I imagine that many of you will be pondering the time when you leave medical school and start your foundation years. Rather like sailors on a ship leaving the sheltered waters of a harbour embarking on their first voyage across a sea, many of you may be feeling a little nervous about the next step. However, we need not fear if we remember that the Lord will always be with us wherever we go. (1)

Throughout my foundation years, I found it a huge encouragement to remember the Lord's promises to the Israelites in the Old Testament. Although we are now under a new covenant, I think there are helpful things to learn. The Israelites faced ever changing environments, threat of enemy attack and lack of normal comforts. (2) Often their reaction was to fear, and to question why their position was difficult. (3) They had to be reminded that the Lord would fight their battles (4) and lead them by day and by night. (5) What applied to the Israelites is also valid for us today when we face fears, uncertainties and feelings of abandonment by others. We need to take courage and trust that the Lord will never leave or forsake us. (6)

what does it mean that the Lord is with us in our work?

I remember lying in bed trying to get some rest before my first night shift, whilst I was on a paediatric rotation. My heart was beating rapidly with doubts and fears about what I could encounter and whether I could cope with the challenges ahead, passed through my mind. Doubts like 'will God still be with me?' unhelpfully took hold. I messaged a friend who said they would pray for me and set off to work. After all my fears, I found the night to not only be manageable but enjoyable. I could see God's provision in helpful and supportive colleagues he placed around me, and in the prayers of other believers. I was thankful for the peace that he gave me in knowing that I am in Christ. (7)

During my first year, I underwent an elective operation. I remember being collected from the pre-op bay and taken to theatres by an anaesthetic assistant called Naomi. As I walked into the anaesthetic room, I remember looking around at a cold, sparse and empty place with white walls, a hard, stone floor and bright white lights (probably an ideal room from an infection control point of view!). It suddenly dawned on me that I would soon be in that bed in front of me, in a much weaker, more vulnerable state as a patient. Faced with that thought and coupled with the uncertainties about the operation, I started to feel more anxious. Part of me wanted to run away. Thankfully, I took courage remembering that Jesus promised the Spirit to us and that we shouldn't let our hearts be troubled. (8) As the anaesthetist was inserting the cannula I spoke briefly to Naomi about her name and it dawned on me that she could be a fellow believer. Then I was injected with a drug that made the room spin, which was very unpleasant. The only thing I could do was to close my eyes and wait for the anaesthetic to knock me out. Around that time, I felt a hand on the back of mine which was probably Naomi's, but it was a great comfort as it reminded me of God's presence.

During my first rotation in F1, after a very busy day, we had a very poorly patient in his forties with advanced liver failure and chest sepsis. Earlier on, the consultant had decided that this patient wasn't a candidate for higher level care (such as HDU or ITU). Practically, I understood this to mean that he was not for critical care reviews, if he got more unwell. After 5pm, I was the only doctor left on the ward. I was asked to review the patient as he was deteriorating. I found him to be in significant respiratory distress and understandably very agitated, despite maximal oxygen. I knew I needed help as I was out of my depth. The SHO said he was too busy to come to help, and the on-call registrar didn't answer his bleep. I felt abandoned. But just at that moment, my gastro registrar (who had been running late from a clinic) arrived to see how I was getting on. I remember thanking God for his grace in granting me that caring registrar at that time, who helped me come up with a management plan.

As with sailors heading out to sea, you know that in foundation years you will get some days that are rougher and other days with calmer seas. You will need to be wise and follow God's leading in your life. (9) You will get plenty of moments of joy and excitement. But always remember the Lord's promise that he will never leave you. (10)

you will need to be wise and follow God's leading in your life. You will get plenty of moments of joy and excitement. But always remember the Lord's promise that he will never leave you.

Leo Hacking is a junior doctor in Kent