I met someone recently at a meeting who was my SHO when I was a JHO (an F1 in new terms). He was a complete shit, I hated him and despised being on call with him. He didn’t answer his bleep, went to bed on nights and wouldn’t get out of it other than for theatre, lied on ward rounds that he had seen patients when he hadn’t and terrorised us little newly qualified doctors.
Hard to imagine now, but I was too scared and intimidated to ever confront him or tell a more senior doctor of his misdemeanours. I hadn’t seen him for 15 years until we met again at this meeting. He was very chatty initially, he asked after everyone in Bighospital and was keen to brag about how great he was.
I told him that I had learnt a lot from him, “Really? That’s so great” he said. 15 years is a long time to regret not speaking up for yourself “Yes” I said, smiling at him “I learnt about how not to be an SHO. You were awful to us. Good to see you!”.
Being a good senior means different things to different people, take my Bighosptial bestie this week, she gave a junior colleague a row for failing to do bloods on our sickest patients, failing to write in the blood results in the blood folder and failing to repeat a sample that was clotted.
The little shit listened whilst she asked him to do his job more carefully, he grunted. Five minutes later he took her aside and told her off for daring to speak to him on the ward, in future she was to take him off the ward to speak about such matters.
What these F1’s don’t understand yet is that they are trainees, they are baby doctors who know almost nothing. I am also a trainee, as are all my consultant colleagues in a way. We are all constantly learning and developing.
An operation that I am doing under supervision will involve frequent “no, use your hook here”, “I don’t like that”, “I think you should reposition”, “you shouldn’t be so rough”, “stop fucking about and put a stitch in that” and that’s from the good guys.
Bad guys tell you “that was a serious error” or “oh fuck, get out of the way”. One trainee was even told he was going to be killed after an operation.
It’s the nature of my job that I am constantly criticised and I welcome it because it makes me better. Nobody has time to politely and politically correctly tell you that I am dissecting around the portal vein in a terrifying fashion, they say “you’re a bit rough there, careful” and that doesn’t make me want to cry.
Medical school is not preparing students for the realities of surgical training and feedback. There is no other way of doing it, it is instantaneous and instinctive and there is a live patient that one person is responsible for at the heart of it all. If I cause a 2 litre haemorrhage from the IVC because I am careless someone might die, and my boss is responsible for that. If they are letting me do the operation, then they get to endlessly comment on what I am doing, be it good or bad.
One of my bosses raps us on the knuckles when we make an error, it doesn’t bother me. All of us surgical trainees are constantly and endlessly criticised and refined and so we improve. There is no other way.
This little oik, that my pal gave a row to, wants to be a surgeon, a general surgeon no less. If he wants to get even 6 months down the line he is going to have to learn to take some criticism and not see it as a personal failure but an opportunity to improve.
Learning to take criticism is easier than learning to give it. I am a fan of the so called shit sandwich; good thing, the bad thing, another good thing. “F1, you managed to request most of the bloods and that was good, but you missed the three sickest people on the ward which was bad, you remembered to hand over that they were sick to your night shift colleague that was good.”
It is harder than parenting to be honest. I’m going on a course soon to learn more about this dark art, I’m hoping to have a whole picnic of techniques for criticising people!