Preparing for FY1 - Part 2 (20 July 2023)

SPEAKER_00 0:00

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SPEAKER_01 0:31

Hello everyone, and welcome to this episode of Career Conversations run by the Trainees and Members Committee at the Royal College of Physicians of Edinburgh. This is the second episode in our mini-series for New FY1s, where we'll be discussing general advice about managing life at work, including how to keep on top of your portfolio and leave entitlements. I'm Libby Sampi, and today I'm delighted to speak with fellow TMC member Dr. Marilena Gianudi.

SPEAKER_00 0:56

Hello everyone. Yes, my name's Marilena. I'm a cardiology registrar based in Leeds, and I'm also on the Training and Members Committee. Great.

SPEAKER_01 1:03

Well, thanks so much for joining me today. So I thought we could start by talking a little bit about what FY1s need to try and organise before starting work. Do you have any thoughts about what is good to try and tick off the list of things before starting FY1?

SPEAKER_00 1:16

I think the main thing is just getting to know what your trust expects of you. So try and keep on top of all the paperwork. Before you start work, you're gonna get millions, isn't over exaggeration, obviously, but lots and lots of emails coming through different departments at HR, you know, your rotor coordinators, and I think sometimes it can seem very overwhelming, but it's just really important to take the time to read them properly and to do all the tasks that they ask of you. Book your HR meetings early. The sooner that you do that, the sooner that your name is on the system, and then the less likely you are to have those little glitches when you start. So, you know, not having your IT password set up, not having your card ready, not having all your access granted to everything that you need. So I think it is just these couple of months before you start. The most important thing is just being organized, reading all your mail and doing all the tasks that are asked of you. And it's quite difficult to give, you know, specific examples of what you should do because each trift will want something different. But I think as a general rule, that would be what I would suggest.

SPEAKER_01 2:17

Yeah, there will be lots of emails coming through and just making sure you read through them carefully and send back whatever it is that's required. It's definitely the top tip of the day, probably. I suppose other big points are things like making sure you're in touch with the general medical council, you'll have to pay your provisional license fee. It's usually around August. This is slightly discounted when you're in FY1, FY2, but just keep an eye out on your emails for that.

SPEAKER_00 2:41

And I guess following on from that, at medical school, we're all overwhelmed. You know, MPS was there, MDU was there, Wenslean was there, and you signed up to everything because you would always get, dare I say, a free book or something with your sign-up, which you thought would be really helpful. And certainly those organizations have been established for a reason and they do offer junior doctors lots of different benefits by being a member. And I don't think this is necessarily the platform for us to say which one is better than the other, but I think you need to take the time to read through what you have signed yourself up for. Because even though the money that you would be spending as an F1 is quite small, from what I remember, it was only something like 20, 25 pounds. That does increase as you get more senior. And actually, it's good to know what you've signed yourself up for, what kind of help that these companies are offering you, whether it is insurance, whether it's legal help if you need that, so that you actually know what you have, what you might need, and what you don't necessarily need or want.

SPEAKER_01 3:40

So that would be for sort of indemnity covers and things. I agree. I think it's just good to have a read up about which ones and what they offer and choose the one that's most suitable for you. And obviously, of course, you have things like the BMA as well, which is an optional trade union. So it's worth considering what you want to be getting involved with at that point and consider whether you want to sign up before starting FY1. Well, this will come through on your emails, but a lot of hospitals have the doctor's mess, so somewhere where you can go and relax, and they often have some coffee and sometimes snacks and things, and you can sign up being part of the doctor's mess, which means you can use those facilities when you're at work. And often they take a little bit out of your pay slip each month, or you donate a bit each month or each year to have access to that. It's probably different in all the different boards and different hospitals, but certainly some hospitals do do that. So just keep an eye out if that's the case.

SPEAKER_00 4:28

And the mess is actually really good for social events, and I think certainly if you're in UF1, I think whether you're in a place where you've previously worked or you went to university with, it is a good opportunity for you to go to those events to meet the people that you'll be working with. Because F1 is a time where camaraderie is really needed. And I don't think anyone really knows what you're going through other than the other F1s. And whether you're starting a new trust in a different city and you don't know anyone, or actually you feel as if you've got your support network of friends from the university you went to, I think it's a really good way to meet people and to build up your social network whilst working, which will actually help your work life as well a lot.

SPEAKER_01 5:06

They often do have events throughout the year, which always is good fun. I suppose just something that is useful to be aware of come August, you do have to pay for a lot of things. So you have GMC fees, indemnity, but also probably deposits for flats if you're moving around the country and you obviously haven't had your first paycheck yet. So it's just worthwhile being aware that there might be quite a big expense in August and just preparing for that as best you can.

SPEAKER_00 5:28

And the only other thing is parking. So hospital parking, take the time to, if you are entitled to a parking permit, get it organized before you go. If you're not entitled to a parking permit, plan your visit before you go to the hospital and your travel every day. So it's all those little things of what life is going to be like from August onwards that you just need to try and troubleshoot before you start to make the start easier than it otherwise would be.

SPEAKER_01 5:52

And jumping off the back of that, checking whether you're entitled to travel expenses, because sometimes you need to get insurance on your car that covers business travel. It's just worth looking into that so you know what you're entitled to and how to claim it. I think it would be good to chat a little bit about supervisors and who clinical and educational supervisors are.

SPEAKER_00 6:10

So every year of training, you will have your clinical and your educational supervisor. Usually, when you start F1 and on your first job, your educational supervisor will also be your clinical supervisor. So in your first job, one of the consultants will be tasked to be your supervisor and they will be there to give you advice both clinically and they'll kind of follow you throughout the year. And I think certainly in some hospitals and trusts, your F1 educational supervisor may actually follow you on through F2 as well. But usually your first supervisor of the year acts as both, and then they remain your educational supervisor throughout the year. And as you change your jobs, your clinical supervisor will change. And I think getting to know your supervisor is really, really important. Taking the time to organize your first meeting with them, I would say ideally within the first month of starting work, even more ideally within the first two weeks, is essential because they will want to get to know you, will want to get to know who you are as a person, what you want to achieve from the job, how they can help you achieve that. And also they're very good at troubleshooting, whether it's a problem that may arise clinically, whether it's a problem that may arise personally, whether it's a problem that may arise that could affect how you work or the way you want to work. These are people who have been put in the roles because they've had lots of experience in dealing with trainees, and they have had training themselves as to how to be a supervisor, and it's really important that you try and establish some form of working relationship with them. Obviously, some people might not get on 100% with their supervisor, so it may just be that it's a purely working relationship and they find that they could go somewhere else for pastoral support or mentoring, but ultimately your supervisor, especially your educational supervisor, is responsible for you, so much so that your portfolio will require for you to meet them on a regular basis and to fill out forms to say that you have done so.

SPEAKER_01 8:03

I think that's a great summary, really. I think probably the main thing is try and reach out to your supervisor early within the first week or two. It's good to find out who they are, email them proactively and organise a meeting. So you'll have your first meeting, and it's really good to set out your aims for the block and just figure out what experiences you can have on the wards or you know, even clinics and things, and plan this with them. And then you'll have a meeting at the end also to sort of sign you off for the block. And depending on the supervisor, you might have sort of mid-block or wardrounds with them. It just it really depends on the hospital and the department itself. But you should have at least two meetings with them at the start and the end, if not more. I suppose that leads us quite nicely onto portfolio for anyone who hasn't heard about portfolio or knows what it is. Essentially, it's something that you will be doing for a long time. For FY1 and FY2, you'll have online portfolios. Different regions of the country have different online portfolios, I think. So England have Horace and Scotland have Touras, for example. But at the end of the day, you're all expected to have the same requirements to progress past FY1 and FY2. So that includes a certain number of learning hours, supervised learning experiences where someone's watched you take a history and given feedback, and then multi-source feedback from members of the MDT that you reflect on with your supervisor. And as I say, usually you have meetings with your supervisor to sort of keep an eye on how things are going with your portfolio along the block, make sure you're on track. Do you have any advice, Marilyn, about how to keep on top of your portfolio as you're working?

SPEAKER_00 9:30

What I attempted to do, because I'm quite a visual person, is I created a spreadsheet of everything that I needed to get done in my portfolio. And whether that was, you know, a curriculum requirement or one of the practical skills, as soon as I got that signed off or like match something to the curriculum, I would put a tick in the box to say that I did that. And that was very good visually for me to see what was missing, what I still needed to do. But it also really helped when I went to my supervisor meetings because your supervisors don't have that much time and they will need to scroll you through your portfolio to see what you have, what you don't have. If you go there organized and you say, look, I've got this, this, and this, I'm still struggling to get this procedure, or I don't know how to map to this part of the curriculum, then they can advise you on how to do that. Well, who do you contact for, you know, a cardiovasion or an NG tube or come to my clinic and we can talk about this and I can sign you off? And I think that's just a really good way of keeping on top of it. Obviously, everyone has their own way of doing it, but I think it's something that you need to think about at the start of the year, especially when you're first starting off, it can seem quite overwhelming. Oh, I'm starting on course and I have to do this portfolio. And you can quite easily fall into this can wait, this can wait, this can wait. And what's really important to remember is your portfolio isn't going to be checked the following August when you're due to rotate. ARCPs, so your annual review of competency and progress meetings for the year tend to happen in April May time. So you're giving yourself about eight months to get everything that you should have otherwise technically done within a year. So it's really important that you, yes, give yourself some time to settle in. You obviously need to give some time for people to get to know you before they start doing assessments so they can monitor your progress. But I would certainly be saying from October onwards, you need to start getting your assessments done and then you're not stressing at the end.

SPEAKER_01 11:23

Yeah, absolutely. And don't be scared to ask people, sign you off for things or to give you feedback and every opportunity you see, take it because you don't know if that opportunity is going to come back up again. And so you have to be quite opportunistic with it. Before your first meeting with your supervisor, it's quite good if you have time to have a look at the curriculum and try and piece together, oh, I could get that here, I could take that off there, and ask them for advice on it as well. If you're not quite sure where you're going to get their race skills from, for example, and they'll be able to guide you through that.

SPEAKER_00 11:50

And the other thing that I would add to that is if you're going to ask a consultant or even a registrar for an assessment, say you're on a long day or you're, you know, on a night shift, I would always ask at the start of the shift and say, look, I really want to get an assessment signed off today. I need this, or can we do a safe-space discussion? And your senior will try and make the time to do that. And yes, it can be a very busy shift and that's not possible, but I don't think there's anything worse than finishing a shift and then someone saying, Oh, by the way, can we do an assessment for something that happened hours ago? Because these things can be a tick box exercise if you make them into tick box exercise, but ultimately they have been made to help you progress with your training and to help you reflect on your clinical judgment and on your clinical skills. And you can't do that if you haven't prepared for that in the right way. And to prepare for that, you have to be ready, but your assessor also has to be ready.

SPEAKER_01 12:43

Yeah, absolutely. In order to get the most out of these assessments, there's nothing better than getting feedback from someone who's witnessed you working and doing your job and giving you constructed and useful feedback. So I agree, definitely use it. It's an educational tool that is useful to use. It's hard to not sometimes think of it as a tick box exercise, but try and rephrase that way of thinking, I think is the good way to go about it.

SPEAKER_00 13:04

And just following on from that very briefly, just with multi-source feedback, because I think that can also seem a little bit overwhelming. So for anyone that doesn't know, multi-source feedback is when you ask the people that you work with who have to not just be doctors, so you do need to ask members of the multidisciplinary team, whether they're pharmacists, occupational therapists, dietitians, physios that work on the wood, to fill in a form about what it's like to work with you. I think the timing of that is very key because you need to let people know who you are as an individual and as a doctor before you do that. Obviously, leaving it till your third block, you're just not giving yourself enough time. I would ideally say that you do it in your first or second job of the year, but give yourself two to two and a half, three months to settle into the job. And then a little bit before you rotate, you send out the multi-source feedback. I would ask people, you know, would you be happy to fill this in for me? What we tended to do because everyone was asking for it at the same time, was create a list and we would just put it in the doctor's office. We would ask all members of the MDT, would you be happy for us to send your phone? And then everyone could just take the emails from the same list. And if you ask and then feel free to chase some people up, sometimes you'll find that people can be slow to reply, but just make sure that that's done early, but having given yourself enough time for people to get shown you.

SPEAKER_01 14:24

Absolutely. I think definitely trying to do it in your first or second block is a definite. You can't really squeeze it in in the third, given that April, May is when the arc peers. That's a good summary of the portfolio. I thought as well, sort of important parts of FY1, FY2 starting work is annual leave and study leave. Obviously, it differs from department to department how you would request annual leave. Sometimes you need to email the rotor coordinator in advance. Sometimes your annual leave is blocked into the rotor and there's a little bit of wiggle room to switch with people, but sometimes it's difficult. Do you have any advice about annual leave requests and how to go about requesting that?

SPEAKER_00 15:02

I would just try and plan it early. I would have a look at your rotor as soon as you get it. You get that six weeks before. If there's an event that you know is a must-not miss for you, whether it's that you're getting married, your best friend's getting married, you want to go on a once-in-a-lifetime trip, I would tell the rotor coordinator as soon as that email is released. Yes, they may not be able to do anything about it straight away, but they can certainly help advise you as to who to talk to about getting the leave and how to go about swaps. If you do need to swap, I think the main thing is just talking early. There is nothing worse than trying to organize leave two weeks before you have to go because nine times out of ten, that is just not going to happen. I think with study lead, things can be a little bit easier, especially for F1 training days. Most people around you will be asking for those days. So the road coordinators are more or less aware of those. And you all have to do ALS during F1. So again, those days can be relatively easy to get off. You may need to do a swap. Again, you don't organize ALS the day before. So as soon as you're given an ALS date, let your rotor coordinator know. You can even let your ward node say, I will not be here on those days. And it is just about asking your rotor coordinator either before you start work or as soon as you start work, look, how do you want me to go about requesting my leave?

SPEAKER_01 16:14

Yeah, I think this is true. And if there is, as you say, something really, really important, you to go to a friend's wedding, for example. If it's in the next block, there's no harm in getting contact with that rotor coordinator before you've even got your rotor. So they can try and put it into the rotor before it's all set.

SPEAKER_00 16:28

I completely agree. And I think you'll see that as you get more senior, you will sometimes be given an offer of which block you would like to work in within a rotor, because they do just tend to be recurring weeks that you have, and that just gets you in the mode of trying to plan ahead. I don't necessarily think that will be the same for F1 Ep 2. It might be, but certainly just talk early. Do you not need anything last minute? Yeah, absolutely.

SPEAKER_01 16:53

And for study leave entitlements, it's a little bit different between FY1 and FY2. At least in Scotland, in FY1, you don't have any full non-fody leave to take. It's used up on your mandatory teaching sessions, so you'll automatically get all of those. And the road coordinator will be aware of them. In FY2, you technically have 30 days, I believe, at the moment, like at time of recording 30 days of study leave entitlement. But again, lots of this is taken up with mandatory teaching. You get your two days for ALS, and you can take the taster weeks, which is up to five days each for two taster weeks. Again, it'll vary how you apply for study leave, find out how you do it. I know in Scotland at the moment you do it via Touris, which is where the portfolio is, and do it early in advance so that it gives your department enough time to put it into the rotor, make swaps, etc.

SPEAKER_00 17:40

And I think for England, F1s are allowed up to 15 days to delete, but as you said, lots of it will be your mandatory F1 training days. We will post some useful resources on our podcast footnotes. So you can always refer to them, but you can't go wrong by just talking to your rotor nators and your local deanery as to what the requirements, the entitlements rather, are for you.

SPEAKER_01 18:02

And I suppose it's worth pointing out it will obviously be different for academic foundation trainees who will have access to more study leave. And this will obviously vary between foundation schools. So just make sure you're aware of what you're entitled to and go from there essentially. But we'll be sure to put up some links for you to have a read through. Were there any other points you wanted to discuss, Marilena?

SPEAKER_00 18:22

I think just reiterate what we said last time, which is please enjoy yourselves. Please always ask for help. I know that it can seem quite overwhelming before you start, but if you can try and change that into a feeling of excitement. You have been working for this for the last five or six years. So now is your time to actually put to practice what you've learned. And do please just speak out. Whether, as I said, it's clinically, whether you're struggling, there is always somebody there, whether it's your supervisor, whether it's a senior reg, whether it's another consultant that you're on with, whether it's the foundation course lead, there's always somebody there to listen to you. So please just enjoy yourself. That's what I want to really get across for.

SPEAKER_01 19:02

I think that's a perfect way to end the podcast. Thanks so much for chatting with me, Marilena. Thank you, and good luck, everyone starting. If you would like to hear more information and discussion about starting FY1, then please come along to our annual evening medical update, Top Tips for New Doctors in July, where speakers will be discussing more about starting work, including a question and answer session. Please find more details on our website. We hope to see you there.