After spending 4 months as an F1 doctor in the UK, I’ve had time to reflect on the realities of the role and the healthcare system. Here’s my unfiltered take:
Not much is expected of F1s
In many ways, being an F1 feels like a year of adjustment. The expectations for clinical decision-making are low, and your role is primarily focused on administrative tasks and service provision. While this ensures patient safety and smooth team operations, it often leaves little room for hands-on clinical learning. It also means that you often have to fight for learning opportunities, especially hands-on clinical skills or procedures, as these are typically reserved for more senior trainees.
Unfortunately, structured learning opportunities aren’t always handed to you. Junior doctors frequently need to advocate for themselves to gain experience in procedures, attend clinics, or shadow senior colleagues. For those who aspire to be proactive learners, this can be frustrating. However, I’ve found some strategies that help:
Expressing interest early: Letting your seniors know you’re keen to observe or assist with certain procedures can make a difference.
Utilising quiet periods: On quieter shifts, ask to go to theatres or clinic.
Seeking out areas you might want to do a taster week in: Many postgraduate centres and/or foundation schools will have a register of tasters available and the first step is to speak to your educational supervisor and connect with colleagues across different specialties. This is a chance to do clinical work in a specialty you don't have as a job so make it count!
Service provision is the priority
The NHS, as a resource-limited healthcare system, places immense emphasis on service provision. Junior doctors are an integral part of keeping the system running, and the demands of the job often prioritise patient flow over individual development. This can make it difficult to align your clinical learning goals with the realities of the job.
While this focus on service ensures patient care, it’s easy to feel like a small cog in a massive machine. Balancing this with your career aspirations requires adaptability and determination.
Limited time with patients
One of the most disheartening aspects of being a junior doctor is the lack of meaningful time with patients. The heavy workload, combined with administrative tasks, leaves little room for in-depth conversations or thorough examinations. This can feel at odds with the patient-centered care ideals we’re taught in medical school. If you need to take more time to do something, do it. It's a tough balance but worthwhile.
On top of this, mandatory reflection and portfolio work must be completed in your own time. Keeping up with logbooks, clinical case discussions, and e-portfolios can feel overwhelming, but carving out a regular schedule for these tasks can help. I’ve found that dedicating a specific evening each week to update my portfolio ensures it doesn’t pile up.
Organising leave is easier than I thought
On a more positive note, I was pleasantly surprised at how straightforward it is to organise annual leave. While it requires some forward planning and coordination with your rota team, most supervisors are understanding, provided you request in advance and my colleagues have all been willing to swap shifts to make it work for all of us! Having these breaks to recharge is essential for maintaining well-being in such a demanding role.
The wage is not a 'London liveable wage'
It’s no secret that the F1 salary isn’t designed to account for the high cost of living in London. After rent, bills, and essential expenses, there’s often very little left. Many of my colleagues find themselves commuting long distances to afford cheaper housing or relying on family support to make ends meet. This financial strain adds another layer of stress to an already challenging year.
My Experience in the Academic Foundation Programme
Being part of the Academic Foundation Programme has been a unique highlight of my F1 year. The monthly academic sessions provide a refreshing change of pace, allowing me to engage in research, attend workshops, and network with like-minded colleagues. These sessions are invaluable for broadening my perspective and equipping me with skills beyond clinical practice.
Since my AFP is in OBGYN, I’ve been working on projects that align with my interests. Balancing this with clinical duties requires careful time management, but it’s been rewarding to see progress in areas that I’m passionate about.
Overall, being a doctor in the UK is a unique experience, filled with both challenges and opportunities. While the system has its limitations, finding ways to navigate and thrive within it has been a journey of resilience and resourcefulness. For anyone embarking on this path, my advice is to stay proactive, seek out opportunities, and remember why you started this journey in the first place.
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