The bumpy transition from student to junior doctor – an unseen struggle

A recently published article in BMC Medical Education exposes the personal detriments that professionals experience as they ascend up the ranks from the role of medical student to junior doctor.

Stepping up from medical student to junior doctor is known to be a daunting and challenging transition. Though being stretched and ‘thrown in the deep end’ can be beneficial to their learning experience, it also increases stress. While getting to grips with the role in long shifts, they are also responsible for patient care. Can their job role and commitment for patient care be associated with poorer self-care?

This question was investigated by researchers at the Faculty of Medicine, University of Queensland, in a study led by Dr. Sturman, who reported the experiences junior doctors had during their career development.

Junior doctors were recruited from a range of hospital settings, and interviewed to find out about their experiences when adjusting from the role of medical student to junior doctor. After this process, two clinical academics and an intern conducted a descriptive analysis of the information collected.

There’s incredible self-doubt when you become an intern that you don’t have as a medical student.

As a result, some persistent concepts arose. Three main themes were ‘steep learning curve’, ‘relationships and team’ and ‘seeking help’. “There’s incredible self-doubt when you become an intern that you don’t have as a medical student” one interviewee said. Overall, the participants described the transition as physically, mentally and emotionally draining.

Key experiences were a decrease in confidence, self-care and social wellbeing. It seems that while the juniors were focused on caring for others, and were happy to raise patient related concerns  with senior staff members, there was an unwillingness to voice their own personal problems.

To try and understand the cause for this, the researchers suggest some key factors in the professionals’ working environment, which may contribute to these negative impacts.

You’re both at the bottom and somewhere up in the middle of the food chain at the same time because you are making decisions and directing patient care, but at the same time you’re at the very, very bottom of that chain.

The supportive team structure which can alleviate the stress of this experience may be hindered by a divide being in place between senior staff and the junior doctors, as one participant implied – “You’re both at the bottom and somewhere up in the middle of the food chain at the same time because you are making decisions and directing patient care, but at the same time you’re at the very, very bottom of that chain”.

Disconnection between the staff can be further exacerbated by the movement of professionals to and from various teams within the hospital. As shallow relationships are maintained, not only the social wellbeing of the junior doctors, but their skills could be affected.

This study speaks out to medical educators to raise awareness of the personal detriments experienced by junior doctors in this phase of learning, and suggests that improved team support systems and teaching methods could help smooth the bumpy transition from student to professional.

The advice that I would give is don’t be afraid, everyone is there to help you and everyone is there to guide you along.

It also voices the lessons learnt by junior doctors who have been through this stressful change, as one interviewee said “The advice that I would give is don’t be afraid, everyone is there to help you and everyone is there to guide you along, don’t be afraid to ask questions because ultimately it’s all in the best interest of the patient.”

If the wellbeing of junior doctors were to improve, perhaps this could also have a positive impact on their colleagues, and even the patients that they treat.

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