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Covid-19: what do trainees need to know?

BMJ 2020; 368 doi: (Published 27 March 2020) Cite this as: BMJ 2020;368:m1276

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Re: Covid-19: what do trainees need to know?

I read with great applicability, Abi Rimmer’s recent article.

As a final year medical student, soon to be deployed, the article sheds great light on the realities facing current juniors during this pandemic. For us as students, we are being asked to step up early and join our NHS family.

Becoming an F1 is an exciting but dauting inevitability once medical school ends. Usually a honeymoon period of rest and sun may succeed it, with the celebratory excitement of graduation enough to temporarily mitigate the fear. This year, a truncated elective and cancelled graduation mean no such time to evade these emotions. As of next week, many medics from my University will be by their F1’s side, learning the ropes, offering a helping hand.

A privilege it is indeed, as we are asked, not told to join the workforce. But, as stated in paragraph three, training has been greatly disrupted. What if my first rotation was due to be respiratory, or ITU? Will I still be completing my rotation? As mentioned in the section regarding rotations, much anxiety surrounds an inability to demonstrate a “commitment to a specialty,” with many doctors unlikely able to complete their time in those which may inform their future registrar applications. The article provides much reassurance at this ambiguity.

Rotas are new territory for us as students, with new emails almost daily from the BMA, particularly regarding contracts. Highlighted issues are suggested to be first resolved internally, where possible, although I wonder about the chaos behind the orchestration of rotas during the most normal of times and wonder if the reality is that simple. Much support is being offered to us as students however about upcoming FiY1 contracts and those which may present earlier for students yet to graduate, as for myself.

Burnout is perhaps a much-anticipated inevitability for junior doctors, widely by senior clinicians and even the general public after Adam Kay’s popular diary entries transfixed the nation (1). But we know that this should not be an expectation, but that doesn’t negate the spellbinding stories that play on repeat in our heads. If it wasn’t a worry enough, the pandemic has intensified such fears for many of us, despite our desire to commit. Many students and junior doctors are likely to be working longer hours, but the article mentioned a “statutory” but also “moral” duty to protect doctors during this crisis. Our NHS heroes are no good to us, if they are physical and mentally exhausted including moral injury. (2)

I was surprised to read of the BMA’s support for continuous food and rest facility provision by trusts. I am sure many of us wonder how many hours, days, nights we may be working, how many meals may go missed or forgotten. I take great reassurance at this recognised priority for all NHS staff.

We must first and foremost protect each other and our own mental well being during these unprecedented times, as the article alludes. My romanticised entry to becoming a doctor has taken a dramatic amendment, but amongst fear, is a readiness, to help our NHS.

1. Kay, A. 2018. This is going to hurt. Picador.
2. Greenberg, N. et al. 2020. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ 2020;368:m1211

Competing interests: No competing interests

10 April 2020
Emelia K Boggon
Medical student