I am currently an f2 within the South Thames deanery...

 am currently an f2 within the South Thames deanery. I did my f1 at Lewisham hospital and am doing my f2 at Hastings hospital part of the east Sussex nhs healthcare trust at the moment.

My experience as an F1 at lewisham was overalls really good. In terms of induction we had 4-5 days that were lecture based and 3 days shadowing. All of this is a bit of a blur and while there was definitely some good information it was all a bit of an overload. The most useful thing was the shadowing. I chose a rotation combining acute general medicine, trauma and orthopaedics and elderly care. This was a pretty standard f1 combination.

I started on acute medicine, lewisham is an interesting hospital in terms of the medical teams as it is no a ward based but a take based system. There were three f1s put on a team (Monday,Tuesday,Wednesday,Thursday) each team was divided under two different consultants one f1 under each and a float f1 to go with the busier team. We all took turns being the float over the four months. There were also two SHOs under each team. 

For example I was on wednesday team under a specific consultant - every two weeks your consultant would be on call (my team every other Wednesday) and from that day all the patients who came in under the medical take would become your patients, they were then distributed throughout the hospital on different wards and would remain yours for their stay.

There were pros and cons to this, post take days would be manic with up to 50 new patients on your list and probably 10-15 left over from previous takes. All of them would be on different wards so you would be running all over the hospital doing jobs and ttos and it's also quite stressful for the nurses as they are ward based and have several different medical teams to deal with. Then over the two weeks you gradually discharge patients and do it all over again! The pro is that there are troughs with less patients when you are less busy. Overall this is a very very busy medical job and the bad side is you often had to work long hours past your contracted ones with lots of sick patients especially post take. The good side is that I learned loads, the quality of registrars and SHOs was brilliant and you had lots of opportunity to do procedures and saw a huge variety of patients with different acute medical problems.

I went on to do trauma and orthopaedics which was much less busy and working much more sociable hours. The registrars and consultants were friendly but we did often feel a lack of senior support- feeling like the most senior medical members of our team. This was in part due to some poor quality locum SHOs. Overalls the orthopaedic job was enjoyable, we were always encouraged to come to theatre and had a manageable amount of patients. We were also encouraged to actively participate in audits and had the time to do this compared to when I was doing my acute medical job.

Lastly I did an elderly care job, which unlike my medical job was ward based and this made a huge difference. We had 28 patients with me as two SHOs. Our registrars were brilliant and really supportive. The job was busy with some very unwell patients but it was manageable and we almost always left on time. I really enjoyed this rotation. It was also nice to be ward based as we got to know the members of the MDT much better.

Overall as I said I really enjoyed my time in Lewisham and I feel like I learned so much. The quality of y seniors was brilliant and they were all very supportive. All the consultants I worked with were very friendly and approachable. Lewisham has the benefit of being a DGH with a friendly atmosphere, but a London DGH so generally very busy with a broad cohort of patients. The downside of Lewisham is really how busy it is, especially in the general medical job with a regular expectation of the juniors to work longer than contracted hours. The four months really was an exhausting experience. The take system can also be confusing to begin with but you soon get a hold of that once you've done it a few times. We also had to work 12 days straight when working a weekend.

Socially Lewisham was brilliant, everyone I worked with from f1s to registrars were very sociable. There were lots of mess events and socials and a pub on site where people often went after work. Being based in London there were also mess events in Central London locations which were really fun. 

Gitanjali Amaratunga

3 days induction...

My job started with a 3 day induction - standard stuff like infection control, fire safety, IT things, and just about how the hospital works.  This was followed by 2 days shadowing the current F1s whose job you will be taking over.

I felt very supported from the beginning and the team is lovely. Nurses are very helpful and willing to help, as are the pharmacists on the ward. There is always someone you can go to and ask for help and I don't feel that I can't call to ask my registrar or even my consultant something. No question is too silly.

One medical on call weekend per month -this is tiring but I feel that this is where I learn the most. Again, very supported.

No night shifts as an F1, on medicine.

Lots of opportunities to practise clinical skills e.g. ABGs and even more to present cases, which is helpful for the portfolio.

Learn to manage time well and prioritise jobs that are the most important.

The hospital, in my opinion, is the perfect size if you want to be eased into F1 and I have found that the doctors are all very keen to teach. I tend to finish on time most days. Occasionally you will have a lot to finish and end up staying later but this is not the norm.

The town itself is very nice. Wouldn't say the night life is great but the F1s arrange a lot of nights out and I've always had fun.

FY1 Dr Komal Naeem (Maidstone Hospital, South Thames)- First rotation = resp

I am a foundation year 1 doctor in Medway Maritime Hospital...

I am a foundation year 1 doctor in Medway Maritime Hospital which is located in Gillingham in Kent.  It is part of the South Thames deanery. The majority of doctors who work in South Thames deanery will have one year in London and one year in the surrounding areas of Kent or Sussex.

I chose to have my first year in a district general hospital (DGH) outside of London because of the following benefits:

1) Better teaching experience as there are fewer F1s and senior doctors have more time to teach juniors

2) Smaller hospital means a less daunting first work experience – easier to find your way around, make friends etc.

3) Cheaper living than in London particularly when one is in so much debt after medical school!

4) I wanted to do more specialised jobs in my second year rather than my first as I still haven’t decided which career pathway to choose and therefore wanted to keep my options open in my first year.

About the hospital:

Medway Maritime is the biggest hospital in Kent and has a wide and diverse range of patients. Gillingham and the surrounding Medway towns are fairly deprived areas and the demographic of patients is often of a lower socio-economic background. This means that not only are the patients poorly educated and unemployed, they often also have very poor health. The experience I have gained in the last couple of weeks in Medway has been incredibly interesting and eye opening! As patients often present very late the clinical signs and pathology are like nothing I have ever experienced before in medical school. I am learning about rare conditions, how to manage critically ill patients and how to negotiate situations where communication is often very difficult.

Unfortunately the hospital is currently in special measures mainly due to the A&E department not fulfilling time pressures and other quotas. This is something to be aware of but by no means a reason to put you off applying to work in this hospital. If anything I feel that junior doctors are better supported as a result of this and there is a feeling within the hospital of comradery and team work here is excellent. However it does mean that the hospital is very busy and under a lot of pressure to see and treat a vast number of patients. Therefore Medway is not the place to apply if you are looking for an easy job as all the placements appear to be very busy. However it does mean that you get to do a lot of hands on yourself and learn a huge amount as a result.

Induction

There was a week of induction – 3 days of lectures and 2 days of paid shadowing. Personally I feel that the lectures were not particularly useful other than as an easy way to start the job and meet people. Most of the useful stuff I learnt was during the shadowing element and therefore I would argue that this should be longer. However the support that I experienced in my first couple of days as an F1 from other members of staff within the hospital was so good that I didn’t feel out of my depth too much.

Teaching

Every Tuesday there is a 2-3 hour teaching session on various clinical topics run by either specialist nurses or doctors. Some are more useful than others – depending on the topic/ teacher etc. You have to attend 70% of the sessions in order to pass the year which is actually more difficult than it sounds considering how busy all of the jobs are. However there are also e-learning modules which can be completed and count towards teaching attendance. In terms of other teaching it is variable depending on your job and therefore  consultant and team. However my experience is that most senior doctors are happy and willing to teach and they are enthusiastic to get juniors involved in procedures and time in theatres.

Social activities

Medway has an active doctor’s mess which costs £10 a month to join. There are monthly pay day parties which involve free pizza for lunch in the mess and a night out in the evening. There is a social club on hospital site where most of the evenings out start and is a good place to hang out after work. The surrounding areas of Gillingham and Chatham are not particularly exciting and unfortunately do have a bit of a reputation for being anti-social after dark! However there are one or two acceptable clubs/ bars in Rochester which are good with a big group of people. Medway has 42 foundation year 1 doctors and therefore there are always lots of people to socialise with. Maidstone is only 20 minutes away and has a good selection of bars and clubs. London is a 45 minute to an hour train ride away and therefore is also do-able for a night out.