Part 2…
Electives
Electives is time spent away from your medical school, often abroad. Many students find it as one of their most memorable experiences. The timing of the electives depends on the medical school but they are usually between 6–12 weeks.
Even though my elective was not as I had initially planned it, it was one of the highlights of year 5. I am incredibly grateful to my supervisors for allowing me to carry out a medical education project on ‘Bilingual Assessments’ in English and Welsh. This project gave me the ability to develop research skills, work with a team of doctors and students, using my skills to contribute towards medical education.
I submitted my work for the ASME (Association for the study of medical education) conference and my work was accepted for the Annual Scholarship Meeting 2021, where I presented my work and talked about this project with a panel of professionals as part of the programme.
During my electives, I also had the opportunity to hold weekly online zoom teaching sessions alongside my friends and teach students on a national and international level!
Overall, this elective has taught me to find something I feel passionate about, put in small and consistent efforts and I will eventually see the results! Also, I learned to never be afraid of trying new things, reaching out to supervisors and doctors and look for alternative ways to make the most of my electives.
For more on the specifics of organising an elective, please have a look at one of the collaborative posts on my Instagram @lifeofawelshmedic about organising electives.
Foundation Programme
- The Foundation Programme is a two-year, work-based training programme which bridges the gap between medical school and specialty as well as general practice training.
- The foundation programme is part of the continuum of medical education. It ensures that newly qualified doctors develop their clinical and professional skills in the workplace in readiness for core, specialty or general practice training.
- The Foundation Programme aims to ensure that all doctors deliver safe and effective patient care and achieve excellence as per GMC guidance.
- Training programmes are designed to ensure that all foundation doctors undergo a balanced programme which enables them to meet the competencies and outcomes set by the GMC as described in the curriculum.
Types of Research studies
- Letter to the editor: These papers communicate brief reports of data from original research that editors believe will be interesting to many researchers, and that will likely stimulate further research in the field. As they are relatively short the format is useful for scientists with results that are time sensitive.
This letter was written in response to “Socially Distant Medical Education in the Face of COVID-19” [1]. This letter highlights the advantages of virtual education such as flexibility as many students could view the educational content from the comfort of their homes. It also highlight other disadvantages of virtual education like it’s inability to emulate clinical experience gained from the hospital environment.
- Original research article: Original research articles are the most common type of journal article. They’re detailed studies reporting new work and are classified as primary literature.
This study is a qualitative study of Australian GPs conducted using semi-structured interviews. The aim was to look at the challenges that GPs face when providing appropriate end of life care. It shows that GPs were aware of patient’s approaching end of life and care was adjusted accordingly. How GPs provided end-of-life care depended on patient traits and GP characteristics. The conclusion from the study was that GPs were able to adjust their care plan as patients approached end of their lives. However, under certain circumstances this was not discussed. Future studies should investigate the impact this has on care. For more on this study please visit here.
- Case Studies make other researchers aware of the possibility that a specific phenomenon might occur. This type of study is often used in medicine to report the occurrence of previously unknown or emerging pathologies.
This is a case of Pulmonary histoplasmosis case study published in National Library of Medicine. It shows that the disease in asymptomatic patient is self-resolving and requires no treatment. However once the symptoms progress to moderate or severe — prolonged for > than 4 weeks, treatment with Itraconazole would be required. Other treatments like methylprednisolone, systemic antifungal therapy may also be indicated. Respiratory support may also be required such as intensive care depending on the respiratory status. This case demonstrates how all interprofessional healthcare team members need to be involved in arriving at a correct diagnosis. In illnesses like pneumonia, it is important to keep in mind about the rare causes and information like patients not responding to optimal therapy and the working diagnosis is either wrong or the treatment modality chosen by the physician is wrong and needs to be adjusted.
- Review Articles Comprehensive summary of research on a certain topic. Reviews are written by leaders in a particular field after invitation from the editors of a journal. This includes things like literature reviews, meta-analysis and systematic reviews.
Types of Foundation Programmes
- The Specialised Foundation Programme (SFP) (previously known as Academic Foundation Programme) provides a great opportunity for foundation doctors to develop research, teaching and leadership/management skills.
- Foundation Priority Programmes (FPP) has been developed to support specific areas of the UK that have historically found it difficult to attract and retain doctors in training. These programmes also offer a range of incentives.
- The Psychiatry Foundation Fellowship recruitment process changed for programmes starting in August 2023. The application process is separate from the UKFPO application process and is managed by the Royal College of Psychiatrists (RCP).
More details on different types of foundation programmes can be found here.
Transition to FY1
Initially I would shadow Foundation doctors and help them with common jobs at the beginning of foundation year 1.
Closer to the start of Foundation Year training I would actively participate in ward rounds, on-call shifts and other teaching sessions in order to integrate myself into the team.
On Call Shifts:
I managed on-call shifts by:
- Adopting a positive mindset by leaving problems before entering the shift. I was able to have a friendly conversations with my colleagues and help each other out with difficult tasks.
- Prioritising tasks appropriately when bleeped. I have had experiences where I was bleeped about several patients and I had to prioritise patients using the A-E approach (Airway, Breathing, Circulation, Disability and Exposure).
In the above three scenarios I would use the A-E approach and prioritise patients according to where the problem is the most. For example if it is an airway problem, I will see to that first (Scenario 3). The patient in scenario 2 appears to be septic (a circulation issue), therefore, I will ask one of my other colleagues to urgently review the patient and initiate sepsis management. I will ask one of the staff nurses if they could catheterise the patient. The main takeaway here is to to demonstrate leadership skills and assign tasks effectively to the fellow staff members so you can attend to the most urgent cases first.
- Clerking new referrals and preparing them for post-take ward round, if I am in the assessment unit.
- We would use ‘divide and conquer’ approach whereby we will divide ourselves in groups covering different wards then going through jobs individually.
- We would also categorise tasks and assign them to individuals for example requesting & chasing bloods, x-rays and other tests as well as reviewing acutely unwell patients.
- It is also really important to escalate patients to seniors especially during emergencies.
Portfolio:
It is really important to keep on top of your portfolio right from the beginning. There is the the Horus and Turas portfolio.
The exact format of each e-portfolio may vary but they generally include:
- Personal and Professional Development Plan (PDP)
- SLEs (Supervised learning events such as mini CEXs and CBDs).
- Assessments
- Clinical and Educational supervisor meetings
- Reflections and ARCP
Employment and how you get paid:
I was paid on the same day each month and my pay consisted of basic pay, nights as well as weekends or any locums. We would get paid towards the end of each month and our pay will be displayed on ESR.
As a foundation doctor in training you will earn a basic salary between 32,000–37,000 from April 2023.
There are online pay calculators that will help you better understand student loans, NHS pensions and how to calculate tax.
Money tips:
- Use ESR to keep payslips, P60 and Essential pension documents.
- Check your tax-code and correct it yourself online
- Keep track of expenses incurred as part of the job including memberships to GMC/MDU and BMA because you can reclaim tax on these.
- Use money saving strategies like cancelling unnecessary subscriptions, and searching for discounts.
There are useful websites such as Wesleyan and podcasts such as Money-Medic for further advice.
Apps to be used:
Learning as well as acquiring Knowledge: We don’t get tested on our knowledge regularly like we used to as medical students therefore, keeping my knowledge up-to-date has been something I have had to do independently and be more proactive about. Also, the Foundation school has been organising mandatory teaching sessions for us to help us develop.
Relaxing and looking after your mental Health: For those of you, who have followed me from the start, probably know that I enjoy my nature walks and activities that bring me joy and help me unwind after a long hard day of work. Whether its a phone call with loved ones or walking in park, these activities help me to relax and gain energy for the next day.
For more on annual leave, study leave, courses, conferences and exams in foundation years please visit here.
In conclusion, final year definitely had stressful moments but overall, it was the year I learnt about myself, my experience widened and I was able to prepare myself for the world of work.
