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What We Can Learn from FiY1s

Updated: Dec 13, 2020

When the effects of the pandemic first started to ripple through medical school, no student group was disrupted more than finalists. The plan was simple: a rigid timetable of exams, transition into formal clinical activity via an apprenticeship block and then starting as a fresh-faced F1 in August.

What actually happened was an acceleration through the process: exams cancelled, early registration and a new cohort of junior doctors in a truly unique position. Now that these students are formally in their Foundation posts, it’s worth taking a step back and looking at what we can take from this.

1: You matter!

The FiY1 scheme was implemented with two main aims: to support healthcare services in a demanding situation and to further facilitate the transition of this group into formal Foundation training. The fact that medical students were entrusted with this responsibility demonstrates the value to society and it’s something we often forget.

It can be easy to draw a hard line between medical school and post-graduation, but we should reframe the final year as a sort of middle ground, where your attention is shared considerably between exams/academics and the skills you’ll need for the future. Aspects such as ward systems, clerical duties and common prescriptions (such as fluids and analgesics) become more important.

As a final year medical student, it’s worth getting used to the idea of being a junior doctor, even if you don’t feel like it! I’m sure most of the FiY1s felt hopelessly underqualified, but they provided essential value to the NHS and can now look back as valuable members of a historical event.

2: The importance of peripheral knowledge

By “peripheral knowledge” I mean the skills and facts you don’t necessarily “revise”. This can include the roles of allied health professionals, where things are on the ward, how to perform admin duties and the “afterthoughts” of patient care. I’m sure when the finalists signed up for the FiY1 process, the amount of time they’d spent on this “peripheral knowledge” probably correlated quite well with how prepared they felt.

The best way to learn these skills is of course to spend time on the wards and with junior doctors, but also taking the time to read blog posts and articles from previous years can identify the main “I wish I’d known…” topics that can facilitate the transition.

3: The need for community

Everyone who was already in the NHS hierarchy must have felt a collective empathy for the FiY1s, and this was demonstrated with the emphasis on supervision. Junior and senior doctors, as well as wider allied healthcare professionals, were essential in aiding the rapid transition from medical student to FiY1, which also had the benefit of learning points for medical leadership.

In addition, support within the FiY1 community was a much-needed source of consistency and information in such a time of uncertainty. We need to appreciate and emphasise this supportive culture for the next generations of junior doctors, as the added pandemic stress is unlikely to fade in the near future.

Final thoughts: certainty of uncertainty

If the entire situation taught us anything, it’s that disease does not care about plans, politics or the status quo. When the fireworks lit up London in the first seconds of 2019, we would not have expected that a year later the first cases in a global pandemic would have trickled into view.

Medicine can throw up unexpected situations on a daily basis, and to some extent we control this as best we can. When larger, more profound surprises occur then we rely on existing systems and expertise to get us through it. We have learnt an incredible amount from this situation and now hopefully have better systems for public health, telemedicine and portable delivery of healthcare.

As a medic who may well be part of the NHS in the next few years, I look at the FiY1s as a source of inspiration, learning points and reflection. At the very least, I feel slightly better prepared knowing that when I enter F1, I’ll be supported by junior doctors who know more than arguably anyone else about entering a system feeling woefully underprepared.

To the new F1s, well done and good luck.


Author: Hardeep Lotay

I’m a Cambridge medical student with an interest in medical communication and education. In particular, I enjoy creating content for students, patients and professionals that addresses lifestyle education and general wellness; nutrition, exercise, sleep, stress and mental health. I hope to contribute to a pro-active healthcare model that embraces personalised healthcare and telemedicine.

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