Episode 5 Junior Doctors: Your Life in Their Hands

Emergencies...

Have we got pads on?

..bad behaviour...

..bedside battles...

-Alfie, Alfie?

-..and buckets of blood.

It's a tough job being a doctor.

It's even tougher when you're young.

Am I right, or not?

I feel like a child, because in their eyes you probably are.

-Untried...

-I don't want to scare you. It's my second day.

-The first time any of us do anything, we're going to be

-BLEEP.

..and inexperienced...

-Everyone's in the same boat.

-Push it through.

-Twiddle, twiddle.

No-one knows what they're doing.

..but after years of studying...

Oh dear.

..it's time to put theory into practice on medicine's front line.

No-one's died yet,

which is good, but maybe I'm being a bit too careful.

Over the past two months, our eight newly qualified doctors

have been living and working together.

All right, how you doing?

Second years, Amieth and Ben have a year's experience behind them.

That's a serious amount of food for one person!

While for first years Lucy, Aki and Andy...

Come on, iron!

-..Milla, Sameer and Priya...

-I'm so hungry.

When I get hungry I get moody.

..it's been a nonstop battle to keep up.

I've just lost touch with my life. I need to ring people. Crap.

But having survived eight weeks on the wards...

Is it done?

No, not yet. That was just the anaesthetic.

..they're learning the sacrifices they must make for their careers.

I'll be here for another half hour.

I've got to go and stick my finger up someone's bum.

It's just one of those things.

And some are beginning to wonder

if being a doctor's worth the struggle.

I'm quite tired and almost a bit disinterested.

I've definitely had days where I've thought is this what I want to do?

Climbing the career ladder demands hard work,

focus and determination.

After weeks of basic ward jobs, the juniors are setting their sights

on getting their feet off the bottom rung.

First year Milla has always wanted to specialise in skin disorders.

My mother had an incredible dermatologist

who inspired me in dermatology

and since then I've just been really interested

and the reason is because it encompasses

so many different conditions and it actually is a little bit of surgery

as well as a bit of medicine so I think it's the perfect job for me.

This is by the Queen's hat maker, isn't it?

I'd describe myself as a Chelsea Girl, yeah.

I love this one. I love going to balls. I get invited to many of them.

Fantastic.

In her first few weeks as a junior doctor,

Milla found herself on call

across the hospital on gruelling night shifts.

I'm not going to get my jobs done.

You get so many things to do and then you're bleep starts going off

again and again just like this.

Where is this ward? Have I just come from it? Yes. OK.

Finally, this morning,

Milla gets the chance to specialise in her dream department.

Today is my first day in dermatology.

After having come back after my one-week break

in the south of France. It's really exciting.

Let's go and see my patients.

The dermatology department treats more than 9,000 cases a year.

From mild eczema...

I think it's going in the right direction.

..to badly infected insect bites.

-Hi, Helen.

-Hi there.

First patient of the day is Helen who was admitted to A&E

with a vicious outbreak of psoriasis all over her body.

-You poor thing. It looks so painful.

-Milla has come to take blood.

A sharp scratch coming up.

I'm in dermatology for four months.

We move around the different specialities.

Junior doctors get to experience a bit of everything

until they make their decisions which is quite good.

But I'm really interested in dermatology

so I'm very lucky to have got this job here.

It's good.

OK. Lovely. Thank you very much, Helen.

Can you show me your pretty legs?

Also suffering with severe psoriasis

is Milla's next patient,

62-year-old Mohammed.

-Gosh, it's quite smelly, isn't it?

-Yeah.

His skin is being treated with coal tar,

similar to that used on our roads.

How often do you have this done?

-So you've had psoriasis for that long?

-Yes.

The tar helps slow down skin growth, as well as easing the pain.

How does it affect you physically?

You said both physically and mentally.

And so 40 years, you said?

-About, say, 40 years.

-Wow.

And you're still smiling?

Yeah, I'm still smiling, yes.

-OK, thank you so much.

-Thank you.

I hope you have a wonderful afternoon

and I will hopefully see you tomorrow, Mohammed.

-OK, thank you.

-Thank you. Bye.

With Milla's sights set on a career in dermatology,

she's beginning to see the effects skin conditions have on lives.

'I think some people forget

'that dermatology is a very important speciality'

because if you had another medical condition that was affecting,

let's say, your stomach or your lungs or whatever,

it's not visible to the ordinary person on the bus or on the street,

so it can affect patients' confidence

and the way that other people perceive them.

It's nice to be able to help out with those kinds of things.

As Milla settles in to the dermatology department...

Some nice big breaths in and out through your mouth for me.

..housemate Andy is focusing on a career in the operating theatre.

-All right, see you soon. Bye.

-Bye.

I think at the moment, I want to be an orthopaedic surgeon.

It's pretty competitive,

so you have to get plenty of experience doing that.

She's on teicoplanin for her hip...

But with so much work to do on the wards, theatre has to wait.

All right, thanks.

I've got... one, two, three, four, five,

six, seven, eight, nine, ten,

11, 12, 13, 14, 15, 16, 17, 18, 19.

So I've got about 20 patients.

Pretty busy day, not ridiculous but pretty busy.

Hi, my name's Andy. I'm one of the general surgical house officers.

I'd like to speak to you about one of our patients.

'If you want to go to theatre as a junior doctor

'you have to make the time.'

You have to get all your jobs done

and hopefully go into theatre in the afternoon,

but that's easier said than done, really.

Andy, the youngest of the juniors,

is driven by a passion to succeed.

# Bring it on

# Bring it on, bring it on Come on, bring it on... #

I'm quite a competitive person.

I'm going to win...

I like to do well at stuff.

I want to do my best and try to do the best for each patient.

-You can't grow a beard.

-That is true.

How long have you been growing that?

My biggest weakness is not being able to grow facial hair.

-Cheers.

-Cheers.

Today, Andy is getting an unexpected opportunity to help out in surgery.

It's exciting. It's the first time I've been asked to go to theatre,

which is really cool.

I hope it's a bit of a reward cos I worked hard in the last few weeks,

I've done nine days, ten days back-to-back,

so this is a reward, I guess, getting to go to theatre.

Hi, you all right?

The operation requires constant X-ray monitoring

so Andy needs protective clothing.

This is a lead apron,

which I have to wear because of the continuous taking of X-rays,

which is obviously harmful radiation, so...

I get to wear a skirt, which is a bit weird, but there you go.

So we're taking a big metal nail out of someone's leg.

And hopefully I'll get in to help do it.

But yeah, it's a massive buzz, getting to go into theatre, for me.

Really, really exciting.

-Hi, Ian.

-As Andy arrives,

the operation to remove the nail from the patient's leg is under way.

I reckon there'll be more bone over the top of that than you know about.

Skin knife, Andy?

And for the first time in his life,

Andy gets a chance to make an incision on a patient.

That's a good bold cut.

But just as Andy is getting a taste of surgery...

PHONE RINGS

..there's a phone call from the ward.

Unfortunately for Andy,

he's being called back to the ward, as his patients need seeing to.

All right, I'll see you soon, Ian.

It's a setback, but like all junior doctors,

Andy's first responsibility is to his patients.

I got to go into theatre, make the first cut,

which was awesome, exciting, haven't done that before.

'But yeah, I had to leave to go and do some stuff on the wards.

'I felt a little bad'

but the main job of a junior doctor

is to look after patients on the ward

'and going to theatre is really like a bonus.

'It's something you need to do

'for experience if you want to do surgery'

but it has to come second to your ward jobs, really.

It's back to the wards for Andy.

-Hello, Mr Watson. Hi.

-Hi.

Good to see you again.

-You want to get ready first, don't you?

-Yeah.

But for Milla, her day in dermatology

is proving to be all she had hoped for.

She'll be carrying out a biopsy on psoriasis patient Helen.

It's her first big challenge in dermatology,

and unusually for a doctor with little experience,

one she will be doing unassisted.

It's amazing that so soon into the placement,

I'm being allowed to do biopsies on my own

because they are actually surgical procedures.

So my registrar obviously thinks

that I'm ready to be doing them on my own, which is fantastic.

Cos that's something you do as a registrar,

house officers don't get to just go off and do procedures on their own

so it's very exciting.

Hi, Helen, hi.

-I'm going to do your biopsy.

-OK.

The biopsy is needed to find out

whether Helen has skin diseases other than psoriasis.

-OK. What we want to do is just take a sample of the skin.

-Right.

So we can send it off to the lab

for them to look at it under a microscope.

First, a local anaesthetic.

-Are you comfortable like that?

-Yes.

All right. Just relax.

A sharp scratch coming up, OK?

That was it.

-OK? Any pain?

-No.

-No stinging or anything?

-No, no, it's fine.

Just relax.

-So, it's all done?

-No, not yet. That was just the anaesthetic.

-Oh, right.

But that was it, I promise you that was the worst.

You shouldn't feel anything else now. That's fine.

-Can you feel anything?

-No.

-Any pain?

-No.

Once the area is numb, Milla extracts a small plug of tissue.

That was it. I just need to put a little stitch in.

And that was literally it.

I think that's pretty good. It will come together quite nicely, I think.

-You're free to go. Are you feeling OK? You look quite shocked.

-I'm fine.

-Are you OK?

-I'm fine.

-You're not feeling unwell or anything?

-No.

-Not dizzy or anything?

-No. OK, well, I'll see...

-Yes. Thank you so much.

Let me know if you have any pain and we'll give you some painkillers.

I'll just help you out.

I really enjoyed it.

It was so much fun doing it on your own, yeah.

Yeah, it feels fantastic. I'm off to drop my sample off.

It went fine. It was good. I've really enjoyed that, actually.

It's quite nice to be completely independent.

So, yeah, no, I'm really quite happy with that.

I've just got one of your blood results back

and your potassium is quite low.

Ten past seven and Andy's struggling to get through his ward rounds.

I'm going to have to take a blood sample from your artery, there.

Any chance of getting back into surgery vanished hours ago.

I was meant to finish about two hours ago.

But stuff happens to your patients and maybe it's me

not handing things over but I feel I have to sort it out.

I like to make sure it's done so I can go in the morning

and know what's going on with all the patients, be in control.

So, I never really leave on time, ever.

But, yeah, I think it's just the way it is, really.

So, you've had one of those done before?

Andy's final job, before he can go, is to do an arterial blood gas.

He needs to find an artery on patient Mark.

Sharp scratch.

It's after days on end of long shifts, tiredness has set in,

and like all junior doctors,

Andy is discovering that fatigue is the biggest challenge of all.

I'm going to get my colleague to have a go because I can't get it.

I'm sorry, I know it's really painful, I apologise.

Unable to find an artery, Andy asks for help.

-Yes, mate.

-Can I hand over this patient to you?

-Course. No worries.

I just... I think I'm so tired now after ten days...

-Yeah. All right, mate, go home.

-Thank you. See you later.

-See you later.

Tired and with a long way to go before becoming

a fully fledged surgeon, Andy is realistic

about the pressures facing a junior doctor.

I've definitely had days when I have thought, "Is this what I want to do?

"Is this right for me, medicine?"

I'm sure in every job at the start, you have days where you're like,

This is awful, I hate it, I'm miserable."

But if you take a step back from it,

actually, compared to a lot of jobs, it's pretty good.

Back at the hospital, after the being fired up

by weeks of emergencies, it's a quieter night for Amieth.

Hello. I've come to take a blood test and put a line in for you. OK?

And it's revealing just how tired he is.

I like A&E, I think you get a lot of interesting things

but at the same time, you get a lot of quite mundane things.

It's very tiring. And I don't always know what to do with the patients.

Next, another minor case for Amieth.

16-year-old Daniella thinks she's lost a contact lens in her eye.

I can't see the lens. Come with me to the eye room and we can do that.

Take a seat.

-Knock knock.

-Just irrigated with a litre.

Struggling to find the lost lens,

Amieth is joined by senior registrar Dr Cleaver.

Head back.

So, how long has this been stuck in there for?

-I don't really know if it's there.

-It's not.

It's not there.

It turns out there is no contact lens in Daniella's eye.

It's not even behind the eyelid. All right?

You've got a scratch where it was.

The buzz of working in A&E is wearing thin for Amieth,

and he is starting to consider other career options.

I was interested, originally, in emergency medicine

and I like things that happen quite acutely.

But much of what happens in places like A&E is less interesting

and much more routine and also, the hours don't really appeal to me.

I'm interested in anaesthetics and in critical care

so I would like to end up in there.

The next day...

Have a good day.

..Amieth is up earlier than usual.

He's getting the chance to check out a change of direction in his career.

Today, my shift starts at five in the evening

but I'm going into the hospital early today

because I'm meeting with a consultant anaesthetist.

'I'm really interested in anaesthetics

'and I would like to do it as a career.

'It's a really interesting job

'that involves some really cool drugs, as well.'

# ..Move like Jagger

# I've got the moves like Jagger

# I've got the mo-o-o-oves like Jagger... #

Today, I will be basically keeping a patient alive

whilst giving them these drugs that make the surgery possible.

# ..Move like Jagger I've got the moves like Jagger

# I've got the mo-o-o-oves like Jagger... #

Do you know where the admission note would be?

Also keen to further his career, Andy is back on the ward.

He wants me to get there or to speak to me. There are some issues.

And he's got another chance to get scrubbed up and assist in surgery.

We've got a chap who was playing football yesterday

and he went to run for the ball and heard a big gunshot at the back.

Of course, that's not someone shooting him

but it's classic for your Achilles tendon rupturing,

so tearing that tendon at the back of your leg.

So we're going to go in there and open up at the back

and, basically, stitch it back together again.

This time, there are no phone calls to pull him away from his dream job.

So, the suture we put inside is non-absorbable.

Andy cuts the stitches, repairing the ruptured Achilles tendon.

That's good. Nice and short again.

I'm cutting the knot.

But under his gown, Andy has left his bleep in his pocket.

So, the concern is that...

BLEEP! BLEEP!

..that can be a source of infection.

Cut that to probably about half a centimetre long. A bit shorter.

That's good. Good.

BLEEP! BLEEP!

BLEEP! BLEEP!

# Hit me on my beeper, hit me on my beeper

# Beeper, beeper, beeper, beeper... #

BLEEPER CONTINUES

BLEEP! BLEEP! BLEEP!

# ..Hit me on my beeper, Beeper, beeper, beeper, beeper

# Hit me on my beeper, hit me on my beeper. #

Once again, things haven't gone as smoothly in surgery

as Andy would have liked.

Cheers, Ian. That was really good.

I just left by bleep in my pocket, basically.

I was like, "This is really embarrassing."

I had set it to auto repeat so it was just one person from the ward

ringing me but it was obviously just repeating over and over again.

'Little things like that are the sort of things that happen

'early on as a junior doctor.'

I'm sure you learn from every little thing like that

and I'll leave it on the side next time.

As Andy leaves surgery, Amieth is about to start.

Come along in. Come along in.

OK.

-So, you're thinking of anaesthesia as a career?

-That's right.

-OK.

Senior anaesthetist Dr Kevin Haire has agreed to let Amieth shadow him.

So this is an anaesthetic room where I spend most of my life.

Hello, again. This is the young doctor I was telling you about.

It is nice to meet you.

So he is going to spend an hour or two with me.

-I'm focusing on you, yeah. OK. Is that OK?

-That's fine.

The patient, Roxana, is having surgery to remove her gall bladder.

We're going to give you oxygen to breathe for a minute or so,

just to fill up your lungs with oxygen.

That's lovely. Just relax, a bit closer.

And while you're breathing that,

I'm just going to give you a little sedative, like a pre-med,

it might make you feel a little woozy. All right?

OK.

-Feeling a little dozy?

-Mm.

-OK.

This time, you're going to go right off to sleep.

Throughout an operation, the anaesthetist's role is crucial.

As well as putting the patient to sleep, it's their job

to keep them unconscious and pain free.

I've given her an intravenous induction agent

and a muscle relaxant so we're going to have to take over for her,

so we need to close down the valve and very gently

squeeze the bag.

Perfect.

A world away from dealing with minor injuries in A&E.

Amieth is now doing the job of Roxana's lungs.

He's breathing for her and keeping her alive.

-Am I doing OK?

-Perfect.

Absolutely perfect. The core skill an anaesthetist needs to have

is to be able to manage an unconscious patient's airway.

That's an absolute core skill of anaesthesia.

We're a slightly unusual speciality in that most of us

are more comfortable once the patient becomes unconscious

-than we are with them awake.

-So...

Once Roxana is safely anaesthetised,

she's wheeled into theatre.

OK. Everyone happy?

With the operation under way, there's a chance for Amieth

to find out more about anaesthetics.

I was wondering what you thought about

the pros and cons of being an anaesthetist?

Well, the reason I enjoy anaesthetics is, to some degree,

I think it's an absolute privilege that...

within - like this lady here -

a short time of meeting her,

I'm actually really completely responsible for her.

I've taken over everything about her,

her breathing, her heart, everything.

She is relying on me completely to do my job so she must trust me.

I can respond to that by giving my complete attention to her...

Yeah.

..and make it my job to make sure

she gets safely through this procedure, whatever happens.

That's one of the things I like about anaesthetics, too.

You have hundreds of people in the hospital

but this is the only patient that you need to focus on.

Exactly. Yeah, yeah. Exactly.

I see it all as positive, all positive.

The operation is over.

Dr Haire's final job is to gently bring Roxana back to consciousness.

So we're coming into land, now. So we've turned off our anaesthetic.

Start washing it out.

Everyone does this slightly differently,

this bit of the procedure, so...

Well done. Just lift your head a little for me.

The operation's finished. You're just waking up. There we are.

Well done.

-Right, OK. Amieth?

-Yeah, thanks a lot.

-I hope that was helpful.

-Yes, that was very good.

-Good luck with your shift.

-Thanks a lot.

-I'll think about you tonight

when I'm at home, watching television.

-OK?

-OK.

'My impressions of Amieth are he's a clear thinker,'

I don't think he's scared of hard work,

he's committed and I think he's thinking about it quite carefully,

and probably, if you've got all those things on your side,

you'll probably be fine.

'It's been quite fun today, actually.

'It's a very different environment from being in A&E.'

It's much more calm and relaxed.

But at the same time, you're always thinking

and you're always making sure everything is OK.

So there's a lot going on behind the scenes in there, in theatres

that a lot of patients

aren't aware about but I think it's absolutely fascinating.

I knew I wanted to do anaesthetics

but coming here has just whet my appetite a little bit more.

With his day of anaesthetics over,

it's back to A&E and minor injuries for Amieth.

Hello, I'm Dr Amieth.

Could you tell me why you have come in today, please?

It's the end of another long day for the newly qualified doctors.

# I never thought today I'd be what I am now. #

-Hi.

-Hi.

-How's it going?

-Not bad.

I'm stuck on this. It's doing my head in.

-Are you all right, today?

-Er, yeah, yeah. I'm tired.

However, for one junior doctor, the day is just beginning.

First year Priya is battling her way through a week of night shifts.

'Ever since I've started working, it's been quite difficult for me'

because my life has revolved around being in hospital.

'I've had to sacrifice a lot - seeing my family my friends.

'It's all been a massive adjustment in my life.

'Because I've just started, I'm willing to invest that time.'

I just hope that there is light at the end of the tunnel

and things do get better.

# So get yourself fixed up

# I'll take you out one time. #

Priya's shift is from eight in the evening until eight in the morning.

Good evening.

And the strain is beginning to tell.

-I'm so sleepy already.

-Mm?

-I'm already sleepy.

Tonight, I would like a quiet night, to be honest. I'm a bit tired now.

So, yeah, I want it to be a bit easy-going, to be honest.

First task for the night team is to deal with the cases

handed over by the day team.

The story of my life, I've been handed over loads of bloods.

Loads and loads and loads of bloods.

Mm.

Ah... Right.

As the only first year junior doctor on shift, Priya's job

is to be constantly on call for patients across the hospital.

You're going to go down for a scan but we need to put a cannula in,

one of the lines.

With no emergencies to break the monotony,

most of the night will be spent dealing with simple tasks.

It is now 1:40am,

I'm about to go to one of the wards

to check a patient's antibiotics.

I'm Priya, one of the surgical doctors.

-I understand you're to have an operation today.

-That's right.

I need to take a blood test from you, unfortunately.

CLOCK TICKS

PRIYA YAWNS

As a long, slow night draws to a close,

and her shift is about to end, Priya gets a call.

When did he come in?

That's so rude of everybody.

No, I don't. Has he got his things there?

It's a call from a ward. They need Priya to prescribe medication.

OK, I'll come up. That's really annoying. OK, I'll come back. Bye.

SHE SIGHS WITH EXASPERATION

Why, oh why? So, this patient is an inpatient. He has an operation today.

And I just got a bleep saying I haven't prescribed any of his meds.

I was like, "I was never told to prescribe any meds."

It's just a bit like, "Oh, OK, really? Was I meant to do that?"

I know for a fact if it was my patient, I would have done it.

It would have been sorted in the day.

Fact.

Drive.

Job done. Priya can head home.

But working nights is taking its toll.

Now I've done my fifth night in a row, I'm feeling it,

I'm feeling the crunch.

I'm quite tired

and almost a bit disinterested, which is really bad.

Right now, I'm living for the present.

I'm not inking about my future career.

At times, it's fun.

Other times, I just don't want to be there.

I just want to chill out and not have to run around, rush around,

doing things.

But I guess everyone has that moment in their job.

Not everyone is supposed to love their job all the time.

At last, home.

Well, almost.

Wrong house!

SHE LAUGHS

Oh, dearie, dear.

# When I come to London I can get lost all day... #

Over the past nine weeks, our junior doctors have struggled

to balance getting ahead in medicine with holding on to a social life.

For once, Andy's thoughts are not on his career.

He's planning a night out with his housemates to a comedy gig.

Aki has got some free tickets to Live At The Apollo

but he can't go so he has given them to me, Ben, Sameer and Milla.

We should do that this evening which should be pretty awesome.

It's quite exciting.

I guess that's one of the things about living in London,

doing stuff like this, really, um, being in the thick of it all.

# ..Getting lost in the underground

# Trying to figure my way round. #

Enjoy the show tonight. I hope you can get in, by the way.

How did you come across the tickets?

I just applied for them a few weeks ago.

I totally forgot and then,

I changed my shift and everything and I can't go.

-Do you think you've chosen the right career?

-Yeah, definitely.

-I can't imagine doing anything else. You?

-Yeah, that's true.

I can't think of anything better to do,

so everything else must be even worse.

-See you later.

-See you later.

While Aki and the rest of the juniors head to work,

Priya can relax.

Her run of nights finally over,

she's heading home to Durham for some TLC.

When things are a bit hard, or you've had a rough time at work,

because you've been working super hard, the best way for me to relax

is to be with my family who are so caring and they pamper me.

They are sympathetic to the way I am. They really, really look after me.

Since I've started working,

I've had to make a lot of sacrifices in my day-to-day life.

Family, food, friends, all the Fs in my life.

'I do see myself in about ten years, hopefully, being a consultant.

'And beyond that, being able to have a successful family life,

'get married, maybe.'

God, I said married, didn't I? So crazy. But it is important.

For some people, career is the main thing in their life.

I really do love medicine and I really do think it's important

to be committed and involved in your job and your career,

but not at the expense of the other pleasures in life.

# Now you're on your own

# Won't you come back home... #

Oh, hello, Priya!

Hello, my darling.

Coming from a family of doctors including brother Harpreet...

-Nice to see you.

-..conversation quickly turns to work.

-I'd like some naan, please, Mum.

-Naan, first, or rice?

-Naan, please.

-Me first, Mum! I asked for it first.

-Sorry, darling.

-So, Priya, how are you finding this job?

-First job.

-First job.

Yeah, it's OK. A bit stressful at times. Working very long hours.

What about your social life?

-I don't have a social life any more.

-Why?

Because I told you, I come home really late

and by the time I go into my room, it's half past ten.

What am I supposed to do? I don't know, it's too tiring.

But I'm really happy to be home.

-You're doing really, really very, very well, my Priya.

-Aw.

-She's a doctor.

-Thanks, Mum.

Sensing the doubts Priya might have about a life in medicine,

her brother offers some guidance.

I work crazy hours. There aren't enough hours in the day.

That's the same way I worked,

the same way people I know have done the job.

It's a sacrifice you have to make.

-You have to be prepared...

-So, I'm not doing any more than anyone else?

-So I'm not special? Thanks.

-You might be doing more

but I think it is part of what a normal,

decent junior doctor should be doing.

-Yeah.

-But always remember, you can always do better, first of all.

-And in 12 months, you'll be applying for your next job.

-I suppose.

Obviously, I know I have to apply for jobs next year.

But you're right, the job that I do get next year

is a job I'm going to be doing for the rest of my life

so I might have to work super hard for two years

and make many, many sacrifices but the end point is really good.

-Exactly.

-Fair enough.

SIREN WAILS

At the Chelsea and Westminster Hospital,

Amieth is back in the day job in A&E.

An emergency is coming in.

A man has suffered a serious accident on a building site.

We just got a call through from the ambulance. They're bringing in

someone who's been injured so there's probably a lot of bleeding.

The idea, really, is to get everyone prepared,

the surgical team, the plastics team, A&E team.

Amieth, can you go to the actual ambulance

and go to meet the patient on the vehicle?

Let's go outside.

The patient's injuries are so severe,

several different specialist doctors are called in...

All right, on my count, are we ready? One, two, three.

Very good, well done.

..including senior anaesthetist Justine Elliott.

It's a chance for Amieth to see another anaesthetist in action...

When did you last eat and drink?

..this time, in an emergency situation.

Sharp scratch.

While Dr Elliott checks the patient's airway

and prepares him for emergency surgery,

Amieth swiftly finds a vein for essential blood tests.

Right, I've got an orange in this side.

Excellent. OK, good.

PEOPLE TALK OVER EACH OTHER

I don't know if that's been flushed, I didn't prepare it.

Here's the saline.

-I've got bloods.

-Make sure all those bloods are sent away.

-Yeah.

I'll just put this through the machine now. I'll get an HB on it.

I managed to get a really big, fat, chunky cannula in him,

took off lots of blood samples so I'm going to send them off to the lab

and, um...

that's probably going to be it from my point of view

because there are quite a lot of people around.

Really, what he needs is the plastics team or the surgical team

to look at the wound and decide how to close it properly.

With the patient out of immediate danger,

Amieth heads back to the routine of minor injuries.

But it's been a good opportunity

to learn more about his chosen career path.

I do often look at the anaesthetists and I think, you know,

I'll be there in a few years' time, hopefully.

I find what they do really interesting.

So, it is nice to come into close proximity with them

so I am pretty happy right now, but quite hungry, too.

While Amieth racks up some vital experience

for a career in anaesthetics...

Your skin is looking even better, isn't it?

..Milla is enjoying the first results of her work in dermatology.

It looks amazing. You're looking well.

Your face has improved hugely, hasn't it?

-Yeah.

-Good. It's good to see you.

Let's keep going that way and in a few weeks,

we'll have you back to normal again, hopefully.

-I hope so.

-Definitely. OK, thanks, Helen.

Helen has now been discharged so she is no longer an inpatient.

She's going to come into daycare to have all of her creams applied.

She's looking a lot, lot better.

-How are you?

-I'm fine, thank you.

I wanted to come and see you and see how you are doing.

Mohammed is back to see Milla

for more tar treatment for his psoriasis.

-Can we come and take a look?

-Yeah, sure.

-We'll let him get changed first.

-Oh, OK.

-Yes.

-Sorry.

-Five minutes.

-Perfect.

I'd love to actually give you a hand with the treatment,

if that's all right? To actually get to do some applications and things,

that would be quite cool.

OK? Good. OK. I'll give him a few minutes.

-Hello.

-Hello. Hi.

-Hi. Oh, wow.

That's fantastic.

Yeah, so these are the...

-Has it got better in terms of bending your legs?

-Oh, yeah.

It's so great to see such an improvement, isn't it?

Before, we used to take an hour to paint, all four of us, didn't we?

-I love the way you call it...

-Painting.

-Exactly. Paint.

It's an art form.

How long have you had the psoriasis for?

And this is probably the best your skin has been, in that time?

-Yeah, yeah. Much better now.

-Really?

-All done.

-Good.

-Cup of tea?

Yes, please.

The improvement in Mohammed and Helen and the dramatic

difference dermatology brings

to people's lives has convinced Milla that it's the career for her.

Thank you so much. See you in a bit.

'It's wonderful to come back and see patients'

and see how much they've improved

in the little time that they've been with us.

It's phenomenal how you sometimes see these skin conditions

that are so widespread and they just improve so rapidly.

It feels really, really good to be able to see the patients

and to see their skin improving and to see their spirits improving.

And obviously, they're becoming more confident.

5:30pm and Ben, who's on a day off,

has come to meet Sameer, Milla and Andy for their night of comedy.

I don't even know what time I'll get away.

But as usual, work is ruining their plan.

It looks like I'm going to be here

for about another two hours, um, unfortunately,

which means I won't really get to go to the Live At The Apollo thing,

um, which is such a shame.

Hey, Milla, how are you?

Are you coming tonight? Oh, really?

Andy's got his hands full, too.

I'm still here, too. I'll be here for another half an hour.

And comedy is the last thing on his mind.

I've got to go and stick my finger up someone's bum.

It's just one of those things.

That leaves Sameer and Ben to enjoy a night of laughs.

At the venue, it looks bad.

-What does it say, no admission after 7:15 PM.

-And the time now? 20 to.

Entry is first-come, first-served. And they are late.

We are not going to get in.

After an hour of queuing, all the seats are full

and thanks to their demanding careers, another planned night out

fails to come together for the junior doctors.

-How was the thing?

-Didn't get in.

-What?!

We hung around for Sameer and you for a bit so we got there,

queued for like an hour and gave up.

-That's

-BLEEP. It's a bit of a shame.

-Yeah, it is.

There's no way we could go because we never finish in time.

-Yes, that's the thing. You can't plan to do anything.

-No, basically.

I made the right decision. The patient is still alive.

And you didn't waste your time!

Despite failing to make the comedy gig,

there is hope on the horizon for the junior doctors.

Milla has invited her housemates to a party

and Aki is thrilled by the prospect.

It's to Aki, "Since you are so utterly and completely fabulous,

"you are totally invited to an unmissable party to celebrate

"the Take Heart charity". Hopefully I will be able to make it.

A new day and Andy is off to a good start.

So far, his attempts to work in surgery

have been disturbed by unwanted interruptions.

Today, he is back where he wants to be, in theatre.

This time with his bleep safely to one side.

First job for Andy, the aspiring surgeon,

is something he is not too familiar with.

I don't know, I haven't grown much facial hair!

Paul, the patient, has an infected appendix and it needs to be removed.

Urgently.

If it isn't, he could develop blood poisoning and die.

Have you got the forceps?

Thanks.

For junior Dr Andy,

being on the front line of a life-saving surgery is a first.

With the infected appendix safely removed,

Andy gets to stitch his first patient.

-Am I allowed to touch the suture?

-Yes.

-Is that a bit deep, or...?

-Yeah, just go underneath the skin.

-Is that OK?

-Let's see.

-It's OK, good.

-And on the other side?

-Yes.

-Does it come out behind the skin?

-Yeah, just there.

-Just there.

I will give it a go!

Thanks, Michael. That was awesome letting me do the suture.

His first full operation and with full marks from the registrar,

a future in surgery looks set.

I got to do a bit of suturing, I've never done that before.

So, yeah, it was exciting.

I was a little bit conscious I wanted to make his wound good at the end.

But I just went for it and it was awesome.

And to be able to do that and get paid for it is an amazing job.

It makes me realise that's what I want to do.

With a tough week coming to a close...

How are you?

..and careers starting to take shape,

Milla's party is looking like the pick-me-up everyone needs.

-Are you going to this thing tomorrow?

-Yeah, I am quite up for it.

-Although I have no clothes yet.

-And the theme is rock'n'Raj.

-What the hell is that?

-W-T-F!

-So, yes I am going to go.

But it's going to be stressful tomorrow evening.

On the Facebook event there's like hundreds of people going.

And they are all beautiful.

Absolutely beautiful. Every single one of them.

-There'll be 300 Millas walking around.

-I'll have to talk posh.

-And about 300 Hugh Grants.

-Really?

-Yeah.

So if you are a fan, you might like it.

-At the house, Priya's back.

-Welcome home.

And she hasn't come empty-handed.

-Is this kebabs?

-With help from Mum and Grandma, Priya has stocked up

for the coming weeks.

-That's chicken.

-Yeah.

-Lamb, yum. I'll have that later.

-And your favourite.

-Kidney beans!

-Yum.

-That's it.

The time with her family has given her a new confidence

as a junior doctor.

'It was really nice to be home.'

Eating good food, just looking out for each other. Goodbye, Mum.

'I appreciate that and because I appreciate it,

'I am less sad I am back in London'

and have to kick-start my gruelling work.

Love you, bye.

'Now that I have established myself in my work and routine,'

I am less daunted by what lies ahead.

-Bye!

-Miss you.

At Chelsea and Westminster Hospital

all the juniors are back on the wards.

It's like painting your nails.

I'm not allowed to paint my nails because I am a doctor now.

On the fourth floor, Priya, fired up from her trip home...

I'm going to ask her if she's had bloods.

..is determined to make a new start.

She has to take blood from Bridget which is easier said than done.

Her veins are legendary throughout the hospital.

She is very, very difficult to bleed and will tell you

and me that she has no veins, which anatomically is impossible

but physically when you see her it's very easy to believe.

I have been delegated the task of taking blood from her.

I am set up for failure already but I will give it my best.

Like other junior doctors,

Priya has found taking blood a surprisingly tricky job.

'I am more accepting of difficult situations.

'Initially, when I would fail something difficult'

I would beat myself up about it.

'Now, I have accepted it happens to everybody.

'And I am less anxious about such situations.'

-Do you mind if I take blood from you today?

-Not at all.

-Thank you so much.

You are looking a lot better, I must say.

Bridget has been admitted with serious stomach pains.

Two goes maximum, we agreed on.

It is vital Priya manages to get blood samples

to establish how healthy her liver and kidneys are.

A sharp scratch...

Are you OK?

SHE WINCES

Ye gads!

-It's all right.

-What happened?

-Keep going.

-No, no, no!

-I withdrew it.

-Why?

-You moved and screamed.

-Don't be a quitter. I'm not quitting.

I will try again. If you scream,

I will carry on but if you say "Take it out,"

that's the only time I will take it out.

Sharp scratch.

-Are you OK?

-Yes.

-Let me know if it hurts too much.

-It's fine.

Still fishing.

-Have you got it?

-I have got some.

Oh, well done!

Yes! Isn't she wonderful?

You are wonderful.

-For tolerating having a needle started.

-Did you get enough?

Yes, I did. I've got more than enough.

Thank you so much for giving me some of your blood. See you later. Bye.

I just did what is the impossible. I managed to take blood.

I like Priya because of her gentleness. You want to please her.

She's very gentle and kind. She will be a great doctor.

When you are working so hard, long hours and moaning

and whingeing about how tough life is and the sacrifices you make,

in terms of what you get to do with the limited free time,

when you come and meet a patient who is so welcoming, so appreciative

and lovely and a pleasure to be around,

it makes those sacrifices worth it.

For juniors Aki, Andy and Lucy, the working day is behind them.

-And ahead is Milla's fancy dress ball.

-Rock'n'Raj, what is that?

-Lucy is getting a sari on.

-You're not!

Priya lent her one.

Are you joking? No!

-What are you wearing?

-A turban.

-You don't have a turban!

-What time are we going, guys?

-I will need an hour.

-An hour.

I'll go for a nap then!

# What's she, what's she?

# The belle of the ball. #

-It is very '70s, east coast American rock'n'roll.

-Wow!

Giving me the thumbs up there.

Whereas I am Oriental Justin Bieber!

-Are you all right, Lucy?

-They stress me out, those boys.

-You look good.

-Thanks. You too.

-It's getting a bit gay now!

Once dressed,

it's a short taxi ride across West London for a night of rock'n'Raj.

By the time they arrive, the party is in full swing.

And it's not long before Milla makes her grand entrance.

-Hello!

-Hello, Milla!

-Nice hair.

-Thank you.

For our newly qualified junior doctors,

it's their first night out together in weeks.

Guys, thank you so much for coming. You look incredible.

It's so good to see everyone dressed up once.

-We're always in work clothes.

-It's true.

I am still in my work clothes.

How nice is it to actually be outside of work?

The job massively compromises your social life.

Even if you don't intend for it to. You are knackered all the time.

I think I've sacrificed a lot of my social life over the last few weeks.

But at the same time, I feel like it's worth it.

There's a way you can sort of learn how to cope with both.

I wouldn't change anything.

Guys, this is what I call a positive opportunity for partying. P-O-P.

And we have to find some more. Thank you for joining me tonight.

To a wonderful evening!

And with that, the young doctors hit the dance floor.

# I'm losing control What a feeling

# Just let go You're on top of the world

# What a feeling What a feeling! #

Next time...

It was going pretty well until now.

..the junior doctors face their biggest challenges yet.

As they come to the end of their first placements.

The patient I saw earlier has fainted.

Have they got what it takes to become fully fledged doctors?

When was the last time you had a drain?

I can't stick a needle in without his consent.

That's assault and I could go to jail for that.

Subtitles by Red Bee Media Ltd.