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Deployed to the deep end – being a junior doctor during Covid

(from left) Junior doctors Bravean Kulendrarajah, James Chambers and Louise Baker

Throughout 2020 thousands of final-year medical students from across the UK were deployed to help during the Covid-19 pandemic. Foundation Interim Year One (FiY1) posts were created so junior doctors could be fast-tracked to the frontline. The recruitment process was managed by Health Education England, with doctors travelling from as far as Belfast to take part.

A year on, how are the class of 2020 feeling about their early graduation into acute care?

We spoke to three junior doctors who have been working in Royal Stoke University Hospital’s busy Critical Care unit to find out.

Dr James Chambers

Dr James Chambers, 24, from Stone, has always wanted to study medicine. James and many of his fellow students had just finished their final year as medical students and were counting down to when they would graduate and officially become doctors.

James said: “When we were asked to help out, we weren’t quite sure what we would be letting ourselves in for, but it was a once-in-a-lifetime opportunity to contribute to something much greater than ourselves and myself and colleagues leapt at the opportunity to get involved.

“One of my first struggles was getting used to working in PPE. In summer it was far too warm and it was difficult to hear with the masks. Everything took longer too - changing PPE between patients on the ward round and cleaning everything down felt exhausting. But I think like everything, you adjust to it and now it just feels like normal.

“The best bit of the experience has been interacting with patients’ relatives and friends. Everyone is so thankful for everything we’re doing. It’s really humbling to hear and often helps you get through the day.  I remember a five-year-old girl’s voice on the telephone saying “thank you for looking after my daddy, doctor” - that was a really sweet moment for me. 

“Being on the frontline at an earlier stage has helped to improve my independence as a clinician, making me a more confident doctor as a result. It’s helped to build our resilience for the future.”

Under the usual Foundation Year One (FY1) system, medical practitioners undertake a two-year general postgraduate medical training programme. This forms the bridge between medical school and specialist or general practice training. But last year students had to start work straight away.

Volunteers were asked if they would like to join the interim programme for experience until their rotations commenced in August 2020 and medical staff, rota co-ordinators, medical staffing and occupational health staff at UHNM raced against the clock with colleagues in Keele University’s Medical School to have everyone in place as soon as possible.

Dr Mark Poulson is a consultant in emergency medicine and associate medical director for postgraduate medical and dental education at UHNM.

Dr Poulson said: “The FiY1 role is a completely new one, with doctors deployed in the midst of the pandemic at relatively short notice. The FiY1 doctors have contributed enormously to our response and have rightly received high praise. The prospect of being launched into acute care early would have been incredibly daunting in normal times, but to do it because of a pandemic is really something else. They have thrived and risen to the challenge and we are very grateful to them for their support, selflessness and dedication.”

Dr Bravean Kulendrarajah, 24, grew up in London. He was initially asked to help out on the paediatric unit.

Dr Bravean Kulendrarajah

Bravean said: “As a child I had to go to hospital for frequent asthma treatments. When I saw the doctors and nurses talking to patients and making a difference, it inspired me to do something in healthcare. I applied to do medicine, where I felt I could make a real difference to people’s lives.

“I wanted to do my part to help out during the pandemic. We had to dive in at the deep end and figure things out as time went on. It was such a huge responsibility and I felt scared about covering such a varied range of conditions with little previous exposure and knowledge, but it was also exciting to be able to learn more and nurture my skills. Although paediatrics wasn’t one of the specialties I had chosen, I am now thinking of pursuing a career in it.

“My housemates are doctors and were also asked to help out in different specialties. It was nice coming back from work and talking about our day and we learned a lot from each other. We would all have good and bad days, but we helped each other out whenever possible.”

Junior doctors around the country have had to make big sacrifices to step up for the NHS.

Bravean said: “There are a few things us final year students have missed out on, like the opportunity to practice medicine in a country with different healthcare resources. Also, our final year ended really abruptly and it meant we weren’t able to say goodbye to friends we had studied with over the past five to six years.

“The learning curve of this experience has felt steep and unending, but it has made me into the doctor I am today.”  

As a child 24-year-old Dr Louise Baker, from Clavering, near Cambridge, had wanted to be a vet. But the experience of working with children with special needs changed her mind and made her realise she would prefer to work with people.

Dr Louise Baker

Louise said: “There is no way you can fully prepare for something so unexpected and unprecedented, but I had a good support system in place. In our little F1 community, we listened to each other and cheered each other on. I remember having a particularly bad day once and one of the other F1s noticed. Without needing saying anything they just showed up with a bar of chocolate and a cup of tea. It’s really important to have people who just ‘get it’ and don’t need explanations. On the bad days when you haven’t managed to sit down or eat and all you’re seeing is really sick Covid patients, it can be exhausting and demoralising. Luckily, the good days usually make up for the bad days.

“Everyone I’ve worked with has been kind, supportive and encouraging. I have been taught by many people and over the past 10 months I have learned more than I ever imagined I could.

“It has been a sacrifice to spend months without seeing my family, but I feel that everyone has a duty to help out in a crisis.”

Over the next few weeks junior doctors across the trust - now fully qualified FY1s - will begin to move on to different placements as part of their rotation.

Dr Poulson said: “FY1s represent the next generation of care and we couldn’t be more proud of what they have achieved here. We are confident they will have learned a great deal both as clinicians and about themselves. The experience has undoubtedly been very hard for them, but the fact that they entered into it wholeheartedly and have succeeded is a marker of their dedication, determination and resilience – all things needed to be a good doctor.”

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