Letter to my junior doctor self: 'There will be moments of terror and pride'
Dear Nish,
You’re a month in. I know what you’re thinking, even though you daren’t say it. It’s a bit of an anti-climax, isn’t it?
Those champagne-fuelled celebrations with your friends are a distant memory. The disbelief at the doctor prefix on your debit card has been replaced with resentment. The thrill once sparked by a bleep on your pager now makes your heart sink. Some days you try to slink back into the gaggle of students, wishing you hadn’t wanted to get out of that clan.
I'm a new junior doctor and I already hate my job
Read more
I know you feel daunted. But that’s understandable. You’ve taken on a weight of responsibility for other people. The cocooned, academic existence you once inhabited has been replaced by a harsh terrain of hierarchy and discordant emotion. I’d be more worried if you weren’t afraid. It is, as someone once said of life, like trying to learn the piano by giving a recital at the Royal Albert Hall.
I know it feels like you’re wearing scrubs from a dressing up box. I know you believe you’re the weakest link, but you’re not. You have a long way to go, and a lot to learn. But there’s a more insidious hurdle to confront first – the one of your own making. You’re scared you’re a fraud.
Being a good student often came down to deploying bits of obscure medical knowledge, with well-timed accuracy. For now, you think being a good doctor is too. Soon you’ll decide it’s about restoring each patient back to the character they’ve slipped out of. And later, you’ll define it as practical wizardry. Eventually, you’ll decide it’s all of these. Each day you’ll reshuffle their order of importance, and conclude you’re not doing any of them well enough.
Don’t wallow in your failure to meet your distorted definition of a good clinician
Let me save you some self-flagellation. Don’t wallow in your failure to meet your distorted definition of a good clinician.
Every doctor has a set of personal of traits their patients value. For you, your capacity to listen, your knack for connecting with a stranger, and your sense of humour will form the core of your therapeutic armoury. You’ll waste time looking for affirmation that you’re more than these – don’t. Appreciate them, hone them and use them wisely.
I know you think others are handling this better than you. They aren’t. Colleagues will tell you they’ve deftly slipped in five cannulas while you’ve abandoned your single search for a vein; they leap straight into chest-straddles at every resuscitation call; and the nurses already mistake them for the registrar. They’re probably not being truthful. The hermetic, fragile atmosphere of the hospital makes it a thriving petri dish of melodrama.
Instead, focus your energy on what you can bring. You’ll see our environment through a new lens. You’ll witness inefficiencies, broken promises and the avoidable delays that melt into a doctor’s background picture. That doesn’t mean they can’t be changed. Or that you can’t be the one to try.
Even when you feel your most unworthy, look over your shoulder. You’ll see others treating students like funfair goldfish (“No point in giving them names, they never last that long”). Don’t follow suit. Remember how good the day at medical school was when a doctor noticed you. That’s now in your control.
'Don't be a smart arse' – a junior doctor's survival guide
Read more
And don’t lose the curiosity mirrored in their eyes. It is a peculiarity that the gift of medical experience brings with two contradictory truths – an increasing awareness of the holes in our knowledge, and more responsibility for decision making. Ask questions freely now. It’s a privilege that comes with being a junior doctor.
Inevitably, you’ll make mistakes. Admit them, learn from them and share them with others. Most of all, forgive yourself. Your patients will need you to.
Finally, don’t be in such a hurry. Your friends might decide which specialty to uphold, and who they want to epitomise. It will take you longer. Your track will take turns that you can’t even imagine. Don’t panic – enjoy the ride. You have plenty of time to find your niche.
You’ve taken your first step as an imperfect apprentice in a lifelong lesson. At the centre of that lies a single relationship, that of one person seeking the help of another. As you immerse yourself in the wondrous complexities of this vocation, never lose sight of that. There will be moments of terror and excitement; of tears and of pride. It’s a privilege to be on this journey. And, although you’ll question this many times in the days to come, you’ve earned it.
Dr Nish Manek is a GP trainee and the national medical director’s clinical fellow to Dr Arvind Madan, director of primary care for NHS England.
Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.
If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.