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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Sunday, 10 August 2014

Black Wednesday

It's official - I am one of the unemployed masses.  Well, sort of - available and willing to locum at a hospital near you!  And that's what I've been doing this week, weathering the perceived storm that is 'Black Wednesday'.

Black Wednesday instils fear in Joe Public and junior doctors alike - the first day of work for thousands of newly qualified doctors, and simultaneously changeover day for most doctors in training (i.e. everyone from a senior house officer to senior registrars).  It's hard to imagine any other job where on a Tuesday you could be working a 13 hour shift in Exeter, and expected to rock up to your new job in Inverness the next day.  The finger is often pointed at the newly qualified ones as to why the death rate is allegedly higher on Black Wednesday; I think you could make a strong case for the mass move of all junior doctors as a bigger factor.

Although you get an induction, every hospital has different computer systems, different parameters for certain blood tests, different ways of requesting tests, different ways of managing some acute medical problems, different departments available on site...  And hospitals are big places!  Running to a crash call in a hospital you don't know is rather tricky when you don't know where you're going and you don't know who anyone is (sometimes it's useful to know that the guy running next to you is the anaesthetist).  The whole week is an upheaval - the above scenario of moving across the UK is not uncommon, and is seemingly rarely considered in rota planning.  I know a number of my colleagues who only got their rotas the week before starting their new job in a new place.  This means sometimes working a 19-day stretch if you're unlucky enough to finish one job having worked the weekend, and start the next scheduled to work the next.  And that's before you throw night shifts into the equation.  In one case my friend has been rota'd onto nights the weekend she is supposed to be getting married!  Given that changeover day is exactly the same every year and the rota itself can only likely change very slightly, this all seems a little ridiculous.  The flexibility in the system is created by junior doctors themselves - swapping last-minute on calls and cross-covering to allow someone an afternoon to at least move house.

I offered to do extra night shifts on Wednesday and Thursday nights, thinking I must be the craziest person in the NHS.  Given how many night shifts I have already done in the last four months and how completely frenzied they often are, the thought of doing them on a week where no-one knows what's going on seemed foolhardy at best.  But actually it was great - certainly at my hospital they threw a lot of doctors at the situation of handover week, and gave a bit of purpose and use to doctors already working in the hospital such as myself who are doing 'F3' (i.e. finished their first two years of clinical practice and now taking a year out).  We offered the continuity of those logistical uncertainties that come from simply working in a new environment, as well as being an extra person to call upon for the newly qualified doctors.  Well, at least I hope I did...  For me it was a useful combination of learning to advise junior docs and continuing to gain more clinical experience as a junior doctor myself.  In my job, every day is a school day.  Pretty great, huh?

People get very worried about the medical knowledge of new junior doctors.  But this week's experience tells me that while new junior doctors may lack experience, crucially they know how to ask for it.  Perhaps people should focus a little more on easing the transition between jobs of the thousands of doctors in training at the rungs higher up the ladder.  After all, they're the ones that all these newly qualified doctors will turn to on their first days when things get tough.

In the mean time, I'm off to get my life back before Fulbrighting begins.  Can you believe it?  A year ago it was just a pipe-dream, and now I'm about to move to Connecticut for 9 months.  But more on that later.  

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