The President took the chair and welcomed everyone to the Zoom meeting. Dr Freeman started the meeting with two minutes silence in memory of Professor Glenn Neil-Dwyer and Dr Derek Browne of Brockenhurst.
She introduced our speakers, Drs Yarrow Scantling-Birch, Lara Hyson and William Sherwood who spoke to the title ‘Learning on the Job’. They were former recipients of Foott Memorial Bursaries [Yarrow gave his report last year to a live audience]. Yarrow wanted to update the Society on the work experiences of young doctors during the SARS-CoV-2 pandemic and arranged this presentation with colleagues.
Yarrow Scantling-Birch started the presentation. He said he became an F1 doctor with great expectations. The arrival of the pandemic changed everything. He described the life of an F1and F2 as ‘go to work, go home, not enough sleep and little social life’. A weekend on duty is not only seeing the tide of patients being admitted but also a lot of administration. Now that he has just started his F2 year in acute medicine the only illness he sees is Covid, which is very repetitive and at times miserable from the high number of deaths. But now he also has to be thinking of the other things he needs to be doing to become an ophthalmologist. He has to prepare for membership exams, arrange presentations, arrange to do research and earn enough points to get on the specialist ladder. Covid19 also saw an influx of retired doctors to be supervised as well. One of the most difficult things he has to do is dealing with phone calls from relatives who cannot see their very sick relations in hospital. He thinks these calls put a lot of pressure on young doctors. He also did a spell in obstetrics during his F1 year but he is not fond of this rather messy speciality.
The second presentation was from Lara Hyson, who is an F1 doctor at St George's. She first served an assistantship to get a feel for practising medicine before her elective. She planned to spend her elective doing ophthalmology, in which she would like to specialise, first in Havana at the General Calixto Garcia Hospital and then in Guatemala. She spoke little Spanish at first but as the teaching was all in Spanish she had to learn the language quickly. Her boss presented Lara with a copy of her ophthalmology textbook, in Spanish, saying she would examine her on it before writing her report when she was due to leave. She gained a lot of experience in the more minor eye conditions working in outpatient clinics. She also attended daily teaching sessions, ward rounds and surgical operations. Covid struck the world half way through her term there. Not wanting to be trapped in Havana, and also because she felt she should be working in the UK at this time, she had to arrange a circuitous journey home as there were no longer direct flights from Havana. On return she was told ‘she was a doctor now’ and made an ‘interim F1’. She was attached to an F1 to learn the ropes. Being an F1, she said, was like being a ping pong ball bouncing between everyone and working 12 hour shifts 6 days a week. She was for a time in ICU where she had to know all the histories in detail of the 28 patients in her section. She said there will be brighter days ahead and that she was proud to be a member of the NHS. One thing she highlighted is the difficulty at present for F1 and F2s getting support to enrol on the right courses for future speciality training. She thanked the Society for the award which had made her trip possible.
Our third presentation was from William Sherwood who graduated unexpectedly, due to the pandemic. He was told by the University he could still travel to Vietnam and Nepal for his elective. Just after his arrival in Vietnam the country locked down due to 5 cases of Covid being identified. The Vietnamese authorities were aggressive in their 4 layer contact tracing and he was expelled from his digs and spent a long time in Ho Chi Min airport. His supervisor in Southampton told him to go ahead with the Nepal section and he just managed to get the last flight out to Kathmandu. He said the Vietnamese lock down paid off. While GB has had 3.16 million cases and 83,000 deaths [at the time of his talk] Vietnam had 1520 cases and 35 deaths. In Pokhar in Nepal he joined the Nepal Ambulance service which is a pre-hospital service staffed by professionally trained medics to deliver medical services to patients especially in remote places. After this he was due to go to a hospital in Kathmandu but decided that it was too dangerous to work in a hospital there as Covid was becoming rife in towns. Nepal had 266,000 cases at that time and almost 2000 deaths. He managed to get on the last flight out to the UK. Once home he discovered on the TV news that medical students were being graduated early to work in hospitals. He therefore decided to offer his services to his local hospital in Poole to precede his prearranged F1 post. He served as an ‘interim’ F1 in a red zone elderly care ward. He found the support of the other F1 doctors very helpful. Due to severe restrictions of PPE only one doctor could visit the patients on a ward each day. One of the most difficult things, he found, was talking on the phone to relatives about patients he knew little or nothing about. After Poole he joined the West Middlesex Hospital as planned on the acute medical unit. Though quiet when he joined at the end of summer by November the beds began to fill steadily with cases of Covid and over Christmas there was a massive influx of patients. Operations were cancelled and the surgery wards turned into covid wards. The ICU was full. He said continuity of care was almost impossible. He was sent to different wards every day and patients were moved around so quickly the nurses did not know them. Often patients he was clerking could become so ill they would be moved on to a high care area almost before he had finished and all the time new patients kept arriving. He said flexibility and calmness were king as well as working together as a team. He was due to start surgery now but as all surgery was cancelled he was not sure what would happen. In the summer he will be joining the emergency medical unit as an F2. He thanked the Society for the bursary even though he could only complete part of his elective.
During a discussion with the audience afterwards a number of observations were made. There seemed to be little support for F1s from the Royal Colleges or the University Medical Schools. F1s and F2s could be redeployed without warning. Their experience was in-depth for Covid but nothing else. The juniors are concerned about their futures and the lack of training and supervision regarding their future careers. They all considered no-one had benefitted from the pandemic.
The President thanked the speakers for their most enlightening talks and they were thanked for the trouble they had taken over their presentations. She said she would like the Society to keep in touch with them.
There being no other business the meeting was closed.