0:00:02 > 0:00:05Seven junior doctors...
0:00:05 > 0:00:08- Start CPR.- Stop doing the drugs, please, and help here.
0:00:08 > 0:00:11Open your eyes for me.
0:00:11 > 0:00:13- Showtime.- ..on the front line of medicine.
0:00:13 > 0:00:15It looks busy, man.
0:00:15 > 0:00:17All the wards are bleeping me at the same time.
0:00:17 > 0:00:19..with all its blood...
0:00:19 > 0:00:21- We're removing everything. - Second adrenaline.
0:00:21 > 0:00:23I love screwing.
0:00:23 > 0:00:25- ..sweat...- I think lots of doctors are competitive.
0:00:25 > 0:00:27..and tears.
0:00:27 > 0:00:29You're not going to die.
0:00:37 > 0:00:39The doctors of your future...
0:00:39 > 0:00:41I want to be the best junior doctor.
0:00:41 > 0:00:43..facing life...
0:00:43 > 0:00:46- Lion King moment.- ..and death.
0:00:46 > 0:00:48He's tired. I think he just wants to go.
0:00:48 > 0:00:50Have they got what it takes?
0:00:50 > 0:00:51- Cheers.- Cheers.
0:01:06 > 0:01:1125-year-old Jin is about to start a nine-hour shift in the emergency
0:01:11 > 0:01:14department at Wolverhampton's New Cross hospital.
0:01:23 > 0:01:27I have to remark on the fabulous weather that is
0:01:27 > 0:01:31far and in between and rare in the British culture, isn't it?
0:01:31 > 0:01:34So we have to enjoy this bright weather, but unfortunately,
0:01:34 > 0:01:36I am working. I hope it's a sunny A&E,
0:01:36 > 0:01:39in the sense that everything will be smooth and chilled,
0:01:39 > 0:01:40so let's go for it.
0:01:41 > 0:01:44Jin is a second-year junior doctor.
0:01:44 > 0:01:48However, he didn't always have that ambition.
0:01:48 > 0:01:52I wanted to be an accountant, I wanted to do business.
0:01:52 > 0:01:55At one point, I even wanted to be a Hollywood actor, believe it or not.
0:01:55 > 0:01:58Obviously, I'm not good looking enough, but...
0:01:58 > 0:02:01But all those things crossed my mind, but obviously,
0:02:01 > 0:02:03you can tell that none of them was suited to me.
0:02:09 > 0:02:11I won't be able to survive without coffee.
0:02:11 > 0:02:12Why not?
0:02:13 > 0:02:16Addiction, habit.
0:02:16 > 0:02:17Compulsive behaviour.
0:02:18 > 0:02:20- There you go.- Thank you. - No worries.
0:02:23 > 0:02:25It looks busy, man.
0:02:28 > 0:02:30I think that expression said it all.
0:02:31 > 0:02:36On an average shift, Jin will see around ten patients.
0:02:36 > 0:02:37How can I help you today?
0:02:37 > 0:02:42One of those today is football fan Mr Fowler.
0:02:42 > 0:02:44He's come in with a suspected abscess.
0:02:44 > 0:02:46Is the abscess in the belly button, or...?
0:02:46 > 0:02:49They don't know. They just said it was an abscess that burst.
0:02:49 > 0:02:51Yeah, I can't see any abscess.
0:02:51 > 0:02:53- No.- What's coming out of the belly button?
0:02:53 > 0:02:55Pus and blood is coming out of it.
0:02:55 > 0:02:57I'm getting pain right across my stomach.
0:02:57 > 0:03:00So, now, right now, would you say it's gone better?
0:03:00 > 0:03:01No, it smells worse.
0:03:01 > 0:03:04- How bad's the pain?- It gets to about seven.
0:03:04 > 0:03:06Is it sharp or dull?
0:03:06 > 0:03:09- Sharp.- No fever, no shakes?
0:03:09 > 0:03:12- Yeah, I've been getting shakes. - If you wait here, I'll be back,
0:03:12 > 0:03:13- all right, so...- OK, no problem.
0:03:13 > 0:03:15As a junior member of the team,
0:03:15 > 0:03:17Jin must check in with senior
0:03:17 > 0:03:21colleagues to ensure he's making the right decisions.
0:03:21 > 0:03:23The only thing that makes any difference in terms of morbidity
0:03:23 > 0:03:25and mortality in somebody who is
0:03:25 > 0:03:27septic is the speed at which they get antibiotics.
0:03:27 > 0:03:29I couldn't see any visible abscess on the outside.
0:03:29 > 0:03:32Neither can I. But that I don't find reassuring, that I find worrying.
0:03:32 > 0:03:34But wouldn't he be really unwell?
0:03:34 > 0:03:35But he's getting there.
0:03:40 > 0:03:44The consultant is concerned Mr Fowler is at risk of sepsis,
0:03:44 > 0:03:46a potentially fatal infection.
0:03:46 > 0:03:48Jin urgently needs to give
0:03:48 > 0:03:51medication and take a blood sample to rule this out.
0:03:51 > 0:03:53We'll keep you updated. We'll give
0:03:53 > 0:03:55you the antibiotic and we'll put you on a drip, sir.
0:03:55 > 0:03:57We'll see what the blood test shows.
0:03:57 > 0:03:59You might have to come into hospital.
0:03:59 > 0:04:01But, let's take it a step at a time.
0:04:03 > 0:04:04At the moment, we're treating him
0:04:04 > 0:04:06like he's going to get really unwell.
0:04:06 > 0:04:07You know, we're putting a line in,
0:04:07 > 0:04:09we're giving him fluids, IV antibiotics.
0:04:09 > 0:04:12I'm doing a whole range of bloods, we're going to call the surgeons.
0:04:12 > 0:04:15You know, we're treating him like he's going to get really unwell.
0:04:15 > 0:04:17But we will see how unwell he gets.
0:04:19 > 0:04:24Junior doctor Osama is on his way to start his shift in obs and gynae.
0:04:24 > 0:04:26# Look back and watch me smack that
0:04:26 > 0:04:28# All on the floor
0:04:28 > 0:04:30# Smack that Give me some more... #
0:04:30 > 0:04:33Junior doctors have three placements a year.
0:04:33 > 0:04:35This is Osama's last.
0:04:40 > 0:04:44So, this afternoon there's about 15 operations going on.
0:04:44 > 0:04:45I guess I want to be operating
0:04:45 > 0:04:48all the time and I guess these kinds of lists
0:04:48 > 0:04:51are perfect me to get my experience up.
0:04:51 > 0:04:5726-year-old Osama was born in Iraq and moved to Britain in 2001.
0:04:57 > 0:05:00Unfortunately, a big world event happened,
0:05:00 > 0:05:039/11, and my name was Osama.
0:05:03 > 0:05:07I used to walk around school and everyone was chanting my name.
0:05:07 > 0:05:10I thought, "Wow, gosh, I'm so popular in school."
0:05:10 > 0:05:13I quite like my name, although it's quite unpopular name at the moment.
0:05:13 > 0:05:16It's like being called Adolf during World War II.
0:05:17 > 0:05:21Osama is over halfway into his placement on obs and gynae.
0:05:21 > 0:05:24Although still only a first year junior doctor,
0:05:24 > 0:05:28today he has the big responsibility of looking after a medical student,
0:05:28 > 0:05:3023-year-old Simon.
0:05:30 > 0:05:33It's the job I'm going to be starting, hopefully, in August,
0:05:33 > 0:05:35so it's really good to get a good
0:05:35 > 0:05:37insight and sort of following him
0:05:37 > 0:05:39and his day-to-day jobs is really useful
0:05:39 > 0:05:40to give me an insight into what
0:05:40 > 0:05:42I'm hopefully going to be doing in the summer.
0:05:42 > 0:05:45So, she's having a cystoscopy done.
0:05:45 > 0:05:47Just a camera test, looking at the bladder.
0:05:47 > 0:05:50Osama's first job is to meet patients having operations today.
0:05:50 > 0:05:52He's asked Simon to lead a
0:05:52 > 0:05:55consultation with a patient due to have a bladder procedure.
0:05:55 > 0:05:57And do you know what you're having done today?
0:05:57 > 0:05:59I've got problems with my bladder
0:05:59 > 0:06:01from radiation damage after I had a lot
0:06:01 > 0:06:03of radiation when I had cancer.
0:06:03 > 0:06:05- OK.- So they're going to try and sort it out today.
0:06:05 > 0:06:07And do you take any regular medications at all?
0:06:07 > 0:06:09- Omeprazole.- And nothing else to thin the blood?
0:06:09 > 0:06:11- No.- Nothing for blood pressure?
0:06:11 > 0:06:13- No.- Or heart disease or anything like that?
0:06:13 > 0:06:15- I've got a pacemaker. - You've got a pacemaker.
0:06:15 > 0:06:17And do you have any things you need to take that?
0:06:17 > 0:06:18- No.- What's the pacemaker for?
0:06:18 > 0:06:21Sometimes, my heart will stop when I was asleep, but start again.
0:06:21 > 0:06:24But not quickly enough, so if I got up...
0:06:24 > 0:06:27- I've got you, yeah.- ..I just pass out.- OK. Perfect.
0:06:27 > 0:06:30I mean, not so perfect for you, but, yeah, I guess.
0:06:30 > 0:06:34- Thank you.- Thank you very much. - OK, thanks.- Bye.
0:06:34 > 0:06:36- Smashed it.- Pretty much.
0:06:36 > 0:06:40Yeah, no, no, you actually asked all the questions.
0:06:40 > 0:06:43You did everything correct. And your patient manners were really good,
0:06:43 > 0:06:47which I really like. Like, I love admiring patient manner.
0:06:47 > 0:06:51I'm learning a few things from you, you know?
0:06:51 > 0:06:54As well as medical supervision,
0:06:54 > 0:06:57Osama is also expanding Simon's vocabulary.
0:06:57 > 0:06:59Simon, you've smashed it so far.
0:06:59 > 0:07:00- Yeah.- So far, so good.
0:07:00 > 0:07:02- No flopping.- So I like "smashed it."
0:07:02 > 0:07:04He was like, "nailed it," as well.
0:07:04 > 0:07:06I like how he calls everyone bro.
0:07:06 > 0:07:07Including the nurses.
0:07:07 > 0:07:10I think that, you know... Really good.
0:07:14 > 0:07:16In the emergency department,
0:07:16 > 0:07:18Jin is still ruling out
0:07:18 > 0:07:20life-threatening sepsis for Mr Fowler,
0:07:20 > 0:07:22who has a suspected abscess.
0:07:22 > 0:07:25I wish I could make the core decision myself, but I don't have...
0:07:25 > 0:07:27Unfortunately I'm too junior for that.
0:07:27 > 0:07:30I don't have the relevant experience or knowledge to do that.
0:07:30 > 0:07:31I want to be the best, though, the best.
0:07:31 > 0:07:33I want to be the best junior doctor.
0:07:33 > 0:07:35His condition hasn't deteriorated,
0:07:35 > 0:07:39so Jin now needs to consult the on-call surgeon about the next step.
0:07:39 > 0:07:41Discharge is coming out of the belly button.
0:07:41 > 0:07:43Yellow and foul-smelling discharge.
0:07:43 > 0:07:45He's not unwell in himself, is he?
0:07:45 > 0:07:47He is uncomfortable. Just sharp umbilical pain.
0:07:47 > 0:07:49Seven out of ten severity.
0:07:49 > 0:07:51If it's not a proper abscess, there is nothing we can offer,
0:07:51 > 0:07:53because it is not a surgical problem.
0:07:53 > 0:07:57Just a course of antibiotics will be more than enough.
0:07:57 > 0:08:00The patient's blood tests are back and it's good news.
0:08:00 > 0:08:04Let's see. That's fine, that's fine, that's fine, that's fine.
0:08:04 > 0:08:05He looks... OK.
0:08:05 > 0:08:08I've spoken to the surgeon and he doesn't need to be admitted.
0:08:09 > 0:08:12Hi, sir. I've spoken to the surgeon,
0:08:12 > 0:08:15and they feel that you don't need to be admitted.
0:08:15 > 0:08:17We've measured your blood, blood culture, you know,
0:08:17 > 0:08:19we've looked at your observations.
0:08:19 > 0:08:22I've had a word with the general surgeon and they feel that you don't
0:08:22 > 0:08:25- need to be in hospital.- OK, so what is it, do they know?
0:08:25 > 0:08:27It could just be, you know, a superficial infection,
0:08:27 > 0:08:30not necessarily an internal abscess.
0:08:30 > 0:08:33If it's an internal abscess, you would be very, very unwell,
0:08:33 > 0:08:35so we're happy to discharge you.
0:08:37 > 0:08:40On the respiratory ward, Anna is starting her shift.
0:08:42 > 0:08:47I was a very squeamish child and would cry at the sight of vomit and
0:08:47 > 0:08:48sometimes vomit myself.
0:08:48 > 0:08:52I remember being on a bus once and the person in front of me
0:08:52 > 0:08:55was feeling sick and I remember I came out in these shivers.
0:08:55 > 0:08:59It has kind of been such an extreme change now to being a doctor where
0:08:59 > 0:09:01I'm sometimes vomited on.
0:09:01 > 0:09:02I don't know what's happened.
0:09:02 > 0:09:06I've kind of become desensitised to it over the years.
0:09:06 > 0:09:10With ten applicants for every place at medical school,
0:09:10 > 0:09:12she's come a long way to be a doctor.
0:09:12 > 0:09:13I feel really nervous.
0:09:13 > 0:09:16But she didn't have an easy start on her placement
0:09:16 > 0:09:18nearly two months ago.
0:09:18 > 0:09:21Oh, gosh. It's got a cover on it, so we're fine.
0:09:21 > 0:09:23I feel a bit like a spare part at the moment.
0:09:23 > 0:09:27- Ow.- I'm not really sure what I'm meant to be doing.
0:09:27 > 0:09:28- Whoa.- I did have a moment today
0:09:28 > 0:09:31where it felt like everyone was dying.
0:09:32 > 0:09:34In my head, I'm just panicking
0:09:34 > 0:09:36and not actually thinking about the answer.
0:09:36 > 0:09:39I don't think I've made the right decision here, and hate it.
0:09:41 > 0:09:43It's an important day for Anna.
0:09:43 > 0:09:45She's having her final assessment.
0:09:45 > 0:09:48If she doesn't pass, she'll have to repeat the whole year.
0:09:48 > 0:09:52Being a doctor is competitive and I think medicine,
0:09:52 > 0:09:56kind of the competitive personality fits medicine very well.
0:09:56 > 0:09:59I think lots of doctors are competitive.
0:09:59 > 0:10:01I'm not competitive at all.
0:10:03 > 0:10:08You know, I just like to get along with everyone and have a nice time.
0:10:09 > 0:10:12Not passing F1, I don't know.
0:10:12 > 0:10:16I think I probably would have a moment of despair
0:10:16 > 0:10:18where I would think, "Shall I just give up?"
0:10:18 > 0:10:20But, fingers crossed, I pass.
0:10:27 > 0:10:31Jin has been working long hours for several weeks in the emergency department.
0:10:31 > 0:10:35It's now seven hours into his shift and a patient has been
0:10:35 > 0:10:39brought in who's overdosed on antidepressants and painkillers.
0:10:39 > 0:10:4228 mirtazapine.
0:10:42 > 0:10:44Approximately 20 co-codamol.
0:10:44 > 0:10:47How many Naproxen? What's his GCS?
0:10:47 > 0:10:51Examining motor, verbal and eye response,
0:10:51 > 0:10:52Jin needs to rate the patient's
0:10:52 > 0:10:54level of consciousness on what's known as
0:10:54 > 0:10:56the Glasgow Coma Scale.
0:11:00 > 0:11:02Jin must be accurate with his GCS score
0:11:02 > 0:11:04so the team can monitor whether
0:11:04 > 0:11:06the patient is deteriorating.
0:11:06 > 0:11:08So next time I'll do that if I can't wake up a patient?
0:11:08 > 0:11:11Dr Qureshi has some questions about his assessment.
0:11:11 > 0:11:13How did you rate?
0:11:13 > 0:11:15So, motor, verbal and pain.
0:11:15 > 0:11:17Motor, verbal and pain?
0:11:17 > 0:11:20- Is it pain?- Which medical school did you go to?
0:11:24 > 0:11:27No, motor, verbal, and what was the last one?
0:11:33 > 0:11:37- Sorry, I'm just really tired.- Do you want me to leave you alone now?
0:11:37 > 0:11:40- Kind of.- Have you had enough? - Kind of, yeah.- OK.
0:11:40 > 0:11:41When are you in next?
0:11:41 > 0:11:43- Tomorrow.- OK.
0:11:43 > 0:11:45Well, on Monday... Are you here on Monday?
0:11:45 > 0:11:47- No.- Are you in on Tuesday?
0:11:47 > 0:11:49- Yeah.- OK, on Tuesday, I want...
0:11:49 > 0:11:52I will ask you the Glasgow Coma Scale,
0:11:52 > 0:11:54the competence and how you measure it.
0:11:54 > 0:11:57And if you don't know it by then, I'll tell your supervisor.
0:11:57 > 0:11:58OK.
0:12:04 > 0:12:06Not very happy, obviously.
0:12:06 > 0:12:07I know she's just joking,
0:12:07 > 0:12:10but she's just embarrassed me in front of everyone.
0:12:12 > 0:12:15Sometimes, you know, you can take it too far, I think.
0:12:17 > 0:12:18How would you feel?
0:12:18 > 0:12:22How would you feel if you were embarrassed like that in front of everyone?
0:12:34 > 0:12:37They're not kids. They are doctors.
0:12:37 > 0:12:38We're all adults, we're all
0:12:38 > 0:12:43professionals and it was not really a telling off, but it was
0:12:43 > 0:12:48trying to make Jin realise the importance of basic principles of
0:12:48 > 0:12:53assessment in an acutely unwell patient, and essentially that is the
0:12:53 > 0:12:55essence of his job in emergency medicine.
0:12:55 > 0:12:57And if he's not able to do that,
0:12:57 > 0:12:59then I think it's a failure on our part,
0:12:59 > 0:13:01as well, as consultants,
0:13:01 > 0:13:05that we are not giving him that proper teaching and training.
0:13:05 > 0:13:08You cannot work in an emergency department and not know what
0:13:08 > 0:13:11a Glasgow Coma Scale is and its components are.
0:13:11 > 0:13:13Just had a long day and I just, for some reason,
0:13:13 > 0:13:15my mind just switched off.
0:13:15 > 0:13:17I guess it was the pressure.
0:13:17 > 0:13:19Everyone was watching me and it's just...
0:13:19 > 0:13:20My mind went blank.
0:13:23 > 0:13:26With an hour until they're due in surgery,
0:13:26 > 0:13:30Osama and Simon are focused on fuelling up for the job.
0:13:30 > 0:13:35But, first, Osama must smuggle Simon into a secret part of the hospital.
0:13:35 > 0:13:37So, you can't tell anyone about this.
0:13:40 > 0:13:42So, this is for junior doctors.
0:13:42 > 0:13:44I guess Simon's going to be a junior doctor very soon,
0:13:44 > 0:13:49so I guess he is kind of, but don't tell anyone.
0:13:49 > 0:13:53So, you go by the name of Barry and you're a senior registrar.
0:13:54 > 0:13:56Oh, Emeka's here.
0:13:58 > 0:14:00How are you doing?
0:14:00 > 0:14:02So, bananas, potassium.
0:14:04 > 0:14:07And then obviously some vitamins. And tuna.
0:14:07 > 0:14:09This is the secret for any surgeon.
0:14:09 > 0:14:12They need a lot of protein.
0:14:12 > 0:14:16I lived off this stuff for six years in med school.
0:14:16 > 0:14:18It just reminds me of med school.
0:14:18 > 0:14:21So, hopefully, I'll be able to recapture the knowledge from med school,
0:14:21 > 0:14:24as well, when I'm in theatre.
0:14:24 > 0:14:27This is why I can eat this. You fancy playing some football?
0:14:27 > 0:14:29Let's go for it, man.
0:14:30 > 0:14:33The competitive world of junior doctors
0:14:33 > 0:14:35even extends to table football.
0:14:35 > 0:14:37How do you win this game?
0:14:37 > 0:14:40I think you have to score more goals than your opponent.
0:14:40 > 0:14:41You think so?
0:14:41 > 0:14:43I think that's a goal to me, bro.
0:14:43 > 0:14:45Is it? Oh.
0:14:45 > 0:14:47The thing is, every time I get a goal,
0:14:47 > 0:14:49you automatically get two participation points.
0:14:49 > 0:14:51- OK.- Two more participation points.
0:14:51 > 0:14:53Two more participation points.
0:14:53 > 0:14:56I remember you telling me like today is a big day in theatre.
0:14:56 > 0:14:59Yeah. I'm taking my student, Simon, with me.
0:14:59 > 0:15:02- OK.- He wants to be a surgeon. He's really good.- Oh, really?
0:15:02 > 0:15:05So he's really keen to be in theatre, so I'm taking him with me.
0:15:05 > 0:15:07So I guess I want to show him what it's like.
0:15:07 > 0:15:11To be fair, it sounds like you're a pretty dope mentor.
0:15:11 > 0:15:12Oh, thank you, bro.
0:15:12 > 0:15:16- If I were Simon, I'd feel lucky to have you.- Aw.
0:15:16 > 0:15:17Bro, I'm blushing.
0:15:17 > 0:15:20Oh, there you go, bro. I need to go.
0:15:20 > 0:15:22I smashed it.
0:15:24 > 0:15:27Jin's confidence has taken a knock this week.
0:15:27 > 0:15:30So, off shift, he's meeting up with senior colleague
0:15:30 > 0:15:33and friend, Raul, to get some advice.
0:15:33 > 0:15:35- Oh, man.- So, how's it going?
0:15:35 > 0:15:37Yeah, I had a run-in with Dr Qureshi.
0:15:37 > 0:15:40- Oh, yeah.- She's grilled me about the Glasgow Coma Scale.
0:15:40 > 0:15:42- Oh, yeah?- And...
0:15:42 > 0:15:43Oh, yeah. I heard about this.
0:15:43 > 0:15:45You heard about it? A little bird told you, yeah?
0:15:45 > 0:15:47A little bird being the whole of the A&E.
0:15:47 > 0:15:49It's a little fishbowl, man.
0:15:49 > 0:15:51Whatever you do, everyone knows about it the next day, man.
0:15:51 > 0:15:52- Yeah.- No, that's all right.
0:15:52 > 0:15:55It was the end of a nine, ten-hour shift.
0:15:55 > 0:15:57- Yeah.- I was wrecked. My mind went blank.
0:15:57 > 0:15:59- Yeah, yeah, yeah.- The pressure of everyone looking at me and...
0:15:59 > 0:16:02I think, with that kind of stuff, you know it.
0:16:02 > 0:16:04If I were to ask you about it now, you'd be able to tell me.
0:16:04 > 0:16:05Yeah, definitely, definitely.
0:16:05 > 0:16:07But, when you're so tired, you can barely think.
0:16:07 > 0:16:09I was quite similar.
0:16:09 > 0:16:11There would have been days where I did everything right and I'm
0:16:11 > 0:16:15like... Your level of confidence grows. And then, because of that,
0:16:15 > 0:16:17you come across more stuff and you think you can do it yourself.
0:16:17 > 0:16:19Yeah, I've had that.
0:16:19 > 0:16:21Exactly. Some are like, "Yeah, I'm on this one."
0:16:21 > 0:16:24I'm one of the most confident F2s in A&E, right?
0:16:24 > 0:16:26- Yeah.- And on another day, it comes crashing.
0:16:26 > 0:16:27Exactly. And you miss something huge.
0:16:27 > 0:16:30And you're like, "Oh, I can't believe I missed that."
0:16:30 > 0:16:31- That's true.- And then, all of a sudden,
0:16:31 > 0:16:34"Yeah, it was a good thing." I know it's not the nicest thing,
0:16:34 > 0:16:36being criticised in front of staff.
0:16:36 > 0:16:38- I find it difficult...- Why's that? - I'm a bit of a perfectionist.
0:16:38 > 0:16:40You're going to make mistakes.
0:16:40 > 0:16:42Sometimes, I'm like, "Yeah, I can boss this."
0:16:42 > 0:16:46But, when I'm feeling out of depth,
0:16:46 > 0:16:49I'm not afraid to ask for help.
0:16:58 > 0:17:01Anna's on her way to meet her supervisor, Dr Bateman,
0:17:01 > 0:17:04for her final assessment.
0:17:04 > 0:17:06He decides whether she's done enough
0:17:06 > 0:17:08to become a second year junior doctor.
0:17:08 > 0:17:12When we see young doctors just finished medical school,
0:17:12 > 0:17:15and they come onto the wards and it's a completely different field.
0:17:15 > 0:17:17They don't have feedback in the same
0:17:17 > 0:17:19way that they do in medical school
0:17:19 > 0:17:21in terms of how they're performing and, you know,
0:17:21 > 0:17:23you do see students sink or swim.
0:17:24 > 0:17:25Hello.
0:17:28 > 0:17:29So just to catch up with you again
0:17:29 > 0:17:33and this is the final validation from your foundation programme,
0:17:33 > 0:17:36so it's really nice to see in the last two months in
0:17:36 > 0:17:39respiratory you've had very positive feedback from your clinician,
0:17:39 > 0:17:41Dr Carter.
0:17:41 > 0:17:44And running through your checklist,
0:17:44 > 0:17:47you've basically completed all the requirements.
0:17:47 > 0:17:51You've had positive comments from your practical procedures,
0:17:51 > 0:17:53your clinical work, and from the rest of the team in respiratory,
0:17:53 > 0:17:55which is really helpful.
0:17:55 > 0:17:58Any comments about... Obviously, you're two months into respiratory.
0:17:58 > 0:18:00Any comments, anything else you'd like to raise?
0:18:00 > 0:18:02I think I can be quite shy, sometimes.
0:18:02 > 0:18:04I think I do need to push myself to,
0:18:04 > 0:18:06I don't know, kind of get stuck in.
0:18:06 > 0:18:09Yeah, I think so. And I think one of the most important things is,
0:18:09 > 0:18:12essentially, there's a huge range of evidence,
0:18:12 > 0:18:14we've been saying with the other trainees,
0:18:14 > 0:18:16and you've shown good engagement with all these things,
0:18:16 > 0:18:19so we're quite happy that you've done all the things that you were
0:18:19 > 0:18:21- required to do.- Oh, good.
0:18:21 > 0:18:23It's been a pleasure. I think you've done really well.
0:18:23 > 0:18:25I've seen a change in Anna in the
0:18:25 > 0:18:29- sense that I think Anna is probably more confident now.- Thank you.
0:18:29 > 0:18:33A lot of the doctors have fed back on her compassion and her
0:18:33 > 0:18:36professionalism. I think she's recognising herself
0:18:36 > 0:18:39she's doing a good job and that she's good at what she's doing.
0:18:39 > 0:18:41Being competitive doesn't
0:18:41 > 0:18:44necessarily mean you're the best doctor for your patient.
0:18:44 > 0:18:47What patients need is, you know,
0:18:47 > 0:18:50a doctor who cares and a doctor that's going to work hard for them.
0:19:21 > 0:19:23Have you already seen the patients in DCU?
0:19:23 > 0:19:25In obs and gynae,
0:19:25 > 0:19:29Osama and Simon are about to assist Mr Saeed on a major procedure.
0:19:29 > 0:19:31A full hysterectomy.
0:19:36 > 0:19:39Literally, we're inducing this lady into menopause.
0:19:39 > 0:19:40We're removing everything.
0:19:40 > 0:19:42We're removing the uterus, removing the ovaries,
0:19:42 > 0:19:44removing the fallopian tubes.
0:19:44 > 0:19:46We're removing everything.
0:19:46 > 0:19:48So, yeah, this is the biggest operation in gynae.
0:19:50 > 0:19:53Osama has back-to-back operations,
0:19:53 > 0:19:57but on general surgery, Emeka is having a slow day.
0:19:57 > 0:19:59I'm looking all right today, you know.
0:20:03 > 0:20:05Oh, wait, who's this?
0:20:07 > 0:20:10I don't understand how he's got enough time to do this stuff.
0:20:12 > 0:20:16I guess, sometimes, you have days where there's not much going on.
0:20:16 > 0:20:19So I'll probably send a reply to him at the end of the day,
0:20:19 > 0:20:21after the big operations.
0:20:21 > 0:20:23There are three applicants for every surgical traineeship.
0:20:23 > 0:20:25As a junior, you're always trying to
0:20:25 > 0:20:28compete with other juniors to try and get into theatre.
0:20:28 > 0:20:31So, for example, the registrar will try to get into theatre.
0:20:31 > 0:20:33The senior house officer will try to get into theatre.
0:20:33 > 0:20:34The F1s will try to get into theatre,
0:20:34 > 0:20:38so you're always trying to compete to try to get into theatre.
0:20:38 > 0:20:40Mr Saeed is giving Osama more surgical responsibility,
0:20:40 > 0:20:45which will help him stand out from his peers for a traineeship.
0:20:45 > 0:20:48Mr Saeed is kindly going to step out of this one and let the registrar
0:20:48 > 0:20:49do most of the operation
0:20:49 > 0:20:52and therefore I'll be stepping up to do what the registrar's role is.
0:20:52 > 0:20:54And then the medical student,
0:20:54 > 0:20:57who is becoming a doctor soon, will be doing my role.
0:20:57 > 0:20:59Getting experience like this is
0:20:59 > 0:21:01literally like a once-in-a-lifetime kind
0:21:01 > 0:21:02of thing, to become a surgeon,
0:21:02 > 0:21:04so you need this kind of experience.
0:21:07 > 0:21:10The team will remove the womb, uterus,
0:21:10 > 0:21:13fallopian tubes and part of the cervix.
0:21:13 > 0:21:15You'll be helping soon.
0:21:23 > 0:21:25So this is the womb here, look.
0:21:25 > 0:21:27This is the bladder here in front.
0:21:27 > 0:21:31- OK.- The cervix was here, so we push this all the way down.
0:21:31 > 0:21:34This is the top of the vagina.
0:21:35 > 0:21:38Oh, my word, it's such a long cervix.
0:21:40 > 0:21:43Osama has the responsibility of suturing the wound.
0:21:46 > 0:21:48It's was a really good experience.
0:21:48 > 0:21:50You can just see the anatomy really well.
0:21:50 > 0:21:54Did you see, like, the ovaries, uterus, fallopian tubes...?
0:21:54 > 0:21:56Yeah, it all came out.
0:21:56 > 0:21:57It was good.
0:21:57 > 0:21:59Osama smashed it. So, all good.
0:21:59 > 0:22:02It went well. Yeah, there were some really nice anatomy in there so
0:22:02 > 0:22:05it's a really good learning experience, as well, for me.
0:22:05 > 0:22:08If you want to be a good surgeon, you need to get as much theatre
0:22:08 > 0:22:10experience as possible, so you have to sacrifice some time.
0:22:10 > 0:22:14Simon, he's only a medical student, but he's already sacrificing, like,
0:22:14 > 0:22:16coming in extra to do this.
0:22:16 > 0:22:18Like, other medical students are literally at home right now.
0:22:18 > 0:22:21All your colleagues are, like, chilling at home.
0:22:21 > 0:22:23Yeah. Exactly, they are at home.
0:22:23 > 0:22:27That's what you have to do to become a good surgeon.
0:22:27 > 0:22:29Now Osama's finished his shift,
0:22:29 > 0:22:32he can finally get to the important business of replying to Emeka's
0:22:32 > 0:22:34earlier text.
0:22:34 > 0:22:36He's taken about 20 selfies,
0:22:36 > 0:22:39which is kind of the usual number for him per day.
0:22:39 > 0:22:41But, wow.
0:22:41 > 0:22:43Oh, this is cute, look.
0:22:43 > 0:22:45Wish you were here.
0:22:45 > 0:22:48I'm only just starting the selfie game, so, I don't know,
0:22:48 > 0:22:51I don't think I'll be able to hack it, but I'll try and challenge him.
0:22:54 > 0:22:56Emeka has smashed this.
0:22:56 > 0:22:59I need to learn from him. I'm like his apprentice, essentially.
0:22:59 > 0:23:01Hopefully, one day, I'll be at his level.
0:23:11 > 0:23:14Successful day over,
0:23:14 > 0:23:16Anna heads home to celebrate her
0:23:16 > 0:23:19huge achievement with boyfriend Fraser.
0:23:22 > 0:23:24Look, we've got a tiny prosecco to celebrate.
0:23:24 > 0:23:26Yay! Tiny prosecco.
0:23:26 > 0:23:28- Well, it is a weeknight.- Yeah.
0:23:28 > 0:23:31- How did the meeting go?- He was really nice, my supervisor.
0:23:31 > 0:23:32He said that he could see I'd got
0:23:32 > 0:23:35- more confident and that he thought I was a good doctor.- Wow.
0:23:35 > 0:23:37Yeah, it was really nice.
0:23:37 > 0:23:38And he said I was in the top third.
0:23:38 > 0:23:40- Top third?- Yeah. Bossed it, man.
0:23:40 > 0:23:42Bossed it. Well done.
0:23:44 > 0:23:45Whoo.
0:23:56 > 0:23:59Jin is coming to the end of working a week of late shifts.
0:24:01 > 0:24:05Do you want to know the reason why I love tuna so much?
0:24:05 > 0:24:08It's because I'm really good on the drums and I can play a TUNE-a.
0:24:11 > 0:24:15He's been called to assess a patient with a persistent nosebleed.
0:24:15 > 0:24:17How can I help you today?
0:24:17 > 0:24:19- Nosebleed.- Nosebleed, yes.
0:24:19 > 0:24:21Both nose, or one nostril?
0:24:21 > 0:24:23- One nose.- Continuous?
0:24:23 > 0:24:25- Continuous.- No other symptoms?
0:24:25 > 0:24:27No.
0:24:27 > 0:24:33With the help of ENT doctor Oommen, Jin cauterises the septum,
0:24:33 > 0:24:35the cartilage that divides the nose.
0:24:36 > 0:24:38Cheers, mate, thanks.
0:24:38 > 0:24:40He did the cauterising very well.
0:24:40 > 0:24:42Achieved the right result.
0:24:42 > 0:24:44So we're just going to use the cream
0:24:44 > 0:24:47and send the patient home.
0:24:47 > 0:24:49- All right?- Yeah, thank you. - No worries.
0:24:49 > 0:24:53This is exactly what they mean when you say junior doctors learn on the job.
0:24:53 > 0:24:56Now that I've seen one, I should be able to do it by myself.
0:24:56 > 0:24:58There's different ways of learning on the job.
0:24:58 > 0:25:01You can be grilled by a consultant, which isn't particularly nice.
0:25:01 > 0:25:04Handsome henchman, dealing with a patient.
0:25:04 > 0:25:06There's learning from patients themselves.
0:25:06 > 0:25:08Yeah, it's all sort of collaborative.
0:25:08 > 0:25:11They come together to give you an experience, really.
0:25:12 > 0:25:14After struggling to recall
0:25:14 > 0:25:18the Glasgow Coma Scale on a previous shift with Dr Qureshi,
0:25:18 > 0:25:21Jin has done some important revision.
0:25:22 > 0:25:23Hello, Jin, how are you?
0:25:23 > 0:25:25Hi, Doctor Qureshi.
0:25:25 > 0:25:27I'm very well, thank you.
0:25:27 > 0:25:29- Are you OK?- Yes. - What did we learn, then?
0:25:29 > 0:25:31So, in terms of...
0:25:31 > 0:25:32It's E4, M6 and V5.
0:25:32 > 0:25:35- OK.- E4 would be opening eyes simultaneously,
0:25:35 > 0:25:38or opening eyes to voice or opening eyes to pain or not opening eyes at all.
0:25:38 > 0:25:42- OK.- Motor would be obeys commands or localises the pain,
0:25:42 > 0:25:44or withdraws from the pain,
0:25:44 > 0:25:47flexes to the pain, extends to the pain, or doesn't respond at all.
0:25:47 > 0:25:51- OK.- And voice would be fully alert, or disorientated or confused,
0:25:51 > 0:25:53or uttering inappropriate words,
0:25:53 > 0:25:56or uttering complete incomprehensive sounds.
0:25:56 > 0:25:59So why do you think it is so important?
0:25:59 > 0:26:03So, it's important to assess GCS because you need to see the level of
0:26:03 > 0:26:05impairment consciously,
0:26:05 > 0:26:07which would guide future management neurologically.
0:26:07 > 0:26:10I hope you didn't feel I was very harsh?
0:26:10 > 0:26:12At the time I did, but... I sort of knew I had to do it,
0:26:12 > 0:26:14but I didn't know it inside out, bang, bang, bang.
0:26:14 > 0:26:16But now I do, so it's definitely
0:26:16 > 0:26:18been beneficial to me in the long-term.
0:26:18 > 0:26:21- Right.- I feel like a real doctor. - You feel like a real doctor?
0:26:21 > 0:26:24No, I'm not saying that I didn't before, but, like...
0:26:24 > 0:26:26Oh, God. You know what I'm saying.
0:26:26 > 0:26:29I didn't mean it in that way.
0:26:29 > 0:26:32Retrospectively, it has actually improved me as a doctor.
0:26:32 > 0:26:35Because you've had this viral pleurisy for three weeks,
0:26:35 > 0:26:38it's going to put a lot of strain on your muscle.
0:26:38 > 0:26:40Particularly the muscle lining of
0:26:40 > 0:26:42your rib cage and the lungs because it's
0:26:42 > 0:26:44getting irritated by all the cough.
0:26:44 > 0:26:46Before, I was OK, but it's
0:26:46 > 0:26:49definitely developed me in that regard.
0:26:49 > 0:26:52And it has been a painful learning experience, but one, no doubt,
0:26:52 > 0:26:54that's made me a better doctor.
0:26:54 > 0:26:57It's nearing the end of Jin's shift
0:26:57 > 0:27:00when Dr Qureshi comes to say goodbye.
0:27:01 > 0:27:03She's leaving the department.
0:27:03 > 0:27:05See you, Dr Qureshi.
0:27:07 > 0:27:09In the short time we've known each other.
0:27:09 > 0:27:11The short time we have known each other.
0:27:11 > 0:27:12Yes. It's been a pleasure.
0:27:12 > 0:27:14Yeah, if I end up going to Preston, is it?
0:27:14 > 0:27:16I have friends in Preston, so...
0:27:16 > 0:27:19- You come and see me, yeah.- They might be working there, actually.
0:27:19 > 0:27:20You might bump into them.
0:27:20 > 0:27:23What are you going to tell them, not to see this doctor?
0:27:23 > 0:27:25- Stay away from her? - I'll warn them about you.
0:27:25 > 0:27:27I will give them a heads up on the WhatsApp.
0:27:27 > 0:27:29Best of luck. I'm sure you'll be fine.
0:27:29 > 0:27:31- Yeah, thank you, thank you. - All right.
0:27:31 > 0:27:33- Genuinely, thank you. - Best of luck with everything.
0:27:33 > 0:27:35- Thank you very much.- OK.
0:27:40 > 0:27:43I quite like having a student with me.
0:27:43 > 0:27:45It's kind of a sense of power.
0:27:45 > 0:27:47What mistakes have you made?
0:27:47 > 0:27:50As soon as I got news of it, I was like, "Oh, man,
0:27:50 > 0:27:52"I need to go, like, counsel you."
0:27:52 > 0:27:53I feel a bit naked.
0:27:55 > 0:27:57I love screwing.
0:27:57 > 0:27:58Here's to the future.
0:27:58 > 0:28:00- Cheers.- Cheers.