all of the newly minted doctors commencing their internship, I extend a hearty
congratulations. This year will be challenging and rewarding, energising and
exhausting. It will be a period of rapid learning and adjustment, with
decisions to be made and skills to be learnt.
presence of an effective mentor is invaluable in your development as a doctor.
The #TipsForNewDocs hashtag distills pearls of advice from a tribe of mentors,
who not too long ago stood where you are now.
have mined the collective wisdom of the Twitterverse to provide you 9 tips that
I wish I knew when starting as a junior doctor.
1. A diagnosis is not always the end game
Patients don’t come to see you because they want a
brilliant diagnosis. They come to see you because they just want to feel
— Gavin Preston, M.D. (@GavinPrestonMD) 18 November 2017
is power in diagnostic uncertainty. It should be embraced rather than shunned.
should become comfortable with writing ‘chest pain of uncertain origin’ rather
than ‘costochondritis’ or ‘musculoskeletal pain’. Maybe the patient discharged
home with the label of ‘musculoskeletal chest pain’ is having an early
myocardial infarction. Maybe the patient chooses not re-present because due to
false reassurance that it’s “just muscle pain.”
patients’ may expect to leave hospital with a label for their symptoms.
However, these labels can sometimes cause more harm than good.
a thorough history and examination, rule out the serious causes, provide
symptomatic relief and provide reassurance. Become confident in communicating
2. Failure can be the best teacher
It’s not mistakes or failures
that should concern you; it’s your response to them that will define your
journey as a doctor#TipsForNewDocshttps://t.co/vqaNwUt6bR
— Damian Roland (@Damian_Roland) 2 August 2017
are learnt by doing, not by observation. This means that you are going to miss
a few arterial lines along the way. You’ll have to pass the laryngoscope to
your supervisor more than once.
feel ordinary at the time.
this instinct. Learn to fail the right way.
involves failing in the safest way possible. Have a go, but know your
limitations. Strive to do no harm with your attempts. Go away and forensically
analyse why you weren’t successful. If you are deliberate about your practice, you’ll be well on the
path to expertise.
3. It is a team game
Wise words from consultant on#juniordoctors. Nurses spend all day with a patient, doctors see them for brief
encounters. If they are worried, be worried. Their assessment is just as
important as yours#TipsForNewDocs
— Dr Sammy (@sbattrawden) 10 November 2017
nature of our work involves us seeing a snapshot of the patient’s illness only.
We spend a bit of time with the patient on the ward round before moving on to
the next. Your nursing colleagues are with the patient and their family all
shift. Their observation of your patients’ progression is priceless – ask for
their help, their thoughts, their opinions.
will often become familiar with the patients’ values, needs and fears through
generally, if your nursing colleagues are concerned, you should be concerned
4. Communication is the key to ensuring appropriate
Let us not forget that bedside
skills such as#endoflife discussions as important as procedural skills #MedEd#TipsforNewDocs
— Melanie Sulistio, MD (@melsulistio) 25 October 2017
population is ageing. It is our responsibility to ensure that the care we are
providing to our elderly patients aligns with their wishes and values.
the communication skills that allow you to ascertain these values. Encourage
your patient to discuss this with their family and loved ones. The greatest
tragedies I’ve seen have been of too much medicine in this vulnerable
is good practice to ensure that goals of care are discussed and documented for
all patients admitted to hospital. For those that are discharged, encourage
follow-up with their GP for these conversations.
5. Remember why you started
“Find meaning and purpose in your
everyday work” –@MichaelKidd5#TipsforNewDocs
— UofT Family Medicine (@UofTFamilyMed) 30 August 2017
are a lot of menial tasks that are essential to the smooth running of a medical
team. A lot of them will fall to you.
you’re snowed under by discharge summaries, recharting medications or your
tenth after hours cannulation, take a step back and look at the big picture.
back to why you started this journey. Start with why, and carry on.
6. You’re never too important for the small things
Don’t ever be too big to do the
small things for your patients.
— Sam Ghali (@EM_RESUS) 23 August 2017
have been in so many situations where fetching a warm blanket or a cup of tea
can provide more relief than anything you prescribe. Do the little things to
make the big difference.
7. Hospitals can be big, scary places
What has become routine for us
may be one of the scariest times in our patient’s life. Never lose sight of
— Sam Ghali (@EM_RESUS) 3 August 2017
you remember your first visit to the hospital? Before you became desensitised
to the monitors, needles and organised chaos?
back to those days, and do your best to put yourself in the shoes of your
patient. Take the time to explain things. Your routine may be someone else’s
8. Look after yourself
#TipsForNewDocs Talk to your friends, your family, seek help, be kind to
each other. https://t.co/A2ytuqB2oo
— Christopher Mowatt (@desnremi) 2 August 2017
year will be testing.
pressure can build and sometimes become too much. That’s okay. What is not okay
is trying to solve these problems on your own.
sure you take your meals breaks. Stay hydrated. Take a deep breath every now
and again. Exercise when you can.
your own GP is essential. Make time for friends and family. Be intentional
about your work life balance. Look out for your mates – we’re all in this
9. And most importantly…
— David Little (@DrDLittle) 1 August 2017
Avant and onthewards
Avant has partnered with onthewards, a free
open access medical education website dedicated to creating resources for the
doctors of today and tomorrow. onthewards was developed to address the gap in
formal education specifically designed for, and aimed at, medical students and
junior doctors. Educational topics are selected by junior doctors for junior
What started as podcasts for junior doctors
grew into a website available to everyone after increasing interest from
doctors across different hospitals expressed their interest. Avant and onthewards
have committed to working more closely together to develop risk management
content tailored for junior doctors.
Avant sponsors onthewards as part of our strategic partnerships program.
The blog has been
republished with the permission of onthewards. The views expressed do not necessarily represent the views of Avant.
Avant is not responsible for the accuracy of any information contained in the
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