Starting F1: your first month in the NHS

Make the system familiar

The Foundation Programme develops clinical and professional capabilities across F1 and F2. Your first priority is understanding how your hospital works. Attend induction, check access to clinical systems and learn who provides immediate senior support. A useful personal induction sheet records contacts and processes, without patient information.

• Find the emergency call procedure, escalation contacts and out-of-hours team.
• Locate prescribing guidance, results systems and handover arrangements.
• Confirm your rota, mandatory training and named supervisors.

Agree achievable learning goals

Arrange an early supervisor meeting. Bring a short list of skills you want to develop and ask how observation and feedback can fit into the working week. A small number of specific goals is easier to act on than a long list of intentions. Review these goals when the placement changes.

Build reliable daily habits

Before leaving, clarify outstanding jobs, identify who will follow up results and hand over concerns. Ask for help whenever a task exceeds your competence. Keep a brief learning note after useful feedback, then identify one change to try on the next shift. Protect rest and raise workload or wellbeing concerns early through your local support routes.

A practical plan for your first week

Foundation Year 1 (F1) is a supervised training year. Start by separating tasks that need immediate preparation from goals you can work on over the placement. Before your first shift, know how to contact the senior covering your area, how to access local guidance and where to find the handover list. You do not need to memorise the whole hospital system on day one.

During the first week, ask a colleague to show you the local process for requesting investigations, documenting decisions and escalating an unwell patient. Procedures differ between organisations. If you have not used a system before, arrange supervision rather than assuming it works like your previous placement.

• Before the first shift: confirm where to attend, access arrangements and the escalation route.
• During the first week: identify your supervisors and attend the required induction.
• During the first month: agree learning goals and review how the rota and workload are affecting them.

Keep an evidence log that helps you learn

A useful learning entry is brief and specific. For example, after receiving feedback on a handover, record what was unclear, the structure you will use next time and when you will ask someone to observe you again. This creates a learning cycle rather than a list of tasks completed.

Keep all portfolio material anonymised and follow local information-governance rules. Your foundation school will explain the required assessments, reports and deadlines. Do not assume that an activity counts simply because you attended it; confirm how it should be recorded and what feedback is needed.

Plan a sustainable first month

Choose a small number of achievable goals around your actual rota. A goal such as preparing a clearer problem list for ward rounds is easier to practise and review than a broad aim to become more confident. Bring examples of your progress and any barriers to your supervisor meeting.

Rest, induction and safe clinical work come before extra portfolio projects. If you are struggling with workload, access to supervision or wellbeing, raise this early through your supervisor and local support routes. Asking for help is part of responsible practice, not evidence that you are failing at foundation training.