Cancelled exams. Cancelled electives. Cancelled placements. An indefinitely postponed graduation and a call to join the frontline in the fight against COVID-19.
This is the reality for final year medical students, facing one of the toughest decisions they are likely to make in their lifetime.
Following the recent announcement by Matt Hancock, the secretary of Health, the government announced that over 5000 final year medical students will be graduating early and joining the frontline to join healthcare workers in the fight against COVID-19. This was a decision that caught many by surprise, including the aforementioned final year medical students across the country.
Early Provisional Registration and Foundation Interim Year 1 (FiY1) posts
Final year medical students who have graduated from a UK medical school will be eligible to volunteer and take up Foundation Interim Year 1 doctor posts (including those on the primary list and reserve list for the 2020-21 UK Foundation Programme).
In order to be granted provisional GMC registration, doctors must be part of a Foundation Programme, i.e. be in a recognised Foundation Year 1 (F1) post, which can be a short-term post such as an FiY1 post.
Students must choose whether or not they wish to obtain early provisional registration and join the frontline. There is no obligation for students who have recently graduated to serve in the NHS immediately.
According to the BMA, these will be paid posts on a fixed term contract for 4-5 months before individuals would normally have joined the foundation programme.
Volunteers will have the choice to work in hospitals trust near to their medical school or at the trust they have been allocated to work in as part of the UK Foundation Programme. The local foundation school will be responsible for overseeing the training of interim F1s during this time.
Plans for final year medical students are dependent on the individual medical schools and local arrangements. This is dependent on whether medical schools have fully assessed the competencies for new doctors required by the GMC. The aim is for final year medical students to join the workforce as soon as practical.
Some medical schools are only letting final year medical students work as HCA’s for the time being
Sources: UKFPO, GMC, BMA. It is important to note that these new job posts may be subject to changes, so we encourage you to stay updated by regularly reviewing reliable sources.
Are Final Year Medical Students Ready?
The lack of clarity is resounding. We have spoken to final year medical students from various medical schools across the country; some who have just officially graduated having sat their exams only a few weeks ago and others who have had their final exams cancelled. Not quite the victorious end which many have dreamed of; nevertheless, life must go on. We asked what their questions and worries were with regards to the government announcement. The main questions were surrounding:
What is to be expected of them?
Will they have the appropriate supervision that they need?
Is there enough PPE to protect them from the disease?
Is their knowledge sufficient enough to step up to the task being asked of them?
How will they be viewed if they don’t step up?
What is in place to ensure a smooth transition from being a medical student to being a doctor?
“Hearing that both my written and clinical exams had been cancelled was a huge relief. It’s common knowledge that finals are amongst the hardest exams you’ll have during your time at medical school. However, the novelty soon wore off. The decision to get final year medical students working early was communicated to the public before it was communicated to us. We found out at the same time as everyone else, despite these decisions directly impacting our lives and unfortunately, many of us do not feel ready. Our exams were scheduled for May/June so whilst our knowledge is adequate, it is not as good as it should be. Additionally, the pressing nature of this situation means many issues have not been addressed. The most important being that after June, many of our housing contracts will be up. How are we expected to work without having anywhere to live? Despite my reservations, I’m more than happy to help the NHS during this time of crisis, but I do not believe it should be as FY1’s. The thought of having to take up a role that I have not fully mentally or academically prepared for is very daunting.” – Final Year Medical Student
Should medical students even be asked to step up in this capacity?
It’s a tough ask but it reveals the extent of the dire times that we are currently in. With shortages of healthcare staff existing nationally prior to this crisis, the guidance to self-isolate for two weeks if you or anyone you live with has any cold like symptoms has resulted in even greater shortages. In as much as we need more support, students must be aware of what they’re stepping in to: a system already bursting at the seams now overwhelmed with a pandemic which shows no current signs of slowing down.
The reality of the problem
A lot of doctors say that the best learning is done on the job, but the current circumstances are very different. We spoke to a doctor (SHO) about what he feels final year medical students should know.
“When I first started as an F1 I was nervous to prescribe paracetamol for patients. Frantically checking co-morbidities and drug interactions etc. Getting stressed taking bloods from patients or trying to place cannulas and do ABGs in real life scenarios knowing I was responsible.
Now imagine the same scenario times 100. I have 25 COVID-19 positive patients. When you go in there with an apron, gloves and a mask, and the patients are coughing everywhere. Look frail. Struggling to breath. Basically, dying in front of you. Consider how you will feel. Not only the pressure of trying not to come out telling everyone you failed. But also, to try minimise your own exposure to this deadly virus. But then also consider the emotional stress.
This is not something to take lightly.
I appreciate all of you willing students and I applaud your bravery. But I want you to truly know what you're volunteering for.”
Let’s talk peer pressure
Competitiveness amongst medical students is nothing new. It’s what you’d expect when you're bringing together a number of students amongst the top 10% of the country. But now is not the time for peer pressure to be rampant, each individual needs to act according to what best suits them at this time. Although these interim FY1 posts are voluntary, there is the worry that if you don’t volunteer, you will be missing out on a once in a lifetime experience, being left behind or looked down upon by your peers for being too scared to face the pandemic. Rather than peer pressure, let us ensure we are extending support and encouragement to our peers, reminding that no matter what they decide to do in this time, it is okay.
Whether you decide to step up now or later, you are still as valuable.
Our MM Tips
Do what’s best for you. Discuss with friends or family, or make the decision on your own. Weigh up the pros and cons and understand the challenge ahead.
It's okay to be afraid. Fear is a completely natural response. You are not alone. The current uncertainty is likely to be unsettling but you are capable. The GMC are responsible for acting in the best interest for medical students, doctors and patients and if they and your medical school believe that you have received sufficient training to practise as a doctor, you have no choice but to take their word for it.
Familiarise yourself with the Advice available and stay updated.
British Medical Association: If you haven’t yet, join the BMA – membership is free for Final year medical students up until October the 1st. https://beta.bma.org.uk/advice-and-support/covid-19/your-contract/covid-19-early-provisional-registration-for-final-year-students
Join the BMA Medical Students Facebook Page: https://www.facebook.com/BMAstudents/photos/a.341683459180314/3454069574608338
UK Foundation Programme: Make sure you are familiar with the advice from the UKFPO. Ensure you are receiving what the UKFPO guidelines state: Induction, Full supervision, Debriefing, Recognition of your contribution at this time, Remuneration, Indemnity, Access to other resources provided to foundation doctors. These are essential components that should not be foregone to you starting work despite the times we are in. These components are necessary in order to keep you safe and well covered.
Make use of the resources available
Facebook Group: https://www.facebook.com/groups/medics.academy.final.2020/
Medics Academy FREE F1 Prep: https://www.medics.academy/courses/F-Docs-Programme
Foundation Doctor Handbook are offering FREE copy of their app: Foundation Doctor Handbook - Assessment advice, management algorithms, reference docs and clinical calculators. Everything a FY Dr needs! Apple: https://t.co/AzzAAFVxL4?amp=1, Android: https://t.co/eTUyJxFWWt?amp=1
Coronavirus Tech Handbook: https://coronavirustechhandbook.com/medical-students
BMA Wellbeing Support: There is always someone you can talk to. The BMA Wellbeing Support services provides confidential 24/7 counselling and peer support services open to all doctors and medical students on 0330 123 1245. BMA - Wellbeing support services https://www.bma.org.uk/advice/work-life-support/your-wellbeing/counselling-and-peer-support
Written by Olamide Dada