June 2010 and June 2011, a total of 3,689 employees cited concerns over long working hours as the reason they had decided to stop working for the NHS in England. But 10,257 did so between June 2017 and June 2018 – an increase of 178%.