2) Reflect - this allows you to spot mistakes, ways of improving, and learn about yourself.
3) Document - if it isn't written down, it didn't happen.
5) Use a chaperone if examining a patient - make sure to document who was with you. This is for your career.
7) Hospital Policy and Guidance - use it, usually evidence based and means your decision is supported
9) Embrace uncertainty - medicine is a science, but biology is complex. Psychiatry - even more so.
11) Respect all staff - you are not captain of the ship, you are one of the rowers.
13) Use Baysian thinking - be deductive in your reasoning, look toward establishing or ruling out diagnoses. You will get things wrong...
15) Never forget social care - patients will need help, so ask about family support, home, transport.
17) Read previous notes - you don't know your patient until you do. In psych we read up to 10 years worth before even saying 'hello'
19) Prioritise - see urgent cases first, uses NEWS scores as a good way of prioritising
21) If it isn't working - reconsider diagnosis or treatment, seek senior help
23) Learn your formulary - get ahead by developing a knowledge of what you use regularly.
25) Use 'SBAR' - it is developed to provide actionable clinical information quickly.
27) Keep time in mind - that 'easy thing' may end up taking an hour. Always keep a buffer.
28) Consultants - are your friends, teachers and safety net. Treat them with respect.
30) Potassium - learn the ECG changes, be proactive, if in doubt, retest.
32) Sepsis: diagnose early, treat early, increase survival. See hospital policy and call microbiology for advice.
33) Urine output - catheter if possible
35) Make a plan - have an idea of what is happening before you call the Med Reg.
37) Same for surgery! Do not be afraid to call.
39) Practice - keep doing examinations, you will never be surprised of an undiagnosed diastolic murmur if you have heard 3000
41) Teamwork - care is a team dynamic. You do 5% of the work, the nurses, patient and other teams do the rest.
43) If you are struggling - seek support early. Mental health or physical. Your hospital is duty bound.
46) Imaging - call radiology and think clinically, what does this shadow mean?
48) Join a union and get insurance.
50) Be realistic in your expectations of self - not everything has to be 50/50.