In planning this article it has been good to reflect on my 12 months as a house-officer. I clearly remember feelings of I'll never survive!' as I contemplated the prospect in my final year, particularly knowing that sleep was towards the top of my list of favourite pastimes.
What I hope to do is to take you through the year, and look at various different aspects of being a house-officer. To broaden this article from that of a purely personal perspective I have taken advice from a friend currently doing housejobs. I know something about the preparation phase as my husband and other friends are now applying for their first jobs.
I will split this article into three sections:
- Preparation: choosing a job
- Practice: doing the job
- Perspectives: life after jobs?
Preparation: choosing a job
In some ways this is the most significant factor as it will have considerable influence on your enjoyment (or otherwise) of the year. I am aware that there is little choice at some medical schools where computerised matching schemes have the final say, but there is generally some scope for input from the student.
There are various issues to research prior to job application: location, boss, rota, residences, out of work facilities (sporting and other). This can be done by visiting the hospital and/or making a quick phone call to the house-officer in post. (It may sound obvious, but do remember first to ask them if they don't mind having a quick chat, the information you gain is likely to be limited if they are on-take with 16 patients waiting to be clerked or in the midst of a professorial ward round...) In general they will be happy to help you as they well remember being in your position! We should also consider issues such as church life, other Christian fellowship (do you know of fellow Christians applying to or already at the hospital?) and the location of family and friends.
Housejobs are stressful and tiring and I think we should plan carefully to allow ourselves adequate support systems. One of the major reasons I was keen to stay in Bristol was the church I had attended ended since my early student days - I could immediately name three families who would have taken me in, irrespective of my state of tiredness, and to me that was quite important!
Clearly we need also to be praying and asking others to pray with us and for us as we make these decisions. Sometimes it can help actually to write out a list of priorities and then to pray through this to ask God for the right motivations.
Practice: doing the job
So you've qualified! As the sights and sounds of the graduation ball fade gradually into your memory, August 1st is approaching fast, and with it the fear of the unknown...
'My first night on take - will I survive?', 'I can't possibly get up that early every morning!', 'I just hope there's no arrest calls on my first day', 'I can't remember anything', 'What was all that pharmacology stuff about?'... These and other unspoken fears may be passing through your mind, whilst the wage packet at the end of the month seems an unreachable goal!!
There are no magic answers, only to say that these are common to everyone, you will have senior cover as you start and after a few weeks you will probably be surprised at how far you've come! I can also say that after five or six years of studying it is great to be qualified and to be doing the job. You are suddenly a member of the team, having to take initiative and responsibility. There is (if we only have time to realise it) considerable job satisfaction as a doctor!!
On the other side of the coin it is a time of change of lifestyle, tiredness and stress, and at times this is particularly acute. I remember having to tell a family bad news about their elderly father in the midst of a hectic day on take, being left with an intense feeling of emptiness and confusion as I tried to pick up on the 'next case'. It is in the light of everyday situations such as this that we fall back on our support systems - church, family and friends to nourish and care for us. For this to happen we need to be honest with ourselves (before God) and with others, being prepared and willing to receive from them. It is easy to sit in church half-asleep waiting for someone to pick up on our need, but sometimes we have to articulate it so as not to be disappointed! From my experience when I have forgotten my pride and acknowledged that I need someone, for example, to pray for me, I have then experienced God's blessing in a special way.
We should also be aware of some of the effects of sleep deprivation which are not simply tiredness. I tended to cry a lot more, struggled to concentrate for long periods and found difficulty in making decisions outside work. (I did get engaged during the year so it wasn't too serious!) As someone who was quite active during my student days I also found it required much greater effort to initiate activity.
There are challenges to us as we interact with other members of staff and doctors on our team. This can be fun though we have to maintain our perspective of being 'in the world but not of it'. I hope I am not being too hard if I say that I experienced general attitudes of cynicism, faithlessness and materialism amongst doctors, many of whom became friends during the year. We have to maintain prayer, fellowship and Bible study if we are not to be caught up in this.
The quiet time routine will doubtless have to be modified to adapt to working life - and no, I don't mean -we should shelve it!
I spent many hours in my car on the M5 during my second job and began to practise praying as I drove (and not only about other drivers!). Other ideas include meeting up with a fellow house-officer to pray before work, praying whilst walking along corridors, and singing favourite hymns or choruses en route to the blood gas machine at the other end of the hospital. On occasion I remember gritting my teeth and saying 'thank you Jesus for the opportunity to serve this patient' as I crawled from my on- call room into a silent hospital moments after falling asleep. I'm not super- holy or a masochist, but I think it heIped change my attitude to the patient being a person rather than an inconvenience.
Perspectives: life after jobs?
One of the major stress points in a house-officer's year is the realisation that 'August 1st - Part II' is just round the corner. The arrival of the BMJ jobs section is eagerly anticipated, CVs are re-written and are filled and application forms are filled. Life suddenly seems quite serious as careers are mapped out and postgraduate qualifications discussed.
There are no easy ways out of this one but the principles are the same, ie we must pray and make priorities, remembering to 'fix our eyes on Jesus'. God is faithful and can be trusted. One of my personal aimsforthis year is to trust God more and it seems that I am being faced with a number of relevant life-situations! To maintain eternal perspectives is the best way of approaching our medical careers as we press on towards the goal to win the prize for which God has called (us) heavenwards in Christ Jesus (Philippians 3.14).
So, what happens after all this if you wake up one morning, realise it's months since you prayed or read your Bible and wonder where your Christian identity is. . . ?? My advice would be to take initiative and start again. You are not the only one to find yourself in this position. Do not let guilt stand in the way, as Clive Calver has said God is the God of the 2nd, 3rd. 4th chance. CMF office in London will give you names of local Christian medics; get yourself to a local church or alternatively go and talk to a local church leader. Pick up your Bible and read through John's Gospel, book to go on a Christian conference or summer houseparty to build up some fellowship and support. God loves YOU and gave his Son for YOU. . go for it!
In conclusion, houselobs are a year of change and at times challenge us emotionally, spiritually and physically. We can't get to church or other Christian meetings as regularly as during student days but we can still get to some and thus it may be a bit extreme to consider it a 'year of drought'. To refer back to the opening scripture reference, as we trust in the Lord and place our confidence in him, we can rest secure and anticipate fruiffulness even as we enter the year of house jobs.
- A Christian Doctor in the House: Robin and Fiona Jameson (65p)
- What are you Aiming At?: Denis Burkitt (free)
(both available on request from CMF)