The Foundation Years Champion

This month's guest blog is written by Dr Patrick Hughes ST6, West of Scotland

As I enter my final year of training, I’ve been thinking a lot about a mentoring role I’ve adopted over the last couple of years, and specifically what the future might hold for it when I finish.

The so-called “Foundation Years Champion” has changed and developed during this time but is essentially very simple: when the new FY2s start their psychiatry job I join them at induction and introduce myself; I arrange to meet with them individually and I get to know them – their names, their ambitions, their anxieties about their new job; what they want to achieve in the next 4 months; what they want to achieve in the next 5 years.

I’m friendly and enthusiastic and together we brainstorm a few ideas around how best they might use their time with us in psychiatry. Is there scope for them to spend some time with liaison? Are they interested in shadowing some CAMHS clinics? Would the FY2 interested in neurology like to join the medically unexplained symptoms clinic for a couple of sessions? What kind of audit or quality improvement project might look good when it comes to their anaesthetics interview? I don’t necessarily organise anything for them – they need to take responsibility for their own learning – but with my local knowledge I can point them in the right direction.

More importantly, through my words and my actions, I make it clear to them that it is perfectly valid to pursue these experiences and that ultimately, they are here to be trained. This is a fact which is often lost on FY2s, and I think that very often their experiences in hospital jobs only consolidate the idea that service-provision takes priority and that they’ll learn all they need to just by being here and getting on with things.

Following these initial meetings, I write a brief summary of our chat and send it to the trainee and their supervisor. This is not a list of instructions or demands; it is a record of what we have discussed and what the trainee feels would be valuable to try and achieve during this post. Whether these aims are achieved or not is down to the trainee and their supervisor. I am just the advocacy worker - articulating the trainee’s wishes and making them known.

After this, my input is much less structured. Mid- and end-point meetings are offered, and although most trainees do not take me up on this, they are aware that an additional source of support is available to them should they need it. Beyond this, I do very little that wouldn’t be expected of a friendly colleague: saying hello and asking them how they are doing when I meet them in the corridors or see them at teaching.

Where did it all begin?

The idea for the Foundation Years Champion came about after survey data from the GMC’s National Training Survey (NTS) and the Scottish Training Survey (STS) showed that levels of satisfaction among the Foundation doctors in our department, particularly relating to educational environment and availability of adequate experience, were lower than those of their Core Training counterparts. Supervisors at this time acknowledged that, while they were quite comfortable with the training needs of their Core Trainees, they were less confident when it came to Foundation doctors.

It was felt that a dedicated clinician to support these trainees and advocate for their needs might be beneficial. After the first year, we saw marked improvements in NTS and STS feedback from Foundation doctors, with the pink and red flags disappearing and a new green flag for educational governance. Our local survey also showed improvements in their perception of the support available to them and the extent to which they felt their training was being prioritised.

Mentoring and peer-mentoring programmes are increasingly a part of supporting doctors in training, and no doubt the Foundation Years Champion has parallels with other projects going on elsewhere. I believe Foundation trainees may warrant special attention though. Many of them are undecided on the career path they are going to take and a positive training experience or professional relationship at this stage could have an enormous impact on the road they decide to take. I have had the pleasure of supporting a number of FY2s to apply for Core Psychiatric

Training over the last two years, and with more doctors than ever now rotating through psychiatry as part of their Foundation training there is a real opportunity here. However, this will only lead to increased recruitment if the experience we give them makes them want to come back. More than this, I believe that as a group they are also the most in need of this kind of support, potentially being less assertive and less likely to take control of their own learning at such an early stage in their career.

So what does the future hold for the Foundation Years Champion?

I’d like to see it continue. It’s nothing fancy; it’s a small intervention that amounts to little more than a fellow trainee, slightly further along the road, taking an interest in the FY2 and trying to help make their time in psychiatry as valuable, worthwhile and pleasant as possible, in the hope that some of them might want to come back.

How much you would want to formalise such a role I can’t say. Certainly, forcing someone to do it would be pointless. But, if there were a will from the health board or the training programme or even the College for it to continue; if the benefits of the role were recognised and explicit; then it becomes a much more attractive option for the busy higher trainee to take on.

As the Foundation Years Champion, I have gained enormously from this experience, and not just because of the progress it has helped me make towards my own training competencies.

Foundation doctors are at a very exciting stage in their careers, and having the opportunity to get to know them; to find out what motivates them; what they want out of their careers and their lives; and doing something to help them along the way, however small, has been extremely rewarding. And I would recommend it to anyone.

N.B. Psychiatry Priority Programme: