Checklist for Starting a new Job in Hospital: The Mindful Surgeon

Starting a new job or placement can be both exciting and challenging. Whether you are an international medical graduate, a trainee in the NHS, or a seasoned professional moving to a different location, the process of acclimatizing to a new environment can vary in complexity. So far, I worked in eight different hospitals, in two different countries, and seven different specialties. From sleepy small general hospitals to severely busy tertiary University Hospitals. This is the first year, in the last 6 years, I get to continue my job in my current hospital. I am so used to the fact of being the new girl, that it feels odd to stay in one place for this long time.

Because I had to move so many times ( not always my own choice), I almost have a checklist of things to do when I start in a  new place. For surgical trainees, it is a bit different. You must give a couple of months for trainers to get to know you, trust you let you operate the way you want.  Meanwhile, the hospital staff also get to measure you up and give their unsolicited feedback to the trainers about any incident that they judged with their “overrated vast experience”! And yes, my sarcasm is not hidden in that sentence! It is no secret, that racism, misogyny, and bullying are rampant in NHS. If you are a female doctor, on top of that you are of color, on top of that you are an international medical graduate; chances are, your experiences can be vastly different from some of your counterparts.  

So, I had to come up with strategies to quickly acclimatize to a new hospital, earn people’s trust, and quickly establish myself as trustworthy, reliable, and hardworking. I have made my fair share of mistakes and learned from them. These strategies helped me to settle quickly and get the most out of that placement. Here I will share those tips so that you can make the best out of your placements too.

1. Research the Hospital and Placement:

The first step to a successful start is thorough research. Find out everything you can about the hospital, its location, and how many other hospitals are part of the network. Each hospital can have its unique way of functioning, Many of the hospitals will also have clinical guidelines on the internet, you can learn them or store them on your phone so you can access them later. This was very useful when I moved to the UK and started my first-ever job. I received very positive feedback about how quickly I was settling into my new role, than my counterparts despite the different system, and culture from my country. Every bit of knowledge helps.

2. Know Your Teams:

If you're joining a specific department, research the consultants or supervisors you will be working with. This information can be valuable for building a strong professional relationship from the beginning. Add their details to your surgical logbook for ease of adding operations. You can also see their interests, for example, if someone has a strong research background then they can help you build your research portfolio. If they are specializing in an area that you are interested in, then you can approach them for that. Some hospitals will also have their teaching, research, or other projects that they are developing on the Internet.

3. Connect with Your Network:

Reach out to your professional network to see if anyone you know is already working at the hospital or in the same region. Their insights can provide valuable information about the placement and the environment.  I was also interested in finding out which consultants train more and which consultants can be good mentors or supervisors. You can also go to social media, like LinkedIn.

I will add one note of caution, however when you do collect this information, as they will be biased by the experience of the individual but also their intent towards you! I will share a personal experience; I had the opportunity to work in a particular placement. So while I was doing my research, a colleague of mine ( also IMG) warned me that he found the place to be very racist and severely demoralizing. So, I chose not to take that placement which would have been beneficial for me in increasing my knowledge base.  However, I later found out that particular person was a bit conniving sort of individual. So bottom line, get multiple perspectives.

4. Pre-Placement Visit:

Whenever possible, try to organize a pre-placement visit. This visit can help you meet your potential colleagues, familiarize yourself with the facilities, and gain an understanding of the work environment. You can do it in a day of clinical governance/audit/MDT as you get to meet most of the consultants. Go to the wards, introduce yourselves to the sisters, rota-coordinators and secretaries, theatre lead nurse, and be open to their help /advice.  If you are starting in a new country, ask for a week to shadow and you can use that as a pre-placement visit. Understand the referral structures for your department, what cases you'll handle, how to request support, what is the team structure like, and what specialties you cover.

5. Understanding Your Rota and Contract:

If you have specific exams or life events scheduled, make sure to communicate them with your superiors as soon as you know about them. Knowing your rota and leave allowances will help you plan your schedule efficiently. In the UK, the BMA contract states you should have your rota at least 6 weeks before. This is not always the case. But if you have an important event planned, then mail HR to give you the contact of your colleagues so that you can contact them for a potential swap. Check your rota and contract, and make sure they are sticking to their work schedule. BMA has a rota checker, so if you are a member, you can use it. Check how many annual and study leaves are available and book them as early as possible.

7. Identify Your Allies:

If you are a normal human being, you probably will be nice to everyone. This is very important. It doesn’t matter what their station or job role is, everyone deserves our respect. Most people will reciprocate respect with respect.

For example, Ward clerks are huge bundles of knowledge and can help you with a lot of kinds of stuff. Porters will tell you about shortcuts to go somewhere quickly. In my one placement, the catering staff who I will always greet will always ask me if I had anything to eat while I was running around during my on-calls!  

In any workplace, there will be individuals who can help you navigate challenges and those who may prove more difficult to work with. Identify your allies or "Yoda" who can guide you, as well as potential challenges or "Palpatine" who may not be easy to collaborate with. Plan to mentally prepare yourself when you are working with them.

8. Collaboration and Socializing:

Socializing with colleagues outside of work can be beneficial for team bonding. It's an opportunity to build relationships and show that you're more than just a colleague. If have moved to a new country, most of us initially don’t venture out from the community niche. That is a mistake, as work and personal life are separate. But socializing gives you a chance for them to see you as a human being. Also, studies show that people who have a friend at work are more likely to enjoy the workplace. So, keep your mind open.

9. Know the Layout:

Identify where various facilities are located within the hospital. This includes operating theatres, offices, and other important areas related to your work. Familiarize yourself with the hospital layout, theatre locations, ICU, ward phone numbers, and bleeps. Take a picture of these essential details and save them on your phone for quick access.

10. Educational Goals: Additionally, set your educational and professional goals early on. Whether it's research, audits, or quality improvement projects, knowing how to get involved can help you stand out and excel in your role. Share that early with your trainers. This will show you as a keen, enthusiastic team member who takes initiative.

Starting in a new hospital or healthcare placement is daunting, but with the right approach and thorough preparation, you can make the transition smoother. Take the time to research, connect with your colleagues, and establish a strong knowledge base. Building a network of allies and setting clear professional and educational goals can also contribute to a successful start. Embrace the challenges, stay open to learning, and remember that every step you take helps you grow and excel in your new role.