Core Surgery Applications - Part II The Interview

So, interviews have started this week for CST and sorry this post maybe late for some of you. The interview can be split into two parts which need to be prepped for:

a) The hard portfolio
b) The actual interview

The hard portfolio is a very important way to demonstrate all your skills, achievements and also your organisation. Its upto you whether you use a lever arch file with dividers or a book. Either way there are principles that you must follow and some tips to make your book look impressive:

1. Have a contents page and ensure dividers correspond with this
2. Organise your book in logical sections
3. Avoid bunching up lots of pages in one pocket, your portfolio should read like a book so that interviewers can quickly flick through
4. Include a recent copy of your CV after the contents
5. Ensure that you add any certificates for courses as well as your MBBS certificate etc...
6. Don't forget your GMC certificate, copy of your application form and anything else they mention on the website
7. Organise printouts from your e-portfolio into CEXs in one pocket, dops in one pocket etc with the most recent and flattering first! Also don't forget the minipats/msf print outs
8. If you can print copies of presentations/posters in colour then please do to make them stand out 
9. Don't forget teaching achievements!!!
10. If you have a record of the operations you have helped in/done so far that will also be impressive. As a non trainee you can register and use the Intercollegiate Surgical curriculum Portfolio "ISCP" (www.iscp.ac.uk). I recommend this as it shows that you are already familiar with the programme that they will use for all surgical training. It is also a very nice way to display your operative rcord (if you have one). Do not worry about absolute number of surgeries as they know that not everyone has had much exposure to surgery.
11. Be comfortable and prepared to reply to any question on anything in your portfolio!!

I have included pictures of my portfolio below to give you an example of how you can set one out if you're not sure where to begin.

The next bit is the actual interview. There are many books to help you prepare, the one I recommend is "

Medical Interviews: a comprehensive guide to CT, ST and Registrar interview skills - Over 120 medical interview questions, techniques and NHS topics explained". It has lots of good examples and basically goes through how to structure answers to questions. Also, this WEBSITE has some good free content.

First of all, turn up looking smart and clean as well as early. Make sure you have brought your portfolio as well as all the necessary paperwork including photocopy of front cover of your passport, photo ID, passport pics etc... Try not have a smoke (or drink) before hand ;)

My interview (in 2011 for the London Deanery at Lions court) was split into three sections:

CLINICAL STATION: 

please note. This is the most important station and weighted the most. I had two examiners and each gave me a scenario to answer.

• The first scenario was of an elderly woman post anterior resection 1 day ago. You are called to see her as she has a low urine output. It is important with this question to say you would firstly ensure that basic ALS principles are applied by ensuring patient was stable ie ABC... Then I said I would take a history and examine the patient to look for evidence of bleeding, infection, peritonism (think anastomotic leak) etc... Then look at the obs chart and look at trends for urine, fluid balance, BP, PR, temperature as well as latest bloods esp post-op. I would ensure patient is stable and let registrar and consultant know. You need to mention what possible differentials are going through your head and how you would exclude...
• The second Scenario was of a patient who rolled over in bed and came to A+E with a fractured humerus. BE ACREFUL AND LISTEN TO QUESTION AS I APPROACHED THIS AS A TRAUMA AS THOUGHT HE FELL BUT ITS NOT! Basically, on xray he ad luscent areas. You need to say you would suspect pathological fracture and screen for malignancy through history, exam and then can possibly send off tumour markers/myeloma screen etc... make sure you show them you know which tumours metastasise to bone and how you would check for them.
• Some of my friends got asked how they would manage a kid who came in with a supraconduylar fracture (must talk about risk of neurovascular compromise if displaced) as well as abdominal tenderness after falling off tree. In both these scenarios ATLS principles are important and ensuring you tell seniors early on (the latter point goes for everything)

MANAGEMENT STATION: 

This station was a tad disorganised. I was again given two scenarios to talk through.

• The first was that one of my F1's tells me that he felt persecuted by the Consultant. You have to show that you would be understanding and caring toward your colleague but also resepctful of the right channels to pursue. You would ask them why they feel bullied. If its because they don't have enough knowledge maybe you could offer to tutor them etc. Otherwise you would encourage them to discuss with their supervisor/pastoral mentor to get advise. You would act in a supporting role. Whatever you do, don't say you would tell them to "man up" - it doesn't go down well no matter how tempting...
• The next was how would I ago about organising the rota -  snooze fest! Basically you need to balance adequate training in terms of clinic, study leave, operating time with annual leave.   I spent a lot of time talking about annual leave, THEY WERE NOT IMPRESSED!! Basically rota also needs to be EWTD compliant so other ways you can ensure people get adequate training is by using simulators etc...

PORTFOLIO STATION:

By far, this was the nicest station although it is less weighted than the others. I had a panel of 4 judges and they had looked through my portfolio before-hand (you hand it in before your other stations start) and asked questions about my teaching (including plans I had for developing this blog and website :)). I was also asked:

• What speciality I want to do and why? (I mentioned plastics and also let them know that I am aware how competitive it is by rattling off some statistics on past numbers etc)
• How will I develop my CV to increase my chances of getting a number in plastics? 
• Other people where asked: what in their CV shows a dedication and commitment to medicine, teaching, why they chose that particular deanery...

Anyway, I hope some of this is useful and I will try and get some more info on his year's interviews to help next year's applicants. Good luck and remmebr to be confident, relaxed and know your porfolio/CV.

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

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

HAPPY 2011

Happy New Year to everyone, and hoping 2011 will bring all your wishes true. I am quite sad to be leaving 2010 behind, as it has been a successful year for me. Ranging from a successful research project which i presented at a national conference (BSET) on the use of iliac conduits on ameurysm repairs, passing the MRCS examination, as well as successfully obtaining an academic run-through fellowship in general/vascular surgery.

2010 has been a busy year, but has been very fruitful. I am looking forward to starting my surgical training in August 2011, and I am still in shock that my next job interview will be for a consultancy post. :o.

In the coming weeks I will be updating the blog/website regularly, so stay tuned.

Romesh