Of the many other incidents that I have experienced, some have been incredibly heartbreaking, others have been happy and some are hysterical
in which case I will do a full clerk, draw bloods, put up a line and transfer to ICU or the high care unit, depending on the severity of the problem. The day is unpredictable, and can swing from calm to chaotic in minutes. At 5pm the day staff
leave and my colleague and I are left to man the unit and attend deliveries. Sometimes a stable unit and a quiet labour ward will mean that we get a good night’s sleep, but most often we run between a busy theatre and labour ward, and the very ill infants in ICU. We usually catch two hours of sleep somewhere, and at 6am we start with postnatal rounds. We are relieved by the day staff at 8am and head home after a post-call round. It is exciting to finish
internship and finally enter the medical arena as a fully- fledged doctor. After two
years of supervised training, you have the confidence and skills to manage on your own. But with this newfound status comes increased responsibility, and a need to be objective about your capabilities. On my first night call, I was acutely aware that I was now the senior doctor on site. My colleague for the night was a friendly intern and I was struck by the realisation that I was the most experienced person immediately available, and in the event of an emergency, she was going to ask me for advice. We had a busy call with a few emergencies, but we managed well; she commented afterwards that I was so calm in a crisis, when I had in fact been acutely stressed! We have been well
prepared by our internship training, and we know more than we think. However,
the community service year is perhaps our most dangerous rite of passage. During our internship, we are supervised and still considered to be “in training”, leaving less room for error. During community service we have a bit more experience, but we are still junior doctors. We must now tread the fine line between trusting our clinical acumen and intuition in
making confident clinical calls, and overestimating our abilities. I trust my gut – if I start to feel uncomfortable, I phone my senior. The key to a successful and rewarding community service year is to enjoy your increased responsibility, but respect that you are still a junior doctor, who can and should ask questions when you feel out of your depth.
TIPS FOR FUTURE COMMUNITY SERVICE DOCTORS:
■■ Make an informed decision when you apply for posts. Going rural or not? Wanting experience in a specific field? Not keen on working overtime? A quick Facebook search for “Interns” or “Community Service” will take you to forums full of contacts at numerous hospitals. Contact doctors working in a post to get advice on what the facility is like, whether you can request to work in a specific department, whether they have sufficient senior back-up, whether overtime is compulsory, and other pros and cons.
■ ■ Ask for advice when you are unsure. Make use of your senior colleagues, who have more experience than you do and will usually be willing to help! If you are going to be the lone doctor in a rural town, acquaint yourself with the numbers of doctors at your referral centres for when you need telephone advice.
■ ■ Remember that balance is key. The community service year can be demanding, both physically and emotionally. Make time to rest, to engage in a hobby outside medicine, and to catch up with your friends and family. Your own health must be a priority if you are going to look after the health of others.
JUNIOR DOCTOR | VOLUME 2 | ISSUE 1 | 2011 | SOUTH AFRICA www.medicalprotection.org
BACKGROUND: MLENNY PHOTOGRAPHY/ISTOCKPHOTO.COM
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