My first rotation as a foundation year 1 doctor was in gastroenterology. Although the first few weeks were filled with the usual anxieties and worries about starting work as a doctor (especially in the middle of a pandemic!), I quickly began to really enjoy my time within this speciality. Looking back, it was a great way to kick off my medical career.
I was working within a busy tertiary centre hospital in Sheffield. The department was split into specialist gastroenterology and hepatology teams. As foundation doctors, we worked within both of these teams. We also did the gastroenterology post-take ward round – seeing all the patients who had been admitted under gastroenterology over the last 24 hours.
What kind of things does a gastroenterology job involve?
- WARD ROUND: We always began the day by seeing patients on ward round – this was always senior-led, which was great whilst I gained confidence in the speciality. However, this level of senior support may not be the case for all gastroenterology jobs where you will see the patients independently on ward round (although senior support will always be available!). This can be both a pro and a con – whilst you may want that level of supervision initially, as you find your feet within the speciality, you may find it better for your own professional development to see patients alone before debriefing with a senior.
- INVESTIGATIONS: On any medical job, you will get lots of experience requesting and interpreting investigations, for example, blood tests, scans, endoscopy, ascitic fluid results, stool samples. It is an excellent job for getting used to interpreting deranged LFTs! There were also opportunities to go to endoscopy and see some scopes.
- REFERRALS: Again, this is something that is true of most medical specialities. However, gastroenterology patients can be complex and require input from many teams. For example, dieticians, physiotherapists, occupational therapists, specialist nurses, pharmacists, surgeons, and a whole range of other medical and surgical specialities. It is a good job for getting used to talking with different specialities.
- CLINICAL SKILLS: Gastroenterology is a great job to gain experience with additional practical skills, for example, nasogastric tubes. It is also a chance to learn clinical skills beyond that expected of a foundation doctor. For example, I was able to learn how to perform paracentesis. Not only is this something that is useful for future job applications, but it also came in handy on other medical rotations and on the medical take clerking patients. Many gastroenterology patients can be tricky to get venous access on, so it was good to get up to speed with venepuncture and canulation and learn how to do this under ultrasound guidance.
Why should you consider it?
Overall, this was a fantastic job and a rotation I really recommend. My top reasons for this are:
- There is a wide range of acute conditions like upper GI bleeds, inflammatory bowel disease flares, and chronic conditions like bowel cancer and liver disease. This made the job varied and exciting.
- It was helpful to gain experience in how these conditions mentioned above are managed. Gastroenterology patients can be complex, and their management very specific, and so gaining experience as a foundation doctor was helpful for future jobs.
- I got to work alongside a big team of other junior doctors and medical trainees and a wide range of other specialities and members of the MDT. This was really useful for professional development and for help when needed!
Things to consider before applying
As with all jobs, some things were challenging. These were:
- It is a very busy department and therefore as a junior you can have a lot to get done during the day. I always found that I was well supported but compared to my friends within other departments and medical jobs I had later, it was the one with a higher workload. This is hugely variable depending on the staffing level for that day, and obviously is department and trust specific.
- Gastroenterology patients can be very poorly and deteriorate very quickly. This can be challenging as a junior doctor. However, I was always very well supported, which stopped me from feeling out of my depth.
- As a medical job, you will most likely be part of the acute medical rota. This is not a gastroenterology specific thing, but out of hours work and night, shifts can be tiring and makes that work-life balance trickier.
All in all, this was a really good job. It was busy and, at times stressful, but I learnt so much and did so alongside a really great and diverse team of people. Overall, I really recommend this as a job during foundation training.