Your first night on call as an FY1

Clinically reviewed by Dr Nick McIntosh, Emergency Medicine Senior Registrar (ACEM) · November 2026

The short answer

  • You’re never the only doctor in the hospital.
  • Bring food, a charger and working logins.
  • Get a proper handover: the sick patients, the jobs and the resuscitation decisions.
On this page
  1. How cover works overnight
  2. What to bring
  3. The handover you need
  4. Before your first night: checklist
  5. Once the calls start

Your first night on call is a rite of passage, and almost everyone finds it daunting. A little preparation turns it from frightening into manageable.

How cover works overnight

Overnight, you’ll cover several wards and many patients you’ve never met. Your registrar covers the same patients, but with bigger responsibilities: they may be admitting new patients, or in theatre if you’re covering surgical wards. The critical care outreach team sits behind you both. You’re never the only doctor in the hospital, even when it feels like it.

Many UK hospitals use a Hospital at Night team, a multidisciplinary night team whose calls are often coordinated centrally by a senior nurse or practitioner.

What to bring

  • Food and water for the whole night, and something extra. Snacks to share with the nurses and the rest of the night team do wonders for morale.
  • A phone charger.
  • Logins you’ve tested on every system you’ll need.
  • The key numbers saved in your phone: your registrar, the critical care outreach team and switchboard.
  • A pen, and a copy of the handover.

The handover you need

Before the day team leaves, make sure you know:

  • which patients are sick or worrying, and what would make the team more worried
  • the jobs they’re handing over, each with a time and a trigger
  • the resuscitation decisions for the patients who are unwell
  • the patients they’d like you to review.

If a patient sounds unstable, ask for a bedside handover.

Before your first night: checklist

Once the calls start

The rest of the night comes down to a few skills: deciding how fast to go to each call, knowing when to call your registrar, looking after yourself and handing over well in the morning. The free guide also works through the ten calls you’re most likely to get.

General education for doctors, not advice about a particular patient. Your hospital’s policies and your seniors always come first.

Sources (5)
  1. Good night and good luckMedical Protection Society (Stewart K, Woothipoom P)
  2. Hospital at Night - Working together to deliver safe and effective overnight careNHS Lothian (med.scot.nhs.uk)
  3. Acute care toolkit 1: HandoverRoyal College of Physicians
  4. Safer Care SBAR: Situation, Background, Assessment, Recommendation - Implementation and Training GuideNHS Institute for Innovation and Improvement (hosted by NHS England Improvement Hub)
  5. Anticipating and managing fatigue associated with doctors’ working patternsBritish Medical Association (BMA)

Adapted from First Night On Call, chapter 1: Before you start, version 2026.1, UK Edition.

Get First Night On Call, free

The phone guide for FY1s starting nights: how to triage calls, the ten calls you’ll get, when to call your registrar, and checklists. About 20 minutes to read.