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And I'm really happy to present today and to clarify a lot of what questions and, um, you know, er, things about the surgical training pathway in the UK. Um, so let me just share my slide with you. Can you see my slides now? Yes. Yes, we can see them now. The slide. No. So, um, basically in two, in 2016, I was 1/4 a fifth year medical student, fourth year medical student I decided to do, I want to do surgery. I've been looking into places to go to do surgery and a lot of other places than the UK had a lot of obstacles. There was some sort of, um, a lot of difficulties to get into the training session and training posts and jobs in these countries. So I've decided to take the path going into the UK. Now, at that time, I did not have a lot of guidance. So I took it myself to just read and read and read and try to get what, what is needed to continue my career in the UK as a surgical trainee, I was interested in trauma orthopedics and the, I've just gained an ST three number this year in Tramon orthopedics. So, um, I'll talk, I'll talk to you today in our session about through the surgical pathway in the UK. How is it, how it is organized for the UK graduates? And then we are gonna talk about how you as an IMG can come to the UK and try to ha well, I won't say hack but try to get into the system in order to benefit the most and get the, get the career that you want to. So for the, for the next 10 minutes, I'd ask you all to just forget everything you know about the training, surrogate, training in the UK. I'm sorry, in the US or in Jordan or in Australia or in Canada. And we, I would like you to focus on this image specifically. Um If you do that, II I, I'll make sure that at the end of this presentation, you'll understand the system in the UK. The system in the UK is totally different from the system elsewhere and the names of the of the levels are a bit different. There is a lot of er national selection processes. So if we focus on this image here and if you look at this image, this image would be color coded till the end of the presentation, we're going to do a of comparisons with this image. But if you focus on this, then we can just move to the next system. So if you, if you are a, a student in the UK, you get your medical degree, that's the first be that you can get. Then after that, you move to something called the foundation program. OK. Foundation program is a two year program. It's a training program. It's basically uh one year where you will have a provisional GMC registration. After you finish that year, you will have a full GMC registration. Then after that, you move to the foundation year two. Both of these rotations would be in different specialities. You would be doing four months, there are four months rotation. They'll do, you'll do medicine, uh surgery, ed, uh GP. Um you'll do a lot of uh rotations and it, it differs between the job that you got. OK. So w whenever you finish your foundation year two, you start looking into your options. If you want to seek a further career in the surgery, you need to go through something called a core surgical training program and this core surgical training program, this is the next step. It's a two year program as well. It's rotational every six months, you will be in a different department and you need to do your core surgical competencies and you need to do your MRCS, which is the membership exam for the Royal Colleges and to, to be able to finish these two years. Now, in order to get into core surgical training. Now, now just, just remember foundation then core surgical training at or what we call S OS. You need to go through something called a, a national selection process, which is basically like in er, which is just on the, at the level, at the national level in the UK, you need to understand the the candidate need to understand that there is something called the self assessment, which is a scoring matrix. You need to score yourself against and give yourself a number and the score that would be used for your interview and your selection in the core surgical training. And there is always competition ratio. The latest competition ratio in core surgical training is about 4.5 to 1 this year, competition ratio was a bit higher. But this is the ratio means that from every four candidates who apply, they'll take one, usually there is about 600 posts all over the UK. So 600 jobs in di in over the UK from north to south including Scotland. Then after that, after you finish your core surgical training, you've done your mrcs, you've done all of your rotations, you then aim to get into higher surgical training or what we call the speciality training. OK? This is specific for this for the the speciality that you want to work in. For example, you want to do ent so you need to do two years of core surgical training. Then after that, you need to apply for the ent high specialty training or high surgical training. Ok. And this people in this level, they are called registrars. And sometimes you can find these numbers ST three to ST eight, which means speciality training in the year three to speciality training in the year eight. Now, why do they start from three? Because people already done their core surgical training, which which is CT one and CT two. So they already start from three. In order to get into the higher surgical specialty training, you need to go through a national selection process as well. So another Kabul Moha all across the UK, you need to do the speciality, self assessment and you need to know the competition ratios for the higher speciality training that you're applying for. If you do this and you, you got accepted, you have six years in the speciality, then you do your fellowship er exam for the Royal College in the specific speciality that you're doing and then you'll get your CCT which is certificate of completion of training and you become a consultant. So that is a very, so in our presentation, you need to just look at that and understand the specifics of it because we're gonna do all the comparisons. The first comparison would be we're gonna see how an I MD who came from another country can fit into this system. OK. So in Jordan, when you come from Jordan, you do a medical degree, it's six years. Then after that, you do an internship, look at the color codes. They are the same. So the internship year in Jordan is equivalent to the F one year in the UK. OK. So basically, rather than having one year of MTRS in, in Jordan in the UK, they have two years of MTAS. OK. After you get your internship, you can, you need to get your GMC registration and to do that, you need to do your English exams, which is Islets or OAT, you need to do your B one or B lab two, which is now from next year, it would be the UK MA or the after it will be the UK ML A and then you get your GMC registration and then you go through 11 of these three pathways. OK. The first one, it's a training program called the stand alone F two program, which is, which you can apply for here. This is a coupled program which means both of you. If you, if you are, if you are accepted in this year, you'd get directly into the next year without any, er, without any uh national selection process. Here, it's another national selection process. You need to apply to the last program I think. Er, um I'm not sure if it's still running but it's another option that you can use. And what most people actually do is do one year in experience in NHS. It would be a non training job as an F two or as an sho sometimes it's called as well. A junior Clinical f. Then after that, what you can do, you need to go into core surgical training. So to get into your core surgical training as well, it's the same process. You need to go into a national selection process. You need to score yourself against a self assessment and you need to know the competition ratio. And on top of that, you need something called the crest form. The crest form is certificate of readiness to enter speciality training. That means it's a form that you need to fill. When you work with a consultant in the UK for at least three months, they will be able to fill that course, that form for you. And that would allow you to move to be accepted or at least to be considered for the core surgical training. Then after that, you do the core surgical training and the pathway would be the same as we described in the first image. I think that's clear. Anyone have a question till now, please write it in the chart. Now in the UK, it's not always straightforward. That's another thing you need to understand the system is too complicated. The national because it's a National Health Service. There is a lot of jobs that need to be covered. So it's not always training in the UK. Sometimes you have something called the non training pathway. It's similar, you do the medical degree, you do the foundation program. But then after the foundation program, you do something called foundation year three or you work as a non training CS H OS Ho means Senior House Officer. It's, it's basically the same level as core surgical training, but you will be employed by the hospital, not by the hee which is a health education England. You need to do your Mr CS in order to sign your competencies, but you won't have a proper education program that you go through your opportunities to go into theater, to get into clinic, to get your competencies signed off are much less than the core surgical training. And I've actually done some something similar to that before getting into the core surgical training. Now, some people would do that and then go directly into higher speciality training and try to apply there if they felt their competencies, other people would go to something called the trust grade registrars. This is basically at the same level as the registrars in the training, but they are not training. It's the same non training posts. It's a slow career progression, difficult to get your, it would be much more difficult to get your competencies signed. And if you do your Fr CS and signed your competencies, you may be able to apply through the Caesar pathway, which is the alternative pathway to the actual training in the U UK. If you become a consultant through this pathway, you will get ac you'll get Caesar and then you can work as a consultant. I know that this seem a bit complicated but you need to know that in the UK, wherever there is a training post, there is always an alternative of a non training post because the service is too big and they need a lot of doctors to cover it. So the training, the trainees won't be enough to cover that service. So the always hospital will look for more doctors to cover the gaps. And the ros now this is a quick comparison between the surgical training in Jordan and the surgical training in the UK. So in Jordan, you get your medical degree, you do your internship and then from the internship, you go directly to the surgical training. Yeah, the surgical training you do what you do in most cases, you have a one year of general surgery. So for example, if you're doing in trauma and orthopedics and um the Jordan Jordan, the University of Jordan Hospital, you do one year of general surgery, which actually would be the same level as a foundation year two because this is year two after graduation, this is year two after graduation. And then you there are core surgical training here two years and then your PDY 23 and four would be equivalent to the core surgical trainees. And then your PDY five and six, which is the last two, the the latest two years of your training would be equivalent to the ST three and ST four. So basically when you finish your training in Jordan, you'd be similar to a middle, middle level registrar in the U in the UK. Ok. Now I know that there is a lot of, a lot of debate about this area. I've tried, I've tried my best to just make sure that, er, things looks equivalent on both sides. And I, I see a lot is a lot of the guys who finish their speciality training in Jordan, they can apply for either high speciality training or as, as we said, in the previous slide as a non training registrar in the post or in the job, they want to. Now, obviously, after you finish your speciality training, you apply for the Jordanian Board and you become a specialist. And according to the Jordanian Medical Council, you need to work from 5 to 10 years in the specialty. It depends in order to get to be a consultant with other, with other um um requirements for that. So if you can see to be a consultant in Jordan, you'd need about 11 to 16 years op post to graduation. If you become to be a consultant in the UK, you need about 10 years. If you don't go into any, if you were successful at every step in the way, which is really difficult to go. So I'd say from 10 to 15 years in the UK, you would become a consultant in the special in your chosen speciality, my journey. So I'll let you know specifically what I've done. Er, so I can't. So, so I be so I became a registrar in to orthopedics. So I graduated from Jordan University of Jordan 2018. I in my internship, I've done it in the Ministry of Health uh BAA Hospital 2019. I've done Islets blab one, blab two. I got my GMC registration just after the end of my internship. My first job in the UK, I got the offer in November 2019 and I started in January. So January 2022. So from the GMC registration till I got a job, it was about 3 to 4 months. I applied for like 200 as everyone do. You applied for about 200 jobs to get the job? Then I've spent about one year and a half in an UN training job in the NH SS. I worked in London and King's College. That was actually a bit challenging that when you're, when you're non training, it's the opportunities that you have are not as abundant and as easy as the trainees who are equivalent to you have. OK. So I've done about these 1.5 year, one of them I considered as an F two and I've signed my Crest form and then in November 2021 which took me about one year and a half in the NHS I applied for the core surgical training. I'm sorry, in 2020 I applied for the core surgical training and the post started in August 2021. So I got my surgical training to interrupt. You, you have one minute left. Yeah. So if you finish all of this and then, uh, you apply, I've done my two years here and then I've applied for, uh, ST three Interment orthopedics and they got the job in Nottingham at be starting in 2024. Now, all, all of this good and, well, we need to answer the next question, how you're gonna start. So the first thing you need to know and do, um, is that to work in the UK as a doctor, you need full GMC registration and a license to practice in the UK, which means you need to do your exam, your English exams, you need to do your lab one and blab two or the UK MA. If you are at a younger stage, if you are a bit in down in your training, you can do your MRCS exams and that would allow you to register with the GMC. So forget about everything. Now, you need to make a clear plan, how you're gonna get your gym C registration because otherwise you won't be able to come and work in the NS. Ok? And it depends on your level, as we said, if you are a student, these are the three things that you need, three things you need to do and be working on. If you are 1/4 5th or sixth year medical student, you need to do. These first one is read as much as you can in order to understand specifically what's going in the UK because it's totally different from what we do in Jordan. I've read about 2000 pages of documents on the GMC website on the I CS P, which is a training portfolio for surgical trainees in the UK. And um I've worked on my CV. So you need to work on your CV as well. You need to do your audit, your research, your publications and your presentations as this will give you points in your core surgical training and high speciality training. I know that uh Doctor Ahmed, I just have a couple of, a couple extra, a couple of extra slides. So I'll, I'll go on. Um So, and you, when you're a student, you have a lot of time, you don't work from 8 to 5 every day. There is less stress than I'd say in a medical job. So my advice, use that time, do research, don't do research that won't get published. So just stick to your professors who are known to have publications because you'll get points on the publications, not just the research. So get a research who you can publish, understand what an audit mean because we don't do audits in Jordan regularly. Except I think recently some people start to do these projects but previously they, they couldn't audit is one of the cornerstones in the clinical governance in the UK and the NHS. So you need to understand specifically what an audit is and how you can do an audit and how you can present this audit. So either locally in your department or in some conferences nationally in Jordan or er outside Jordan. OK. So focus on that. In order to have a guided, a guided approach, you need to check your self assessment document and these self assessment documents, you can find them on the website. On hee you, you just tried core surgical training, self assessment 2023 on Google. And you'll have the document and the first uh option. The last thing I'd say as a student, if you, if you are sure that you want to do your training in the UK, I suggest that do your electives in the UK, the elect. I've done my elective in the UK in 2020 18 and 2018 when I was 60 medical student. It was a great opportunity. I've gained a lot of experience. I've gained a lot of connections and I've done, I've done a case report and I published, published that which I used in my court surgical training down the line. So you can gain a lot of the elect of doing electives in the UK. So try to do them if you want to do elective and you have the budget, everything is feasible. So do them in the UK, if you're an intern as well read as much as you can because knowledge is your, is your power actually. And it, you would be much more guided to do that, do your licensing exams during your internship and work on your CV, as well specifically as we said in the, for the students, because you, you, you still have a bit of time speciality training in Jordan as well. Read as much as you can. It's a bit tricky sometimes to come from a different system. So my advice is get your Mr CS that would allow you to study some resources from the UK. You can do that part A and part B try to secure a clinical attachment that would help you to understand what is the NHS and how to work in the NHS because if we can conclude I finished. So I know guys that it's really difficult to get some advice. Sometimes I'm happy to be contacted on my email, my linkedin on my Facebook. Please feel free to contact me and I'm happy to answer anything and give you guidance in any way I can. Uh Thank you very much. All if you have any questions.