Being a medical reg Avinash Aujayeb To be, or not to be: that is the question: Whether 'tis nobler in the mind to suffer the slings and arrows of outrageous fortune, Or to take arms against a sea of troubles, And by opposing end them? To die: to sleep….. William Shakespeare (Hamlet 3/1) 8pm local DGH • • • • • • • Handover Hospital full Patients in corridors in A and E 12 waiting to be seen in MAU Ward has 4 critically sick patients Day reg in middle of an arrest Night SHO has rung in sick • Familiar?? What do you do? • Run away • Break down, cry and try do your best • Resign there and then • Prioritise, you know your strengths and limitations and rally the team round you? Role of the med reg In my own words : A leader A manager A nice person with maybe some extra knowledge/skills ( some obscure fact about fabry’s disease in all likelihood) but the confidence to apply that knowledge and skill 1. Do not re-invent the wheel 2. Do the simple things right 3. Ask for help My time • • • • • Acted up as ST 1 for 4 months ST3, ST4 in 2009 with ITU experience OOPE for 12 months ST 5 in tertiary care, ST6/7 now Pleural fellow next year with CCT at some point Anecdotes…..Case 1 • • • • • St3 SRH Cardiac arrest Notes given- bilateral PEs post hip fracture Thrombolysis 15 min into arrest, realise wrong patient’s notes in my hand…. • What do you do now? Case 1 • • • • • • Speak to family that night Admit fault Coroner’s inquest Press present! Praise for openness and communication No harm done Case 2 • 47 year old with sepsis (background severe learning difficulties) • ITU review- to keep on ward • Speak to family- explain situation • Get consultant involved • Patient gets worse, goes to ITU and dies • 2 weeks later- formal complaint- “Dr Aujayeb did not listen to us and did not realise X was really ill” • What do you do now? Case 2 • Rationalise • ?Scapegoat • Good documentation saved the day ( do simple things right) • How would you feel when that comes in and your supervisor says “ can we have a quiet chat please?” All doom and gloom?? You get presents! • 8 bottles of sherry once… • Always biscuits/chocolates! •Great time on OOPE- Oz, Nz, Asia, Africa •Lots of spare time •Publications •Surveys/Audits •Protected study timedegree in clinical education •Good group of friends •1 year or more in placesform relationships with other staff- job offers now •Flexible training opportunities •Fingers in many piestraining, teaching, MRCP, deanery, IMG support, GMC fitness to practise •No overall responsibilities?? Your ideas, concerns and expectations now • The buck stops with me overnight. How do I cope with this? • What can I take on or delegate? But the F1 is so busy…. • Inability to do that chest drain or that pacing line • Thanks for listening. Questions?