As I have been promising, www.iwanttobeasurgeon.com is getting a makeover. I've reformatted it and there is a lot new content now including a research skills section. The old website will be down for the next few days and the new site will be relaunched on FRIDAY! So watch this space and let us know what you think of the new look...
Amel
PS
Good luck to everyone sitting Part B this February and I hope you found some of the blog posts relevant.
Monday 31 January 2011
Tuesday 25 January 2011
Application form
In general, most application form for all the specialties are similar. ACF application form consisted of
1. Listing academic achievements
2. Courses
3. A brief paragraph on audits.
4. Brief paragraph on teaching experience.
5. Brief description about my research projects, and then the next question asked to write in detail about one of the mentioned research projects.
6. Brief description about why I wanted an academic job.
7. Brief paragraph on my commitment to the specialty I am applying for.
8. Extracurricular activities
However, in my interview, I was asked to talk I'm detail about my academic achievements, research projects, and my interest in academia. There is not much emphasis on audits, however it is advisable to have one completed cycle as it is essential to be shortlisted for an interview.
I was lucky enough to have worked in a reputable hospital during my F1 year and with my interest in surgery and research, I was able to undertake a few research projects. Although it was very hard work, during my F1 year I was able to successfully pass MRCS part A exam, nationally present my research project as first author, as well as publish 3 papers (2as first author, and the second as 2nd author). Furthermore, I am in the process of writing 2 further papers for publication.
My advice for aspiring surgeons and academics would be to start early. It requires a lot of hard work, but show your enthusiasm to the consultants in your hospitals, and you will have opportunities to undertake useful projects which will help boost your CV to be successful in your choice of job.
Next post will be about setting up portfolios in preparation for interviews.
Contact me by email iwanttobeasurgeon@gmail.com for further information, or via this blog, and I will aim to answer any queries as soon as I can.
Romesh
1. Listing academic achievements
2. Courses
3. A brief paragraph on audits.
4. Brief paragraph on teaching experience.
5. Brief description about my research projects, and then the next question asked to write in detail about one of the mentioned research projects.
6. Brief description about why I wanted an academic job.
7. Brief paragraph on my commitment to the specialty I am applying for.
8. Extracurricular activities
However, in my interview, I was asked to talk I'm detail about my academic achievements, research projects, and my interest in academia. There is not much emphasis on audits, however it is advisable to have one completed cycle as it is essential to be shortlisted for an interview.
I was lucky enough to have worked in a reputable hospital during my F1 year and with my interest in surgery and research, I was able to undertake a few research projects. Although it was very hard work, during my F1 year I was able to successfully pass MRCS part A exam, nationally present my research project as first author, as well as publish 3 papers (2as first author, and the second as 2nd author). Furthermore, I am in the process of writing 2 further papers for publication.
My advice for aspiring surgeons and academics would be to start early. It requires a lot of hard work, but show your enthusiasm to the consultants in your hospitals, and you will have opportunities to undertake useful projects which will help boost your CV to be successful in your choice of job.
Next post will be about setting up portfolios in preparation for interviews.
Contact me by email iwanttobeasurgeon@gmail.com for further information, or via this blog, and I will aim to answer any queries as soon as I can.
Romesh
Monday 17 January 2011
Core surgery recruitment and Academic Clinical Fellowship
With the interviews for core surgical training underway, there's a lot of tension at work place.
Having secured an academic clinical fellowship, I have the luxury of sitting back and enjoying the rest of my foundation year 2 training. Sadly I'm not particularly enjoying the care of elderly attachmet as most involves countless paperwork and a lot of babysitting patients while they wait for nursing/residential home placement.
So what is academic clinical fellowship? Many have asked me this and it's surprising how little people know of such oppurtunity.
It is essentially a specialty training programme with protected time for research. Most candidates will spend the first 3 years doing a pre-pilot research with the aim of applying for an externally funded pHd or an MD. On completion of the pHd/MD the candidates will slot back into higher specialty training. It is essentially a run through training in which all candidates entering ST1 training is almost guaranteed a CCT (Certificate of Completion of Training).
Now you may think, then why don't many people apply for it?
The same reason I mentioned above; not many are aware of such opportunities, and it is also only suitable for those who are interested in research and academia. Competition is fierce with less than 10 ACF in surgery available in the whole of UK at ST1 or ST2 level.
My next blog will be about how to prepare your portfolio for ACF/ core surgery, how to fill out applications, and how to utilise the time to get the most out of foundation training.
Stay tuned.
Romesh
Having secured an academic clinical fellowship, I have the luxury of sitting back and enjoying the rest of my foundation year 2 training. Sadly I'm not particularly enjoying the care of elderly attachmet as most involves countless paperwork and a lot of babysitting patients while they wait for nursing/residential home placement.
So what is academic clinical fellowship? Many have asked me this and it's surprising how little people know of such oppurtunity.
It is essentially a specialty training programme with protected time for research. Most candidates will spend the first 3 years doing a pre-pilot research with the aim of applying for an externally funded pHd or an MD. On completion of the pHd/MD the candidates will slot back into higher specialty training. It is essentially a run through training in which all candidates entering ST1 training is almost guaranteed a CCT (Certificate of Completion of Training).
Now you may think, then why don't many people apply for it?
The same reason I mentioned above; not many are aware of such opportunities, and it is also only suitable for those who are interested in research and academia. Competition is fierce with less than 10 ACF in surgery available in the whole of UK at ST1 or ST2 level.
My next blog will be about how to prepare your portfolio for ACF/ core surgery, how to fill out applications, and how to utilise the time to get the most out of foundation training.
Stay tuned.
Romesh
Thursday 6 January 2011
MRCS stations October 2010
MRCS Station October 2010
I will be briefly talking about the stations I had in my MRCS part B OSCEs. I will Mention them in the order I faced each station.
My first station was scrubbing. There were two examiners inside the station, and one was acting as the nurse. The description stated that you can ask the "nurse" for anything you want him/her to do. The examiners check the hands under the UV light at the end to see if you had covered all the areas during scrubbing. During the scrubbing, I was quizzed on the advantage and disadvantages of chlorhexidine and iodine, and when I would use one over the other in surgery.
Critical care: essentially the same station described by Amel. I was quizzed on TURP syndrome. As I managed to get through all the questions, the anaesetists quizzed me further on pharmacology of furosemide, and Mannitol, the mechanism of action. They also asked about the indication for intubation in a patient (all covered in Kanani's critical care vivas).
Communication skills. 10 minutes to read some notes about a patient who fell down some stairs after a drunken night out. He sustained a splenic haematoma, and the plan mentions that he needs to stay in the hospital for few days. The task is to convince the patient not to self discharge. The patient is very adamant that he wants to leave. Just had to make sure that he was not under the influence of alcohol, and has capacity to make decision. No one in my circuit managed to convince him to stay.
Pathology: scenario of a patient who presents with fever, new onset cardiac murmur, and has a previous history of rheumatic fever. The discussion was around major and minor criteria of endocarditis, most common organism, and treatment. The discussion then went onto cardiac transplants, and side effects of immunosuppression. Very straight forward station.
Critical care: scenario of a patient who was trapped under collapsed building. Discussion was around ATLS management of trauma, rhabdomyolysis, hyperkalaemia(potassium from muscle getting into the circulation).
Anatomy (specialty). Trunk and thorax. Dissection specimen of abdomen. Asked to point out stomach, duodenum, and pancreas. The different parts of stomach, blood supply. The arteries that bleed in duodenal ulcer. Parts of pancreas, blood supply, function of pancreas (exocrine and endocrine). Blood supply to the colon.
Anatomy 2. Live model present. Asked to point out tibialis anterior tendon on person. Point out Achilles tendon, Extensor Hallucis Longus, and digitorum. Dorsalis pedis and posterior tibial pulse. Show what happens when tibialis andterior and posterior contract together (inversion of the ankle). Point out where peroneus longus attaches. Nerve supply of tibialis anterior, and peroneous longus. Show me where you would test sensation of superficial and deep peroneal, and sural nerve. Demonstrate ankle and knee jerk, and the nerve roots.
Anatomy 3. Dry skeleton. Asked to point out the different parts of the humerus, and sites where nerves can be damaged. Asked what lies around the radial nerve in the radial groove (lateral and medial head of triceps). Origin and insertion of rotator cuff muscle. The examiner pointed to the ASIS and asked me what that point is called, and asked what attaches there (sartorius). Asked which nerve gets compressed around there and what is the pathology called (meralgia paraesthetica). Asked about origin and insertion of quadratus femoris.
Clinical skills: catheterisation on a plastic model (with a live patient sitting on the other side). Quizzed on what I would do if I can't get the catheter in (try bigger size, in experienced hands introducer, or SPC if still can't catheterise. Then quizzed on management of a patient who presents with abdo pain, and tachycardia.they were describing a ruptured AAA case, and how you would manage the patient.
Round 2.
Cardiovascular examination. Patient had a pacemaker. Asked about what precautions I should take; ppm check, careful use of diathermy.
Comm skills2. 10 minutes to read notes about a RTA victim with pulseless leg. Task was to call the trauma consultant to come to hospital. Quizzed about ATLS, management of open fractures, compartment syndrome.
Comm skills 3. Assess cognition of a patient awaiting elective hip replacement. Patient has AMTS of 2/10. Asked what I would do; collateral history from family, GP etc. If new, then investigate cause for confusion. Postpone surgery for now as needs investigation of confusion.
Examination 1. Knee exam of a patient with relatively new arthroscopic ports. Tender medial and lateral compartments, and patient had crutches hidden behind bed. Differential diagnosis: OA, and rheumatoid, tests I would do (weight bearing x-rays, bloods). Finally management of knee pain.
Hernia and scrotal examination: patient with bilateral inguinal hernia, and a hydrocoele. Simple question on differential diagnoses of lump in groin/scrotum, and management of hernias.
Head and neck examination. Examine a patient who has pain in submandibular region pain on eating. I performed normal neck exam, and then bimanual examination of submandibular glands, I wasn't able to feel any abnormalities, and was a but worried that i may be missing something. The examiner then said to me "I appreciate this is a normal patient...but what would you find in a patient with similar symptoms" I breathed a sigh of relief and talked about submandibular calculi. Asked about what nerves can be damaged in submandibular gland surgery, and quizzed about anatomy of parotid gland.
History. Take a history of a patient with increased urinary frequency, hesitancy, and dribbling. Basic questions on management of BPH.
Critical care 3. Scenario of a patient who had a reversal of ileostomy 3 days ago, now has abdo distension, spiking temperatures. Asked about bowel obstruction, and anastomotic leak. Differentiating true obstruction from pseudo obstruction (no bowel sounds in pseudo, and tinkling In true obstruction).
History. Patient with back pain, and numb great toe. Probable disc protrusion and compression of nerve roots. Quizzed about cauda equina, and how I would manage this patient.
Overall, very fair and straightforward exam. The examiners are generally very nice and will help you work out the answer. There are lots of staff that take you from one floor to the other, so no chance of being lost. The exam however is very long and tiring.There is a break between each 9 station where you get coffee and biscuits.
I will be briefly talking about the stations I had in my MRCS part B OSCEs. I will Mention them in the order I faced each station.
My first station was scrubbing. There were two examiners inside the station, and one was acting as the nurse. The description stated that you can ask the "nurse" for anything you want him/her to do. The examiners check the hands under the UV light at the end to see if you had covered all the areas during scrubbing. During the scrubbing, I was quizzed on the advantage and disadvantages of chlorhexidine and iodine, and when I would use one over the other in surgery.
Critical care: essentially the same station described by Amel. I was quizzed on TURP syndrome. As I managed to get through all the questions, the anaesetists quizzed me further on pharmacology of furosemide, and Mannitol, the mechanism of action. They also asked about the indication for intubation in a patient (all covered in Kanani's critical care vivas).
Communication skills. 10 minutes to read some notes about a patient who fell down some stairs after a drunken night out. He sustained a splenic haematoma, and the plan mentions that he needs to stay in the hospital for few days. The task is to convince the patient not to self discharge. The patient is very adamant that he wants to leave. Just had to make sure that he was not under the influence of alcohol, and has capacity to make decision. No one in my circuit managed to convince him to stay.
Pathology: scenario of a patient who presents with fever, new onset cardiac murmur, and has a previous history of rheumatic fever. The discussion was around major and minor criteria of endocarditis, most common organism, and treatment. The discussion then went onto cardiac transplants, and side effects of immunosuppression. Very straight forward station.
Critical care: scenario of a patient who was trapped under collapsed building. Discussion was around ATLS management of trauma, rhabdomyolysis, hyperkalaemia(potassium from muscle getting into the circulation).
Anatomy (specialty). Trunk and thorax. Dissection specimen of abdomen. Asked to point out stomach, duodenum, and pancreas. The different parts of stomach, blood supply. The arteries that bleed in duodenal ulcer. Parts of pancreas, blood supply, function of pancreas (exocrine and endocrine). Blood supply to the colon.
Anatomy 2. Live model present. Asked to point out tibialis anterior tendon on person. Point out Achilles tendon, Extensor Hallucis Longus, and digitorum. Dorsalis pedis and posterior tibial pulse. Show what happens when tibialis andterior and posterior contract together (inversion of the ankle). Point out where peroneus longus attaches. Nerve supply of tibialis anterior, and peroneous longus. Show me where you would test sensation of superficial and deep peroneal, and sural nerve. Demonstrate ankle and knee jerk, and the nerve roots.
Anatomy 3. Dry skeleton. Asked to point out the different parts of the humerus, and sites where nerves can be damaged. Asked what lies around the radial nerve in the radial groove (lateral and medial head of triceps). Origin and insertion of rotator cuff muscle. The examiner pointed to the ASIS and asked me what that point is called, and asked what attaches there (sartorius). Asked which nerve gets compressed around there and what is the pathology called (meralgia paraesthetica). Asked about origin and insertion of quadratus femoris.
Clinical skills: catheterisation on a plastic model (with a live patient sitting on the other side). Quizzed on what I would do if I can't get the catheter in (try bigger size, in experienced hands introducer, or SPC if still can't catheterise. Then quizzed on management of a patient who presents with abdo pain, and tachycardia.they were describing a ruptured AAA case, and how you would manage the patient.
Round 2.
Cardiovascular examination. Patient had a pacemaker. Asked about what precautions I should take; ppm check, careful use of diathermy.
Comm skills2. 10 minutes to read notes about a RTA victim with pulseless leg. Task was to call the trauma consultant to come to hospital. Quizzed about ATLS, management of open fractures, compartment syndrome.
Comm skills 3. Assess cognition of a patient awaiting elective hip replacement. Patient has AMTS of 2/10. Asked what I would do; collateral history from family, GP etc. If new, then investigate cause for confusion. Postpone surgery for now as needs investigation of confusion.
Examination 1. Knee exam of a patient with relatively new arthroscopic ports. Tender medial and lateral compartments, and patient had crutches hidden behind bed. Differential diagnosis: OA, and rheumatoid, tests I would do (weight bearing x-rays, bloods). Finally management of knee pain.
Hernia and scrotal examination: patient with bilateral inguinal hernia, and a hydrocoele. Simple question on differential diagnoses of lump in groin/scrotum, and management of hernias.
Head and neck examination. Examine a patient who has pain in submandibular region pain on eating. I performed normal neck exam, and then bimanual examination of submandibular glands, I wasn't able to feel any abnormalities, and was a but worried that i may be missing something. The examiner then said to me "I appreciate this is a normal patient...but what would you find in a patient with similar symptoms" I breathed a sigh of relief and talked about submandibular calculi. Asked about what nerves can be damaged in submandibular gland surgery, and quizzed about anatomy of parotid gland.
History. Take a history of a patient with increased urinary frequency, hesitancy, and dribbling. Basic questions on management of BPH.
Critical care 3. Scenario of a patient who had a reversal of ileostomy 3 days ago, now has abdo distension, spiking temperatures. Asked about bowel obstruction, and anastomotic leak. Differentiating true obstruction from pseudo obstruction (no bowel sounds in pseudo, and tinkling In true obstruction).
History. Patient with back pain, and numb great toe. Probable disc protrusion and compression of nerve roots. Quizzed about cauda equina, and how I would manage this patient.
Overall, very fair and straightforward exam. The examiners are generally very nice and will help you work out the answer. There are lots of staff that take you from one floor to the other, so no chance of being lost. The exam however is very long and tiring.There is a break between each 9 station where you get coffee and biscuits.
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