Saturday, 12 July 2014

The unwritten rules of being a junior doctor/ 25+things you wished you knew before becoming a doctor

Well I thought it was about time that I did a junior doctor version of my post about things you wished you knew before starting medical school ( ) so here goes:

1. (And this is the most important) Never say the "q" word. The q word is the dirtiest swear word of the medical world. In the rare event your day is "Quiet" DO NOT SAY IT!! If you do utter the word then be prepared to be blamed by all staff when seemingly every patient on the ward becomes deeply unwell.

2. When referring a patient you can prepare your referral as much as you like and still guarantee the senior you are discussing with will ask that one aspect you forgot to look up such as the all important serum-rhubarb level.

3. Crash bleeps like to go off when you are in the middle of a procedure or breaking bad news

4. Crash bleeps like to get cancelled as soon as you arrive at the correct location having run from the opposite end of the hospital.

5. As per above "crash call cardio" is an excellent way of getting your recommended exercise.

6. The patients you get called to see with low urine outputs/ poor oral intake will probably have drunk and/or peed substantially more than you have during your on call shift.

7. You will have to make some truely awful referrals/ investigation requests at the recommendation of senior doctors (surgeons I'm looking at you) and by the end of your fy1 year you could probably make a decent second hand car salesman after the amount of shit you have been peddling to other specialities all year.

8. For the above the words "my consultant would like" absolves you from blame for crap referrals.

9. You will get blamed and/or shouted at for the crap referrals anyway.

10. A great ward sister/ charge nurse who likes you will make your rotation survivable. Doubly so if said nurse is also an avid ward baker.

11. You will just be finding your feet in a speciality when you rotate to the next one. Return to go, do not pick up 200.

12. The most difficult to bleed patient will also be the one who needs daily/ twice daily bloods.

13. You won't have to do a female catheter until there's a patient that none of the nurses can catheterised and then suddenly you are expected to be the expert...

14. If you are a female doctor then in spite of your stethoscope neck adornment and totally different dress code you will get called nurse by patients 85% of the time.

15. To misquote pirates of the Caribbean: Your finish times are more like a guideline...

16. However late after your shift it is if you are on the ward you will still be considered fair game by other staff for more jobs.

17. As soon as you have qualified (if not as soon as you have started medical school) be prepared to be accosted by nurses/HCAs/cleaners/catering staff/ friends/ family/ the cousin of the great great granddaughter the lady who lives 3 houses away requested you look at and instantly treat their rash.

18. All rashes look the same to an FY1

19. The treatment for most rashes is emollients and/or steroids anyway.

20. You will develop a robust stomach that cannot be touched by indigestion. This is because you will strengthen it by consuming a lot of your lunches either whilst fast walking between wards or while typing a discharge summary with one hand and eating with the other.

21. If you start reviewing a patient whilst eating lunch however you may have gone too far.

22. Most of your friends will be doctors.

23. You will spend a lot of your social time discussing medicine with other doctors.

24. On the rare occasion you manage to venture away from the medical crowd for socialising please see point 17. You will still find yourself discussing medicine...

25. Scrubs are lifesavers when laundry day came and went about a month ago.

26.  You will find a pair of comfy shoes and wear them to pieces as the thought of breaking in new shoes on the wards is unthinkable.  (In my case I wore my shoes until there was decent sized holes in the soles.  I only threw them away when I stepped in a patients vomit...)

27.  You will develop a creepy habit of staring at people with bulging veins and thinking "phwoarrr how easy would it be to cannulate that!"

28. Your patients will rarely have such veins.

I will add more "rules" as I think of them

Dr Halfadoc x


  1. These rules are amazing - so true! I love the concept of crash-call-cardio. If I am eating while hurrying to an arrest do the calories not count?

  2. Only if you have a) followed rule 20 thoroughly and b) finish before you reach the patient (see rule 21)

    If you follow both these then yes they don't count, eat as many chocolates as you can steal from the nursing station!

  3. So very true....especially the Q word being sacrosanct amongst the medical/ nursing profession. I remember nearly selling my soul for an ultrasound request and the golden rule is not to mess with the nurses!! Looking forward to more posts.

  4. Ahah love the list. 18, 24 26 are my fav

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