Abstract
IntroductionThe Foundation Interim Year-one (FiY1) Programme was part of a UK strategy to increase the medical workforce in response to the COVID-19 pandemic. However, the strategy was introduced urgently without evidence. We sought to explore the transition experience of medical student to FiY1 to foundation doctor, with a view to inform future undergraduate education.MethodsIn this hermeneutic phenomenology study, semi-structured individual interviews were completed with nine foundation doctors who had experience of an FiY1 placement. A template analysis approach was taken, and themes reported.ResultsParticipants reported that FiY1 tended to offer a positive experience of transition as a stepping stone to becoming a foundation doctor. Having a degree of clinical responsibility including the right to prescribe medication with supervision was highly valued, as was feeling a core member of the healthcare team. Participants perceived that FiY1 made them more prepared for the foundation transition, and more resilient to the challenges they faced during their first foundation job.DiscussionThe FiY1 fostered many opportunities for junior doctors to bridge the transition to foundation doctor. Aspects of the FiY1 programme, such as early licencing and increased team membership, should be considered for final-year students in the future.
Highlights
The Foundation Interim Year-one (FiY1) Programme was part of a United Kingdom (UK) strategy to increase the medical workforce in response to the COVID-19 pandemic
One interviewee had been involved in a critical incident on the day of the interview, and reflected upon whether having completed the interim placement had assisted him in his capacity to, in his words: ‘carry on or bounce back’, but his conclusion suggests that starting work earlier was responsible for an improved ability to focus on the big issues, and improve resilience, rather than the FiY1 placement itself being a key component: I feel I took a real shot today, and you know, I got everything that I needed to do done, so
Doctors should be aware that this may have a negative impact on the motivation of students on clinical placements to attend and actively engage, and risks making them feel unwelcome. This is the first study of its kind, in which we have identified and explored aspects of the FiY1 programme that added value to the transition between medical student and junior doctor
Summary
There are key transition periods in the career of a medical student—most notably from high school to university, from pre-clinical to clinical training, and upon starting work as a doctor [1,2,3,4,5,6]. In the United Kingdom (UK), undergraduate medical degrees are typically of 5-year duration, after which newly qualified doctors are competitively appointed to a 2-year postgraduate training post known as the foundation programme (Fig. 1). In the UK, around 80% of final-year medical students were granted early provisional registration by the General Medical Council during the first wave of the pandemic [21] These graduates with early registration were eligible to apply for an optional foundation interim year one (FiY1) post through the UK Foundation Programme Office. These roles provided both an accelerated transition into the workplace and the opportunity for supervised clinical work before starting FY1. We sought to explore the experience of FiY1 doctors in this unprecedented situation, and to develop broader understanding on how final-year medical students may be better prepared for the transition between medical student and junior doctor
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