How to survive as a Foundation Doctor in T&O

@ The Royal Orthopaedic Hospital

Starting as an FY1 is daunting enough without contending with the stereotypical orthopod, though the claims of deficient IQ has been debunked1.

Surviving orthopaedics as an FY1 is no different to survival in any other specialty. There are inevitable challenges, but certainly nothing insurmountable for the calibre of individual who can survive medical school.

Even though on day one of your FY1 job your mind will be racing faster than ever, there are only a few things you need to remember and do.

Get organised

Although a very broad statement, it is the fundamental truth of being an FY1. The focus on your duties is morning ward round and subsequent job completion. The ward round can be very fast-paced and often you barely get a chance to finish writing the notes, let alone completing the variety of requests that the seniors may demand.

The inevitable list of jobs will take up much of your day and getting through that list will be easier if you are organised! Here are some tips to keep you organised.

1) Know your patients and where they are. If you can lead the ward round in a confident and efficient way, it’ll be a great start to the day.

2) Keep a stash of forms with you. Common requests include blood tests (haematology, biochemistry, blood bank) and radiology.

3) Keep an up-to-date list of patients with you at all times (but adhere to local data protection policies).

Eat & Drink

You’ll feel that your feet won’t touch the ground. It is critical that you look after your own health as well as that of your patients, so do not forget to eat and drink. This is especially true when you are oncall as your functional capabilities and concentration will diminish after a prolonged period without nutrition. There being too many patients and too many jobs is a common excuse, but that will always be the case. So unless there is a really sick patient that cannot wait, always make a bit of time to keep yourself fed and watered.

Just ask!

A consultant only knows more than you because he or she has done it longer. Nobody has any expectation of you, as a bran new FY1, to know the finer points of anything. You are a there to learn as well as do! If something doesn’t make sense or isn’t clear then ask for clarification.

You are a part of the team and by asking you will demonstrate that you are safe and sensible. In addition to learning it is important to know why you are being asked to do things. You should never just “get a CT scan” or “do bloods” without a specific question. You need to know for your education but also because you have to write down these specifics on the request forms. There is a greater chance of a request being approved with good information and an appropriate reason. Interestingly radiologists no longer accept “the consultant wants it” as appropriate on the request forms.

Get stuck in

Starting as an FY1, you may come to the job with aspirations of what you want do in the future. Even if T&O is not the specialty of your dreams, you should still try to treat every job as if it’s what you want to do. This doesn’t mean that you need to be overly enthusiastic, but keeping an open mind and recognising that every rotation will enrich your experience with broad transferable technical and non-technical skills. This will be vital regardless of the career path you eventually follow.

Attending teaching sessions, reading around the common cases you see and engaging in trauma meetings shows enthusiasm. In addition to facilitating your learning and understanding, it will allow you to gain the trust of the registrars and consultants on the team. The more enthusiasm you show, the more learning opportunities you will get. You never know how far you will make it in a rotation until you fully engage with it.


Welcome to the team! Every member of the healthcare service is your teammate. Treat everyone with respect and the environment you find yourself in will be much nicer. It is of critical importance that you acknowledge the experience of all the people around you and utilise that to improve your own knowledge.


(1) Subramanian, P., Kantharuban, S., Subramanian, V., & Willis-Owen, C. (2012). Orthopaedic Surgeons – Twice as strong as an ox and half as smart. Orthopaedic Proceedings, 94-B(SUPP XXXIV), 5. Accessed November 12, 2017. Retrieved from