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It becomes a point where you can't hear me. I've got the um chat up open on my phone. So hopefully I'll be able to sort of see anything that comes through there. Um Very informal. So if you guys have got any questions, feel free to on mute and let me know or pop them in the chart and I'll try and keep an eye on it. Um So yeah, I hope you guys that you guys find this useful. Um And yeah, get started. Uh Yeah, so I'm Molly. I am, I'm currently working at Doncaster Royal Infirmary, an F one. I graduated this summer from Ho York Medical School. Um I'm currently on General Surgery and I'm rotating onto geriatrics next around December time and then I am going on to A&E um in my second year, I'm moving over to Sheffield and I'll be going on to pediatrics, OB Gyne and then a GP rotation. Um So currently I'm interested in general surgery. Um A&E pediatrics, GP, I put any A&E on there twice. So apparently I'm very interested in that. Um Just, I would say like just a bit of advice in terms of what you're interested in and no matter of what, um, year of medical school you're in, try and keep a really open mind. That's what I'm trying to do. I was quite sure that I kind of wanted to go down the GP route, but since being on general surgery I've just loved it so much. And so I'm happy to, you know, I'm going to explore everything and see what I like the most. Um, so this is just, um, my typical shift is obviously different at every, um, trust, but you shouldn't be working sort of more than 48 hours on average a week. So some weeks I will work more than that. Um, but it does tend to average out. This is, unless you've signed, you can opt out of the 48 hour working week. Um, it's not something I've done and personally, I think that was the right decision for me, but obviously it's completely up to you guys when you get to that point, which means you can be Rod on for an average of more than 40 hours a week. Um, so 40 hours is what we're contracted to. I currently work on average 6.5 hours more than that a week. Um, currently, it's sort of tried to average out was like nine and a little bit hours of, um, nights and I work currently one in 3 to 1 in four weekends. Um, so you get enhancement for that and this is just my work schedule. So, um, how our own calls work at Doncaster and surgery does tend to vary. We do them as like a big block. So you're kind of on call for 56 weeks, alternating between days and nights. Um, so it can be, depending on what you enjoy. I quite enjoyed it, but it was still can be a bit rough because, you know, the, the days and the nights are both long. So you kind of feel like you're not really having too much of a life outside of it, but because of that, you get quite a lot of zero days and days off and like, I got a full week off in a row without using any leave, which was really cool. So normal days. Um, so I work on a normal day, which is what you do most of the time I will work between eight and six o'clock. Um, it varies depending if your medicine surgery, most surgical doc jobs start at eight. I'm not sure from different hospitals whether they finish at six, finish at five, but I don't have to finish at six. If you're on call days, you'll start at eight, which you go to handover at eight and, um, you'll finish at half past eight, which is when handover ends, um, which is then when the night team come in at eight o'clock for handover and you leave at half past eight the next morning we do weekend cover as well, which essentially just cover one of the wards. Um, which for us is eight till five. so yeah, it's just kind of like a normal day. I'll go through it a little bit as well. So normal days and weekend cover, obviously it will vary a little bit from hospital to hospital, but most of the time kind of, no matter what ward you're on your normal day, just kind of follow a similar sort of structure. Um, it's just on medicine, sort of the ward round takes up a large majority of the day. Um, so in surgery from, I like to get there. So my shift starts at eight. I like to get there a little bit before. Um, it's completely people's decisions. Some people get there done at on eight o'clock, but it's not perfectly something I like to do. I like to get there and get sorted. Um, so I'll get the, um, print list which is just essentially a list of the patients, um, which are in the hospital. Um, then on our board. So we have patients that either are elective or emergency. Um, so either they switch over from emergency to elective on a Sunday night. So on a Monday, most of patients are elective. Um, so then I'll note down who is an emergency patient and who is an elective patient because they're seen by different people. Um, so either they're seen by the on call team or they're seen by the sort of elective registrars. Um, so I'll print that down, print that out right of what they are. Then I'll start prepping the notes. We're quite lucky in our trust that we have AC PS. Um, so even if it is that I'm sort of the only doctor that we normally do have an AC P as well. So it does really help to share the workload. Um, can sort of vary with how many people are on. Sometimes you are the only doctor covering top 30 patients. Other times it'll be that there's top two F ones and two Fs. So it can really vary and obviously it varies day to day, which is if it's busy or not. Um, er, so I'll start to prep the notes. I'll go into it a little bit more detail about sort of what you do to prep the notes in a further slide. Um, at Doncaster, we also have departmental teaching um by normally the consultants or the registrars from 7:30 a.m. till eight, which is, I think it's really good. It gets, um, you all sort of together, get to know people and it's, they often give you really good teaching and it's something you can put in your portfolio. So normally eight o'clock rolls around and either the registrar or the consultant will turn up onto the ward and then you do the ward round. Um, it does vary how long they take, depending on how many patients you have. Normally it can take a bit longer, sort of at the start of the week when the registrars don't know the patients that well. Um, so you have to go through quite a lot. Um, so you go round on the ward round. I like to take a laptop with me. And if you can do any jobs while you're on the ward round, then you can. But um surgical ward rounds are quite rapid. Sometimes you literally don't even have time to write in the notes. You just have to take a blank, sort of sheet around with you and write down sort of what the consultant said and then document later depends who you're with. Um But like, don't feel scared to sort of say, do you mind if we just slow down a little bit? Cause there's things that you're not quite catching um for me, especially if it's a Friday or people are going home. I like to make sure that I'm 100% aware of what the consultant or the registrars plan is because if you know, you spend all day trying to get hold of them and it does sort of delay patient care. So say, say they want a CT, you want to find out, right? Why are we doing the CT for one? What happens if the CT is normal? And what happens if the CT shows whatever it is they're looking for um, same with bloods. And if they say a lot of the key thing that they always say is home today, if blood is ok, what does that mean to them? What, what level are they happy for a patient to go home at? It's not normal that we would send a patient home with a CRP zero. So it's like, are you happy if it's less than 100 sort of trying to get specifics because an F one you're not allowed to discharge. So it needs to be quite clear with what they're happy. If someone is being discharged, you want to know, do they want follow up with them if they do, how many weeks do they want it? Do they want them to have extended VT prophylaxis? Um, tends to be if they've had some sort of cancer surgery or some resection, um, like bowel resection, they want them to have 28 days of Sparine. So just figuring out sort of, especially right at the start who needs that? I normally just double check anyway. And if they want them home on antibiotics, how many days do they want? Even? Like some, some will want you to have them a full seven day course. Some are happy with five. So then once the ward rounds done, you'll have a varying size list of jobs to do. Um, so I like to have a little huddle with whoever we're working with. Go through each patient on the ward and discuss sort of what jobs that we've got for that patient because it's not, you don't always see every patient. Sometimes if you've got a group of you, one person will see one and the other person will see the next. So it's good to just sort of be aware of everything. Um, and then sort of divvy up the jobs and then you need to decide which jobs are sort of more urgent and which jobs can. We. Um a lot of the time. It's really difficult because the sisters and the nurses all need to patient flow is really important. Otherwise we end up with a back to pay and no patients can come to the ward. So it is important to get your discharge letters done. But you also, if there's a sick patient, if there's a patient that needs an urgency ct scan or needs bleeding or something that is more time sensitive, like sick patients and patient care always comes first like TT S unfortunately can wait. Um But it's just trying to communicate that with the staff in a way that they don't get annoyed at you. And just um so yeah, a lot of it is sort of prioritizing and deciding what needs to come first. Any admin always can wear if there's more pressing stuff. Um As an F one as well. We always have every Thursday, we have two hours of mandatory core teaching So as an F one to fill your portfolio, you need to have um 30 hours of core teaching, which is what you get the two hours for a week and 30 hours of non core teaching, such such as anything, any learning that you do, you can register that. So in terms of prepping and writing in the notes, um surgery, you don't tend to prep as much as medicine, but it's still quite useful on the ward round. You make to go so much faster if you've got some basic sort of information down. Um So make sure you write the date and the time I write ward round. So just the words ward round and who is leading the ward round. So, you know, just write their initials or if they're a consultant like Mr or Mrs Miss whoever, um I normally don't like to write um the reason for their admission if they've had an operation, how, what operation they've had and how many days it's been since they've had the operation and write their current new score. And if they're scoring for anything, what are they scoring for? Um I like to also write, if the BP is low, I'll also write the heart rate and vice versa. Um And if the rests write their oxygen saturation just so you, it gives it a bit of context. Um I also like to have a look through the notes from sort of up until the previous ward round. Did anyone see them sort of over the day? Was it the ST team, was it the nutritionist, the pain team and what they've done? Did anyone see them overnight? So, were they poly overnight? Did the F one or the on call team have to come and see them? Did they spike any temperatures overnight? And if someone did come to see them overnight? So, of what's been done about it. Um, I also like to look at the operation note. Um, so that all sort of tells you who's done the operation. Um, what it is exactly that they've had, um, just have a skim through, like you're trying to, I'm still not great at it. It's something that you learn after reading. So I have quite a lot of op notes. What complications should you be looking out for? So, if they've had quite a lot of joints or, um, think like a lot of resections, are we looking for a leak or was their operation? Say if they've had their appendix removed? Was it perforated? Are we worried that they might sort of get a bit septic? Um, so, yeah, it's just looking, sort of what they've done in the operation. Were there any complications during the operation and looking at the plan from the operation? Uh, which normally I will tell you about like antibiotics, um, and everything like that. Um, if we can eat and drink and stuff, um, if they're on any antibiotics? What are they on? What day of the course are they on? How long is the course, what is the dose? Have a look, see if they've had any recent bloods and scans and write anything that's sort of abnormal. Um, and then yeah, just make sure you sign and date it and put your designation as well. And if you guys are writing in it, I know quite a lot of my students quite like to have it count, signed by one of the doctors. So if you just ask someone to sign it, um So yeah, common ward jobs that you'll get um from the ward round. So prescribing a patient's regular medication. So what they have on the outside of hospital, uh pain relief, antibiotics, make sure if you're prescribing antibiotics, you always put an end it, it can always be extended. I normally prescribe it for five days. Um If there's no guidance on it on the internet and then if we want to discuss it with micro or if the reg feels like they could do it with an extra two days, it can be extended, but make sure you put end it uh ordering bloods say either for the next day or that day and then obviously taking the bloods um ordering any scans. Um So making sure that in the request you put in a decent amount of detail. Um because if you don't, then it'll just get rejected by the radiologist. So, um, taking bloods doing Cannulas abgs, catheters tubes, um, just any sort of clinical skills. Um, it very much depends what ward you're on as to what, um, whether the nurses can sort of do particular skills. Like, I don't really put that many catheters in or that many NG tubes in the nurses are very skilled and they all do that for us, um, tends to be sort of on call or overnight where you tend to do those. Um So if someone becomes unwell over the day, you can go and see them, um do a follow up a T assessment on them and decide whether it needs escalated, something that you can manage. Um So yeah, making sure that, you know who's there for you to ring on that particular day, it will change day to day. So I like to get the registrars um number. Um It can be a bit tricky sometimes because a lot of the time they're in data. So they're not really contactable, but there is always a senior consultant who with that patient. So you can always ring them and depending obviously each department, how approachable everyone is at Doncaster. Everyone's great. Um So I don't really have any fears about ringing any reg or any consult. Um And obviously you've got your research her as well. Um So you also have cha scans which is, you know, ringing the radiologist trying to get them either vetted and approved trying to get an appointment for certain scans. Um If it's something that needs to be urgently done, I'll often request it and then ring down CT and say, you know, can you please take our patient down as soon as you can? Um So you'll have to discuss patients with other specialties. Um So whether that's cardia renal care of the elderly, they can often be quite difficult to get hold of and it can sometimes be the ping pong game trying to get, you know, everyone's trying to push their patients off onto other people, which is kind of sad, but that's just how it works. Obviously, everyone's got a limited number of beds. Um So in our, in our trust, all the requests to have outside teams to come and look at them. So if I say I'm on general surgery and I want the um cardiology team to come and look, I have to do a paper form to fill in all the details and then they'll come and see them sort of the next day or that day. Um You also have prescribing fluids, um especially sort of prescribing them, try and do it. Um, uh for the overnight team, you don't have to get called to do it because it's really, is quite the bit in when you're, you know, it's 2 a.m. and you're getting bleeped by the nurses to come and prescribe someone's fluids because they're no by mouth. Um, and you're trying to deal with an unwell patient. So if you can just, I try and just save anyone's stress overnight, um by trying to sort of get anticipating what's gonna need to be done overnight and making sure that it's tried to be done in the day. So on call days, eight till half, eight, it's handover 8 30 till 10. We do consultant that's on call 10 to 6 at my trust. We just do normal ward jobs, um, for the on call surgical assessment unit ward. And, um, also if any patients come through that the sh hasn't clocked in A&E I'll clark them, make a plan. Um, so I often just kind of write everything down. So the basics of like getting the Os doing bloods, do they need an ultrasound or a CT? If they, if I think they need something more than sort of an ultrasound or a chest x-ray, we'll have to ring the registrar and just ask them to come and review. Um, also, you know, get the, the cannula, um, they're gonna need VT prophylaxis. Do they need any antibiotics? That kind of thing? You, you're not being asked to decide whether someone's gonna go for surgery or not. That's not your decision. Just getting those big in. So that when the seniors come to see them, they can then make that decision often keeping a patient no, by mouth until senior review because you, you just never know whether someone's gonna want need them to go to the theater. So, at six o'clock till eight o'clock for us, that means we're on call, we'll do the evening ward round and then, um, we, uh, general surgery, vascular surgery, urology, and breast surgery. So you just get bleeps from over the hospital and you go and do the jobs and then from eight till half A you've got a protected time to do handover. So you'll give you bleep and everything to the oncoming F one and just hand over sort of anything that needs finishing or chasing up on call nights, the same just in reverse. Um, other than you're just on call for the whole time, there's no ward round, there's nothing like that. Um So it's very variable of how busy it is, but they are fine. Don't try not to stress too much. Um, so what's a good handover? Um, I like to, if there's any patients that are unwell or I think may become well overnight. Um, anyone that's, for example, just come from theater, um, if they've just been stepped down from critical care. Um, so I like to know when I'm receiving a handover. I like to know then patient's name they're on. What's the best number? What's the hospital number? And if you're telling me that someone's unwell or you're expecting them to be unwell, what is the plan from the day team if they are to deteriorate? Is there a plan? Um, any urgent jobs that need to be done. So chasing scans, chasing bloods, taking bloods at specific times. For example, if you start treatment for hyperkalemia and it needs rechecking, what time do you want me to recheck it? Uh Gentamicin, what times it need taken is that kind of thing? And I also like to know what is the plan sort of from the, whoever's requested these things. Um If it's positive, what is the plan, then if it's negative, what is the plan? So examples that you get sort of for jobs on call, um fluid prescribing, sliding scale insulin, prescribing job prescribing. Um someone that's recently started scoring quite highly with the news. So it can be new temperature spikes, tachycardia hypertension, someone that just the nurses are concerned about so potentially sort of the DVTRP pneumonias, they've got a reduction in consciousness uh new if um you'll also be called to sort of confirm deaths overnight and speak to families, um either with updates or just to sort of inform that that, that inform them that their relative has died. Um Parking any new admissions that come in, um putting catheters in doing bloods, we have a really good clinical support team at Doncaster. So any a lot of clinical skills I don't actually have to do overnight. So Cannulas bloods, blood cultures, ECG S and I just sort of make the decision that they need doing. And then one of the clinical support teams will do it for you and then just chasing scans and blood. So just giving people a ring and saying like when is either when is the scan gonna be or can you do the report? So, Clark in patients. Um it's I will say it's easier than I think people are worried. It's going to be, you know, you train him for five years, you know, you guys are gonna know how to do a great history. Um So yeah, you just want a detailed history of why they've come in when whatever is happening started. Think Socrates personally, I use it for everything, not just pain, just a good mnemonic of sort of being able to go through all the important things really. You need to know about anything that someone's presenting with. Um, I'd like to just do a quick systems review. So, you know, ask about the urination if they got any pain, any change to urine, blood in the urine, any change to the bowel movements, blood in the stool, um, pain when passing a bowel movement, any chest pain, palpitation, shortness of breath, uh any sort of um, confusion, ask them, you know, are they orientated in time place person just trying to do like sort of a full review just to see if there's anything that you're missing. Um, any red flags, you know, weight loss, blood in the stool, urine, vomit, anything like that. So you also want to know social history. It's quite important as well to try and figure out what the situation is at home for. That helps with discharge planning. So, are they gonna need more support, um, when they're at home, especially if they're sort of an elderly person. Do they smoke? Do they drink? Um, do they take any recreational drugs? Drinking is like a super important one because people can come in to hospital, for example, with, um, pancreatitis due to alcohol and then go into really, really severe withdrawals because they've not told anyone that they're drinking alcohol. Um, I've had one lady that ended up on critical care because she just was really, really poorly even though we were trying to get her on the detoxification scheme, but she just, she wouldn't take any of it. Um, so yeah, she was really poor. She trying to get a really thorough alcohol history is really important, especially in general surgery, medication history, including over the counter medications, making sure you ask allergies because you only have to go back to the patient and reask it because they won't let you prescribe anything. If you have a, um, electronic prescribing system. If a patient is on insulin, you also want to know sort of what insulin they take. How many units they take when they take it. Is it one they take in the morning, one they take in the evening? Is it a nerve rapid that they take with meal times? And I normally ask if I prescribe it on the system. Are you happy to manage your own insulin? Normally they bring in their own insulins, but it just, you need to prescribe something on the um, system past medical history. Be specific as well because the amount of times you ask people any medical problems. No, absolutely nothing. And then they're on like a whole host of drugs or, you know, they've had a heart attack three years ago and they forgot about it. Just so I always ask any problems with the heart, any past heart attacks, any strokes, any lung problems, any diabetes. I just try and ask like a few quick fire questions for stuff that will be quite important. So you do wanna do a thorough investigation when you're the one examination, when you're the ones that are clocking them to do an abdominal exam and then you obviously want, you want to have a listen to the chest, have a, listen to the heart, just check that they're not got any obvious neurological deficits. Do they, do they need apr exam? Do you need to look at the external genitalia? Make sure they've had observations done, making sure that their regular medications and the VT prophylaxis prescribed, making sure they've got pain relief, antiemetics, all that kind of thing, make a plan and then get a more senior doctor to review them. So, quite a lot of um, things about how to sort of keep mentally fit, um, while sort of being in medicine and surgery. I think a big thing is the mindset. Um, try to look for the positives like there is, especially in the media at the moment. There's a lot of stuff, obviously that's, you're bad about being a doctor. There are stressful times. But, you know, overall I've really enjoyed the first sort of two months being a doctor. So, you know, it's something you wear for five years and it, I do really enjoy it. Just try and keep the enjoyment for the profession and the enjoyment in looking after patients. Make sure that outside of work you still do what you enjoy, whether that's watching your favorite TV series, going to the gym, meeting up with friends, make sure that you make time for it. Um Don't over commit yourself or burn yourself out. So that's what you're taking in on lots of extra projects or trying to pick up lurks. You just need to know for your own mental well being when to say her. Um especially when you're an F one. You know, they try and get you to do a lot of things because you're keen and you want to learn, but you also need time off. Um get to know your colleagues. I would say all staff, not just the doctors, you spend a lot of time with nurses hcas all the members of the MDT. It makes your life a lot easier if you all get on and sort of getting to know your patients as well. It makes it a lot more rewarding. Um, sort of when people get better and you see sort of things that you've put in place, start to pay off if you are, um, sort of know the patients and sort of speaking to their families, it does make it much more fun making sure you get enough sleep. Um, you want to make sure you pick the right job for you as well. I think don't do something because you feel like that's what you should do. Or, you know, you, if you want to be a GP, that works two days a week and that's what will make you happy. Absolutely. Do that if you want to be a surgeon at all costs and that is what makes you happy and you want to do that and you won't be happy doing anything else, then do that as well. You have to really sort of look at, not just the job, like, look at what the consultants do. What's their wrote is like? And then make a sort of a decision based on if you think it's going to work within your life, um, try and be as organized as you can. Um, meal prepping and sort of to do list, really do, sort of save your life. Um, really makes up on call days easier if you've got a batch full of meal prep. Um, I think as well, just don't rush. You have a really long career. Um It's not a race to become a consultant, try and enjoy it. Um Yes. So this is just sort of um an overview of, sort of if you want to be a surgeon, how you get there. So you guys obviously are at medical, medical school already. Um Then you do F one and your f two years and then after that, um a lot of people now are taking, you know, F three F four or five years doing a bit of lurk doing travel, get giving yourself time to sort of build up that portfolio. Um Then you can do your core surgical training, which is two years and then you apply for your specialty training and then it will be to consultant. So building a surgical port failure, what things you can do whilst you're at medical school, there's, there's loads of things you can do. Um I think don't stress if you're already quite far along in medical school and you've not done very much and there's so much time, I'm an F one, I've not done that much towards a surgical port failure because I didn't want to do it. But there's so much time in F one and F two, so many more opportunities and so just don't stress and so you can join, you know, surgical mentorship schemes. If there's not one running at your medical school, try and get contacts for um any of the surgeons in your area and give them an email, I'm sure they'd be more than happy to sort of have a chat with you guys. Um I would say attend as much theater as you can, um, from all different specialties and document this in an log book. I'll go into a little bit more how to get into theater in a little bit. Um So there is a good log book as well, which I'm gonna link um a little bit further along any surgical conferences. So whether that's undergraduate ones run by a medical school, ones by the Royal College of Surgeons, just keep an eye out online. Um It might not necessarily give you points towards, um, like towards your portfolio, but it's really good to speak about in interviews to show you've had like sort of a long interest in surgery. If you've got a surgical society, try to join the committee, be a member if there's not one at your university, try and set one up. Um I would say as well when you're on the wards, if there's any interest in surgical cases, take note of them. Um, try and do some research, write reflections. It'll show you've had sort of a long standing interest in surgery if you can, um, organize some teaching sessions or be sort of help organize the conferences and keep evidence of sort of everything you do get feedback forms if you can try and coordinate with other. Um So yeah, if you can try and um work with other medical schools, make it more of a regional or a national event. Um that goes a long way towards the portfolio as well. Uh Can people still hear me? Ok. Um So yeah, if you can try and um work with anyone outside of your medical school, that's really good. Uh You, you can get involved in any research or audits, all hopefully ones that are sort of surgically themed and that will help if you can do a surgical elective um or try and pick an F one or F two, um pick a one A F two, F one or F two rotation, I would say, preferably an either try and get it to be your first rotation and F one because then it means that your clinical supervisor and your, your educational supervisor is a surgeon for the whole year, which is really good or try and get it in F two because SS actually get assigned the time. So you'll get a chance to sort of build up your um port failure in terms of your third time. Uh try and do an extra degree into. Um I'll go in a bit of sort of um what helps in terms of the portfolio in a little bit. Um But if you can sort of show that you're interested, it's really good to speak about in interviews. So getting written feedback from doctors. Um, so make your own feedback forms. If it's not something that you have to do for your course, um, discussing surgical cases, it's really good just to sort of bring to interviews that you can show you've had a long standing interest in surgery, you're interested in discussing surgical cases and you've got proof of that from feedback from doctors. So, so of what you can do as a medical student on surgical wards, I would say try and get there for eight, which is sort of the ward round or the handover, introduce yourself to the doctors. Ask if you enjoyed the ward round, ask them if there's anything you can do. It's really good to learn how to write in the notes and how to prep the notes if you're there sort of eight o'clock time, that's how you will meet the registrars and the consultants because they're not on the wards for most of the time. So that will give you the opportunity to be like, hi, I'm a medical student. Could I join you in theater or it'll give you the opportunity to sort of ask them about anything. Um I the F one and F two, if there's any cases that you could talk about any histories, you can go and take or go to the sort of surgical assessment unit and that'll give you the opportunity to clerk patients. And we have a lot of our medical students just going to be sort of the first ones to clerk them and then if there's anything I feel that needs adding, we'll go and do that together. And if someone comes in, well, I'll always be happy to sort of let the med student go and do the A two E while I supervise and sort of help them through anything if they need any help. Um, so tips for getting into theater, I would say if you can find out what theater system you use at your hospital in Doncaster, it's blue sp and see if you can get a log in for it because that will then show you what operations are happening that day and when they're happening who's doing them. So it doesn't mean it means you don't have to sort of wait around all day. And if you know what time the operations are will most likely gonna be or you can see when the patient's gone in the an anesthetic room. Um So then you know what they to go into and who's gonna be the main surgeon, what the case is gonna be? Um I would say just if you can, if you meet them sort of on the board round or just go to theater and introduce yourself to the consultant or the registrar that's going to do the operation. Ask if you can observe or scrub in nine times out of 10. They will say yes, they're often really keen to have F ones or medical students in there. They like to explain things they like to teach. Um, so don't be scared to introduce yourself. Um, they'll be happy to have you for sure. If you go to the ward round, you know, ask, oh, anything interesting in this today, I'd really love to come and observe, come to scrub in most of the time. They'll sort of tell you what's going on and tell you sort of when to come down. If you're not on a surgical placement, I would ask either the teams that are based at the hospital or whoever you've got a contact with in your university and try and find out who the surgeons are in the what specialty you're interested in. Ask them, you know, have you got mister whoever's email and just email the consultant or the secretary and just say, introduce yourself, say, you know, I'd really, I'm really interested in surgery, please. Could I come and join one of your lists? And often they'll say, yeah, my list is on Thursday at eight till six. Like, you know, feel free to come down. So tips for getting into research, um sort of quality improvement projects, audits very similar to getting into the. So I think you just need to, if you're on the ward a lot, you'll get more opportunity to meet the seniors and just, you know, ask them if they've got any research projects going on at the moment, any audits. Um if you've got any emails for sort of registrars or consultants, ask, you know, if you've got any ideas for projects that you'd be really interested in, but you just need that support. Ask them if you'd be there if they'd be a supervisor also, you know, a lot of the time they're really happy to have sort of f one medical students as data gatherers because it's, you know, quite a boring part of the research process. Um Yeah, I've been offered to be a part of loads of research whilst I've been, you know, as an F one. So just if you just ask them if they've got anything ongoing that you could be a part of. So in terms of selection and for surgical training, this is what it is at the moment, it's very subject to change. Things are sort of moving away from portfolios, moving away from being first authors because it means that a lot of research is getting published. It's not very good just because people want to be published. Um So you have to do the MRSA exam. Um It's worth 10% of the overall selection and this is how they shortlist who goes on to interview. So the top 1200 for 2023 are going to go on to interview and then 30% of the overall score is based on your portfolio which I'm going to go into now and 60% is based on the interview. So really don't stress if your portfolio is not where you want it to be, you've got loads of time and also it's certainly um sort of worth 30%. So don't stress too much. So I've broken down sort of everything that you need as part of your portfolio. So I'm going to go through it, step by step operative experience. Um So to get the top points, you need involvement in 40 or more cases. Um So obviously, then it goes down based on how many cases you have. So these need to be all registered on e log book. Um I've linked to the one that I use, which a lot of people use. Um And I'll sort of show it to you at the end as well. So once you've got all these registered, so you need a sort of report for each specialty. So whether that's general surgery, um trauma and author, and then you need to get the consultant to sign that report. Um So you only need one consultant per specialty. So even if you see sort of 10 different consultants operating, just get one consultant to sign it that you were there for all these operations um with the full name GMC number and the date. Um they can only be the only ones that count towards a surgical port failure are ones that either you've assisted in or ones that are supervised trainer scrub procedures. So essentially you've done the procedure and the consultant or registrar has been scrubbed in and assisted. Yeah. Um So you only can have one, report for each specialty as well. So just one for general, one for that kind of thing. So, surgical conferences. Um so these need to be um ones that are accredited by UK Royal College of Surgeons. Um So ones that undergraduate don't count towards portfolio, but I'll definitely say if you guys have them at your university, definitely go to them because it's a really good way to show your sort of longstanding commitment to it. And so you just, this is just the evidence that you need. Um So yeah, 32 and one still get your points. Um So yes, surgical experience. This is where I think it's, if you can, it's definitely really important to try and get a job in F one or F two as a surgical, as a surgical job because that'll give you four points for it or try and organize an elective in surgery because that will also give you four points, but not to worry sort of if you don't because you can do tests a day, um, in F one and F two. So you could do sort of five days or a week, um, as a test a week in general surgery or trauma and Ortho surgery and you would still get some points for that. Um So yeah, you just need sort of a letter from the, one of the consultants, the dates that you've been there, that kind of thing. So I've just got a few questions that are coming through. So I just thought I'd answer them while we were on them. Um, so the slides, yes, you'll have access to the slides. There's a feedback form where you can pop your email in. Um And then I'll be able to send you a certificate, attendance and slides as well. Um Is it worth paying to be an affiliated member of the royal close to? Um I think that's very individual. I actually, I'm not yet an affiliated member because I'm definitely going to sign up to it. But I want to wait until I feel like there's something that it's going to sort of benefit me from. So when I want to attend a conference or something that it's gonna obviously sort of be cheaper. Um So just sort of look on the website. If there's any events and things that you're interested in coming up soon, then definitely sign up. Um, obviously sign up at some point. Um But I will sort of time it around stuff that you're gonna be interested in. Um, just save money at the end of the day. Um So yeah, operative experience, you can start that at any stage. I start a few sort of when I was in. Um, yeah, one is medical school. The only thing is I would say, even if you've just observed, it's really good to have it all documented anyway, because then it'll show you've had a longstanding interest in surgery, which is something that it's not going to count towards your portfolio score, but it will count towards um, like your interview score showing that you've got, you're dedicated. Um But yeah, definitely log everything from medical school. They still count. If you do 40 assisted procedures in medical school, then you've got four points. It doesn't, just because you weren't a doctor at the time doesn't mean that they don't count. So if you can assist in 40 procedures while you're at medical school, while you've got more time, definitely try and do that. Um So quality improvement and audits, obviously, we've just had a chat about how to sort of try and get involved in them. And I'd say it's, I would say it's easier whilst you're in F one just because you're there literally 50 hours a week. You get to know these read and the consultants really well and they're really keen to get you involved and stuff. You definitely can do them while you're at medical school. For sure. And you can try and do them as like an SS IP or equi that you do as part of medical school and it's just about getting the contact really. So whether that's spending more time on the wards or emailing people. Um So from speaking to some of my colleagues, it seems like this sort of aspect of it might be changing in the future because it just means that because they want you to be sort of a lead or first author in research just means a whole load of rubbish ends up getting published because people are not doing it because they're interested, they're doing it because they want the points which is kind of not what it's supposed to be about. Um So yeah, so the same thing with presentation and publications trying to get involved in research, um, I would just, you know, try and speak to surgeons and, um, registrars while you're on the ward, um, asking if you've got a particular interest in something. Um, so if you've got a particular interest in something or you think that there's something that you would like to research or something, you would like to do a quick on ask them sort of if they'll be your supervisor and then see if you can sort of get entered into any, um, get invited to present anything at any conferences or this. I know at my medical school there was, um, things that you could present at. Um, not necessarily going to give you sort of all the points as if you were at a national or an international sort of meeting or something, but it's good to just get the experience regardless and, you know, there's not going to be loads of people that are getting these 10 points because they've been managing to sort of present at national conferences or meetings. But if you can try and get, I think the key is trying to get involved in something that you're passionate about and interested in. Um because I think most likely sort of being first author and stuff is going to maybe come off the portfolio um to try and sort of streamline deaths um released in terms of research. So teaching experience, I think this is something you can definitely do at medical school. Um More so when you're probably sort of in fifth year, because you, you're pretty much there then um trying to sort of get involved in teaching the younger years. So year 12, can you design some sort of um teaching series? Can you organize a scheme where like you get year one's Budi up with year fives, anything that you can think of speak to, you know, that your phase leaders or your, your clinical deans, anyone at the medical school or any consultants or anything at the hospital that you can work with to try and organize sort of a teaching series or a mentorship scheme. And it will really help if you can sort of do that of not just your um medical school. So if you're part of a society, try and buddy with, you know, if you're in Sheffield, try and buddy with the society from Leeds or somewhere, that's sort of a couple of societies, you could all work together and do an organized sort of some teaching sessions, you get sort of more points, sort of, if it's, um, if you just do regular teaching, um, for students you can still get two points. So that could be, um, sort of doing regular bedside teaching or, um, you know, doing regular teaching to, um, younger year medical students. Um, I know we have the opportunity a lot in fifth year to come in and run some sessions for year one and two medical students. Um And if, then you want to either when you're in F one or when you're in fifth year work with your um the medical school that sort of does your, so as mine would be Sheffield, but they've got people based in gun be like a whole range of places trying to um contact the medical school. Is there anything that you can do sort of over all the different sites that they cover? Um So yeah, or trying to get something that's sort of national across the country. So teaching qualifications. Um So this is where you can sort of either do. Um I'm kind of looking now potentially doing like a PD Cert in uh medical education. Can you do? Obviously, it's very tricky because it is quite expensive. Um If you can do an SFP, sometimes they will pay for you to do the PD Cert as part of your F one. So it's definitely something to look into if you're interested in teaching and you're potentially interested in surgery again, this might all change because I know they're trying to stop you on the playing field out because it's unfair that people can, some people can pay for these degrees and some people can't. Um, so, yeah, that's, you can also do sort of, um, inter collects in medical education, um, which would help you here and I think any second degree that you have outside of medicine does kind of set you aside, um, for a lot of different specialties, not just surgery. Um, which can be, obviously, I know how difficult it is. I don't have, personally, don't have another degree. Something that I'm interested in. It wasn't something that a medical school I personally wanted to do because I wanted to decide what I was going to do first and if there was a degree that was going to benefit me, I was going to take that decision then and start doing it then. Um, but it's complete if you guys want it in ate. I know some people feel like they need a break after sort of fourth year, third year. Um, or you can sort of, we, you know, it's not a, it's not a ticking time bomb. You have to, once you have two, you don't have to go straight into specialty training. You can have up to three sort of f years without having to do anything extra. You can go straight into training. Um So just, I've had a questions. When can you do a degree after medical school? Um So it depends the degree. Um One of the PG sets, I'm looking at it's distance learning and it's all online and it's part time. So you could do that whilst you were working. There's definitely things you can do while you are working F one and F two. If you feel like you can manage it, it's different for everyone. Everyone takes the workload a lot differently. So it's got to be something that you decide that you can manage personally. Or if you don't want to do that after F two, you could take a look in year where, you know, you can earn considerably more, doing less hours and then sort of go in, you've got the freedom that you can work anywhere because you've got full registration. So you could go sort of across the country and try and do a degree then. Um and it'll have given you a little bit of time of F one and F two to try and save up some money to do that. So any questions I'll just go and have a look through the chart, see if there's anything. Um I haven't answered. Yeah. Advances about in there definitely is advantages for it. I think it's completely personal. I wasn't sure what I wanted to do. And so I thought if I wanted to do a degree and spend all that money. Um, I would do that after I'd graduated and sort of decided what I wanted to do if you're quite certain and what you want to do, then definitely do it while you're at medical school. Um, because it gives you that year off and you've not got sort of a job and things to do. But if you can't afford it, it's definitely something you can do an ro um where you've got the opportunity to make money as well. So, yeah, in terms of um assisting in theater, it's definitely something you can do in medical school, not all consultants or all registrars will let you assist. But a lot of the time they're happy for you to kind of hold a re tractor or try and suture the skin or happy to get you involved. Um Obviously you're not going to be doing your like procedures by yourself while you're a medical student. But there's definitely ways that they will let you assist. Um And if you sort of go in with the same consultant or you've met them a couple of times, the more you build that rapport, the more they're going to let you do. So in terms of sort of getting them validated, you can either get them validated, sort of at the end or you can um get the consultant to sign them all off at the end rather than after each individual surgery. So the points specifications, I have linked it, but it's if you just search um core training, uh I can't remember exactly what it was that I searched. But if you just search sort of core training um portfolio score and it will come up. So on the, so yeah, if um you'll get a copy of these slides, this is a QR code for the feedback form. There's also a link to the feedback form as well. Um If you guys just fill in the feedback form um with your emails, it means I can contact you in terms of giving you the certificate and sending the slides over. Um So yeah, I'll get them sent over as soon as I can when you guys have filled them in and um there'll be another session this time next week um on sort of the biliary tree pathologies, pancreatitis, that kind of thing. Um So in terms of the log book, there is I popped a link into the one that I use. Um If I just stop sharing, I'll see if I can show you the one if it's still logged in. This is the one I use. You just need the patient ID, date of operation, patient's date of birth. Uh The consultant. What you, how you sort of with assistant? The A S A grade of the student, the patient. So was it a laparoscopy? Was it emergency? When was it, was there a fatal outcome? Any complications? What operation it was where you did it and the operation at. So in terms of the operations, if you assisted in different hospitals and even abroad and electives, um so it definitely depends, you can only get one specialty signed off by one consultant. So if you've done sort of one operation in Sheffield and the rest in Doncaster, I definitely say, get the ones in Doncaster kind of thing signed off. Um Hopefully, you know, by the time that you've got to the end of the wanting to apply, you're probably going to have more than 40 especially if you've done um surgical jobs. Um So I'll try and post the link to the feedback form as well. Uh So yeah, I hope you guys have found it useful. I'm just trying to get the link for you guys so that I can send you your certificates. Um Hopefully I will have also if I've sent you guys an email today, um You should have had a link for the feedback form. Um And thank you so much for joining guys. I hope it was useful and if there's any other questions, just pop them in the chart, um or feel free to send me an email, I'm sure you guys have got my contact mobile. I'm happy for you guys to contact me at any point for any further advice or anything. Yeah, I hope you guys have found it useful. Can you send your email? Yeah, so I'll pop my email in the chart as well.