Consensus amongst Foundation Year One (FY1) doctors at the Royal Liverpool University Hospital was that large discrepancies exist in overall FY1 experience between specialties. Discussion with Foundation Programme Directors (FPDs) revealed that no data had ever been collected to assess this.

I therefore conducted a wide-ranging survey that asked both quantitative and qualitative questions focused upon workload and educational opportunities. The survey was distributed at the end of the FY1 year in August 2018, and asked the same set of questions about all three rotations retrospectively. We received 41 responses from a total of 54 FY1s.

I used the data to produce a speciality-specific report for each of our 19 specialities, detailing how their performance compared to other departments. I then worked alongside our FPDs to produce an action plan for each speciality. These highlighted areas that required improvement, with suggestions from FY1s on how to achieve this improvement. FPDs then met with seniors from each specialty to discuss how our action plans could be most effectively implemented.

Resulting improvements include, but are not limited to:

• A number of ‘essential actions,’ such as rearranging ward round times to ensure FY1s did not routinely work beyond their contracted hours.

• Redistribution of FY1s to areas where workload is more manageable and educational opportunities are greater.

• Introduction of support staff (such as Physician Associates and phlebotomists) in areas where FY1s spend a significant time performing routine tasks.

• A series of ‘quick wins,’ which included addressing IT issues, and rescheduling departmental teaching to ensure that FY1s could attend.

• An increase in experiences that FY1s found useful, such as supervised clinic and theatre opportunities.

This work demonstrates how a simple intervention, such as collecting feedback and using it to produce action plans, can lead to significant improvements for a large group of people.