But what happens when you finally get there and obtain that registrar job? How do you transition from being a JMO to being a registrar? Indeed, there are many overlapping qualities required to perform well in either position. For example, organisation skills, time management and prioritisation, ability to take initiative, and effective communication.
However, the registrar plays a different role on the team to that of the JMO. So, they must acquire a new skill set. This blog will focus on some specific attributes which are helpful for being or becoming a good registrar.
The job of a registrar is a heterogeneous one. Registrars across different streams of hospital medicine face different situations and pressures which may require different skills to handle. Therefore, the following tips have been kept general and applicable to most hospital registrars. These tips on being a good registrar are not exhaustive. However, they are certainly things I wish I knew when I first became a registrar. Best of all, you can start working on them now as a JMO.
While the treating consultant holds ultimate responsibility for the patient, he or she cannot always be present. Decisions may relate to:. The registrar plays a more active role in the team compared to their previous largely reactive role as a JMO.
Some new registrars fail to recognise this new responsibility. Instead, they continue fulfilling the role of a JMO while they wait for the consultant to make decisions. Something they are comfortable with. This reduces the efficiency of the team.
While your consultant wants to know about problems that arise with their patients, they also want to know that a plan is in place. For example, a consultant would rather hear:. Indeed, it may not always be clear to you what the plan should be. Therefore, your decisions especially the important ones should be made after discussion with your consultant.
Hopefully clarified from previous discussions and ward rounds. The start of each term as a registrar is spent deciphering what each consultant prefers to do in different situations.
Remember that being a registrar is a training position. Your decisions may not always be the correct ones. However, if they are guided by what is best for the patient while recognising your own limits, then harm should not result.
See point 2. It may take some time and reflection to adjust to your new role. Aim to minimise other stressors during this period of transition. For example, you may wish to delay studying for your exams for one month until you have settled into your new role.
Almost all registrar positions require a selection process. You must always be able to ask why. A degree of reflection is also vital. It is rare to receive helpful, critical feedback on your performance as a registrar, and also you are often the only registrar performing in your role at any one time, so there is limited ability to learn by comparison to others.
You must therefore strive to learn from yourself. There are the very beginnings of a move away from the idea that healthcare should be explicitly patient-centered and should in fact be person-centered. Recognising that we expect our staff to deliver care and compassion to patients whilst receiving little of this themselves from their workplace is an important first step. Simple things like ensuring that there are adequate and comfortable facilities to rest. Meaningful prioritization of training opportunities.
Finding some way to make Human Resources departments administer contracts in a timely fashion and to accept that births, deaths and marriages are just as significant to doctors as they are to other human beings. The training itself is difficult. The apprenticeship model is fractured, the clinical environment extremely pressured and the capacity for senior physicians to incorporate teaching into their daily practice increasingly limited.
We have to find new ways to teach and learn in these environments which constructively use new technologies and unashamedly put the training of the next generation of doctors at the top of the priority list. In my experience, patients do not mind being part of the education of medical professions, in fact many of them relish it.
We have to be braver in involving patients and colleagues in dynamic learning in the workplace. Be good to yourself. A sustainable work-life balance is achievable but requires some effort. Whilst the nights and weekends mean you miss many regular social events, being free at other times can open up possibilities that would have been otherwise unavailable.
Try to do one thing a month that is just for you. Also recognize that whilst these shifts are hard on you, they are also difficult for those around you. The general physician will never be dead. There will always be a need for this role and as such, this role will always exist in some form or other. It may go under different names and guises but a hospital without some form of continuous general physician presence is not a safe space for patients.
Check the new publications and curriculum map for updates. The transition from SHO to SpR is something that many are ready for, and many have picked up their own tips for. Some people are a little bit more apprehensive, and would appreciate some more tips. Here are a few suggestions from the slemfoam team with special thanks to minDoc. First set of solo ED Reg night shifts coming up this week.
When you start a shift, make sure you know the plans for patients, and follow the plans up. Walk round the department so that every member of staff, porters, nurses and doctors know who is in-charge for the shift, and who to get in touch with.
Have a look in all hidden cubicles and corridors and find the sick patient that no-one knows about. Be curious Seek first to understand, says Graham, who believes this soft skill sees GP registrars genuinely focus all their attention on the patient without distraction.
Show compassion Showing patient care, and willingness to go that extra step — like organising future appointments — separates good GPs from great ones, says Graham. Prioritise Being able to identify and address the health issues that are important to patients in both the short and long-term is key.
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