Becoming a new doctor: a learning or survival exercise?

Brown, Jeremy; Chapman, Tom; Graham, David R.

doi:10.1111/j.1365-2923.2007.02785.x

Cited by 41 publications

(51 citation statements)

References 8 publications

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“…However, as other investigators have also found [3], they reported feeling under-prepared for management and administrative skills, and medical educators should consider explicitly discussing the more technical aspects of the intern role to prepare students for the fact that administrative tasks form a large part of their working day. Although active participation in their hospital communities of practice, and especially junior doctor shadowing, have previously been identified as particularly valuable for intern preparation [1, 2], participants reported having felt pressured to spend time with more senior clinicians instead. They were very aware of the potential negative impact on their careers of poor relationships with senior doctors.…”

Section: Discussionmentioning

confidence: 99%

“…Team support has also been recognised as critical in previous literature, particularly teams which show interest in the junior doctor as an individual [3] and provide regular feedback [1]. Shadowing junior doctors and sharing experiences with peers have also previously been identified as particularly valuable [12, 17]; this sharing may promote the “strong sense of shared social identity” which is known to be a factor in buffering stress [11].…”

Section: Discussionmentioning

confidence: 99%

“…The transition from medical student to first year junior doctor (known as the ‘medical intern’ in Australia) is known to be stressful; it has indeed been described as a test of “fortitude and resolve” [1] and “a wilderness experience” [2]. Although surviving the day to day realities of being “thrown in at the deep end” [3] is believed to socialise the junior doctor and increase his or her confidence [2], reports of high levels of junior doctor anxiety [4] and burnout [5] are concerning.…”

Section: Introductionmentioning

confidence: 99%

“…Although surviving the day to day realities of being “thrown in at the deep end” [3] is believed to socialise the junior doctor and increase his or her confidence [2], reports of high levels of junior doctor anxiety [4] and burnout [5] are concerning. Many medical schools have responded to such reports by introducing intern preparation programs designed to reduce the abruptness of the transition [6], and there have also been a number of calls for more systematic guidance and training for both trainees and supervisors in the junior doctor years [1]. …”

Section: Introductionmentioning

confidence: 99%

“…Educators and supervisors should understand the realities of contemporary intern life for medical graduates, and partner with them to optimise both undergraduate and postgraduate support and learning opportunities. The people who are likely to best understand the intern transition are recently graduated young doctors, who are also known to be key supports to their incoming colleagues [1]. …”

Section: Introductionmentioning

confidence: 99%

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“A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace

2017

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BackgroundThe transition from medical student to hospital-based first year junior doctor (termed “intern” in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition.MethodsFinal-year University of Queensland medical students recruited junior doctors working in diverse hospital settings, and videorecorded individual semi-structured interviews about their transition from medical student to working as a junior doctor. Two clinical academics (NS and JT) and an intern (ZT) independently conducted a descriptive analysis of interview transcripts, and identified preliminary emerging concepts and themes, before reaching agreement by consensus on the major overarching themes.ResultsThree key themes emerged from the analysis of 15 interviews: internship as a “steep learning curve”; relationships and team; and seeking help. Participants described the intern transition as physically, mentally and emotionally exhausting. They learned to manage long days, administrative and clinical tasks, frequent interruptions and time pressures; identify priorities; deal with criticism without compromising key relationships; communicate succinctly; understand team roles (including their own status within hospital hierarchies); and negotiate conflict. Participants reported a drop in self-confidence, and difficulty maintaining self-care and social relationships. Although participants emphasised the importance of escalating concerns and seeking help to manage patients, they appeared more reluctant to seek help for personal issues and reported a number of barriers to doing so.ConclusionFindings may assist educators in refining their intern preparation and intern training curricula, and ensuring that medical school and intern preparation priorities are not seen as competing. Insights from non-medical disciplines into the organisational and relational challenges facing junior doctors and their health-care teams may enhance inter-professional learning opportunities. Workplace support and teaching, especially from junior colleagues, is highly valued during the demanding intern transition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace

2017

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How to be an Educational Supervisor

Evans

2009

Essential Guide to Educational Supervision in Postgraduate Medical Education

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The educational supervisor is not a new concept -it was established in 1987 -but the role has become far more prominent following the implementation of Modernising Medical Careers (MMC), which introduced shorter, more focussed, competencybased postgraduate training programmes. The importance of the role of educational supervisor is emphasised in the General Medical Council (GMC) publication 'The New Doctor' [1], produced in conjunction with the Postgraduate Medical Education and 'Training Board (PMETB). This focuses on the generic standards for training within the foundation years, a period of critical transition from medical student to doctor in which the educational supervisor can be pivotal in ensuring trainee survival and enjoyment as well as advising on career pathways. Equally difficult demands are made of educational supervisors responsible for trainees appointed to core training (CT) and specialty training (ST) posts in run-through training programmes, as well as those advising trainees in fixed-term specialty training appointments (FTSTA) after August 2007. The importance and relevance of educational supervision is enshrined in all specialty-specific competency-based curricula; for example, the Royal College of Anaesthetists states that every trainee must have an educational supervisor.Educational supervision is not just about the educational aspects of postgraduate medical education; and if you are thinking this is not relevant, just ask yourself the following questions:• Who took an interest in my welfare? • Who helped uncover my hidden talent? • Who has been a useful role model for me? • Who helped me face and resolve a difficult situation in my personal or professional life? • Who helped me acquire new vision or direction?

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The Fracture Liaison Service to close the osteoporosis care gap: a leadership educational model for undergraduate and postgraduate trainees

Downey

Torralba

2019

Clin Rheumatol

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Osteoporotic fractures have been rising and are a cause of severe morbidity and mortality. Care gaps exist in osteoporosis treatment and diagnosis, which presents an opportunity for education. A number of healthcare systems in the world have developed a fracture liaison service (FLS) to combat osteoporotic fractures. The Rheumatology division at Loma Linda University Health (LLUH) developed an FLS not only to address osteoporosis care gaps but to also develop a new educational model. An interdisciplinary model of osteoporosis care has been implemented along with a revamp of educational focus on osteoporosis and bone health in the rheumatology fellowship and internal medicine residency. Pre-LLUH FLS studies showed that 85% of patients pre-fracture were never screened nor treated for osteoporosis; post-fracture, only 10% of patients were treated, and only 6% had dual x-ray absorptiometry (DXA). Notably, 30% had a prior fracture. We discuss how the FLS has served as a catalyst for education, not only at our academic center but also as an outreach for our community in order to elevate the care of osteoporosis in our community.

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Becoming a new doctor: a learning or survival exercise?

Cited by 41 publications

References 8 publications

“A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace

“A steep learning curve”: junior doctor perspectives on the transition from medical student to the health-care workplace

How to be an Educational Supervisor

The Fracture Liaison Service to close the osteoporosis care gap: a leadership educational model for undergraduate and postgraduate trainees

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