Introduction
Transitions in medicine are often challenging, none more so than the initial jump from medical student to foundation year-1 doctor (FY1).1 The most recent cohort of doctors have encountered an additional hurdle – reduced exposure to clinical environments during their final years at medical school due to the COVID-19 pandemic. Health Education England advised a longer shadowing period prior to starting work as an FY1 as a means of at least partially offsetting this.2
Materials and methods
Our role as medical education fellows within the postgraduate medical education department was to design and implement a detailed course to ensure that the FY1 transition was as smooth as possible. It aimed to improve confidence and preparedness.
We collected informal feedback from the existing FY1 cohort. The two main themes identified were difficulty accessing IT systems required and feeling isolated from colleagues during the pandemic. Thus, additional objectives were to ensure all new starters had the necessary access to perform their jobs effectively on day one and to ensure they felt supported throughout this period.
A formal questionnaire was sent to the new cohort due to start FY1 to assess how prepared they felt to start their new job, and this included open questions to identify areas of concern. This information was used to create a 2-week course comprised of a variety of talks and interactive sessions (Table 1) to run alongside their extended shadowing. The course was optional and held prior to the official start date. Thirty-three of 37 new starters chose to participate.
Talks and interactive sessions
Throughout the course, the new doctors were given our email and WhatsApp contact details and offered drop-in sessions to discuss issues and concerns. The course also provided the opportunity to get to know their peers – another important source of support.
Results and discussion
100% (n=33) of attendees completed post-course feedback. Confidence scores in all subject domains, measured on a Likert, showed a positive improvement (Table 2). There was an increase of 31% in those who felt prepared to start FY1. Furthermore, 88% felt reduced anxiety and 79% felt positive about starting work.
Confidence scores pre- and post-course
Over 90% were able to access and use their IT logins, F1 WhatsApp group, ID cards, smart cards, online training and ePortfolio prior to starting. We noted that PACS and NHS email access was more limited, 79% and 45% respectively, and we were able to rectify this swiftly.
All attended at least one drop-in session with the education team or contacted us via WhatsApp, and this was noted by over 95% of participants as a positive feature of the course.
Conclusion
In summary, our course has helped our cohort of FY1 doctors to feel more confident and prepared for their new role, and helped them make the transition from student to doctor.
Due to its success, the course will be embedded permanently in the new FY1 induction at our trust. We feel the course model could be replicated at other hospitals to ensure benefits can be accessed by as many new doctors as possible.
- © Royal College of Physicians 2022. All rights reserved.
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