Starting work as a doctor: challenge is essential

BACKGROUND: Previous research on the transition from student to doctor has indicated that new doctors are 'ill prepared' to start work. Subsequent efforts to improve preparation in the UK have involved increasing practical experience for final-year students through an assistantship period. This study further explored new doctors' experiences of transition in light of recent critiques of preparedness and the first author's own experience of the transition. METHODS: A total of 11 Foundation Year 1 (FY1) doctors from West Yorkshire were recruited via e-mail and snowballing methods. Data were collected using semi-structured interviews and analysed thematically, drawing on the knowledge and experience of the authors as a resource. FINDINGS: The interviews told a story of new doctors learning through challenge. Challenges were contextual, often occurring out of hours when new doctors were working more independently. These challenges were experienced as stressful at the time, but were also deemed to be necessary for personal and professional development. When aligned with the new doctor's starting job, assistantship was found to be helpful to new doctors becoming familiar with the new work environment and clinical staff; however, assistantship did not provide all of the solutions for the transition, as FY1s will always encounter challenges during this period. ... interviews told a story of new doctors learning through challenge ... challenges were experienced as stressful at the time, but were also deemed to be necessary for personal and professional development ... assistantship was found to be helpful ... [but] did not provide all of the solutions CONCLUSION: The transition will always be difficult and new doctors cannot be fully 'prepared' for it. Doctors will not be able to encounter every clinical scenario before starting work, and supported practice is necessary and inevitable. Although assistantship interventions are helpful, there should be equal emphasis on developing effective clinical supervision and addressing barriers to new doctors taking on challenges. Doctors will not be able to encounter every clinical scenario before starting work.