Interns undergo their screen test


A new RTÉ series looks at the lives of four junior doctors as they are let loose on the hospital's wards. Paul O'Doherty reports

There are few professions where no sooner have you battled your way through six years of college, passed your finals, donned your mortarboard (women only) and gown, collected your bit of paper, than you arrive at the furnace of a working leviathan where, with your blood pressure racing the unknown and your bleeper orchestrating a symphony of 100 different movements, you're expected to work 80-odd weeks at the coalface, in life or death situations.

Such is the plight of the post-graduate medical student, the subject of a new four-part fly-on-the-wall documentary series, Junior Doctors, which started last night (Monday, RTÉ 1, 9.30pm).

The programme follows Paddy Barrett, Sinéad Beirne, Catherine de Blacam and Paul Carroll serving their internship at St Vincent's Hospital in Dublin, over the course of their first year as junior doctors, as they come to terms with the incredible hardships, compromises and rewards of their chosen profession.

It is obvious from day one that it is incredibly hectic, the camera captures the intensity and eccentricity of a system that demands your undivided attention and that you get to terms fast with the practicalities of being a doctor-at-large as opposed to being a doctor-in-training.

And these practicalities don't just extend to the patient and the minefield of diagnosis, there's also the foot-soldiering for consultants retrieving scans, X-rays, tests and results around the labyrinth of an old, if helpful, bureaucracy and a new environment. While most people in this country would be familiar with the plight of Ireland's junior doctors, the exposure of the third eye during Junior Doctors offers on-the-spot insights into daily routines, the black hole and endless nights of the "doctor-on-call" and the realisation that, finally, you can call yourself a doctor.

According to Dr Sinéad Beirne, "Having waited so long, and gone through such a long intense course and then finally at the end of it all you're handed the bleep and you put on your stethoscope on the first day, it was a great feeling. Even though you didn't know a lot of practical knowledge you've finally reached that stage that you could deal with patients, and it's a complete privilege to be trusted so much."

Unlike the other doctors on the programme, she is the only person with a doctor in her family - her sister Mairéad.

Dr Paul Carroll is part of the professorial surgical unit and, like most of the programme's junior doctors, is in his mid-20s. While acknowledging that he had a "great time in St Vincent's with lots of trials and tribulations", he also admits that during the first two months putting in 90-hour weeks - he lost a stone-and-a-half ("the best diet in the world") - he did, initially, fear that he wouldn't take to the role.

"It's very tough and testing. You're thrown into a job where you're expected to know everything and don't know anything. It's literally an apprenticeship. You learn from the ground up, essentially. On your first day, you don't even know how to take a blood sample or put in a cannula. All your clinical studies wouldn't teach you how to manage a patient. You know in theory but not in practical terms - that's intern year. It's the first time also you see really sick people."

For junior doctors there's also the fear of making a serious mistake. Dr Catherine de Blacam coped with this most taxing of apprehensions in the comfort that "there's always somebody there to ask help or phone to say 'I'm not quite sure'. You could be sharp academically, but you're not used to seeing really sick patients."

Other worries include the life and death situations. Dr Paddy Barrett was initially stationed in the cardiology unit where on his first night on call, one of his onerous duties was to "pronounce dead" a patient at the hospital. "It's an induction of fire. Working on the cardiac arrest team you're exposed quite early on to very traumatic situations on an almost daily basis. Watching someone actually die in front of you is always a traumatic moment. On the arrest team you could be called three times a day, and easily two if not three of those patients could die.

"Generally, you're working in a lot of strange situations and a lot of times initially alone. You learn a lot about yourself and how you react when you're extremely tired in the middle of the night. Sometimes you're impressed with yourself, sometimes you're not," he says.

However, as de Blacam points out, it's not all doom and gloom. "You're really lucky as an intern because you get to know everybody in the hospital. You're the communicator. You're ordering tests and scans and collecting the results, and talking to other teams and doctors and communicating with your consultant, registrar and the nurses on the wards. One of the big highs of the job is that you get to know every single individual in the hospital."

And how did they cope with the cameras? Barrett sums it up nicely when he says: "You don't realise initially when you're walking down a corridor you have a camera crew over your shoulder which everyone else sees and you don't. After a while the crew blended into the background and I didn't really notice any difference and it didn't bother me."

Junior Doctors continues over the next three Mondays and is narrated by Tom O'Súilleabháin, and is filmed, produced (with Paula Williams for Mint Productions) and directed by Traolach Ó Buachalla.