I know there is always a risk of viewing the past with rose tinted glasses but I genuinely believe my experience of training in Medicine 11 years ago was very different to how we treat our young doctors these days.
My first Foundation Year 1 post was on a general medical ward with around 30 beds. There were 2 consultants, 2 registrars, 2 SHOs and 2 FY1s on the firm. Yes we still called it a firm back then. On any particular weekday you could expect 1 registrar, 1 SHO and 1 FY1 to be around. There were enough of us to do other activities – we had time to go to clinic, to do audit work, to start studying for Royal College exams and to get involved in teaching.
We did all our on calls with one of the registrars from the firm. I was paired with Hermione. She was a proper superstar and if I’m honest was probably one of my main inspirations for pursuing general medical training. She was like a swan. Having now been a medical registrar myself I’m sure her legs were kicking furiously under the water, but she was so serenely calm on the surface. She was also an exceptional teacher and taught me how to apply my knowledge to real clinical situations. I always felt supported and we developed a real sense of team during some extremely harrowing experiences.
After our night shifts we would present all the patients we had clerked to the on call consultant. This would give time for invaluable feedback from a variety of seniors on how we had managed our patients.
I’ll always remember getting myself into some trouble with a terminally ill patient on the respiratory ward. I won’t go into details here but my Consultant was so supportive. He couldn’t have been more so.
Towards the end of our rotation our boss invited us all to his house, together with our partners, for dinner. He had checked the rota to find a date when none of us were on call. We were all so touched by the thoughtful invitation and the effort that both he and his wife put into the evening.
What have I described? Adequate staffing, time to train, strong team culture, meaningful feedback and excellent pastoral support. All these factors spurred me on to pursue a career in medicine.
I fear that in 10 years we have destroyed all that for our junior doctors. Very rarely do they ever get to present the patients they have clerked on the AMU to a consultant. They are never on call with the same colleagues. They are stretched so thinly on the wards during normal working days that all the ‘extra’ stuff has been pushed in their own time.
Yes things have had to change given increased demand on health services, but I think if we do not look to the recent past and change how we treat our trainee doctors then we are never going to inspire them, value them, encourage them and build them into the senior doctors of the future.