The Medical SHO

F2 is different. I thought it would be much the same as F1 with less nervousness; it isn’t. I am asked for advice by F1s. I am asked to make decisions with much less senior oversight than previously. I take referrals and, in one notable instance, was asked for direct advice by a GP on treatment of fast AF* over the phone when my registrar was not available. The latter I gave and then, the instant the registrar returned double-checked every word I’d said until he told me to stop worrying and get on with it.

F2 is different but it’s good different. It’s full of learning; procedures, diagnoses, investigations and signs. I’m working with a great consultant at the moment who is one of the most able, accurate and clinically relevant doctors/teachers I’ve met and I’m raking in the information. I’m becoming a clinician rather than a paperwork bitch and that is refreshing. I have good diagnostic days (5/5 of my diagnoses and management plans agreed with by the consultant with little to add) and bad ones (the musculoskeletal chest pain’ that turned out to be a lung abscess and systemic sepsis) but that’s all part of the curve.

F2 is different but it’s bad different. It’s scary to contemplate all the things I do not know and I am reminded daily that there exists great tracts of knowledge I’m not even aware I don’t know. The great march of career progression continues and I should be making applications in December for jobs next year, but I don’t know that I want to decide just yet what it is I want to do for the rest of my life. What 30-year specialty do I apply for when I’ve only worked for 15 months? And more perplexing, what will those specialties be in ten, twenty years? Will A&E be the same? Will acute medicine look after all inpatients with specialist teams just ducking their heads in? What does the future hold?

F2 is different. I am enjoying it. There are moments; some great, some sad. Let’s leave it at that.

Seemed appropriate.

*Technically, atrial fibrillation with fast ventricular response. Atrial fibrillation is a condition in which the top two chambers of the heart, usually responsible for pumping blood into the bottom two chambers (the ventricles) stop beating and instead just quiver uselessly (disorganised electronic activity results in no co-ordinated contractions). Fast AF is the result of the aforementioned disorganised electrical conduction stimulating ventricular contraction at a rapid rate, often >150 beats per minute at rest. Ventricular fibrillation is the same disorganised quivering in the ventricles and is both less common and, in hospital, results in broken ribs and electrocution.

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