Reflections on FY1: What I Wish I’d Known and What I’ll Always Remember

By: Dr Holly Egan (@dreamsofamedic)

As I wrap up my first year as a foundation doctor, I’ve found myself reflecting on what an incredibly intense, challenging, and rewarding experience FY1 has been. From navigating my first bleeps to finding my feet on ward rounds, the year has taught me more than I could have imagined—not just about medicine, but about resilience, communication, and myself.

In this post, I want to share a bit about my own experience and offer some honest advice to those stepping into their new title this August.

The learning curve is steep – and that’s okay.

No amount of finals prep or shadowing can fully prepare you for your first crash call, your first night shift, or the first time you break bad news. That’s normal. FY1 isn’t about knowing everything - it’s about knowing when to ask for help, how to stay calm under pressure, and learning to prioritise.

I remember feeling like I needed to prove myself straight away. The truth? Nobody expects perfection, and especially not in those first few weeks. They just expect you to be safe, ask questions, know when you need help, and to be compassionate.

Be kind to yourself.

Imposter syndrome is real, and it never seems to stop. You’ll feel overwhelmed or out of your depth at times- don’t ignore those feelings. Acknowledge them, talk about them, and know that you’re not alone.

Take your breaks. Eat proper meals. Decompress with friends, family, or even just a podcast on the drive home. You can’t pour from an empty cup, and the foundation years are a marathon, not a sprint.

Communication is everything.

One of the biggest lessons I learned wasn’t clinical - it was about communication. Whether it’s handing over clearly, advocating for a patient, or supporting a colleague, good communication underpins everything.

And never underestimate the value of a kind word. I still remember the SHO who told me, “You’re doing great,” during a particularly difficult on-call shift. It meant everything in that moment.

The little things matter.

Some of the most rewarding moments of FY1 weren’t flashy or dramatic. They were small acts - holding a patient’s hand before surgery, updating a worried family member, or sorting a discharge that meant someone got home for Christmas.

Don’t lose sight of the humanity in medicine. It’s what keeps the job meaningful.

How FY1 changed my career path.

When I started FY1, I thought I had a fairly clear idea of where I was headed – Clinical Oncology. But being on the job changed things. Working closely with some amazing surgeons and completing taster days in Obstetrics and Gynaecology made me realise just how drawn I am to surgery and women’s health. This is the reason why I’ve decided to pursue a career in Academic Obstetrics and Gynaecology - a field that combines the human connection of clinical care and surgical innovation with the impact of research. And the reason I can’t wait for my SFP rotation so I can work to make a difference to the lives of those affected by ovarian cancer.

FY1 didn’t just confirm what kind of doctor I want to be - it helped me become it.

Final thoughts.

FY1 really is a year of firsts - first bleeps, first signatures, first tears, and first real triumphs. It’s the beginning of your career, and though it can feel daunting, it’s also a time of incredible growth.

So, to the incoming FY1s: you’ve earned your place here. You’ll have good days, hard days, and plenty of in-betweens. But you’ll get through them all, and you’ll come out the other side stronger, more capable, and more compassionate than you started.

Welcome to the best job in the world (and good luck)! You’ve got this!!

P.S. Here are some of my practical tips:

• Start simple: Master the basics—writing good notes, reviewing bloods, managing common bleeps. Competence grows from there.

• Write things down: You won’t remember everything. Keep a small notebook or phone note for useful tips, drug doses, phone extensions. And aways make a jobs list.

• Ask questions: There’s no shame in not knowing. Senior colleagues expect it and will respect you more for asking.

• Use your team: Nurses, pharmacists, ward clerks—they’re all a wealth of knowledge and support. Treat them with respect and learn from them.

• Debrief: Whether it’s a tricky situation or just a long day, talk to someone. Informal reflection helps more than you think.