It’s really difficult to describe the usual routine of a Junior doctor as it is constantly changing and dependent on what rotation you’re on (ie. what Specialty you’re working for), the number of patients you have on the ward, the number of very sick patients you have, whether you have clinic that day, whether your co-intern is having their half day or whether you have a Unit meeting, the list goes on…
I’m currently the Plastics Surgery and Dermatology Intern; interesting mix however these specialties overlap a lot. I spend most of my time with Plastics but on Tuesdays and Thursday mornings I am at Dermatology Clinic.
My day always begins at 7am (on Wednesdays at 6:30am!) on the seventh floor where we begin our Plastics ward round. Currently we’re averaging 30-40 patients and the aim is to see most of them or the sickest ones before 8am, when our Registrars have to go to theatre. As an Intern you are really a glorified secretary. You’re constantly running around finding patient files, scribbling madly in them and trying to catch what your registrars are mumbling under their breath; you’re fired questions such as “What are the patient’s obs?” “What antibiotics are they on?” “What are the drains doing” “How’s the urine output?” and you are fumbling around trying to find the answers while documenting and balancing the files of the next patients you’re going to see.
After ward round I usually am doing ward jobs or at some sort of clinic. “Ward jobs” means finishing up the notes from the ward round, doing jobs your Registrars/Consultants have ordered to be done by the end of the day and answering pages (pages… the bane of our existence!). Clinic for any Surgical Specialty is always hectic; it’s always overbooked and patients are always waiting for 2-3 hours (it is a public hospital!). We mainly see patients who are going to have surgery or who have had surgery/hospital stay and are being followed up or those who have been referred to us by other doctors. For most patients I always run them by my Registrar, but if it’s easy I can discharge them on my own.
After clinic (which usually finishes around 4-5pm) it is back to the ward again, this time also checking up blood tests, imaging results and updating yourself on what’s been happening with the patients before you have to see your Registrar. I am rostered to finish at 6pm, I never do. There’s always jobs to do and if there isn’t, you have to wait around for your Registrar to finish in theatre so you can give them a handover of what has happened with the patients that day. I usually am out of the hospital at 7-8pm.
Wednesday afternoons is reserved for the Intern to be in theatre. I usually get to scrub in and assist. The big Plastics cases go on for a very long time and sometimes I’m standing for 6 hours straight! I’m constantly amazed at the art behind Plastics — the crazy things they can do to replace missing parts or manipulate the skin to close what seemed like a gigantic hole!
If I am on Cover shift which is the period between day and night shift, I stay back and am responsible for all the Specialty Surgical patients from 5-9pm. That is about 100 patients! But it is an opportunity for you to be a “Doctor” and make decisions. It’s usually either tolerable or just mad busy. One shift my pager just kept beeping!
It’s a busy job which has its real highs and low lows. The important thing is to separate your work from your personal life, which is very difficult at times. Debrief with someone who understands your job and spend your time off being far away from Medicine as possible.
This is my first entry for what I hope to be a regular segment “Doctor Diaries.” I hope you find it interesting and insightful :) If you have any questions about being a Doctor or Medicine in general fill free to put them in the comments section and I will try to reply directly or address them in the next post(s).