I knew early on in my career that hospital medicine was not for me, for a number of reasons. Choosing general practice was a no brainer.
However, as part of my training I have to revisit the hospital and rotate through different departments. Although I do not share the level of enthusiasm as some of the specialist doctors I recognise the importance of experiencing various specialties because I will need this knowledge and skills to be a proficient GP.
Therefore, when rotating I ensure I do my best to gain as much as possible from the various specialties. Here’s how you can make the most of a rotation, even if you are not that passionate about a particular specialty.
Hospital rotations are hectic, with busy on-call shifts and trainees are often constantly battling chronic fatigue. However, it is so crucial that time is used wisely when in clinics, theatre and on the ward.
During my obstetrics and gynaecology placement I am fortunate to be able to attend a number of specialist and sub specialist clinics. While it is not always possible to have one-to-one teaching sessions during the clinic, I keep an eye out for an opportunity and seize it with both hands when it arises.
This could be asking the consultant to observe me perform a procedure or examination, or presenting a case I have seen alone. This way I gain useful feedback informally but more importantly formally on my portfolio, which not only collates evidence for my ARCP but a personal record for me to review if needed at a later date. The consultant might also be able to complete my assessment right there and then.
While it is difficult, it is definitely possible to partake in an existing audit or quality improvement project (QIP) during your hospital placements.
As an FY1 I participated in several audits relating to antimicrobial stewardship, headaches and chest pain. So, although there may not be the luxury in busy rotations to create your own project, it is definitely a good idea to ask about existing audits as there will be at least one project already ongoing that you can contribute to - and even better if it ends up being published.
I was very fortunate to be given time at work where I could start my own audit when I worked at Saint Francis Hospice. This was invaluable for me, enabling me to help improve standards whilst also meeting requirements for my training.
Reflect regularly, online and offline
When seeing patients in clinic or on the ward I think about the key points I can take away from the case. Even if I do not write the case in my portfolio I take a few moments after the case, (if time permits) or sometimes after the working day to think about what went well or what didn’t and how I can improve to ensure I provide the best care for my patients.
Of course, it is also important to regularly record your reflections online for all of the reasons mentioned above.
I have many interests alongside, and related to, my work as a doctor. I use my time in various posts to speak to others about the work I’m doing outside of medicine and to also find out more about them as individuals and ventures that they might be involved in.
For example, I speak to fellow colleagues about the work I do at DreamSmartTutors, which aims to promote medical careers to students, and they are often in support of what I do and get involved as well.
Look after your health
You can’t make the most of any placement or opportunity if you don’t look after yourself. You certainly can’t provide the best care for your patients if your own health is suffering.
We all know how difficult it is to look after ourselves when we simply don’t have the time to go to the toilet or get that glass of water. However, it is imperative we recognise when we need help and seek support for mental and physical health issues.
A good place to start would be occupational health at your place of work and/or the GP Health Service, which is a confidential service for GPs and GP trainees in England with mental health concerns, including stress.
- Dr Baptiste is a ST2 GP trainee in Romford, Essex