FY1 Shadowing Week
Dear Friend,
Greetings from Cyprus this week!
I’m currently in Paphos, celebrating a close friend’s wedding. I was quite tempted to share some holiday photos and stories, but it was actually my dad who gently reminded me that this is a medicine newsletter—not a travel blog!
For many of you, this is a significant week. From mid-week, you’ll begin your pre-FY1 shadowing—a period introduced a few years ago to help ease the transition into life as a working doctor. During this time, you’ll spend a few days with your new team: meeting your consultants, registrars, nurses, and getting a feel for how the ward runs. It’s all in preparation for the big day: Wednesday, 6th August. Some call it Black Wednesday—a name that’s both ominous and coincidentally also my birthday.
Looking back, I now realise just how valuable the shadowing week truly is. If you approach it well, your first official day can feel much smoother (though you’ll still be appropriately terrified). By following a few simple tips—coming up shortly—you might even manage a couple of hours of extra sleep on the night of August 5th.
1. Introduce Yourself to the Team
The first and arguably most important tip: introduce yourself to every member of your new ward team.
While it might feel more natural to start with the doctors, don’t underestimate the value of building rapport with the nursing staff. Nurses can become your greatest allies—or, if you’re not careful, make your life much more difficult. Earning their respect early on will go a long way in making your time on the ward smoother and more enjoyable.
Keep in mind that many junior doctors will be rotating to different wards or even different hospitals, so while it’s helpful to meet them, the people you’ll really need to form relationships with are the consultants, registrars, and nursing staff.
Make sure you also let people know this is your first job as a doctor. Nurses and other staff see so many doctors each day that they may not realise you’re just starting out. A little honesty can go a long way—people will be more patient and supportive when they know you’re new to the role.
2. Learn Your Way Around the Hospital
It might sound obvious, but some hospitals are like labyrinths. Especially with the addition of temporary wards and bed expansions, there’s often little logic to the layout. You might find an endocrine ward sandwiched between two elderly care wards.
Take an afternoon to familiarise yourself with key locations: your ward, the doctors’ mess, A&E, ICU, HDU, radiology, the canteen, and so on. Knowing where to go can save you time and stress during those inevitable moments when you’re asked to run errands or attend emergencies.
3. Learn from the Current FY1s and SHOs
While your formal induction may be led by a consultant, your real education will come from the current FY1—because that’s who you’ll be replacing.
Consultants often spend most of their day in offices, clinics, or theatres and may not be up to date with the logistics of day-to-day ward work. The current FY1, on the other hand, knows where everything is, how to complete all the necessary tasks, and how to keep the ward running smoothly. Follow them closely, and treat it as your crash course in survival.
Yes, that might include some mundane tasks—writing discharge summaries, updating the handover list, ordering bloods—but it’s the foundation of good ward-based medicine.
4. Practice Taking Bloods
If you somehow made it through medical school without taking many blood samples, don’t panic—you’re not alone. I struggled with it myself after losing a year of clinical practice due to COVID.
The only cure is practice—and lots of it. This week is your chance to improve. Get involved. Volunteer. Even if you fail a few times, it’s better to get the awkwardness out of the way now than on your first proper shift.
Being confident with procedures not only helps patients but also earns respect from your team—especially nurses.
5. Learn the Systems (and Get Your Logins!)
Every hospital has its own IT systems. Some are fully electronic, others still rely on paper, and many are a confusing mix of both. Even within one hospital, different specialties may use different systems for investigations, referrals, or booking clinics.
Take time to familiarise yourself with the software used on your ward. More importantly, make sure you’ve received your login credentials. The last thing you want is to be standing helplessly on your first ward round because you can’t log in—something I’ve personally experienced, and wouldn’t recommend.
6. Enjoy Your Last Weekend of Freedom
Next weekend is your last before becoming a doctor. And while you’ll have days off in the future, they’ll never feel quite the same.
One of the most common struggles doctors face is learning not to carry the emotional weight of patients home with them. Even when you’re off, you’ll often find yourself thinking about a case, a decision, or a conversation.
So, this weekend? Make the most of your complete mental freedom. Celebrate. Relax. Recharge. You’ve earned it.
In Summary
Best of luck to everyone starting this week! This is the moment you’ve been working towards for the past 5–6 years. It’s the start of an exciting new chapter—and one day, like me, you’ll look back on it with pride, and maybe even a smile.
Fortunately for me, I’m currently getting the chance to look back at it sat by a pool sipping a cocktail in the Mediterranean sun. But in a few days, I’ll be back at my desk, writing discharge summaries and chasing blood results just like everyone else.
Drug of the week
Chloramphenicol
This is an antibiotic useful for the treatment of a number of bacterial infections.
This includes use as an eye ointment to treat conjunctivitis. By mouth or by injection into a vein, it is used to treat meningitis, plague, cholera, and typhoid fever.
Chloramphenicol is a bacteriostatic agent, inhibiting protein synthesis.
It prevents protein chain elongation by inhibiting the peptidyl transferase activity of the bacterial ribosome.
Chloramphenicol directly interferes with substrate binding in the ribosome, as compared to macrolides, which sterically block the progression of the growing peptide.
The most serious side effect of chloramphenicol treatment is aplastic anaemia (‘AA’). This effect is rare but sometimes fatal.
A Brain Teaser
A 78-year-old woman presents to her GP with gradual deterioration in vision in the right eye. She has been a smoker for 50 years and her mother suffered from severe age-related macular degeneration (ARMD). The patient is referred to the ophthalmology team and, following further investigations, she is diagnosed with wet ARMD.
What is the most suitable treatment for this patient?
A: Acetazolamide
B: Bevacizumab
C: Chloramphenicol
D: Dexamethasone
E: Vitreoretinal surgery
Answers
The answer is B – 5-bevacizumab.
Bevacizumab is correct. This is an anti-vascular endothelial growth factor (VEGF) agent. VEGF is a mitogen that promotes vascular permeability. Anti-VEGF agents such as bevacizumab have been shown to limit the progression of wet ARMD and stabilise or even reverse visual loss. This is currently the most effective treatment for wet ARMD.
Acetazolamide is incorrect. This drug is a treatment option for glaucoma as it causes a reduction in aqueous humour. However, it is not used to treat wet ARMD.
Chloramphenicol is incorrect. This is an antibiotic that is used in the treatment of superficial eye infections such as bacterial conjunctivitis. However, chloramphenicol is not used to treat wet ARMD.
Dexamethasone is incorrect. This is a steroid that can be given in eye drop form to treat conditions such as posterior uveitis, which is characterised by inflammation of the posterior portion of the eye. However, dexamethasone and other steroid eye drops are not used to treat wet ARMD.
Vitreoretinal surgery is incorrect. Surgical options may be used in a number of eye conditions, including to manage vitreous haemorrhage. However, this is not a treatment option for wet ARMD.
