What to expect on the Job: Your first day in the NHS

Congratulations! Your journey to the UK has finally gotten you to where you’ve been waiting to be- employed as a doctor in a UK hospital. And now you must deal with having your first day in the NHS.

Understandably, you must be very nervous. Perhaps you’ve been out of clinical practice for a long period of time, or you’re unsure about how the environment will be, or just what is expected of you. Never fear, we will walk you through what you can generally expect.


First of all, stay calm and relax. You know exactly what you’re doing, and the great thing is, the people you’re working with are going to be extremely supportive and helpful. If you go through a formal induction by your trust, everything will be made clear as what is expected of you. 

Don’t be afraid to ask questions (never think anything is silly!), and make sure you are clear about any confusion you may have.

Be prepared

Just like your job interview, the very first impression you make with the people you will be working with depends on how prepared you are. This preparation can start from knowing what is expected of you (reading the job description) and understanding beforehand what will be your role in the team.

Knowing different roles in your team

It’s impossible to understand everyone’s role who you will be working within your very first day in the NHS. But one thing keep in mind, a porter’s role is not less important or less valuable than a consultant’s. Everyone has their part to play and that’s how NHS provides care harmonically.

The work environment

The following roles may be present in your ward:

  • Consultants
  • Specialty doctors
  • Trainee doctors
  • Trust grade doctors
  • Advanced care practitioners
  • Nurse practitioners
  • Physiotherapists
  • Occupational Therapists
  • Nurses
  • Healthcare assistants
  • Site managers
  • Porters

Initially, you may have a hard time knowing who is who, but so long as you are polite and respectful to everyone, it shouldn’t be a problem. For many of us, back in our home country, a lot of these roles don’t exist, and that’s why you may have to take some time to understand what tasks they can or can not do. The best way is to ask politely.

Make sure you know exactly who your rota coordinator and line manager are. If you don’t undergo a formal induction, at least ensure a proper sit down with your rota coordinator so you can understand exactly what is expected of you. They will also outline all you need to know by way of sick, study, and annual leave. Whatever papers or forms you’re given, read them thoroughly, and keep them in a folder so that you can always locate them when needed.

Don’t blindly agree to anything and be sure to everything you’re agreeing to. If not already discussed and decided upon, be certain there will be some amount of shadowing before your formally start, or at least a period of time where you won’t have the full brunt of responsibilities until you’ve got a hang of the ward.

Introduce yourself

Your consultant may introduce you to the team, but still, not all of them would be present there. People tend to call you by your first name on the name badge. If you would like to be called in a shortened or different name, ask them politely – or even before they can read your badge just politely introduce yourself.

Be punctual & presentable

Please don’t be late on your very first day on the job in the NHS. Use apps like google maps to plan your journey to the hospital and leave 10-15 minutes earlier than suggested.

Your ward will inform you if you need to wear scrubs or if you can dress semi-professionally,  but whatever the option, make sure you choose a comfortable pair of shoes so that you don’t tire easily. With it, a pair of orthotic insoles are key to keeping your feet happy, no matter your working hours.

Don’t forget the most important part of your outfit: your stethoscope. If you don’t already have one, here are the ones most recommended:

Accessing your NHS email

Pay a visit to your hospital’s IT department or contact them or your HR. After you’ve received your login ID and password, you will need to set up your account. Most are happy to just have to log in on their home computer every night to check for any updates, but personally, it is best to have that email on your phone.

Note that this is regarding the NHS email i.e. bobthebuilder@nhs.net, not the hospital email (in case your hospital offers you an address). Hospital emails may look something like bobthebuilder@xyz.nhs.uk.

How to set up your NHS email on your phone?

NHS email is an outlook web app based email. Any email client like Gmail, Outlook, or your preferred email app in your phone will be able to sync your NHS emails.

  1. Choosing your email client.

    The process here is outlined from the Gmail app, which is available in both Google Play and the App store. You can also use apps like Outlook by Microsoft.

  2. Go to “Add account”

    Select “Exchange and Office 365”.

  3. Type in your NHS email ID

    You should get this from your IT department or the HR. Both the ID and first password. Something like your.name@nhs.net.

  4. Your password

    Ideally your first password should be changed in a desktop and this should be your desired password (not the IT given first one).

  5. Incoming server validation

    You don’t have to do or change anything.  Keep everything as it is.

  6. Job Done!

    Gmail will gradually sync all the emails from the server.

Must-haves for the ward

There are certain apps which will make your life infinitely more easy, so keep them on your phone. The BNF has a directory of drugs that you can look up, along with treatment summaries, basic guidance, and wound care, among other features. It is something you will use regularly when you need to prescribe treatments or check for interactions. SIGN Guidelines is for any of you in Scotland, and most importantly, the Induction app for all your first day needs in the NHS.

You’ll find that sometimes when you need to refer a patient or present one in a board round, and someone may ask you to ‘score’ the signs and symptoms accordingly. This is where MDCalc comes in handy. You can even save scores that you use frequently to allow for quick calculating.

Now let’s talk about the books you’ll need to stay at the top of your game. Depending on the department or level you’re starting at, you may need one or more of the following:

And if you’re not already a member, look into a free one month trial of Amazon Prime. You can cancel even before the time runs out, and you’ll still receive all the benefits associated with Prime, such as 1 day free shipping, access to movies, music, etc.

Settling In

It’s a good idea to try and learn the names of everyone you work with as soon as possible. This is no easy feat, but try your best, because it will make your work environment easier. If you still have concerns about what may be asked of you, check out our post on the role of a junior doctor.

Lieu Days

Many of us new to the NHS are unaware of lieu days and the role they play in keeping us safe and happy. These are days given back to you that you have worked on, for instance, bank holidays. If you are scheduled to work on the ward or be oncall for a bank holiday (where everyone else is given a day off), you have the right to request that day back in lieu. Even if you book a seminar, conference, etc on a weekend that you are not working, you are entitled to ask for a day back. It is your responsibility to keep track of your lieu days and to request the days off appropriately.

If you are also scheduled for a zero day (post nights, post oncalls, etc) that falls on a bank holiday, you have the right to request that day back. Please make sure to go through your hospital’s policy regarding leave to be clear of the stipulations your Trust abides by, and if there is any concern that you are not given what is your due, don’t hesitate to contact your union (ex: BMA). Lieu days are a nice way to have a mini vacation or even add on to your annual leave if you are lucky, so don’t miss the opportunity to request them!

Understand the Culture

As highlighted here Why I love working in the NHS, the team you will be working with may have different people from many different cultural backgrounds. Your success, as well as the team’s success, depends on how the entire team works. This means that you have to be a part of that team as soon as you can. If you feel comfortable on the first day in the NHS to make a joke or have fun, that’s a very good sign.

There is a possibility that you will be asked to socialise in a venue. I would always suggest to try and attend those. If not for the food and drink, at least for the company.

Once you’ve settled in, it’s a good idea to bring in something for your colleagues as a way to thank them for helping you settle in up until now. If you’ve started with others at your level, you all could chip in and bring a cake, cookies, etc and a nice card for everyone. Other than that, take things in stride. No one is asking you to understand everything in the very first day in the NHS, so be patient and keep asking questions.

You’ll do just fine!