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Duties Of A Junior Doctor (What They Really Do)

Duties Of A Junior Doctor (What They Really Do)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

When I was applying to medical school, I’m really not sure I had the foggiest of what my day-to-day would look like and what I’d actually be expected to do as a doctor!

So now having worked as a junior doctor for the last couple of years I thought I’d write this article to try and help you understand what the job entails if you’re thinking about applying to medical school.

Junior doctors enact the plans of more senior doctors (consultants). This normally entails ordering tests or x-rays, referring to other medical teams or discharging the patient home from hospital. Junior doctors will also frequently review sick or deteriorating patients.

But there’s a lot more to the job than that. We’re first going to cover some definitions, then look at a typical day and finally finish off by covering the four most common jobs junior doctors have to do.

The Definition Of A Junior Doctor

I thought it would be helpful to start out with some definitions.

First of all, what is a junior doctor?

By definition, a junior doctor is any doctor who hasn’t reached the top rung of the medical training ladder.

That is, they aren’t either a ‘consultant’ if they work in a hospital or a GP if they work in the community.

So for some specialties that have particularly long training pathways you could, by definition, be a ‘junior doctor’ for about ten years after graduating from medical school!

Now colloquially a ‘junior doctor’ has a slightly different definition.

As you’ll soon realise, it feels a bit silly calling a senior registrar (the step just below consultant) a junior!

Colloquially, a junior doctor would be either a Foundation Year 1 or Foundation Year 2 Doctor- or at the very least someone who’s relatively early on in their training pathway.

Wait, What’s A Foundation Doctor?

Immediately after graduating, doctors in the UK do a two-year foundation program.

In this program, you rotate around different departments for two years before deciding if you want to go into training to become a specialist in a particular area.

A foundation year doctor wearing COVID-19 PPE

So in the first year of work after medical school you’d be a ‘Foundation Year 1 Doctor’ and in the second year you’re referred to as a ‘Foundation Year 2 Doctor’.

This is often shortened to FY1 and FY2 doctors respectively.

A Typical Day In The Life Of A Junior Doctor

Within your two foundation years, you’ll do six four-month placements, each in a different department or specialty.

Now there is significant variation in the work between specialties, but there are also some common themes that link the majority- and that’s what we’ll focus on here.

The two most notable outliers are if you’re working in the Emergency Department or in a GP practice.

But for the rest, the broad template is as follows:

1. Morning Handover

The day starts off by the night team handing over to the day team.

The doctor’s who’ve been working overnight will tell the day team about any patients who’ve been particularly sick or deteriorated over the night.

They’ll also highlight any blood tests or scans that have been requested but the results haven’t come back yet- this is so the day team can keep an eye out for them.

2. Ward Round

The ward round is where the consultant in charge (a.k.a. the boss) goes round and generally sees every patient under their care.

This is normally done as a team so everyone knows what the plan is for each patient.

Depending on how many patients your team is looking after this can take from under an hour to nearly all day!

A group of doctors reviewing a patient during a ward round

On the ward round the consultant will:

  • See how the patient feels this morning- are they in pain? Have they been eating and drinking well? Do they have any questions regarding their treatment?
  • Check their observations- the nursing staff regularly carry out observations (things like blood pressure, heart rate, oxygen saturations etc.) on every patient. These can serve as a useful indicator of how sick someone is (this is the chart at the end of the bed that you see in movies).
  • Examine the patient- examination is a vital skill in a doctor’s toolkit; laying a hand on a patient can reveal a lot more information than numbers from observation charts alone.
  • Check if there are any tests outstanding- are they waiting for an x-ray or for some blood tests to come back from the lab?
  • Decide if any further tests are needed- does the patient need further tests requesting? Do they in fact need more scans or blood tests?
  • Consider if the patient’s medication needs changing- do they need any medications added or taken away from their current regime? For example, do they need to start antibiotics for a new infection they’ve developed while in hospital?
  • Think about the wider plan for the patient- what’s the current aim of treatment? Is the patient awaiting surgery? Is the aim to make the patient well enough to go home? Or is it to keep them comfortable in their last days of life. This wider plan is what will steer the direction of treatment for each patient.

3. Do The Jobs

So the ward round in essence is the boss going round and deciding on a plan for every patient.

The next step for you as a junior doctor is then to enact that plan!

Important note: Step 3 should not be attempted until you’ve had lunch (or at least a coffee) following the ward round

So, in general, you’d make a list of all the jobs that need doing from the ward round and then try and do them in order of importance with your colleagues.

We’re going to look at some of the most common individual tasks you’ll have to do as a junior doctor in the next section…

4. Evening Handover

The last thing to do for the day is to handover back to the evening/night team.

There are far fewer doctors on overnight compared with over the day so the aim is to only hand over the essentials.

Much like the morning handover but in reverse, you’ll highlight any patients that have been particularly sick over the day (in case they get worse overnight) and any blood tests or scans to keep an eye out for.

Common Junior Doctor Jobs

So we’ve gone over the typical day for a junior doctor and how jobs are generated from the ward round.

Now let’s look at some of the most common individual tasks you have to do as a junior doctor.

Reviewing Sick Patients

First and foremost, as a junior on the wards your job is to keep everyone alive!

That means you’ll often find yourself being asked to review sick or deteriorating patients to see if they need any new or different treatment.

You might be asked to review a patient if:

  • The nurses are concerned that the patient is going downhill and they’re not sure why
  • The patient suddenly developed new and concerning symptoms e.g. chest pain
  • They were looking a bit ropey on the ward round in the morning so the consultant wanted you to check up on them in the afternoon

As part of your review you essentially cover all the same things as on the ward round but just by yourself.

So you’ll talk to the patient, check their observations, examine them, look at their recent X-rays and so on.

After reviewing the patient there’s essentially three roads you can go down:

  1. The patient is stable at present and doesn’t need anything changing
  2. You might add or change their treatment +/- order some tests
  3. You’re concerned about the patient so you’d seek senior help

Just flesh out this framework with a bit of medical knowledge and you’ll be ready for the wards in no time!

Requesting & Checking Tests

A massive component of modern medicine is centred around all the different tests we have at our disposal in hospitals.

These range from blood tests to x-rays to actually putting cameras into the body to take a look!

It’s normally the consultant who decides on which tests are required but then it’s your job to make sure they happen!

A junior doctor prepares to take blood from a patient

A lot of hospitals use computer systems to order simple tests such as x-rays, but for the more complicated ones you may have to go and speak to the specialist who’ll actually do it.

The flip side of requesting tests is then checking the results of them.

It’s normally the junior’s job to check all the tests that come back for each patient.

If they’re normal then there’s usually not much to do… but if they come back completely off it might mean you have to go and review that patient or highlight the result to a senior.

Writing Discharge Letters

Arguably one of the more boring (but essential) duties of a junior doctor is writing discharge letters for patients leaving hospital.

This is a letter you write to the patient’s GP that sums up everything that happened to them in hospital.

This is so the GP is up to speed with what’s gone on when they next see them.

A copy of the letter is also normally given to the patient.

If you’ve been working on the wards for the last couple of days you may already know the basic story of what happened to the patient- so can write it up fairly quickly.

However, if you’ve just come back from holiday for instance you may find yourself having to read back through all the notes to try and figure out what’s happened so you can write a coherent summary for the letter… Snooze!

Referring To Other Specialties

The way hospitals work is each patient is admitted under a particular department or specialty.

Which team you come in under depends on the main problem that you present with.

So if you came to hospital complaining of chest pain because you were having a heart attack, you’d be admitted under cardiology.

If you came in because of a broken arm you’d be admitted under orthopaedics (the bone doctors).

This works well because it means patients are primarily seen by doctors who are specialists in their main problem.

A young man with a broken nose being examined by a doctor in A&E

However, there can often be times when the parent team needs to ask for another specialty’s help.

That might be because:

  • The patient was admitted under one specialty but it turns out that wasn’t their main problem. For example, a patient with chest pain is admitted under cardiology but it turns out to be a lung infection instead
  • The patient develops a new problem while in hospital e.g. they fall over and break their hip trying to go to the toilet
  • The treatment the patient needs requires input from more than one specialty. For example, for complex breast cancer surgery it might take both plastic and breast surgeons to do the operation

In all these cases the parent team (the one the patient came in under) has to refer to the other specialty that they need help from.

And yes, you guessed it, that job is one of the duties of a junior doctor.

Referring to another specialty is normally done with a short referral form or by phoning up one of the doctors who works in that specialty.

They’ll want to know what’s happened to the patient so far and what exactly you need them to do.

I remember really testing another doctor’s patience by doing an absolutely awful referral in the first few days after I’d started working.

I’d phoned him up but hadn’t realised you had to have a good idea of what was going on with the patient before you called… So had no idea how to answer a lot of the questions he was asking. Whoops!

Final Thoughts

Congratulations, you made it! You should now have a solid understanding of what a junior doctor actually does!

And that’s one step ahead of me when I was in your position!

Now to be clear, there are a litany of other jobs that junior doctors do that we didn’t cover…

Talking to families, checking medication doses, liaising with GPs… But with the four common tasks we’ve covered gives you the picture of what takes up 90% of our time!

A great way to truly expand your understanding of the duties of a junior doctor is to actually go and shadow one.

If you’ve got any family members who work in medicine they’d be a great place to start to try and arrange a taster experience.

Even if it’s as short as a single day, actually seeing all the things we’ve talked about will really make it stick in your memory for when it comes to medical school interviews.

Either way, using this article as a starting point, I’m confident you’ll have a good enough understanding to take on any questions about the duties of a junior doctor that crop up at your interview!

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.