How are doctors supposed to take care of patients if they don’t take care of themselves? If you overwork yourself consistently sooner or later you will experience burnout. Most of us are not taught much about self-care in medical school. Look after yourself and become a better doctor in the process.

Accommodation

Sadly, the days of doctors being provided with free on-site accommodation are at an end. This used to be available because doctors were resident on-site for long periods of time. However, many hospitals still offer accommodation at favourable rates. Living in hospital accommodation is a good way to meet people that you could rent with at a later date. It is also likely to be within walking distance to the hospital. This may not sound important now but after a week of long shifts the 45 minute commute into work may seem far less tolerable. If a hospital offers accommodation, it must comply with national regulations governing minimum acceptable standards which are non-negotiable:

• Your room should contain a 3-by-6 foot bed, telephone, cupboards, drawers, desk, chair, washbasin, be carpeted and have curtains. It should be heated and regularly cleaned.
  
• There should be a nearby bathroom and toilet, cooking facilities, a common room and on-site laundry facilities. Common areas should be regularly cleaned.

If you have a specific problem with your quarters, contact the designated ‘accommodation officer’ or equivalent through switchboard. There are often websites advertising rooms for rent or check the noticeboard as there are often adverts for rooms to rent.

When you are at registrar level then depending on your speciality you may be contractually allowed to rest/sleep during on calls. However, as a junior doctor this is unlikely to be the case and most trusts stance is that you should not be sleeping at night. So if you decide to rest in an empty on-call room, be aware that this may be against the trust policy. It is not uncommon for a junior to have gotten into hot water when found by the matron or security asleep! Similarly, be extremely careful about leaving the hospital grounds whilst on call unless specific cover has been agreed. Remember that patient care is your first priority so do not put yourself in a situation where you cannot deal with an emergency should it arise.

Alternative careers

What if you have come all this way and decide that you don’t want to be a doctor? Or you like it, but not enough to dedicate your life to it? Little known to many medics, having a medical degree opens many great doors. Chekhov, JPR Williams, Graham Chapman, Harry Hill, Che Guevara and Keats were all once doctors – to name a few:

• Medical training gives you multiple skills that you probably never even noticed. These include leadership, managerial, communicating, teamworking and observational skills; analytic, mechanical, adversarial skills; and the ability to work within a hierarchy and still get what you want. Sheer endurance and persistence (much prized in the workforce), great people skills and many other talents can be developed through medicine. Never think that these are wasted in a ‘non-medical’ career. Having medical training will enable you to bring something special to whatever you do.
  
• However, in general, we would advise completing your Foundation Programme before saying goodbye to medicine. Many people find that they enjoy working more than being a student and having full registration is useful if you ever wish to work in the future.
  
• Do not underestimate the breadth of careers available in medicine. Medicine is probably one of the few careers that gives you flexibility to work anywhere in the world, as the skills you have are translational. You can do helicopter mountain rescue in France, research anticancer drugs for pharmaceutical companies in Australia, enjoy office-based occupational health in Dubai, be a sports physician for Olympic athletes or work at the cutting edge of forensic pathology in New York. A good book for inspiration is the Medic’s Guide to Work and Electives Around the World by Mark Wilson.

Bleep

• Pick up your bleep from switchboard. They will replace the batteries and exchange it for a new one if it breaks.
  
• Leave your bleep on the ward and switch it off if you are not on call, as switchboard may call you even when you are off-duty. If you live nearby or on hospital accommodation, this is especially important, as otherwise you may get a rude awakening in the middle of the night by your bleep going off!

British Medical Association

Becoming a member of the British Medical Association (BMA) not only brings you the BMJ with adverts for professional courses but also provides advice and support in all areas of your work, leave, contracts, tax and financial planning. It is also a negotiating body on behalf of all doctors and is definitely worth the subscription costs. The BMJ is an excellent journal in its own right, it is one of the easiest to browse with its almost magazine-like approach, but it also has summaries of up-to-date research that the BMJ has published that week. Specific benefits of membership include:

1. Personal advice on contracts and terms of service, which DO reap benefits and occasional upbanding, particularly if you are proactive about investigating your contractual terms.
   
2. Assistance and representation in disagreements with hospital management. This is becoming more important as trusts and management try to change contracts and reduce pay. For example, the BMA has threatened court action against trust management that has tried to cut pay, now protected under the New Deal terms. The BMA can assist with claims for overtime and additional hours. Simply the knowledge that you are a member of a strong representative organization can often support your case in disagreements.
   
3. Independent financial advice by salaried representatives on pensions, income protection, etc.
   
4. Insurance services. The personal contents policy is particularly useful.
   
5. The fee is tax deductible.

Car insurance

You may buy your first car during your first year. Whilst you may need to purchase it in July just prior to moving to your new job, cars are most expensive around July–August. Most people know where they will be working from January to February, so if you have the funds and the time, consider buying a car around January/February, when you are much more likely to pick up a bargain.

Car insurance varies a lot. The BMA offers insurance for doctors, but it may be more expensive than you need, particularly if you have bought an old car. Probably the best thing to do is to ring local brokers who deal with many different insurance firms and who can get you the best deal for the cover you need. Alternatively, a thorough internet search is a good way forwards. Many firms give a discount for female drivers. Be aware that you can purchase third-party insurance, fire and theft, if your car is not valuable although this may not build your ‘no-claims’ discount, an important factor in reducing the eventual costs of insurance.

Clothes (laundry/stains)

• Smart clothes are often touted as helping maintain professional demeanour; this is particularly so since white coats and suits are no longer in line with current infection control guidelines. If your trust has a policy on their professional dress code, be careful not to fall foul of it; these things are rarely worth getting into hot water about. Generally, don’t show too much skin, have comfortable shoes, and don’t wear too much flashy jewellery.