From the house officer lottery to Jack Bauer-like interrogation, Dr David Wetherell describes his first day in urology
Back in medical school I remember being dragged through lectures, seminars, exam revision and gruelling OSCEs, but somehow emerging smelling of roses and clutching a medical degree. In the wake of my graduation celebrations, it never dawned on me that this prestigious piece of paper and all that I had learnt over the last five years would seem ultimately useless when I started working as a new doctor.
It never dawned on me that this prestigious piece of paper would seem ultimately useless when I started working as a new doctor
My physical transition from medical student to junior doctor transpired in one day. Rewind to 6.45am on my first day as a urology F1. Turning over in bed, I remember trying to grasp those last precious milliseconds of sleep, before the alarm pierced my eardrum. As I woke up, I will never forget the nervous, excited and stomach-sinking feeling that was taking over my body, as it dawned on me that this was my first day as a real doctor!
Arriving on the urology ward, it reminded me of being a university fresher, where people could single you out from a crowd by your innocent and clueless demeanour. I certainly felt clueless! As I waited for the ward round to start I had inadvertently entered into a game called the “House Officer Lottery”, a game not for F1s, but for seniors to select their pick of the new doctors. I was delighted when I heard: “You there, you shall be on my team”, but dismayed to find that my SHO started the following week.
Bang! We were off! The 100mph surgical round started and soon I was juggling patients’ notes, a TTO, obs, and fluid and drug charts, while trying to decipher the paper labyrinth of clinical notes to find a blank space to write. Only half-hearing the registrar, I frantically scribbled down a volley of abbreviations: “Post TURP and TURB, TWOC today, if PU then home”. I must have looked as confused and blank as the patient, as we moved to the next patient at lightning speed. I soon learnt that the true role of the junior doctor is to be a medically trained, literate and telepathic octopus who is an expert at multitasking.
I soon learnt that the true role of the junior doctor is to be a medically trained, literate and telepathic octopus who is an expert at multitasking
After four wards, 25 patients, 12 PRs and only 33 minutes later, I had an incomprehensible clipboard of scribble and a wedge of ultrasound request cards, that according to my senior were “urgent”. Naively I went to radiology, unprepared to be scorched and cross-examined by the intimidating radiology consultant. Every hospital must have at least one consultant radiologist employed by the NHS to purely refuse the requests of us foundation doctors and make our lives difficult!
As I shrugged off the memories of the Jack Bauer-like interrogation my bleep went off – I was needed in theatre. I donned some blue scrub pyjamas and uneven-sized theatre shoes and headed to the urology theatre. A couple of hours later I reflected on what I had learnt from the list – the anatomy of the bladder, signs of prostate carcinoma and why urologists wear Wellingtons! My feet are soaking and I squelch off to find some lunch.
A mouthful of meatball sub later, my bleep went off. I picked up the phone and expected to hear the words “fluids” or “cannula”, so when I heard “male catheter out” and “balloon still inflated”, I physically winced and sped back to the ward. After some damage limitation and an improvised tourniquet the patient was okay and had thankfully stopped bleeding from the end of his penis. A scenario they failed to teach us about at medical school!
Feeling dishevelled and exhausted, I tried to complete the mountain of jobs still left from the ward round. As 5pm rolled around, so did the surgeons, as they darted around from patient to patient, akin to a medical Benny Hill. Just before home, I wrote 500 blood forms to make sure everyone had one, even if they were not my patient. I eventually escaped the ward at 7pm. I felt lighter and proud that I had survived the day in one piece. On reflection, the transition from medical student to a doctor wasn’t easy. Even now more than a year on, I’m still at the bottom of a steep learning curve. But surely it will get easier…
- About the author: David studied at Leeds Medical School and was an F1 in urology in 2008.