0:00:06 > 0:00:08A typical night in A&E.
0:00:08 > 0:00:12- It's like a battlefield.- Language!
0:00:12 > 0:00:15Full of 20-somethings after a big night out.
0:00:15 > 0:00:17Lots of vomit, lots of unconscious bodies lying around.
0:00:17 > 0:00:19But not everyone's a casualty.
0:00:19 > 0:00:22Squeeze my fingers, please.
0:00:22 > 0:00:26Taking care of them is an army of doctors the same age.
0:00:26 > 0:00:29They've had five years of training...
0:00:29 > 0:00:30Cardiac arrest in A&E.
0:00:30 > 0:00:33..and a rigorous induction into hospital life.
0:00:33 > 0:00:38Take full advantage of being in a bloody good city in a bloody good NHS Trust.
0:00:41 > 0:00:44- I've never done this before. - Now they face the reality of life
0:00:44 > 0:00:47on the wards, and there's no room for error.
0:00:47 > 0:00:49You are the skivvy, the ward bitch.
0:00:49 > 0:00:52He was looking at my badge as if to say, "Who are you?
0:00:52 > 0:00:54"What do you know?"
0:00:54 > 0:01:00We'll be following seven junior doctors at work and at home.
0:01:03 > 0:01:07For the last month, seven of these rookie doctors have been working
0:01:07 > 0:01:11and living together as they embark on their careers in medicine.
0:01:11 > 0:01:16Ultimately, one of the most important traits in any doctor is maturity.
0:01:16 > 0:01:18Take that off!
0:01:18 > 0:01:23First-year doctors Adam and Katherine are just starting out on the wards.
0:01:23 > 0:01:28It's been a tough first few weeks for aspiring surgeon Katherine.
0:01:28 > 0:01:31I still kind of feel like I'm finding my feet
0:01:31 > 0:01:34and I'm finding ways of doing things.
0:01:36 > 0:01:38Second-year Suzi,
0:01:38 > 0:01:40Andy, Jon
0:01:40 > 0:01:44and Keir have just 12 months' experience under their belts.
0:01:44 > 0:01:47At 28, Keir's come to medicine late.
0:01:47 > 0:01:52There's a great satisfaction in putting people back together.
0:01:52 > 0:01:56And rugby fanatic Jon has a packed social calendar.
0:01:56 > 0:02:01I think the reputation that doctors maybe have as work hard and play hard, I think that is kind of true.
0:02:01 > 0:02:04All of these young doctors are newly qualified.
0:02:04 > 0:02:08A lot of them just look as though they have come out of school.
0:02:08 > 0:02:13But the big decision they will have to make next is what kind of doctors do they want to be?
0:02:13 > 0:02:14Surgeon or medic?
0:02:14 > 0:02:17You want to do surgery.
0:02:17 > 0:02:19I don't even have a direction at the moment.
0:02:19 > 0:02:22And are they even cut out for medicine at all?
0:02:22 > 0:02:26Basically, days like today just make me want to quit medicine.
0:02:38 > 0:02:42There are many paths a young medic can follow.
0:02:42 > 0:02:47But the big decision is whether to wield the surgeon's knife, performing operations,
0:02:47 > 0:02:50or be a doctor and treat with medicine.
0:02:50 > 0:02:53Hello. It's Keir, on-call Plastics.
0:02:53 > 0:02:5728-year-old Keir is on a four-month placement in plastic surgery.
0:02:57 > 0:02:59That's a beauty, isn't it?
0:02:59 > 0:03:04As a second year junior doctor, he's got to decide which of the many specialities to follow.
0:03:04 > 0:03:09I was at work helping a joiner put some glass in a window, and it just slipped through my hand.
0:03:09 > 0:03:13- So it was glass that cut...? - Yeah.- OK.
0:03:13 > 0:03:16Can you lift your thumb up towards your nose?
0:03:16 > 0:03:18Good. Obviously, I don't want to cause your pain.
0:03:18 > 0:03:23And I want to make sure that you haven't torn through any of the tendons that attach into your thumb.
0:03:23 > 0:03:25Can you turn it over?
0:03:25 > 0:03:28- Are you a joiner yourself? - No, I'm a painter and decorator.
0:03:28 > 0:03:32Painter and decorator, hence the graffiti around your wound. OK.
0:03:32 > 0:03:36We really need to get in there and clean it out, just to make sure that there's nothing in there.
0:03:36 > 0:03:39If we just left it,
0:03:39 > 0:03:45it would scar up quite nastily in there and it would really restrict the movement of your thumb.
0:03:45 > 0:03:48- And for your job, you need a good grip.- Yeah.
0:03:48 > 0:03:52What I will do is I'll put you on the list for theatre,
0:03:52 > 0:03:54but I'll get one of the registrars or consultants
0:03:54 > 0:03:59to come and have a look, just to see how it's best to do it. Have you got any questions?
0:03:59 > 0:04:03- No.- No? Bonzer! Great. I'll be back in a minute.
0:04:03 > 0:04:07In 10 weeks' time, I have to have decided
0:04:07 > 0:04:11finally what direction the rest of my medical career is going to take.
0:04:11 > 0:04:15With a deadline for a decision, Keir has to make up his mind to be a surgeon or a medic.
0:04:15 > 0:04:17I don't know whether to do neurosurgery
0:04:17 > 0:04:19or whether to do paediatrics
0:04:19 > 0:04:24in order to end up specialising in children's brain problems.
0:04:25 > 0:04:30So I really need to try and work out whether I want to do a surgical
0:04:30 > 0:04:33or a medical career. And I don't know.
0:04:35 > 0:04:42I spent the majority of my childhood not really knowing what I wanted to do.
0:04:42 > 0:04:47I used to be on the university ballroom and Latin dance team for a while.
0:04:47 > 0:04:51I used to do wine-tasting professionally.
0:04:51 > 0:04:53Kind of quite plummy and pruny.
0:04:53 > 0:04:56Rather lovely.
0:04:56 > 0:04:58Play the piano...
0:04:58 > 0:05:01quite badly. I should have practised before you came in.
0:05:01 > 0:05:09But I found that my biggest love, which I do regularly, is dramatics, theatre, acting.
0:05:09 > 0:05:12# Sit down, you're rocking Sit down, sit down, sit down
0:05:12 > 0:05:13# You're rocking the boat... #
0:05:13 > 0:05:18I would say that I've been using acting skills every day that I've been on the ward.
0:05:20 > 0:05:26I'd rather camp it up and ballroom dance with a nurse
0:05:26 > 0:05:30than tone things down for the sake of keeping things calm.
0:05:30 > 0:05:33I can follow you and do the Viennese if you want.
0:05:33 > 0:05:37'I've found that medicine is the career that kind of draws together'
0:05:37 > 0:05:40all of my principal interests into one job.
0:05:45 > 0:05:51For Keir to work out if surgery is for him, he needs to get as much practical experience as possible.
0:05:51 > 0:05:53Do you want to jump up?
0:05:53 > 0:05:58- Ooh. Wheee, you're flying. - His next patient is two-year-old Devon, who's had a nasty burn.
0:05:58 > 0:06:00Do you want to shake my hand?
0:06:00 > 0:06:04- Excellent.- Young patients will always require a little more entertaining.
0:06:04 > 0:06:08- I hear that you've got a poorly hand, is that right?- Yeah.
0:06:08 > 0:06:12- Knocked your hand on the hot grill? Is that right?- Yeah.
0:06:12 > 0:06:16- And is it the back of your hand or the front?- Yeah.
0:06:16 > 0:06:18It is the back of your hand or the front of your hand?
0:06:18 > 0:06:22That's good. What exactly happened? He reached in for some toast, did he?
0:06:22 > 0:06:26He just reached in, caught the top of it.
0:06:26 > 0:06:27Oh, wow!
0:06:27 > 0:06:30Keir needs to check if the wound is infected.
0:06:30 > 0:06:33These are magic scissors.
0:06:33 > 0:06:37Swabbing it will be painful, so he employs a little sleight of hand.
0:06:37 > 0:06:40Ah, there it is.
0:06:40 > 0:06:43This is a special tickling stick, OK?
0:06:43 > 0:06:47I can tickle you like that, I can tickle you up here,
0:06:47 > 0:06:50I can tickle you here. And I can tickle you there.
0:06:50 > 0:06:52- Swabbed.- Thank you.
0:06:52 > 0:06:55I'm going to give you some medicine to make you better, OK?
0:06:55 > 0:06:58- Yeah.- You've got to promise me that you'll take it.
0:07:00 > 0:07:02That's the first time you haven't said "yeah".
0:07:02 > 0:07:05You're starting to get wise to this.
0:07:05 > 0:07:07So we'll put a dressing on and then we'll review it in two days.
0:07:07 > 0:07:12So you need to hold onto that or give it to Mummy.
0:07:12 > 0:07:15- Say thank you.- There we go. - Good boy.- Well done.
0:07:17 > 0:07:21- I've just come to give you your appointment.- Bye!- Thank you.
0:07:28 > 0:07:34Back at the doctors' house, fellow second-year Jon suffers none of Keir's indecision.
0:07:34 > 0:07:38Jon is pursuing his lifelong ambition to be a surgeon.
0:07:38 > 0:07:43I'm studying at the moment for my first part of my surgical exams.
0:07:43 > 0:07:47When I booked this exam, I didn't know what my rota was going to be.
0:07:47 > 0:07:52Unfortunately, it happens it falls in the middle of a week of nights for me.
0:07:52 > 0:07:56Obviously, I've got a pretty thick book
0:07:56 > 0:08:00to revise from. And I've got two of these to get through.
0:08:00 > 0:08:03So, yeah, it's obviously not...
0:08:03 > 0:08:04going to be easy,
0:08:04 > 0:08:10but...who said anything in life was easy, eh?
0:08:10 > 0:08:15But Jon doesn't have a strong track record for great time management.
0:08:17 > 0:08:21I don't really take life too seriously. I like having a laugh.
0:08:21 > 0:08:26Lack of focus on the job nearly saw Jon fail his first year as a doctor.
0:08:26 > 0:08:27There's a lot of red here.
0:08:27 > 0:08:31I've just put it off till the last minute, really,
0:08:31 > 0:08:34which is kind of stuff that I do. That's kind of how I work.
0:08:34 > 0:08:39- Jon's problem is squeezing all his hobbies into a busy doctor's schedule...- Squeeze!
0:08:41 > 0:08:44..and leaving enough time to do his exam revision justice.
0:08:44 > 0:08:48I think if I had a magic wand, I woke up in the morning,
0:08:48 > 0:08:50and they said, "You could be the front man
0:08:50 > 0:08:55"for the biggest band in the world or you could be the best surgeon
0:08:55 > 0:08:59"in your particular field," I think I'd take the superstar surgeon.
0:09:09 > 0:09:12If Jon even wants to make it as a regular surgeon,
0:09:12 > 0:09:16he's going to need to strike a perfect balance between work and play.
0:09:16 > 0:09:18Knock-knock. I'm one of the doctors.
0:09:18 > 0:09:20Tonight is the start of a week of night shifts.
0:09:20 > 0:09:25Tell me a little bit about what went on today that's brought you into hospital.
0:09:35 > 0:09:38Fine, OK. Righty-ho.
0:09:43 > 0:09:46Well, you're not doing too bad.
0:09:46 > 0:09:49What, 86, does that make you?
0:09:49 > 0:09:52My maths isn't too bad, then.
0:09:52 > 0:09:56I'm going to examine you now, if that's all right. Deep breath in for me.
0:09:56 > 0:09:59Jon has chosen to sit his surgery exams early.
0:09:59 > 0:10:02I am quite young to be doing these exams.
0:10:02 > 0:10:05I think it's just a good way to show my kind of dedication
0:10:05 > 0:10:08that I want to become a surgeon, and hopefully, if I pass,
0:10:08 > 0:10:11it's another sort of accolade under the belt, really.
0:10:11 > 0:10:15Knock-knock. We'll give you some antibiotics and we'll keep you
0:10:15 > 0:10:17in with us until you're feeling a bit more better on your feet.
0:10:17 > 0:10:19All right?
0:10:19 > 0:10:22- Yes.- I'm just going to take this phone call. I'll be back in a second.
0:10:22 > 0:10:26The on-call phone's summoning him to another patient.
0:10:26 > 0:10:31- Yeah.- Jon's got his work cut out to fit everything in this week.
0:10:31 > 0:10:35I couldn't foresee that I would be on nights when I was doing my exam when I booked my exam.
0:10:35 > 0:10:38I have to go to rugby training cos I'm the captain.
0:10:38 > 0:10:43I have to come to work, obviously, cos they pay my wages.
0:10:43 > 0:10:46So, yeah, it's all a bit...
0:10:46 > 0:10:52of a mess, really. But it'll be all right in the end. Just nothing could be helped, really.
0:10:56 > 0:11:00Clean the end of that so that we can get a good look.
0:11:00 > 0:11:02Can you feel it?
0:11:02 > 0:11:06Back in Plastics, Keir is seeing another patient with a hand injury.
0:11:06 > 0:11:09This here is bone.
0:11:09 > 0:11:12This is the finger pulp, and this is bone.
0:11:12 > 0:11:15So I can see what I'm dealing with now.
0:11:15 > 0:11:19The tip of this patient's middle finger was chopped off in a gate.
0:11:19 > 0:11:23He needs surgery, and Keir is part of the operating team.
0:11:23 > 0:11:25- Hello.- Are you OK?
0:11:25 > 0:11:27- Yes.- My main problem with this is the nail.
0:11:27 > 0:11:30So we need to remove
0:11:30 > 0:11:33the nail and then flap the skin over the top? Is it?
0:11:33 > 0:11:39- Yep.- I've never done this before. I'm quite excited and a little trepidatious at the same time.
0:11:39 > 0:11:42The big question for Keir - is surgery the direction he wants to take?
0:11:42 > 0:11:47I think it's very difficult when the young doctors of today
0:11:47 > 0:11:49are trying to make their choices.
0:11:49 > 0:11:52They have to make it so much earlier in their careers than I did.
0:11:52 > 0:11:56I got to try a whole load of different things.
0:11:58 > 0:12:02Keir's in a problem, because he knows where he wants to finish up,
0:12:02 > 0:12:05but he doesn't know what to do along the way.
0:12:05 > 0:12:08And it's just difficult for him.
0:12:10 > 0:12:13Keir has only been working in surgery for a few weeks.
0:12:13 > 0:12:21This procedure will give him real hands-on experience, especially as this patient is called Mr Hands.
0:12:21 > 0:12:23Have a go.
0:12:23 > 0:12:24Clasp the bone.
0:12:27 > 0:12:30I'm just literally nibbling?
0:12:30 > 0:12:31Yeah.
0:12:31 > 0:12:34- What I'm hoping to do is preserve a little bit of the joint.- Mm-hm.
0:12:36 > 0:12:44The operation is performed on a conscious patient so Mr Hands can go home the same day.
0:12:44 > 0:12:48The bone in his finger is shortened with a tool called a bone nibbler.
0:12:48 > 0:12:50We're down to about there.
0:12:50 > 0:12:52- Oh, fantastic.- Wow, look at that.
0:12:52 > 0:12:56- That's not a bone nibbler - THIS is a bone nibbler.- Right.
0:12:56 > 0:13:00- You don't mind us talking, do you? - No.- That's all right.
0:13:00 > 0:13:04At the end of the operation, Keir stitches up the tip of Mr Hands' finger.
0:13:04 > 0:13:06Lovely.
0:13:06 > 0:13:08Well done. Grand.
0:13:08 > 0:13:11See you a bit later, all right?
0:13:11 > 0:13:16Keir may be capable, but does he want to pursue surgery as a lifelong career?
0:13:16 > 0:13:19People say that decision's the easiest one.
0:13:19 > 0:13:21I find it the hardest one.
0:13:21 > 0:13:25Major choice - surgeon or medic.
0:13:25 > 0:13:28And you can't tell, can you, cos you like both?
0:13:28 > 0:13:31I know that I would not be unhappy in either.
0:13:31 > 0:13:35In fact, I'd probably be happy in either or both.
0:13:36 > 0:13:37The boy did good.
0:13:37 > 0:13:42Just what I expect. He has... natural ability.
0:13:42 > 0:13:44It would be a shame to lose him from surgery.
0:13:49 > 0:13:53While Keir's getting his head around surgery, first-year Adam
0:13:53 > 0:13:56is starting a new placement on the Emergency Assessment Unit.
0:13:56 > 0:13:59I'm Adam, by the way. I'm one of the F1s on today.
0:13:59 > 0:14:01- Hi, I'm Angeline. - Hi, nice to meet you.
0:14:01 > 0:14:05It's the same ward where Jon's working nights.
0:14:05 > 0:14:11It's fast paced and high volume, with a constant stream of acutely sick patients.
0:14:11 > 0:14:15Patients do not want to be sat around for hours and hours and hours
0:14:15 > 0:14:17waiting for doctors to make decisions about them.
0:14:17 > 0:14:21So if we're slow, it backs up in the A&E, and that's a major problem.
0:14:21 > 0:14:25It's the sort of work Adam's hoping to make a career of.
0:14:25 > 0:14:28- Scratch, scratch.- This is the chance he's been waiting for.
0:14:28 > 0:14:30More jobs, more jobs, more jobs.
0:14:30 > 0:14:34The pace is certainly faster on the EAU.
0:14:34 > 0:14:37And you can tell that you need to get things done quickly.
0:14:37 > 0:14:41Right, focus. That's one person.
0:14:41 > 0:14:43So it's core CT.
0:14:43 > 0:14:44I need to...
0:14:46 > 0:14:50Right, core CT. OK, I've printed off the stickers...
0:14:52 > 0:14:56It does require focus, and I think it's very easy on here
0:14:56 > 0:15:00to get distracted and pulled away in lots of different directions.
0:15:00 > 0:15:03And so it's important to be focused.
0:15:03 > 0:15:06Yeah, I do want to make a good impression on this ward.
0:15:06 > 0:15:11I want them to think that I'm competent and I can get on with my jobs
0:15:11 > 0:15:15and...that I can basically take care of myself.
0:15:15 > 0:15:20- Over the past month, ambitious 24-year-old Adam... - One down, a hundred to go.
0:15:20 > 0:15:26..hasn't found his job living up to his high expectations.
0:15:28 > 0:15:32Would it be all right to take some blood from you? ..Do you want any help?
0:15:32 > 0:15:34You are the skivvy, the ward bitch.
0:15:34 > 0:15:40- At first, he found it difficult getting up to speed on the wards. - At least I know now.- You know.- Yeah.
0:15:40 > 0:15:44His biggest frustration has been too much paperwork and not enough patients.
0:15:44 > 0:15:48How can I kind of like base this on what I want to do as a career,
0:15:48 > 0:15:51because I'm having very little exposure to the actual job?
0:15:54 > 0:15:59Adam's new placement on EAU should give him the patient contact he's been waiting for.
0:15:59 > 0:16:04But it's a tough ward for a first-year junior doctor.
0:16:04 > 0:16:06I'm just going to go ahead of you.
0:16:06 > 0:16:10- It's probably easier to get the beds moved.- OK.
0:16:10 > 0:16:12In terms of the experience they get here,
0:16:12 > 0:16:14they see lots of patients. It's quite a busy unit.
0:16:14 > 0:16:20- And they all just go the normal way - I don't need to fax anything? - The usual.- OK.
0:16:22 > 0:16:26I think the onus is on us to get as many
0:16:26 > 0:16:30jobs done as possible, cos there's a lot of new patients to see. I think 30.
0:16:30 > 0:16:34So...quite high.
0:16:34 > 0:16:39She had a fall. I queried a fractured left shoulder, but Orthopaedics have ruled that out.
0:16:39 > 0:16:45That'll be your first job when we finish seeing the other ones. One thing that I would say is that
0:16:45 > 0:16:47he's taken quite a while to do jobs I've given him this morning.
0:16:47 > 0:16:50I don't know how he's got on. I need to check on that now.
0:16:50 > 0:16:55But one of the things he'll need to learn is to speed up a bit and see more patients.
0:16:55 > 0:16:58We were told as a general rule of thumb that we shouldn't take longer than an hour to clerk a patient.
0:16:58 > 0:17:02So as long as you do the history and the examination in around 40, 45 minutes, and spend maybe
0:17:02 > 0:17:0615 minutes writing it up and doing a management plan, that should be OK.
0:17:06 > 0:17:12Clerking, or checking in a patient, means making a full examination,
0:17:12 > 0:17:17reviewing symptoms and taking a medical history to come up with a diagnosis.
0:17:17 > 0:17:18So do you work at all?
0:17:18 > 0:17:22- Not now.- Not now. Did you before? - Yeah.
0:17:22 > 0:17:24What did you do?
0:17:24 > 0:17:26- Chef.- Oh, really?
0:17:26 > 0:17:33Adam has to complete all this within an hour, which means there's no time for small talk.
0:17:34 > 0:17:38Yeah, yeah. You know the best one I had was in Middlesbrough - Akbar's.
0:17:38 > 0:17:40I think I liked Akbar's.
0:17:40 > 0:17:44But in Newcastle... where did we go the other day?
0:17:44 > 0:17:49Adam should be taking the patient's medical history, but he's going off topic.
0:17:49 > 0:17:51Guess where I come from.
0:17:51 > 0:17:53Where do you think?
0:17:53 > 0:17:56Yeah. Lebanese.
0:18:01 > 0:18:03It's a good guess.
0:18:05 > 0:18:09Half an hour's gone by, and Adam has only just started examining the patient.
0:18:09 > 0:18:12No swelling, that's fine.
0:18:12 > 0:18:19- OK.- This clerking has gone 30 minutes over the deadline, but Adam's not concerned.
0:18:20 > 0:18:23That's fine. I'm doing it at my own pace
0:18:23 > 0:18:27and I'm probably keeping to that time, so I'm quite happy with that.
0:18:37 > 0:18:43As some of the junior doctors finish their shifts, Suzi's only just starting.
0:18:43 > 0:18:47She faces a busy night in the Accident and Emergency Department.
0:18:47 > 0:18:51I expect drunken injuries, people that have been in fights,
0:18:51 > 0:18:53people that have fallen over and hit their head,
0:18:53 > 0:18:57people with suicidal ideas cos they've had a drink.
0:18:57 > 0:18:58Everything, really.
0:18:59 > 0:19:02Everything that A&E can offer.
0:19:02 > 0:19:03Which is everything.
0:19:04 > 0:19:11Over the last four weeks, Suzi has had a baptism of fire, having never worked in A&E before.
0:19:11 > 0:19:13Have you had a drink this evening?
0:19:13 > 0:19:17She's had to face a constant stream of serious emergency cases.
0:19:17 > 0:19:22- Sorry, we're poking you from all sides, but...- We're here to help you.- It's really important.
0:19:25 > 0:19:28A few hours into the shift and an emergency case arrives.
0:19:28 > 0:19:32A 76-year-old woman comes in with breathing difficulties.
0:19:33 > 0:19:35- I'll go.- Come on, then.
0:19:39 > 0:19:43I'm waiting for a patient with COPD to come in. COPD is an airway problem.
0:19:43 > 0:19:47It's a bit like asthma, but people get it when they get older.
0:19:47 > 0:19:52COPD, or Chronic Obstructive Pulmonary Disease,
0:19:52 > 0:19:55is a narrowing of the airways, and can be caused by smoking.
0:19:57 > 0:20:02My name's Suzi. I'm one of the doctors here. Tell me a bit about what's been going on? Pain?
0:20:02 > 0:20:05- Have you been coughing anything up at all?- A little bit yellow.
0:20:05 > 0:20:09But the pain, this time it's going up my neck.
0:20:09 > 0:20:12And I feel distressed.
0:20:12 > 0:20:13Very short of breath?
0:20:15 > 0:20:19The patient is panicking, so Suzi stabilises her breathing.
0:20:21 > 0:20:24She is quite short of breath at the moment.
0:20:24 > 0:20:29She's come in with worsening pain over the past day. I just want to get her chest X-ray organised.
0:20:29 > 0:20:32Her heart's going fast because her chest is bad.
0:20:32 > 0:20:35One can kind of trigger off the other one.
0:20:35 > 0:20:39- How is your breathing normally? - Not great, but better than this.
0:20:39 > 0:20:43- Have you been feeling feverish and warm at all?- Yes.- You have been?
0:20:43 > 0:20:46And this chest pain all came on suddenly? Yesterday, was it?
0:20:46 > 0:20:49Terrible. It's got worse and worse.
0:20:49 > 0:20:50PATIENT COUGHS
0:20:50 > 0:20:52Are you OK?
0:20:52 > 0:20:53Yeah.
0:20:53 > 0:20:55Ohh.
0:20:57 > 0:21:01- SHE COUGHS - What a day.- What a day, indeed.
0:21:01 > 0:21:05Inhaling the drugs quickly calms the patient's breathing.
0:21:05 > 0:21:09Tests reveal a chest infection which could be life threatening without treatment.
0:21:09 > 0:21:13- How do you feel now?- A lot better. - A lot better? Good.
0:21:13 > 0:21:15Any other questions at the moment?
0:21:15 > 0:21:17- I could do with a drink of tea. - A drink of tea?
0:21:17 > 0:21:22I haven't had anything from 2 o'clock to drink. I feel as though I'm parched.
0:21:22 > 0:21:27Relating to people of all ages is an important skill for all junior doctors to have.
0:21:27 > 0:21:29I've only had two biscuits all day.
0:21:29 > 0:21:32- I haven't eaten anything. - You must be starving as well.
0:21:32 > 0:21:34I'm not really, no. Just thirsty.
0:21:34 > 0:21:38I've eaten more than that and I'm starved.
0:21:38 > 0:21:40I'm always hungry.
0:21:40 > 0:21:45I really like seeing patients that are quite old and challenging.
0:21:45 > 0:21:49They've got lots of life experience and they're just interesting patients.
0:21:49 > 0:21:51Mary! >
0:21:51 > 0:21:55Do you want your cup of tea?
0:21:55 > 0:21:57You can only have sips of it, OK?
0:21:57 > 0:22:02- And if you feel sick, or anything, stop. OK?- OK.
0:22:02 > 0:22:05- We don't want you feeling sick, or anything.- Right.
0:22:08 > 0:22:11- Lovely, ta.- There you go. ..You've got one as well.
0:22:11 > 0:22:13Small sips.
0:22:14 > 0:22:17I haven't had a drink since 2 o'clock.
0:22:17 > 0:22:21Not sure a cup of tea quite cures everything.
0:22:21 > 0:22:25If it helps patients calm a bit and feel a bit more relaxed
0:22:25 > 0:22:27and breathe a bit more easily, maybe it's a good thing.
0:22:34 > 0:22:36We'll have a food fight after eating.
0:22:36 > 0:22:41- You missed.- Backfired! - Yeah, but it went nowhere near me.
0:22:41 > 0:22:45While Suzi's grafting on nights, the junior doctors on dayshift
0:22:45 > 0:22:50discuss their future careers and the sacrifices they're prepared to make.
0:22:50 > 0:22:55You look at girls and you know who's going to put career first for the rest of their life.
0:22:55 > 0:23:00- And Katherine's actually too nice, like a home-maker girl, to... - Seriously?
0:23:00 > 0:23:05- No, no.- My mum's already given up on having grandchildren any time soon.
0:23:05 > 0:23:07No, no, you're not going to have them soon.
0:23:07 > 0:23:12But I think things will change with you later. And I think you'll really want them.
0:23:12 > 0:23:15< Katherine, why do you want to be a surgeon?
0:23:15 > 0:23:17I want to do surgery because I like surgery.
0:23:17 > 0:23:24- We, as men, have a slightly unfair advantage in surgery, being we have less to worry about.- It's easier.
0:23:24 > 0:23:27- It's easier. - No, I completely agree with that.
0:23:27 > 0:23:30- I think nothing worth doing's easy. - No, that's true.
0:23:30 > 0:23:35- I will not let anything stop me from having children.- No, same. - That's easy for you to say.
0:23:35 > 0:23:41You might not have to give up as much for a chance of having a child as, say, a woman might.
0:23:41 > 0:23:47- Unfortunately, that is just the way it's going to be. It is unfair. - It is a slight disadvantage.
0:23:47 > 0:23:48I don't know.
0:23:48 > 0:23:54I've worked hard to get into medical school, I've worked hard in medical school, and I'm working hard now.
0:23:54 > 0:24:00I'm not going to base my future career choice, that I've worked really hard for,
0:24:00 > 0:24:02on something that might or might not happen.
0:24:02 > 0:24:08Success has never come easily for first-year Katherine.
0:24:08 > 0:24:10Would you mind if I just do these bloods?
0:24:10 > 0:24:12I'm a bit more sorted after I've done these.
0:24:12 > 0:24:18First year at university, I failed two of my exams and had to spend the entire summer studying.
0:24:18 > 0:24:20That was hard.
0:24:20 > 0:24:24Hi, sorry to phone you. This is really embarrassing, but I've got a patient.
0:24:24 > 0:24:26I can't get a vein on her anywhere.
0:24:26 > 0:24:31Katherine is aiming for a career in the competitive field of surgery.
0:24:31 > 0:24:35I definitely feel I have to work at things if I want to achieve something.
0:24:37 > 0:24:44After last night's chat, Katherine's decided to find out for herself if it really is harder as a woman.
0:24:44 > 0:24:47And who better to ask than a female surgeon.
0:24:47 > 0:24:53I'm hoping she's not going to put me off and tell me that you can't have a life outside of surgery,
0:24:53 > 0:24:58and that you can sort of have it all, as it were.
0:24:58 > 0:25:04Anna O'Riordan is one of only three females out of 74 surgeons in her hospital.
0:25:04 > 0:25:07A lot of people, when I tell them I want to do surgery,
0:25:07 > 0:25:12- they say, "You'll end up wanting a family and you won't be able to do it."- That's rubbish.
0:25:12 > 0:25:14There are plenty of women surgeons
0:25:14 > 0:25:16who have families and very good careers.
0:25:16 > 0:25:22- Have you had the chance to have a family?- Yes, I have a baby girl now. It's been the highlight of my life.
0:25:22 > 0:25:26My colleagues, who are all male and I'm the only woman, they were extremely supportive.
0:25:26 > 0:25:28I couldn't have asked for a better bunch of people to help me.
0:25:28 > 0:25:32So you can only try and guess and plan for the future
0:25:32 > 0:25:38and be willing to compromise and change path as life goes on.
0:25:38 > 0:25:40So you think just go for what you want to do?
0:25:40 > 0:25:44- Go for what you want now.- But be aware you might change your mind? - Yeah.
0:25:44 > 0:25:47- We're entitled to change our minds. - Yes.- We're women, after all.
0:25:50 > 0:25:54Anna's invited Katherine to see her at work.
0:25:54 > 0:25:58It's important that every opportunity you get to go to theatre
0:25:58 > 0:26:01to see an operation, to be involved in an operation,
0:26:01 > 0:26:07that you grab those opportunities to be sure that's really what you want to spend your life doing.
0:26:07 > 0:26:12There are some people who are naturally gifted, so won't have to put in a lot of effort
0:26:12 > 0:26:14and everything will come easy to them.
0:26:14 > 0:26:18For the rest of us, the more time you put into something, the more reward you get from it.
0:26:18 > 0:26:22The patient has a tumour in her kidney.
0:26:22 > 0:26:26The keyhole surgery Anna's performing is highly specialised,
0:26:26 > 0:26:31so first-years like Katherine can't assist. Just watch and learn.
0:26:31 > 0:26:34So the kidney's supposed to lie up here.
0:26:34 > 0:26:38So I'm getting my instruments in. A small incision here.
0:26:43 > 0:26:48'I think it is really difficult, but if I can stick at it, I don't see any reason why I can't do the same.'
0:26:48 > 0:26:50We have to clean the camera.
0:26:50 > 0:26:56'It's just nice to see people that have got that, and there's the light at the end of the tunnel.'
0:26:56 > 0:27:00I am just going to have to work my socks off, just work incredibly hard.
0:27:06 > 0:27:09The three-and-a-half-year-old girl, she's had a week or so history of chicken pox.
0:27:09 > 0:27:13- Around the hospital the other junior doctors...- I'll see this person.
0:27:13 > 0:27:17..are getting on with their day-to-day jobs.
0:27:17 > 0:27:22Keir's back in theatre, but he's still making up his mind if he wants to become a surgeon.
0:27:23 > 0:27:26Whether I want to do surgery long term, I don't know.
0:27:26 > 0:27:32But it's by coming to theatre and experiencing it a lot that I'll get a taste for it,
0:27:32 > 0:27:36or decide that I want to go down a more medical rather than surgical route.
0:27:36 > 0:27:43There's lots of medical problems, OK, which you can treat...different ways.
0:27:43 > 0:27:46And surgery is one of them.
0:27:46 > 0:27:51Us, we surgeons, we treat things by removing them.
0:27:52 > 0:27:56This patient has a tumour in her arm.
0:27:56 > 0:28:00What I'm hoping to get out of it is actual surgical experience of
0:28:00 > 0:28:05cutting round tumours, removing them, sewing back up.
0:28:05 > 0:28:06Keir scrubs up.
0:28:06 > 0:28:13As a second year, he's allowed to assist with the removal of the tumour.
0:28:13 > 0:28:18In order to be a good surgeon, you need the eyes of a hawk,
0:28:18 > 0:28:21the tenacity of a lion,
0:28:21 > 0:28:23and the hands of a lady.
0:28:39 > 0:28:42I'm still at the stage where I do it carefully, concentrating on everything.
0:28:42 > 0:28:47He's a bit slow, but, you know, that's a learning curve.
0:28:47 > 0:28:49He'll just need to practise it more and more.
0:28:49 > 0:28:53And as I was saying, it doesn't necessarily have to be in theatre,
0:28:53 > 0:28:58- but he can take sutures home.- So, we've just got to dress that now.
0:29:05 > 0:29:09Jon and Suzi are back on the nightshift...
0:29:09 > 0:29:14- I am going.- ..leaving Keir to confide in first-years Katherine and Adam.
0:29:14 > 0:29:21Since you qualified as a doctor, and maybe even before, you have wanted to do surgery.
0:29:21 > 0:29:24- Yeah.- You have defined yourself as a surgeon.
0:29:24 > 0:29:27When I was doing my GCSEs at 14, I didn't want to be a surgeon.
0:29:27 > 0:29:30But I don't even have a direction at the moment.
0:29:30 > 0:29:34I'm five years older than most people who are in my job, anyway.
0:29:36 > 0:29:39I don't want to be making a mistake.
0:29:39 > 0:29:43You don't want to piss around any more, you've done that past,
0:29:43 > 0:29:48you want to get on with things, get your training under your belt and just keep going.
0:29:48 > 0:29:52I think if you're going to fluster about any decision, I think it will be this one.
0:29:52 > 0:29:57- And I think justifiably, as well. - It's really worrying, because you look at people like Jon,
0:29:57 > 0:30:03and Jon is already sitting exams for what he wants to do.
0:30:03 > 0:30:06He's sitting his surgical exams.
0:30:15 > 0:30:23Like most first-year junior doctors, Adam needs to speed up to make sure that patients are seen to quickly.
0:30:23 > 0:30:25So he's decided to put himself on a clock.
0:30:25 > 0:30:30For this next one, I'm going to time myself. So, I want to get it all done within an hour.
0:30:30 > 0:30:35That will mean that I won't be able to say or do anything for an hour.
0:30:35 > 0:30:38Because that will push me over the edge of the hour.
0:30:38 > 0:30:42So I'll put a stop watch on my iPhone, and hopefully that will be enough.
0:30:44 > 0:30:47So, time will now go...
0:30:47 > 0:30:53In the past, Adam's been taking over 90 minutes to clerk patients, so he needs to really focus on the job.
0:30:53 > 0:30:56And do you drink much alcohol?
0:30:56 > 0:31:00OK. Um, do you have any funny heart rhythms?
0:31:00 > 0:31:04Adam is slow, but I think, often,
0:31:04 > 0:31:08people need to be trained to prioritise their work.
0:31:08 > 0:31:11So, just look at something in the distance, yeah?
0:31:11 > 0:31:15And I'll just have a look into your eyes. ALARM BEEPS
0:31:15 > 0:31:19All right, yeah. I know, I know. Over time.
0:31:21 > 0:31:24Another patient that's taken too long to assess.
0:31:24 > 0:31:29It's been an hour-and-a-half - half an hour over time.
0:31:29 > 0:31:31There's loads of patients to be seen.
0:31:31 > 0:31:35Adam's next patient has been transferred from a hospital in Scarborough
0:31:35 > 0:31:37suffering from chronic hip pain.
0:31:37 > 0:31:42I understand you had a fall - was it yesterday or the day before?
0:31:42 > 0:31:44- No, it was last week.- Last week!
0:31:44 > 0:31:48Don't laugh when I tell you what I fell off. I was on the carousel!
0:31:48 > 0:31:52You fell off...was it the horse? Doing something fun, right?
0:31:52 > 0:31:56Adam is trying to achieve a balance of good patient care with time-keeping.
0:31:56 > 0:32:00- I'm waiting for a new knee replacement.- Right.
0:32:00 > 0:32:03Every time I'm having a fall, it's making the pain in my knee worse.
0:32:03 > 0:32:05What were you hoping we could do?
0:32:05 > 0:32:09- Cut it off.- Cut your knee off?
0:32:09 > 0:32:11I'll just go and get a chainsaw, hang on.
0:32:11 > 0:32:12THEY BOTH LAUGH
0:32:12 > 0:32:16I know I can laugh now, but it's no joke.
0:32:16 > 0:32:18Do you have anyone to help you round the house?
0:32:18 > 0:32:21- No.- No.
0:32:21 > 0:32:25I can't cope at home... with things.
0:32:27 > 0:32:29- I just want to get shot of this pain.- OK.
0:32:31 > 0:32:35So as I can have some sort of normal life,
0:32:35 > 0:32:40so I don't have to rely on people to do things for me.
0:32:40 > 0:32:42I want to be able to do them myself.
0:32:44 > 0:32:49She's pretty down, pretty depressed, and maybe I did take a little bit longer because of that.
0:32:49 > 0:32:56Maybe I have to curb that and clerk more patients, I don't know.
0:32:56 > 0:33:00But, you know, I'm new, and I kind of felt a bit bad for her, so...
0:33:00 > 0:33:07EAU is a challenge for any new doctor, and Adam's still proving too slow.
0:33:07 > 0:33:10Have you got much you need to do at the moment?
0:33:10 > 0:33:14- I've got quite a few jobs, yeah. - I'll see the next one by myself.- OK.
0:33:14 > 0:33:19- We need to get the beds moving. The most important thing is to get this lady discharged.- OK.
0:33:19 > 0:33:22- So I'll grab Neil to see the patients with me.- OK.
0:33:22 > 0:33:25- We need to get patients out of here. - OK.
0:33:25 > 0:33:32Because Adam's taking too long to clerk patients, he's now being asked to discharge them instead.
0:33:33 > 0:33:40I've been demoted from ward rounds to discharges whilst ward round's going on. Yeah...
0:33:44 > 0:33:49So many things, so little time. No-one's going to care about what you think or say, anyway,
0:33:49 > 0:33:50because you're an F1.
0:33:50 > 0:33:53As long as you get the jobs done, that's what matters.
0:33:53 > 0:33:56So I just have to do it.
0:33:56 > 0:34:00And there's just hundreds of pieces of paper, which are...useless.
0:34:03 > 0:34:09In short, I thought that EAU would be what I was looking for, kind of that fast pace, you know,
0:34:09 > 0:34:13getting to clerk patients, getting to see patients all the time,
0:34:13 > 0:34:16and just a bit of paperwork with discharges and that would be it.
0:34:16 > 0:34:18But in reality,
0:34:18 > 0:34:19so far,
0:34:19 > 0:34:22I don't really like it!
0:34:23 > 0:34:27But I'm all about the acute medicine, so if I don't do this,
0:34:27 > 0:34:30then I've got no career options!
0:34:30 > 0:34:33No, I do, I like...
0:34:33 > 0:34:36Well, I've got no career options right now.
0:34:36 > 0:34:40If all my career options involve this much paperwork...
0:34:43 > 0:34:46Katherine is still working on her career options.
0:34:46 > 0:34:51She's keen to get into theatre and assist the surgeon.
0:34:51 > 0:34:55This patient has cut through the tendons of his little finger.
0:34:55 > 0:35:02It will be very interesting for you, because you've probably seen flexor tendon injuries in clinic,
0:35:02 > 0:35:06but you probably don't appreciate what it takes to repair them.
0:35:06 > 0:35:12The surgeon must find the ends of the severed tendon by opening up the hand.
0:35:12 > 0:35:15So, we found our two distal ends, which are there...
0:35:15 > 0:35:19The next job is to stitch the two ends of the tendon back together.
0:35:19 > 0:35:23It's really scary operating with such tiny structures.
0:35:23 > 0:35:28So what's the rate of rupture after a repair?
0:35:28 > 0:35:30- Any guesses?- Straightaway?
0:35:30 > 0:35:33Yeah, you'd think that, wouldn't you, but it's not.
0:35:33 > 0:35:37It's day 10 to day 14 where it's the weakest.
0:35:37 > 0:35:42Katherine gets her chance to try out some simple stitching.
0:35:42 > 0:35:47What I want you to do, I want you to match this crease to that crease. Take your time, there's no rush.
0:35:47 > 0:35:49Bring your needle out completely.
0:35:49 > 0:35:52Don't go too deep. Let go of the needle-holder. Good.
0:35:52 > 0:35:55Keep your elbows close to your body. It's not easy,
0:35:55 > 0:35:58but if you learn it the right way, it will become easy.
0:35:58 > 0:36:01Brilliant, well done. That's finished.
0:36:01 > 0:36:06I think like with most aspects of medicine, you do have to get a balance, with a personal life.
0:36:06 > 0:36:09My head's saying that surgery is a lot of work,
0:36:09 > 0:36:13maybe I'll burn out, or just give up and get fed up with all the work,
0:36:13 > 0:36:17but my heart's saying that that's what I really want to do, so I should go for it.
0:36:22 > 0:36:28While Jon and Suzi start the night shift, some of the others head for the boozer.
0:36:30 > 0:36:33Ah, it's good to get out of the house.
0:36:33 > 0:36:38First-year Adam confides in the second-years that the day job is getting him down.
0:36:38 > 0:36:43- I'm doing- BLEEP- all clinical work at the moment, I'm just sat there doing paperwork.
0:36:43 > 0:36:45I did like 20 discharges this morning.
0:36:45 > 0:36:50I was locked away in a room. When I did come to clerk a patient, my brain is just not there.
0:36:50 > 0:36:53The headline of the Times today
0:36:53 > 0:36:58- was about 23% of junior doctors quitting the NHS.- I know.
0:36:58 > 0:37:05It does raise an issue that a lot of junior doctors ARE upset with their jobs as they stand,
0:37:05 > 0:37:10and how they're paperwork monkeys, and getting very little clinical experience.
0:37:10 > 0:37:13I've never felt lacklustre before, like now.
0:37:13 > 0:37:18- Like, I've never felt like, do you know what, this is a- BLEEP- job, I want to quit.
0:37:18 > 0:37:21I want to do something else, because this is a waste of time.
0:37:21 > 0:37:26Everybody has thought about that as an F1. And that's brave, just to say, "I don't enjoy this."
0:37:26 > 0:37:28But what we can tell you is, it will get better.
0:37:28 > 0:37:31Days like today make me want to quit medicine.
0:37:35 > 0:37:40Jon's only at the start of a 13-hour shift.
0:37:40 > 0:37:44Dancer Natasha's arrived with chronic chest pain.
0:37:44 > 0:37:47How would you describe the pain?
0:37:47 > 0:37:49- Sharp.- Sharp. - It's when I breathe in, it'll...
0:37:49 > 0:37:51- So, it catches when you breathe in?- Yeah.
0:37:51 > 0:37:57When you were moving and stuff, like dancing, obviously, it's a very active job - no pain?
0:37:57 > 0:38:00No, when I'm dancing, I have no problems whatsoever.
0:38:00 > 0:38:02A few tingly fingers, but that's it.
0:38:02 > 0:38:07OK, fine. Do you want to pop up onto the bed and I'll examine you quickly.
0:38:07 > 0:38:09All right, I'll just take your pulse.
0:38:11 > 0:38:13So where do you teach dance?
0:38:13 > 0:38:16All over, Newcastle, Northumberland.
0:38:16 > 0:38:19What's your speciality?
0:38:19 > 0:38:21Zumba.
0:38:21 > 0:38:24- Oh, the fitness thing?- Yeah.
0:38:24 > 0:38:26Lift this leg straight up in the air.
0:38:26 > 0:38:28Keep it there.
0:38:28 > 0:38:31Very good. And the same with the other one.
0:38:31 > 0:38:34Very good. All right, fine.
0:38:34 > 0:38:36We'll take some blood as well, just to look at markers
0:38:36 > 0:38:40of infection and inflation, and we'll take it from there, OK?
0:38:40 > 0:38:45All right? Just stay there and I'll be back with some stuff for blood in a second.
0:38:47 > 0:38:49It's nice to see young doctors on the ward.
0:38:49 > 0:38:52I mean, they're normally quite old and got no personality, but...
0:38:52 > 0:38:55It's nice to see someone come in and have a chat with you,
0:38:55 > 0:38:58rather than just treat me as a patient, and that's it.
0:38:58 > 0:39:00But, yeah, he's quite nice.
0:39:00 > 0:39:03Nice and straight for me...
0:39:03 > 0:39:09After investigations, Jon's able to rule out anything serious, and Natasha's discharged.
0:39:09 > 0:39:13'We just did a blood test, and that's normal, so she's been able to go home.'
0:39:13 > 0:39:18It was just a muscular pain, due to the strenuous job that she does, she's a dancer and stuff.
0:39:28 > 0:39:31Jon's not the only one working into the night solving medical cases.
0:39:31 > 0:39:38In A&E, Suzi's able to experience a huge variety of medical conditions.
0:39:40 > 0:39:45- Old lady.- Old lady. Just baby-sit, if that's all right?
0:39:45 > 0:39:49It's helping her work out what she wants to specialise in.
0:39:49 > 0:39:52Hello, how are you?
0:39:52 > 0:39:55It's a busy place. But I'm glad I'm in here with you.
0:39:55 > 0:39:59Rose is 76 years old.
0:39:59 > 0:40:02She's come to A&E this evening with chest pain.
0:40:02 > 0:40:07- Are we done?- We are done. - Eeh, there, that wasn't too bad.
0:40:07 > 0:40:10I could just eat something nice.
0:40:10 > 0:40:12- That makes two of us.- Like what?
0:40:12 > 0:40:15- Chips.- Chips and beans.
0:40:15 > 0:40:17Oh!
0:40:17 > 0:40:19I love chips!
0:40:19 > 0:40:24- Do you think by any chance that she'll be OK to go home tonight? - I don't think she'll be going home.
0:40:24 > 0:40:29There are some changes in her ECG, which look as though it could be the heart.
0:40:29 > 0:40:32So we're going to give you some tablets for that, OK?
0:40:32 > 0:40:37'I do like old patients, I think they're challenging to treat.'
0:40:37 > 0:40:41I did a care-of-the-elderly job last year, and it was really interesting,
0:40:41 > 0:40:42and challenging.
0:40:42 > 0:40:44So I wouldn't be surprised if I ended up doing that.
0:40:44 > 0:40:51But I know it's medicine something, I'm just... It could be lots of things, we shall see.
0:40:51 > 0:40:57With Rose stabilised, Suzi can transfer her to another ward in the hospital.
0:40:57 > 0:41:01- I hope that everything gets sorted and you get out soon. All right? - Yes, thank you.
0:41:01 > 0:41:04Thanks again for putting a smile on my face, OK?
0:41:04 > 0:41:07- Yes, thank you.- Thank you again.
0:41:07 > 0:41:08- Bye, darling.- See you later.
0:41:08 > 0:41:11Oh, I think she's lovely.
0:41:11 > 0:41:15A lot of them just look as though they've come out of school.
0:41:15 > 0:41:17I just think old people are really cute.
0:41:19 > 0:41:22He needs bloods, he needs bloods...
0:41:22 > 0:41:24Oh, God!
0:41:24 > 0:41:26It's the middle of the night at the hospital.
0:41:26 > 0:41:29In EAU, Jon is running on empty.
0:41:30 > 0:41:34The time is now quarter to four in the morning...
0:41:34 > 0:41:39He's now worked a week of night shifts, and his surgical exam is on his mind.
0:41:39 > 0:41:43I booked my exam before I knew what my rota was, that's the...
0:41:43 > 0:41:47That is the...erm...
0:41:47 > 0:41:51risk you take, and it came back to bite me in the ass a bit, really.
0:41:51 > 0:41:55I didn't really get much sleep today, so I've been...
0:41:55 > 0:41:59I got up about 10 o'clock this morning, so I guess I've been up
0:41:59 > 0:42:02for...whatever it is, 16 hours or something.
0:42:02 > 0:42:07Which isn't ideal, but I had some stuff I needed to do today, like revision for my exam.
0:42:08 > 0:42:11Right, I'd better see this lady. Where is she?
0:42:14 > 0:42:16Left...
0:42:18 > 0:42:21Hello, my name's Jon. I'm one of the doctors...
0:42:34 > 0:42:39After a 13-hour night shift, Jon finally goes home to sleep.
0:42:39 > 0:42:42He's been awake for over 24 hours.
0:42:42 > 0:42:46This has been the busiest three days I've had as a doctor, I think.
0:42:46 > 0:42:49I've been up for pretty much 27-hours straight now.
0:42:49 > 0:42:56With his surgery exam now only a day away, revision is the last thing on Jon's mind.
0:42:56 > 0:42:59In three hours' time I've got rugby training and then...
0:42:59 > 0:43:02And then I've got my last night, so...
0:43:02 > 0:43:07Erm, I'm pretty tired, I might just go and fall asleep.
0:43:16 > 0:43:22While Jon gets some sleep, downstairs, Keir's practising his surgery skills.
0:43:22 > 0:43:24Blades please. Thank you!
0:43:24 > 0:43:26That's hilarious.
0:43:26 > 0:43:31Practising stitching on a banana is a very good substitute for human skin.
0:43:31 > 0:43:34The patient's looking a little jaundiced for my liking!
0:43:34 > 0:43:38Have you noticed you've got a medical student standing behind you?
0:43:38 > 0:43:40That's fine, don't worry, SISTER.
0:43:40 > 0:43:45The thing about practising is, you don't necessarily practise
0:43:45 > 0:43:48the way that you would do things in real life.
0:43:48 > 0:43:51It's like when you practise the piano,
0:43:51 > 0:43:55you don't go into a concert and play scales and arpeggios.
0:43:55 > 0:43:58But you need to play scales and arpeggios in order to play properly.
0:43:58 > 0:44:00Cut, please.
0:44:01 > 0:44:04- Can we send for the next one?- Yeah.
0:44:04 > 0:44:07I think we've got two strawberries and a fig waiting.
0:44:07 > 0:44:08We'll do the fig next.
0:44:08 > 0:44:11We'll need the tourniquet and the juicer.
0:44:17 > 0:44:21When I'm at work, it's just inside for 12 hours and I don't see the sunshine.
0:44:21 > 0:44:27After sleeping off the night shift, Suzi spends the afternoon at the beach with some friends.
0:44:29 > 0:44:34- I reckon a lot of people retire here. I'd definitely retire here. - I would.
0:44:34 > 0:44:37I'm a little way off the old pension, though, just yet.
0:44:37 > 0:44:40Suzi's been trying to decide where her future lies
0:44:40 > 0:44:45and it seems that her perfect career path has been staring her in the face.
0:44:45 > 0:44:47Did you decide what your speciality is going to be?
0:44:47 > 0:44:53Care of the elderly. Or respiratory, because it's got lots of old people there, too.
0:44:53 > 0:44:55I love talking, obviously.
0:44:55 > 0:44:57And it's great... I know!
0:45:00 > 0:45:06Definitely medicine. I'm more of a chatter than a chopper-upper, so medicine, I think!
0:45:13 > 0:45:19After a few hours' sleep, Jon is also making the most of his time off work.
0:45:21 > 0:45:27As captain of his rugby club, and with a big match looming, Jon didn't want to miss today's training.
0:45:27 > 0:45:30Rugby's really important. Obviously, it's not ideal
0:45:30 > 0:45:35that training's tonight, but I want to make sure that we train well and progress as a club.
0:45:35 > 0:45:40It's a bit of obligation but it's also what I enjoy doing as well.
0:45:40 > 0:45:45Sacrifice is a sacrifice, but if you want to do something, you'll find a way to do it.
0:45:45 > 0:45:48The only problem is, he's also got an exam tomorrow.
0:45:48 > 0:45:54I want to just get the exam done and then I can put that to one side, and concentrate on other stuff.
0:45:57 > 0:46:03The big day's arrived. Jon's driven all the way to Edinburgh to sit his exam.
0:46:03 > 0:46:07I don't really get nervous about exams, so I'm fine.
0:46:07 > 0:46:11And with a jam-packed work and social life, there's been little time for revision.
0:46:11 > 0:46:16The book's about this thick, and I've read about this much. So we'll have to see, we'll have to wing it.
0:46:20 > 0:46:26Sleep and me, we're good friends, but we don't see each other as much as I would like.
0:46:26 > 0:46:30Yeah, it's been a pretty manic last 24 hours, but, um...
0:46:30 > 0:46:34you know, after I finish my exam, then it's over, isn't it?
0:46:34 > 0:46:39So, just go back to normal life. So it's not too much of a faff, really.
0:46:39 > 0:46:42I'm young, I can still do it, it's not going to kill me,
0:46:42 > 0:46:46a bit of lack of sleep. You can sleep when you're dead, can't you?
0:46:47 > 0:46:52Jon's got six hours of exam papers ahead of him.
0:47:00 > 0:47:03Disenchanted first-year Adam hasn't been enjoying work.
0:47:03 > 0:47:07Now he's meeting his boss to talk about it.
0:47:09 > 0:47:15All junior doctors have regular meetings with their supervisors to discuss their career.
0:47:15 > 0:47:18How's it going? What are the problems?
0:47:18 > 0:47:20- You know, what do you need?- Erm...
0:47:20 > 0:47:23Everything going all right, or...?
0:47:23 > 0:47:27No, I mean, like, I'm not... It's not like I'm...
0:47:27 > 0:47:31I'm not hugely enjoying the job, as it stands. I don't dislike it,
0:47:31 > 0:47:36I just feel like I'm only doing very mundane things, and I wasn't using my brain at all,
0:47:36 > 0:47:38if I'm being honest.
0:47:38 > 0:47:42You have felt like you are literally nothing but a ward clerk
0:47:42 > 0:47:45- and a form-filler. - Yeah, pretty much.
0:47:45 > 0:47:48It's a very honest response, and it's very truthful, and I know it is
0:47:48 > 0:47:52- because absolutely everybody feels like that when they start.- Yeah.
0:47:52 > 0:47:56Don't worry about it, you will have more than ample opportunity
0:47:56 > 0:47:59- to take responsibility, make a few decisions...- Yeah.
0:47:59 > 0:48:02- That will happen, just give it time. - I shouldn't complain.
0:48:02 > 0:48:07- No, don't go chasing it, it'll come and find you.- I'm sure it will.
0:48:07 > 0:48:09It'll find you, don't worry.
0:48:09 > 0:48:11'Some of them get to the point of slightly resenting'
0:48:11 > 0:48:13that they're just admin bodies.
0:48:13 > 0:48:17But at the same time, there will be occasions within the same week,
0:48:17 > 0:48:20perhaps on-call, perhaps just when they're covering the ward,
0:48:20 > 0:48:22there isn't senior cover at hand,
0:48:22 > 0:48:25when they've got some real medical emergency to deal with.
0:48:25 > 0:48:29And then suddenly, the admin stuff seems a lot more attractive.
0:48:29 > 0:48:33He was very supportive, and quite understanding of, you know,
0:48:33 > 0:48:37how things are as a new F1, and I didn't really expect that.
0:48:37 > 0:48:42Really nice guy, and I think he kind of gave me a couple of useful tips as well, as I go along the way,
0:48:42 > 0:48:46and tried to get me thinking a little bit about things.
0:48:53 > 0:48:58Adam may be more positive, but has Jon's lack of revision hindered his exam performance?
0:48:58 > 0:49:00Yeah, that was pretty hard!
0:49:00 > 0:49:04Erm, the first paper was just epic,
0:49:04 > 0:49:08it was just so hard, like, I knew nothing!
0:49:08 > 0:49:14Jon's now got to wait six weeks to see if he's scraped through.
0:49:19 > 0:49:23With a renewed enthusiasm, first year, Adam, returns to EAU
0:49:23 > 0:49:28on a mission to prove himself to the head of the department.
0:49:28 > 0:49:29I hope that I do good clerking,
0:49:29 > 0:49:33versus some of the not-so-good clerkings I've done in the past.
0:49:33 > 0:49:36He's been trying to hit the ward targets all week.
0:49:36 > 0:49:39I really want to make a good impression,
0:49:39 > 0:49:41just because I want to be a good doctor,
0:49:41 > 0:49:47and also because this potentially is a part of a career option for me.
0:49:47 > 0:49:52And the pressure's on, because this time the boss is going to time him.
0:49:52 > 0:49:57You need to see this patient, sort them out, do all their bloods, get their whole investigation done,
0:49:57 > 0:50:01make a management plan, write up their drip card, the whole lot,
0:50:01 > 0:50:03in an hour. Do you think you can do that?
0:50:03 > 0:50:07- I'll do my best.- OK. - All right, cheers.
0:50:07 > 0:50:12It's 4 o'clock now, and the timer is running.
0:50:12 > 0:50:16So, we've set Adam this task, to see the patient within an hour,
0:50:16 > 0:50:18and we need to see whether he can get quicker here.
0:50:18 > 0:50:22- Why are you stressed?- Because I... - But you're working with Ashley.
0:50:22 > 0:50:25- Yeah, I know, but... - He's the nicest doctor in the world.
0:50:25 > 0:50:28He should be seeing the patient now, definitely.
0:50:35 > 0:50:39- Hello. What's been going on with you? - Chest infection.
0:50:39 > 0:50:43- OK.- Yeah, last couple of weeks, it just won't clear up.- OK.
0:50:43 > 0:50:46I had to have a cancer operation,
0:50:46 > 0:50:49which left my stomach up here now.
0:50:49 > 0:50:52- Right.- I might have had a reflux or something during the night.
0:50:52 > 0:50:55- Yeah. You're normally well with the breathing?- Yeah.
0:50:55 > 0:50:58He's doing all right, he wants to make a good impression.
0:50:58 > 0:51:00Just look up for me, sir.
0:51:00 > 0:51:0420 minutes in, Adam's moved on to examining the patient.
0:51:04 > 0:51:05Fantastic, OK.
0:51:08 > 0:51:13He's halfway through, and he should be getting on to thinking about taking bloods and things.
0:51:13 > 0:51:18There's 30 minutes to go, and Adam's on-track.
0:51:18 > 0:51:21But there's no time for small talk.
0:51:21 > 0:51:24- What are you doing here? - What do you mean, lad?
0:51:24 > 0:51:27Do you know what, I thought you were Sarah from the back.
0:51:27 > 0:51:30Then I looked at you, and it was, "Ah, it's Charlotte," I was like,
0:51:30 > 0:51:33"Do I just make up that I meant to say that?"
0:51:33 > 0:51:36Sorry, sorry.
0:51:36 > 0:51:4016 minutes left - Adam needs to get his skates on.
0:51:44 > 0:51:45Hello.
0:51:47 > 0:51:49- Are you ready?- I've finished.
0:51:49 > 0:51:51Well done, that was within an hour.
0:51:51 > 0:51:54Adam's finally done it.
0:51:54 > 0:51:58He's hit the target - checking in this patient in under an hour.
0:51:58 > 0:52:01It's good to feel like I'm actually improving, because...
0:52:01 > 0:52:06- so far in F1 I haven't really felt like I've improved in anything until I started in EAU.- You are, yeah.
0:52:06 > 0:52:10This is the first time I've felt like I'm becoming an actual doctor.
0:52:10 > 0:52:12Adam did really well.
0:52:12 > 0:52:13He came on, and he was,
0:52:13 > 0:52:17as often is the case when you're first on emergency admissions,
0:52:17 > 0:52:20it's a bit bewildering, overwhelming,
0:52:20 > 0:52:22and he coped with that very well.
0:52:24 > 0:52:29Yeah, I have improved a lot, but by God, have I got a LONG way to go.
0:52:29 > 0:52:34And I'll make it in the end, even if it kills me.
0:52:41 > 0:52:43- How old are you?- Six.- Six.
0:52:43 > 0:52:45Are you a bit frightened?
0:52:45 > 0:52:48Yeah. There's no need to be frightened, OK?
0:52:48 > 0:52:50We see little brave girls like you...
0:52:50 > 0:52:55Second-year Keir is back in the plastic surgery clinic,
0:52:55 > 0:52:58treating some of Newcastle's junior outpatients.
0:53:00 > 0:53:03Is it hurting all the time?
0:53:03 > 0:53:05- It is.- When I move it.
0:53:05 > 0:53:10It's hurting most when you move, OK. That's cool.
0:53:10 > 0:53:13What we do need to do is clean it, OK?
0:53:13 > 0:53:17Are you feeling a bit dizzy and queasy and rotten?
0:53:17 > 0:53:20- No? Excellent.- Just really hungry.
0:53:20 > 0:53:21You're really hungry.
0:53:21 > 0:53:25After weeks of soul-searching, and careers advice from the hospital,
0:53:25 > 0:53:32Keir has finally reached the conclusion that medicine, rather than surgery, is for him.
0:53:32 > 0:53:36I think medicine, particularly medicine involving children, is just,
0:53:36 > 0:53:39you know, is great fun, and really dynamic.
0:53:39 > 0:53:41Making people feel better.
0:53:41 > 0:53:44That's it, that's what it is, it's making people feel better.
0:53:44 > 0:53:48And it's not just by giving them penicillin, it's also by cheering them up.
0:53:48 > 0:53:51And that's what I like doing.
0:53:51 > 0:53:55I like making people feel better.
0:53:55 > 0:53:57Good. All right?
0:53:57 > 0:53:59It's been nice to meet you, all right?
0:53:59 > 0:54:01And we'll get your wrist back together.
0:54:11 > 0:54:14Keir's big decision made, and a tough week behind them,
0:54:14 > 0:54:18Keir, Adam and Andy get to let off some steam...
0:54:18 > 0:54:21Who's ready to get their arses handed to them on a plate?
0:54:21 > 0:54:25..and for once forget about being doctors - on the race track.
0:54:25 > 0:54:27Are we going to have a winner's and loser's prize?
0:54:27 > 0:54:31You're going to win, aren't you? You're going to make me wear a dress.
0:54:33 > 0:54:35He's looking faster!
0:54:44 > 0:54:49Everything we do, we do hard, yeah? We run hard, we tackle hard, we give them nothing for free.
0:54:49 > 0:54:56And with the exam behind him, Jon can focus on his rugby team's first match of the season.
0:55:00 > 0:55:03And the team secure the result they were after.
0:55:05 > 0:55:08Being on a week of nights, I've had a crazy week, I was tired.
0:55:08 > 0:55:13So to come out here, blow the cobwebs away, and get a win, there's no better feeling, it's great.
0:55:17 > 0:55:20So that's a false victory for you, there you go.
0:55:20 > 0:55:23Andy's the winner, and Keir is the loser.
0:55:23 > 0:55:24There you go, Keir!
0:55:24 > 0:55:27Spray you!
0:55:28 > 0:55:34Jon toasts his team's success, too - in time-honoured fashion.
0:55:34 > 0:55:37# Jon is a horse's arse
0:55:37 > 0:55:42# He is a horse's arse. #
0:55:42 > 0:55:44CHEERING
0:55:51 > 0:55:52Keir has left the building.
0:55:52 > 0:55:55And as race loser,
0:55:55 > 0:55:59all that's left for Keir to do is complete a forfeit.
0:55:59 > 0:56:01Morning. Morning!
0:56:01 > 0:56:03I lost a bet.
0:56:03 > 0:56:06I'm not embarrassed. I'm not embarrassed at all.
0:56:06 > 0:56:10I should have driven quicker. If I bump into one of my patients today...
0:56:11 > 0:56:14..hopefully they won't recognise me.
0:56:14 > 0:56:17Morning.
0:56:17 > 0:56:19Next week...
0:56:21 > 0:56:23- Has he ever done it? - Oh, he's done it before.
0:56:23 > 0:56:28..the balance between being young and professional can be tricky.
0:56:28 > 0:56:32But sometimes letting your guard down
0:56:32 > 0:56:34is as important as keeping it up.
0:56:34 > 0:56:38I saw a man that had a toilet brush up his bottom.
0:56:46 > 0:56:49Subtitles by Red Bee Media Ltd
0:56:49 > 0:56:52E-mail subtitling@bbc.co.uk