Have I made a mistake?

I’m Georgia, a new F1 in Portsmouth. I was part of the infamous corona cohort who were sent to work early as interim doctors to help alleviate the pressure that our hospitals might have faced. Now a few months into my ‘normal’ foundation job, I' about making mistakes. I don’t mean about mistakes in the existential sense of choosing an entirely wrong career and wanting to flee the continent (unless you catch me on an evening ward cover shift) – I mean the prospect of making mistakes at work.

I feel like as is an issue with all social media, #medtwitter is generally a place where people post nothing but humbling successes. F1s doing chest drains in their first week, medical students delivering babies on tubes, other doctors being able to bleep the med reg without their upper lip sweating (n=0). No one ever posts their failures or seems to talk about their ongoing fear of making a mistake, which I felt almost constantly in the first few weeks. Just like when I accidentally followed the F1 to their car at the end of a shift as a medical student, the worry of making a mistake follows me home and wakes me up at night. Did I order bloods for tomorrow? Did I colour in all the boxes on my jobs list? Am I actually a moron?

What they forget to teach us at medical school is that mistakes are inevitable. We are a cohort of perfectionists who place impossible pressure on ourselves, chastised for forgetting a urine dip in an OSCE station or beating ourselves up for forgetting to ask the job occupation of our patients in-laws. But this ridiculous standard isn’t one that you can maintain healthily at work. Perfectionism is impossible, but it seems to always hover above you on the wards; exhorting you to make a perfect decision at the expense of sleep and comfort and sanity – and yet still things will go wrong. You will forget jobs, make prescribing errors, handovers will fail; or was the case for me last week, attend the entirely wrong ward round for a morning.

The biggest learning curve in F1 so far has been to swallow the lump in my throat and accept that I will make mistakes. The clinical environment still needs some work to foster this – blame cultures are scary and can put people off of admitting mistakes in fear of being in trouble. Mistakes are the key to great doctors - they facilitate the accumulation of knowledge. Being uncertain and unsure is key to this, often I’m not sure what I’m not sure about until I am in a situation that uncovers a knowledge gap.

Once you have graduated medical school you have to learn to trust that your foundation of knowledge is enough that no failure is final and despite working as a doctor, we are all still erring humans. As time and experience on the ward increases, the worry of making a mistake begins to fade and you can reflect on the skills that you have developed since the start. Other than that, you just have to get really really good at mindless admin. And knowing which button makes the bleep quiet (TBC). That’s really all there is to it.

Dr Georgia Hinchliffe

Foundation Year 1 Doctor