David Oliver: The structural problems highlighted by covid-19BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2214 (Published 11 June 2020) Cite this as: BMJ 2020;369:m2214
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During the course of a doctor's life, few days are more infamous than the first day they wield a stethoscope and put on their metaphorical white coat. In the United Kingdom, our most junior doctors enter the wards on the first Wednesday of each August to begin their medical careers.
This initial baptism by fire, which occurs at the same time as the senior doctors also change their rotations, could be considered one of the health service's greatest weaknesses. It leaves our newest graduates to fend for themselves in new systems, new teams, new hospitals; it pits them against punishing rotas and places unprecedented demands on their mental and physical wellbeing. Although work shadowing exists across many trusts, it is often undertaken in a manner similar to medical school, with the new doctor merely shadowing and observing.
The covid-19 pandemic has changed many things. This year, for the first time, we have asked the 'Class of 2020' to step forward and begin their careers months ahead of schedule. When the NHS called, few new doctors did not answer. They began the new Foundation Interim Year 1 (FiY1) placements across the country, adding strength to a health service battling one of the worst pandemics in recent history.
Many new doctors have missed saying farewell to their fellow graduates, missed their long-awaited electives and missed their joyous graduations. Amongst the graduates, there is a feeling of loss brought about by an anti-climatic end to their hard-earned degrees.
Yet, a silver lining remains. For the first time, the new doctors were coached by a supervising FY1, often in the role that they are due to take on in August. They learned how to dot the i's and cross the t's in their first prescriptions. They learned how to order the scans and prepare discharges. They learned the things that medical school couldn't teach them. All this was done with their FY1 keeping a watchful eye over them, teaching them and, most importantly, catching their well-meaning mistakes.
Covid-19 has exposed the NHS's many strengths and flaws. The FiY1 placement could be one of the greatest discoveries made during this crisis, as it represents a novel way to protect our newest doctors and ease them gently into the beginning of a great career.
Competing interests: No competing interests