Readiness for the job · not just the exam
Day-one FY1 ready
The competencies of a safe FY1, drawn from the four frameworks that define graduation: Outcomes for Graduates · Good Medical Practice · the Generic Professional Capabilities · the Foundation curriculum. Rate each honestly — appropriate for stage vs needs development.
The 19 framework domains — evidenced over a year, not on day one. Tracked apart so a curriculum domain can't outweigh sepsis recognition.
The day-one checklist
Acute & safety
0/4FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
Prescribing — the highest-yield FY1 safety domain
0/5FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
Clinical skills & reasoning
0/4FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
Communication & person-centred care
0/4FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
Professionalism, ethics & law
0/5FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
Ward paperwork
The frameworks
Outcomes for Graduates 2018
FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
What every UK graduate must know and be able to do on day one — the blueprint the MLA samples.
Good Medical Practice 2024
FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
The standard all doctors are held to (in force 30 Jan 2024) — four domains.
Generic Professional Capabilities 2017
FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
The generic capabilities essential to safe practice — nine domains underpinning the whole canon.
Foundation Programme Curriculum 2021
FY1 readiness, in order
Side-by-side stages are interchangeable — take them in any order. Later stages are greyed as advice, never locked: if your placement needs something now, go and get it.
The unwell patient
you are hereWhat kills patients in your first weeks, and what you will be bleeped about before you have a diagnosis.
Prescribing on the ward
comes laterThe commonest thing an FY1 does and the commonest source of harm they cause.
2 in parallel — either order
Getting through the day
comes laterHandover, documentation, data, discharge, prioritisation. None of it is taught in a lecture and all of it is expected from week one.
Difficult conversations
comes laterBad news, distress, conflict, mental state. Parallel to the ward skills because they are independent capabilities.
Professional duties
comes laterCapacity, candour, safeguarding, confidentiality, self-care. The domain that ends careers when it goes wrong.
Evidence it
comes laterThe framework domains are assessed on a portfolio built across a year. Knowing what evidence looks like now beats assembling it in a panic later.
What you’ll be assessed against once you start FY1 — 3 Higher Level Outcomes, 13 capabilities.