Being an F1 mid-way through my first placement...

Foundation School: Oxford Foundation School

Hospital: Horton General Hospital

Placement: Orthogeriatrics 

Being an F1 mid-way through my first placement, unfortunately I can only pass on limited information concerning my foundation school; however I can relay some info which I would have found useful prior to making my choice. 

What I found quite surprising when applying for jobs in Oxford was the limited range on offer. I found that almost any F1/F2 rotation that I picked would require me to take a hit on one of the six placements. The range of jobs I found here often included quite specialised surgical rotations like Paediatric Cardiology or ENT Oncology, which may not be up everyone’s street. In general I found the Oxford jobs slightly more skewed towards surgery than medicine which one should keep in mind when applying here (that’s not to say there aren’t any medicine ones it’s just about 60%:40% ratio). It’s a good idea to ask any current Oxford F1s (or more senior docs if their memory stretches) about the speciality you are interested in so that they can give you an idea of how many jobs were available when they applied. 

Another aspect of job rotations that is worth considering is where among the numerous ‘central’ Oxford Hospitals the rotation is based. The Horton General Hospital in Banbury is actually about a 30-45minute commute from Oxford town which is something I wasn’t aware of.  The other Hospitals however are more centrally based. While Banbury itself is quite a pretty if small town, it can be quite isolating if one chooses to live in the Hospital accommodation on-site there. I would recommend commuting from Oxford if you enjoy seeing other humans in your evenings as only four F1s lived on site (all of us moved to Oxford within a month). 

Horton Hospital is a very small hospital - you walk to the pathology lab with your blood tubes (no porter or pods required). This obviously has its pros and cons. Pros are that in comparison to the John Radcliffe (JR) the workload is more manageable, you get to know all the staff quite quickly and things like CT referrals are no longer a dreaded ordeal. On the flip side, the senior cover can be very sparse out of hours, learning opportunities are somewhat limited and the variety in patient cases seen are not quite so robust. 

In terms of my placement in Orthogeriatrics, while I cannot complain about the (to be blunt) lack of work in comparison to other placements (and the 1A banding pay), you do feel like you’re not developing as a doctor in comparison to some of your peers. It is a good job if you are orthopaedically orientated as there many friendly and approachable senior consultants and registrars, for such a small hospital, meaning you can get involved in audit projects and get theatre time very easily.  On the other hand for those not so into orthopaedics while it is a good job to ease you into F1, you probably do not learn as much as you would being on other jobs. 

Anonymous F1 

I am currently an F1 junior doctor...

I am currently an F1 junior doctor. I was allocated to the Oxford deanery, which usually means that you will get at least one year in Oxford then one year in Buckinghamshire, Slough or Windsor. I’m in the Buckinghamshire Trusts for my first year doing stroke medicine (in High Wycombe hospital), respiratory medicine, general surgery and trauma and orthopaedics (in Stoke Mandeville hospital in Aylesbury). In my F2 year I will be in Oxford doing community geriatrics, cardiology, then trauma and orthopaedics. 

I tried to choose the F1 rotations that were very general, rather than specialised to give me a broad knowledge base before my specialist posts. I also tried to choose the F1 rotations that I knew would have on-calls, because they are slightly more well-paid (1A and 1B banding).  My second year jobs unfortunately were not my first choice, but I will probably just persevere, as I’m sure it will be a great learning experience. However there is a phenomenon called “swap shop” whereby you can try and exchange your F2 placements, should you find a suitable colleague that would rather have your jobs than their own.  I have found that Oxford deanery is really good at sharing information regarding specialist training taster days – so if you don’t land a rotation that you really wanted, there is still hope to gain a little experience. 

I should also just mention that one of the main reasons I chose Oxford was because they offered the F2 year abroad. Low and behold, when I was accepted and tried to find out how I go about applying for this, I was informed that only this year they decided to stop offering this opportunity in the Oxford deanery. Now this was probably my own fault due to lack of meticulous research prior to application, but if F2 abroad is your dream, please do not make the same mistake! Do the groundwork, even if you are in the midst of finals or about to jet off on your elective! Research is everything. Also, I think the foundation programme will now be releasing more information on specific rotations, such as salary and working hours, which I think is incredibly important in guiding the decision of where to apply. 

My hospital/ medical experience so far… 

I am currently on my first placement – stroke medicine. So far it has been the steepest learning curve that I have ever encountered. Learning how to get organised, prioritising, keeping calm under pressure, asking for help (frequently), speaking to concerned families, breaking bad news, recognising and responding to the sick patient, making phone calls to registrars and consultants (and ensuring I have all the relevant patient information and facts beforehand)  – these are all things I have really developed in my little time as an F1 so far, and I’m sure these will only continue to improve. I really did feel like I was thrown into the deep end, but I have to say, that on the Stroke wards particularly, there is always someone you can call for help if needed, whether it be the ward clerk, pharmacist, physiotherapists, nurses or your seniors. Asking for help is not frowned upon, just as long as you consult the appropriate source of help! The staff here are incredibly approachable and proficient at their jobs and which makes life a whole lot easier. 

The stroke unit itself is the third best in the country, and I can honestly see why. The organisation of the wards and the standard of patient care are fantastic. Additionally if you are doing any medical rotation, you have the opportunity in this hospital, to spend one week every month on the cardiac and stroke receiving unit – which is essentially an A&E for stroke symptoms and acute chest pain. As well as thrombolysis and cardiac arrest calls, this involves clerking, initiating management, which takes you pleasantly back to your medical school days. 

Twice a week we have mandatory lunchtime teaching and then there is grand round and the x-ray meeting once a week – all great learning opportunities if you are keen. They are also good opportunities to get ahead with your foundation year e-portfolio. 

In general my experience at this hospital so far has been good. The only negative I would point out is the inadequate staffing in terms of doctors. Quite often there are few doctors on the ward, which can leave you feeling very flustered, swamped with ward jobs, and unsupported. Resultantly, you tend to work outside of your hours, which I think is a common problem when doing a medical job.

Living and socialising…

I have to be honest, there is little to do around Aylesbury and High Wycombe, but as with everything, it’s the company that brings any social situation alive. The junior doctors here in Buckinghamshire Trusts are a great bunch and are very social active. There is a doctors mess president and team at Stoke Mandeville who organise events for Buckinghamshire Trusts, and there is a doctors mess in High Wycombe hospital that does pizza day every Friday. Wycombe hospital junior doctors also try and get together weekly for drinks and dinner at Eden – the shopping centre right next to the hospital, that has an array of nice chain restaurants. I do think that if you are a real party person, you may be better of in the Londons or the Midlands…it very much seems like we are making the most of what we have here in Buckinghamshire.

In terms of living, I think that it’s important to know that in the Aylesbury area, due to some sort of rule/regulation, there usually cannot be more than two unrelated people living together, unless the landlord has a contract, which permits otherwise. So it can be quite difficult to sort out a living situation with more than two! I think this is very different in Oxford itself, but you may have to read another account to clarify this. Additionally, it is very possible to live in Oxford then commute to the Buckinghamshire hospitals, as a few of the junior doctors are doing just this. I think it roughly takes around 40 minutes. Hospital accommodation is available at Stoke Mandeville and High Wycombe at around £400 per month. Again I am not too familiar with the finer details of these, but I think it’s usually quite a sensible move if you haven’t yet figured out where you want to live or with whom you want to live. If in doubt there is always a deanery-specific Facebook group formed to discuss such matters. 

In summary… 

• Don’t be disheartened if you don’t get your first choice jobs, there’s always some way around it. 

• Do consider choosing a different deanery if you want to do F2 abroad. 

• Being an F1 anywhere can be rough, but never be afraid to ask for a hand if you need it, despite how frequently that may be. 

• Buckinghamshire is a great place to work

• Buckinghamshire isn’t necessarily the greatest places to play 

• I wish doctor’s handover existed before I applied; I think it would have been a brilliant and genuine source of guidance! 

Winnie Uchendu 

F1 Doctor