And here are a few extras I discovered for myself

1. Team morale is everything – Go for coffee with your team. If for some reason your interns or residents don’t drink coffee then tea or an alternative beverage is also acceptable, albeit baffling. Take the opportunity to learn some things if you have time but also just to be normal people chatting. You will occasionally happen upon those magical teams where you all obsessively love each other but more regularly you will develop a friendly enough rapport to function as a good team. Having morale means your interns won’t be scared to text you when they are panicking about something and they will feel safe. That is critical for them, you and patients.

2. Be honest – I remember hearing a registrar say “I’m not sure actually, I have to think about that” to a patient when I was a med student. It was such an honest response. It was an admission of not immediately knowing something but it was also thoughtful. He had taken the patient’s worries seriously but also been circumspect and real. It is ok to not know stuff. It is super weird when people pretend they know everything. One of my favourite bosses recently told me he respects “I don’t know” from his registrars. Don’t make things up. And don’t overpromise. You are learning, we all are, even the really smart people that always answer questions in grand rounds. And not knowing is normal. Imagine if we were all a bit more honest when we were stumped, it would be so much less intimidating and we would all learn so much more.

3, Be vulnerable – If you are struggling, speak up. We are human and sometimes days, weeks or rotations get the better of us. This job is hard. The expectations are relentless and the emotional toll is high. Find your tribe and reach out to them if you are battling. Don’t be fooled by brave faces, everyone does it hard and acknowledging that can help enormously.  If you think someone else is struggling, reach out to them and try to help.

4. When you are in the country and you feel out of your depth, nobody in the city minds being called. We all remember that pain If someone calls me from the middle of nowhere and is worried about a patient I always offer to take the patient. Short of that, I am happy to be called whenever necessary to help. I remember relentlessly calling kind and helpful endocrine and renal and rheumatology registrars when I was in the country as a new registrar with no idea. HALP I would basically scream down the phone. WHAT DO THESE TESTS MEAN? I was always treated with patience. You are not alone in the country, even when you feel like you are and someone is having a scleroderma renal crisis (maybe, I mean who would know). Ask for help. And then store the recollection of that panic away for when you are a senior registrar back in the city and a junior registrar calls you for help.

5. If you are an inpatient registrar, try not to fight with ED, it never helps – Everyone in the hospital has competing stresses. There are times where it will feel like the ED is personally trying to drive you to the brink of insanity with the fifteenth referral since your shift started. I have no doubt that there are also times for registrars in ED where they feel patronised and undermined by inpatient teams and are under pressure to get through the masses of waiting patients. It is important to get along with other departments. It makes every part of your life easier. Try to make it a priority.

6. Don’t dread referrals – This seems crazy. Of course we dread referrals. Please insert this chest drain at 5pm on a Friday? Let me stab myself in the eye instead thanks. But what I mean is try not to be defensive. I used to start most of my conversations with other teams/ED waiting to have the legitimacy of the referral proved to me. It was exhausting, and usually made no difference to the work I was going to have to do anyway. After a few years, I took a new approach. Every call I get now I try to say “How can I help?” at the outset. It sets the tone. It doesn’t increase your work – you will get the call and the referral regardless but when people know that you are happy to help the whole interaction is easier and when you need help or advice in return, they are happy to reciprocate.

7. You will make mistakes – Heaps of them. Copious mistakes. Daily. Most will be really minor. Some will be bigger. Be careful and respect the stakes that you are working with but also cut yourself some slack. Everyone before you has made mistakes. As you grow in the job remember to share your experiences of stuffing up with your junior doctors, vulnerability is powerful because it helps us all acknowledge that we are human and that is good and necessary.

8. Have a good time with your cohort – There are no friends in life like the friends you make while in your training program. Some of my favourtie people on the planet sat beside me doing admissions, night shifts and handovers. That doesn’t last forever and it is pretty awesome.

9. Find a mentor (or three) – I don’t mean a senior consultant who is head of a department, or your idol who you want to be in 10 years.  I mean a person in a similar situation to yourself who is one or two years ahead.  This person is going to be much more helpful in guiding you through the challenges you are facing right now.  Use them to debrief, to help you make career decisions, to navigate the difficulties of getting into a training program, and for support.  Have more than one mentor – they come in all forms.  You may not even consider them formal ‘mentors’.  Use your different mentors for different aspects of your career/life.  Good mentoring relationships are beneficial for both mentees and mentors.   At a minimum they are supportive and rewarding, and at best, life-changing.

10. Think of your registrar years as a really long job interview – It seems all too hard to think about what your bosses are thinking of you on top of trying to do your job, trying to seem generally competent and supporting your interns and residents.  This is not about having a perfect management plan for every patient or knowing every medical fact.  It is about how you conduct yourself professionally – your interaction with them and other staff members, how you support your interns and residents and how you deal with stress. Consultants know it is a hard job, they have been there.  What they are considering when they look at you is ‘do I want to work with this person in the future?’ If you keep that in mind, it will hold you in good stead.

Anna Dunn has just completed her advanced training in Respiratory Medicine.  She is one of the co-founders of Doc To Doc.