What to expect from the FY1 Year

F1 Expectations
What do FY1s think at the end?

•  Very intimidated initially but I grew in confidence
•  So much to do, patients always getting moved
•  No way to know if I was right or managed them ok; need feedback
•  Fire – fighting, so many patients / so few staff
•  Assessments seemed a pain but I have been glad in end to prove competence / be able to demonstrate I can do it
•  Scary at first, but steep learning curve
•  Definitely more confident towards end of year
•  It is tough!

It is tough! So how can you make it easier?

•  Always make it clear to everyone that you are an Fy1 so they know you will need a bit more help e.g. than CT1s
•  Have a good chat to your educational supervisor early in the post & at regular intervals (at LEAST 3 times in the post for appraisals). Tell them about areas where you lack confidence
•  You rarely have a full clinical team around you (shifts / leave / sickness / clinics) but make good use of them whilst there – rounds, supervision / teaching of tricky procedures / tasks, coffee

So how can you make it easier?

•  Good handover; give & demand!!
•  When asking for help use SBAR to give all the info the senior needs
•  When you are asked for help try & get the SBAR type info (e.g. from nurses) to allow you to assess urgency / prioritise your tasks

SBAR

•  Situation; e.g. I am FY1 on X ward & calling about patient Y / I am concerned because….
•  Background; Patient is in for X operation / Y condition, normally ….., has changed in past … minutes / hours / days to …….
  Assessment; I think the problem is…. I have done…..(e.g. O2 / analgesia) Or: I am not sure what problem is but patient is deteriorating
•  Recommendation; Would you please e.g. come & see them, advise me on…. / consider transfer (e.g. to ITU)
•  DO YOU NEED ME TO DO ANYTHING NOW?
So how can you make it easier?
•  When you go home / out / gym / pub / to bed do try & leave it all behind. Handover well, set up what you can e.g. blood tests then have confidence in colleagues to carry on your good work.

Teaching

•  Mixture of purely clinical (e.g. renal failure/ acute coronary syndromes) & more generic subjects e.g. death certification/ dealing with the coroner or subjects such as good clinical note - keeping or consent issues
•  1-2 pm in CSB (room varies), bring lunch if you need to
•  Attendance expected unless on leave of any kind including ‘days off after’. If ‘on take’ team & busy with sick patients that no–one else can take over don’t leave them to die!
•  Let Alison know by email / phone or a note on previous register if you expect to be away
•  70% attendance is required to allow for leave etc

Additional Teaching

•  Also
•  1 (Friday) afternoon each of teaching in the simulation lab – acute medical scenarios
•  1x ½ day ‘Windmills’ course – help with career planning
•  ALS if you don’t have it
•  PLS (if needed for your post)
•  Other resources Doctors.org / BMJ Learning / eLFH at www.e-lfh.org.uk are very useful to you especially if missing a session or tackling and area of weakness
•  Document it in your portfolio

Safe prescribing

•  Key FY1 competency
•  Intend to have you all certified Safe Prescribers by the end of the year
•  Targeted teaching & a copy of old paper / answers to help you
•  E-learning modules
•  Series of formative assessments
• Feedback if you fail
•  Will shortly be a Deanery wide requirement

The Test

•  8 questions
•  On this Trusts prescription charts, TTO & infusion charts so make sure familiar
•  Use BNF , Pocket Prescriber & anything else you want
•  Calculators are fine
•  No ‘phone a friend’
•  may take more than 1 hour – not time limited at all (but warn firm)

E-Portfolio

•  All have usernames / passwords to access e-Portfolio
•  www.nhseportfolios.org
•  Enter username / password to login
•  Changing your portal password
•  Click on Change password
•  Enter your old password & then enter a new password twice.
•  Click on OK

Advice

•  Make a start on your e – portfolio now
•  Be persistent; everybody navigates it
•  Fill in all the demographics etc, a photo is useful
•  Most seniors familiar with format now & have their passwords – you can download help for them from within the portfolio if not!
•  Ruth can get brand new educational supervisors sorted if no passwords etc
•  At appraisal open it up & lead them thru it!!
•  Some items only completed within your login or our login
•  As well as appraisals / assessments don’t forget the certificates / library & PDP / reflective bits
•  Uploading electronically is easiest
•  Paper certificates need scanning - put on computer somewhere & then import
•  Sign the health & probity bits
•  Record all sickness absence - at end of yr1 we need a record & it saves you searching back (GMC very strict!)

Timeline / Hurdles

•  3 appraisals per job (early / middle / late) – chase ed supervisor
•  Aim for 2 - 3 minicex / cbd / DOPS per post - some post better than others – aim high!
•  Demonstrate your competencies/ interests in particular fields
•  In early days we do not expect you to be at standard of ‘end of year 1’
•  I will be viewing…
•  Towards end of 1st post
•  Interim validation
•  For FY2 application scoring (see booklet)
•  Final validation
•  GMC signoff
•  More often if I am worried / you are slacking
•  You will be told where you can improve – the rest is up to you
•  Last year some trainees in CWFS expected to get FY2 jobs here but beaten by applicants from outside with better FY2AP scores - ended up in Stoke / Stafford – so worth a bit of effort
•  Portfolios scored at CMT / BST / GP selection