I was recently tasked with delivering a lecture to new doctors with the title “How to survive and thrive in FY1”, with an otherwise fairly unconstrained remit.
The title confronts you with the idea that the lives of junior medics is inherently fraught and indeed, possibly unsurvivable. This idea finds its origin in more than a kernel of truth: in almost all settings, the front line of healthcare can be a relentlessly difficult place to work, both physically and psychologically. This is due to various reasons, some (though not all) of which are obvious. The currency of healthcare is the quality and quantity of life itself, and the vagaries of human existence.
For this reason, the first two years of medical practice, which are termed “Foundation Years” in the United Kingdom system, are anticipated by medical students with fear, and reflected on by their senior colleagues with a wistful nostalgia, as some might previously have reflected on military national service. Perhaps like the military and some other so-called “vocational” professions, medicine carries with it an expectation of sacrifice. Its practitioners take on some risk that the work may impinge on their wellbeing.
Work-related stress is obviously not unique to healthcare. Perhaps what is unique, however, is that while significant stress might represent a failure in the relationship between an accountant and her work, it is advertised upfront to junior doctors, nurses and allied healthcare professionals.
So what can I say to those attending the lecture? My credibility for delivering it rests only on the fact that I have presumably “survived” the Foundations Years, but won’t my insights therefore be contaminated by survivorship bias? Perhaps the more interesting views would come from those who somehow… didn’t survive.
Like most insights one has, someone else will have described it better than you ever could. In this case, my dominant reflection from my own time as a Foundation Doctor can be paraphrased as: “a problem shared, is a problem halved”. Healthcare is fundamentally a team sport and lone rangers rarely fare well. So learning to share your burdens -and those of your colleagues- equitably, is the best route to a cloudless life as a junior doctor. Allied to this, can be a willingness to step outside the arbitrary boundaries that divide our professions. One consultant I worked with believed that the most unprofessional phrase a doctor could say was “that’s not my job.”
The health service can charitably be described as a complex system; although it may feel more like a loose, chaotic network. In a functioning system, no single task -or mistake- can fall solely on one person. Indeed, failures may be the most important thing to share as they provide the most fertile ground for individual and organisational improvement. Most things can be survived if we share our efforts and embrace failure.