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very much for that introduction. I am Hannah and I'm one of the new ST ones in the Royal Infirmary, Edinburgh. And I'm very pleased to be talking to you today about trauma and orthopedics and kind of the key aspects if you're thinking about a career in it, of what to look out for and start doing to try and build a good TV to get into the run through program. So first of all, I have got a few names of what I'm going to discuss and then have some time at the end for questions. So I'm just going to give you a brief bit about myself as well as the day in the life of a trainee and then a bit of a timeline of the kind of things to do and then go spend most of the time off. The talk on the portfolio and how I'm going to do this is just kind of go through the scoring metrics and identify kind of key things that you should look to try and get for your CB, but also things that I found helpful. Knowing at an early stage to help build mine, I will then go through the application process. And then I've attached some resources at the end that I have found very handy to have. Whenever, um, I was in New Year's position as well as being an F. I wanted to trying to build orthopedics TV. So my name is Hannah, and I'm originally from Belfast in Northern Ireland, and I think from about the last year at school I decided that I wanted to medicine because I loved kind of anatomy and the human body. But I did realize that it was going to be a long career with a lot of exams and studying. So I decided to do a gap here first. Just have a year out, and I went and worked and lived in France for the year, which was great fun. And I actually think give me a lot of skills that I found useful today and getting to this stage of my career. I then went up to the top of Scotland, uh, to Aberdeen University, where I studied there for six years. I did an integrated degree in physiology, which I loved, and then I graduated in the middle of coated and came down to Edinburgh, where I did my foundation Year one and two I then this year have progressed and got onto the ST one run through a program here which I am currently loving. I think I always wanted to do surgery from about fourth year of medical school, and I always kind of had an idea that it was going to be orthopedics. But like to keep my options open and tried every especially and went and saw them all. I think it was an F Y. One where I kinda solidified that it was definitely orthopedics that I was really interested and passionate about. So I then decided to go for that for my actual foundation jobs. I was quite lucky that I did pediatric surgery where you got some pediatric orthopedics in Nephi one which is really good fun. And then I in Nephi to end up doing my first placement was an orthopedics, which is really handy, as that was around the time that I was applying for the program. So I was just gonna, at this point, run through kind of what we do in orthopedics and kind of normal day, I thought might be the best kind of thing. So what we normally do is we start our day at about eight AM, where we have the trauma meeting and at the trauma meeting, the to trainees who have been on call will present all the patients that they've admitted from the day and night before. And at this point, the consultants and everyone can look at the X rays here, the story of what's going on, um, for them from there, whether that be normally operative management or if there is conservative treatments. And this is quite interesting and a really good learning opportunity, because you can hear the discussions going on about the different fractures and the best way to treat them and the operations that can be done and the reasons why that is. So if you ever are on placement in the department, I definitely do recommend coming to the trauma meeting because I think you do learn a lot and you get to understand kind of the X rays and the presentations and operations we do for those fractures. So that's how we start our day and then normally would then go and do a wardrobe of all the in patients see how they're getting on, make plans for them if they are going for an operation. We make sure they are all marked as well as consented for that operation and that they are optimized for theater. And then we see all the patients who also had their operations in the days previously and make sure that they're ongoing care. There's a plan in place for them there. After that. We would then go to the brief at theaters where we then have our list for the day and run through the order of the patients to see and operate on and highlight any things that the theater team need to be aware of. And then there's the full day of operating, which is really good fun, Um, seeing all the different types of operations and doing them on other days. If we're not operating, there will be clinics where lots of patients come in and we see them there. And it's very interesting because I think with the orthopedics is quite a heavily outpatient based um specialty, where a lot of people who need treatments or plans don't actually need to be in hospital and can be seen in an outpatient basis have a plan made. And if they need a surgery, they can come in as a day surgery patient, which is also a really nice aspect of the job. And then, obviously there are some of the war jobs where we can go and make sure all the patients, um, I've got plans in place and are doing well, so that's kind of roughly the things that we do on a daily basis. On the side of that, there's obviously research and things go on at the same time that you can get involved in all it's and just research, which is also really good and part of the job. So I am then going to move on to kind of a timeline of the different ways in to trauma and orthopedics. As I mentioned, I'm currently on the run through program and that starts effectively after F Y two and takes you the full way up to being a day one consultant, having passed all the exams, and that's quite a unique thing for Scotland in the rest of the UK Everyone would normally go through the core surgery and apply for that and that is a two year training program that you rotate through a different variety of surgical specialties. And then at the end of that two years, you would then apply for senior training going in at S T three and at that stage would be focusing and picking your specialty, which would be orthopedics in this instance. So they are very different. And in Scotland, we're very lucky to have this run through training as it's quite nice to be able to apply and be in. And just know that that you're in the one place and you're able to progress through and get to know the department and your peers and be able to then fine tune your skills. And I find personally that everyone, including the consultants, are very invested in your training and want you to do well. So put a lot of time and effort into helping and training you up so you can progress and be an excellent surgeon by the end of it. With regards to the run through program here in Scotland, which I'll talk about the most is that is what I'm familiar with the first two years are you rotate on a six monthly basis, and you have 18 months based within trauma orthopedics, and that will be either elective or trauma. And then the rest of the time will be spent. You have a placement in plastics as well you. So you also get some experience there and find a lot of transferable skills as well. Throughout that you are on a junior on call Road. Uh, you might have heard if you've been on the ward's called two and 81 room, because that's our pager number, and that is whenever you're taking the referrals for the hospital that day. So that will mainly be from A and B or minor injuries. And then you can go and see the patients, make a plan and then, um, come in the morning, present them at the trauma meeting and have that plan. Then hopefully action going forward following the first two years. Normally, what happens is that you rotate through all the different specialties. As you can see, it's written here. Hip, knee, foot and ankle, pediatric spine, your Children elbow, hand and wrist, as well as major trauma. Um, normally in Edinburgh. Specifically, we have a year in five in Jericho. See where it is? A district general hospital. And you have training there and then come back to the Royal following that after your first after you. For six years you've been eligible to sit your completion exams. And following that, you put two years kind of to do that. And in these last two years, most people are then trying to kind of further hone in on their surgical skills as well as getting more experience in their specialty before, at the end of completing their certification to be a day one consultant. So that is quite a brief overview of how the run through program works here and where you can see the difference from core surgery and where you would enter in at that point and s t three. So with regards to getting into trauma orthopedics, um, as you all are probably very aware it is highly competitive, like all surgical specialties, but in particular, I find that orthopedics is probably one of the most competitive. So it is good if you have an interest in it to start trying to build a CV towards it soon. Obviously, there's all loads of time, and if It's something that you decide later on that you would like to do. It's never too late, and I would definitely advise everyone to, um, look and think about orthopedics as a career. But if you do know that something you want to do definitely start early because it will make your life so much easier when it comes to applying to get in. So the key kind of things you might be aware of. But I thought I'd just highlight here that I would start working on, Um, now, first thing would be your operative. The log book. Now this is a free thing that's on the Internet called your surgical. A log book, which I advise everyone, even if it's not orthopedic you're wanting to do is another surgical specialty. I would definitely advise you to get it now and start any time you're in theater. Um, either you are scrubbed in and assisting or you're observing, Um, take the patient's details and log everything you do and see as when it comes to applications. You'll definitely appreciate having done that earlier, because you'll have more experience there as well. I would definitely also recommend if you're on any surgical placements get stuck in and get involved. Make your consultant or register aware that you're really interested, and they will always be keen to get you involved and scrubbed in and explain what's going on. If you've got the opportunity to scrub in, I definitely would recommend, because you definitely get to see a lot more, and we might be able to do some things like centering or sometimes can be on the section. So I definitely recommend and also makes a lot more enjoyable. I think whenever you're watching, sometimes you might not appreciate everything going on, whereas if you're scrubbed in, you'll get a lot more out of it. So definitely get that now, and it's something you can be doing as a student. The next thing that you might be aware of is exams, and the main one is the MRCS. So this is something that you would do. Post graduate people can do it an F one f i two or even into ST one, and it's something part A and part B is important to have completed and finished by the end of ST to, and the part egg is a written MCQ exam and the part B is, uh, Oral Loski like exam. Now they are hard exams, and it's something that you don't have to have getting into the training program. And that's something that most people do have whenever they are applying normally, have part A. And I think most people would end up applying for it, Um, and sitting at at the end of f Y one or the start of F y, too. Moving on audits, um, is also something that you've probably had some experience at medical school, and it's very easy to get involved with, and then publications and teaching publications you can. They take a lot of work, and I'll talk about them a little bit later. Um, but they are good to start the ball rolling early because they do take some time teaching. Whether that is a bedside teaching or organizing teaching. Um series is really useful to get involved with any kind of level, whether that be teaching younger medical students or physician's associates and things like that university. I would really recommend that, and then presentations be the oral or posters and from work that you have done. There's been a lot of courses, which I will also give a lot more details on later that are good to get experience in as well as build skills in and then also leadership and societies having rolls like being on committees or societies. Um, it's really useful to have, as that gives you a lot more more rounded skills from that point of view. So what I was going to start with with work through the Matrix that you have to go through whenever you are applying. So there's a lot of words up there, and I know we've probably talked very fast at the moment, so let you have a couple of seconds to have a quick look at it. Some of you may have seen it before, and although it is something that many of you may not have seen, because it is more specific whenever you're getting down to applying. But I thought but I would start off with going through this to make you aware of the kind of points that you get for the application, and then it kind of helps direct you to see what the important things are to work towards, to try and build a CV for trauma orthopedics, so I'll give you a few seconds. See the layout of that. Now it is important to note that this matrix is always changing. Um, it's always been refined each year. This matrix here that I've put on the presentation is different from the one that I had last year whenever I was applying. This is the one for this year, and it does change only very slightly with regards to Maybe there's different waiting on the points or different wording of things. But in general the key headings of where you were getting your points from or generally the same each year and are very good to just kind of base the importance of these. So I'll point talk through each and point out some handy things, um, that I would have found useful to know if I was at your stage. So the first point of where you can score point is career progression now with some of these things where you're scoring points in either have it or you don't have it, and you can change it or you can't change it, and this is one of them, and this is just with regards to when you're applying and the reason that it is waited this way, um, is to make it as far as possible for everyone who's applying. So, as you can see here on the top scoring point here, five would be for whenever you apply in Nephi to go up to two years of clinical experience since primary medical qualification. So you get five points if you're applying F y, too, three points would be, if you're applying between years two and three of having clinical experiences since graduating. And with that, that would be if you have taken a year out, maybe to do a clinical fellow research or something like that, and then one for more than three years, and it might seem a little bit unfair looking at it like this. But the main reason that they have it like this is due to the fact that if you've had more years out, you've had more time effectively to get publications, presentations to your exams and etcetera, etcetera, and this is just the way of leveling out. So this is one that you can't change what you have, and it's just something that is the way it is moving on to the second one under graduate degrees and qualifications. So this one is whether or not you have integrated. Um, so I believe Edinburgh. Everyone integrates. So this is a good one and that you'll definitely get some extra points. And this is just if you've got a first class or um to one within that. So that is something that is just handy to note, and then the other one is additional achievements. So this is just the kind of level that you graduate with your NBC HB, Um, something that I was gonna note at this point that I found a little bit hard was the fact that whenever I was applying with in Aberdeen University, we didn't have specific honors. Distinction, merit. We had commendation and things like that. And with this whole matrix as a whole, you will find that they're not able to cover everything. And it has to be the way you interpret it as well, for example, And if I graduated with commendation, it doesn't say commendation, but that kind of equates to distinction here. Um, so you have to make your best judgment call and put what you think is fair. Whenever you are scoring yourself for this, the next one moving on to is put up graduate degrees and qualifications. So this is something we're starting to get into the areas of where you can go and get these extra points from. So this is kind of based on whether you have your MRCS part one or if you've got the full one. And if you've gone on to do an M mg or PhD as well. So obviously at the top here you'd be scoring full points if you had a PhD or MG in research. And most people I know who have applied and got in no one got those full points. Um, so it would be more kind of going from three below where you find most people would be falling and you've got kind of a master's or the full MRCS for three and then for part for two points would be MRCS part one. No, I think I stress personally about this quite a lot because I didn't have my MRCS support one whenever I was applying, so I thought I was going to be very far behind compared to everyone else and only actually just got it more recently, following the application and being successful getting it in. So it's not something that is essential. Tha have. When you're applying, however, I definitely would recommend trying to get it, because it definitely does give you that foot up. And I do feel that having your MRCS done and out of the way effectively as soon as possible is very useful, because then you can actually start concentrating on the specialty itself and learning from that rather than trying to do it at the same time. So it's something I personally wish I had done earlier but isn't essential to have done. The other thing I was going to point out here is with the MRCs. Um, I was asked question recently about when to sit it. Most people that I know who got in Dusty once at at the end of F y one started F Y two, and I think that is quite a good time to sit it, because all the knowledge is still fresh from your final exams in your mind. So it's a good time to see that as well. You have your results before applying for your ST application, so I definitely think getting it done as soon as possible is a good thing. But as I said, it's not essential. Some people as well might do things like a diploma or PG search, which is really useful because it gives you more experience in research and teaching, um, like and things like that. But as I said, there's different ways to get these points and no way is the perfect way. But I definitely think trying to score is maximum Ones in this section is very useful. Moving on to training courses attended. This is something that unfortunately can cost a lot of money effectively whenever you're trying to get on to these courses. But these courses are so useful and so good, and I thoroughly enjoyed doing all of the ones that I was on, the kind of key ones that people talk about and try and get onto your basic surgical skills. You're a TLS, and another one that I did and I absolutely loved was the core skills and orthopedic surgery that was run by the Royal College Surgeons. Edinburgh. Up here, there is not an exhaustive list as it says here, and it's very hard because I think some people stress over this section whenever they're trying to put things in as to what would count for me. Personally, I felt that trying to do as many courses I could out there to get the experience and skills out of them was what I aimed to do and then just listed them all and put them down. The kind of key ones that they're looking for are the ones I listed, as well as things like the A oh, undergraduate course you can do and crisp course. And as long as they've got COPD points and you've got some surgical experience, I feel that's kind of the key thing, things that matter and the Royal College excursions. Edinburgh, I think, is a fantastic place and and site to find some of these. There are plastering courses there, factor fixation courses there, all of which I think are so useful to do so. It's definitely one that is a good section for your portfolio, not only to learn skills, but also for the application with regards to this Um, section and with regards to these courses is important to note, though they are always very popular and oversubscribed, and they are notoriously hard to get on to. Um, they're not essential to have attended the specific ones I mentioned, but they are useful and something that I think if you're going into surgical training is really handy to have in particular a TLS my HDLs, as I previously mentioned notoriously hard to get on to. So if I was at your stage at the moment, what I'd be thinking about is as soon as you can graduate from your medical degrees trying to get on to basic surgical skills and getting on to hit two ls and just putting your name on the waiting list as soon as possible and attending them because there are other than the fact they're really enjoyable to do and you get a lot out of them. And at least you've got onto them early. And you have those points in the bank for this section, as mentioned some of the courses that I found easy the future surgeons, key skills courses, actually what I did at university, and I think the Royal College of Surgeons Edinburgh does it here as well, so I would definitely recommend that you know, it's really good practical hands on session. We get to do stuttering and drainage of abscesses and things like that. So it is a really enjoyable one to do this one here is the next one is experience of procedural and manual tasks. But this one to me very much goes hand in hand with your log book and your experience in theater and within a trauma. Orthopedics, as you can see as it goes up with regards to all the points to score the maximum points, is that you are able to demonstrate that you've experienced well beyond what is expected as an F Y two with regards to the comp. So that would be extensive exposure to trauma orthopedic surgery and that would involve being assistant and scrubbed or performing them, um, supervised as well. The more you get experience of this, the more you'll be able to understand the operative procedures and the reasoning for them, but also the surgical skills that come alongside that. So, as I said before, definitely tell any consultant or registrar that you're interested in specialty and get scrubbed in and get experience and add them all to your log book. With this, you'll probably get more experience as an F Y one or an F. Y, too. I found that within my orthopedics job, it was great some days if I was starting at two o'clock, I come in early so I could go and go to the theater and get extra experience without the stress that I was also meant to be at work, but also within the jobs as well. I found it was great because there was times set aside whenever you were on those jobs to go to clinic or go to the theater, so I definitely would recommend trying to get in as the theater as well. For that, it also corresponds other than your surgical experience in theater, too. Practical procedures. So, as you can see going up, it starts off with the one that you can be expected to do as an F Y one and two like cannula and energy tube insertion up until putting on back slabs and then up until fracture reduction chest and insertion, as well as central line insertion, which you may get experience on if you're doing an I T. U job or anesthetics with this section. I feel most people, if you're applying, should be trying their best to score full points on this from being in theater lot, but also things like fracture reduction. Um, in Edinburgh, we have a beers block list down in A and E, and I went and intended that quite a lot. To get experience is reducing just the radius fractures and putting on back slabs. And I found that really enjoyable, but a very good and controlled place to learn how to reduce fractures. So I feel that this kind of section of the application, anyway, is a really useful one. Um, and good one score four points on moving on to teaching. Um, I think teaching is a really important part of the job and something I personally love to do and be a part of. And there's loads of different avenues to do the teaching, which I have found useful for me. Personally, I started getting involved in teaching whenever I was a medical student at Aberdeen. We had a society called pals, which has persisted, learning, and from that we were able to do supported teaching of more junior medical students in anatomy as well as clinical skills, which I found really useful and beneficial both to my learning but also learning how to help and assist in teaching from that. And we were able to organize, uh, teaching tutorials for different things leading up to exams for the younger medical students. And I found that a very useful learning process for myself and got a lot of experience out of it. So that might be something that you guys are able to do or get involved with or have already been involved with at university. Getting involved in societies and teaching other medical students or, as I mentioned physicians to associates, is really useful to do and get involved with. Whenever you progress to your foundation years, there will definitely be plenty of opportunities to get teaching experience, be that bedside teaching or whether that's more formal teaching. Um, at most hospitals, they normally have a surgical skills club, so this is a good place to get involved with the teaching side of things, as well as also attending to develop your skills. So I think there is definitely a lot of opportunities to score maximum points here. It would be to possess formal teaching qualification at masters or above. I personally don't know anyone who has applied and had this, but if you did, that would be amazing. I think it would be really beneficial and good, um, for throughout your career. But most people applying, I'd say, would be trying to aim, at least for the three points. And that would be whenever you work with local tutors to design, organize and deliver a teaching program or a completion of a formal teaching qualification below masters, for example, the diploma or PG start that I had mentioned earlier. Now, if there isn't any kind of society or anything that you are involved with, that can help get involved with teaching, it's very easy to approach people, particularly in during your foundation years. Um, if you've got an idea of something that you think might be useful, you can always kind of set up uh, teaching a series for either medical students or other junior doctors to try and hone in on a topic or a skill. I'm sure all departments would be very keen to have anyone who is keen to do this kind of thing. It would be very supportive of that. Obviously, this is something that would cause or take some time. So with regards to this, I would definitely advise to getting involved in this early, um, to work through it and get it set up and running. The other thing that I have found useful with in teaching is kind of getting taught how to teach in Edinburgh, we're very lucky. There is something called the Clinical Educator program, which I work through and did modules on. And that just tells you the basics of kind of teaching and ways to adapt and how to get people involved and just the principals behind it. So I think actually, having some of that as well as some training and teaching is very useful now. There's no specific points for that here, but whenever you are going through the application, you do technically right out of CV, where you write these things and it's something that I put down as well because it was quite important to me. And it just shows the person who is marking your application and orthopedics that you have also gone above and beyond and done all this extra stuff with regards to teaching something that is very useful is this site called medical feedback? Um, M E f B. And this is something that you guys actually might have been asked to fill in before, and it was developed by two people in Edinburgh. And it is a online form that people can create and get the people that they're teaching to fill out to give feedback on what they thought well and how to improve it. So I would definitely recommend if you were getting involved in teaching be that bed bedside or more formal teaching, too. I don't know this and get an account because it keeps all of your feedback in a safe place that you'll be able to access, reflect on and also produces evidence when it comes to think up applying because for all these things, you need to have evidence to back it up and prove that you have done it. So that is definitely a useful thing that I came across whenever I was involved with teaching. The next section is quality improvement, um, and audit. This is something that I definitely recommend everyone to get involved with. It's something that you have to have done at least one quality improvement or audit project throughout your foundation years. But I think it's very useful to be involved with, to understand the principles of audit and quality improvement and how they can integrate into the care that we give patients. And it is always looking to better improve. The process is that we have in place or to make sure that we're meeting those standards that are set in place, so it is very important. Both for are learning, but also for the care of the patients. So I definitely recommend and getting involved in audit early on. With regards to trying to score maximum points in this section, you would need to have designed a clinical audit, been the main lead for the clinical audit and then gone and implemented change using your own methodology. And what that means is that you have done a full cycle where you have audited something and you've then gone through it and analyze these results, identified areas that can be improved, implemented the change and then come back at a later time to re audit and, as we call it, close the loop on it to get maximum points and show that you have had some change there. Now it is important to note here the differences between each marking station because you may be involved with lots of audits and many people have audits, lots of different projects going on. You may be asked to collect data for them or to do some research for them. So it is important to note the differences for example, for to get two points. One of the statements is that you've participated in different stages of several projects, so you may have been involved with lots of different projects and down a little bit of data collection for all of them. And so that's where you scored two points there. But to get the maximum points, you need to be the main person designing it, leading it and implementing the change as well as being the person to close the loop. Sometimes you might be involved, and someone's already started an audit, and you do one cycle of it and do one look. That's great. But once again it would only get you two points with regards to only participated in one cycle that I think it is great be involved with audits. I personally was involved with quite a few before applying, so I definitely would recommend starting now and getting involved with as many as you can and and you'll learn so much from them and understand them a lot better. And you can actually see the change that you're doing a lot of the time. I think as well people get involved with lots of things. I definitely would recommend trying to identify something that is a good quality and that you can actually see is going to make a change and not just doing it for the process of doing it is quite nice to get something that you actually can see, that there is something that could be improved and then actually make that change from lots of these things, as I will mention later on with regards to publications you can then go on to present your results so you may do one piece of work, but you may then go on to present it at a meeting or conference, and it's then quite good because you're getting extra things on your CV for the one piece of work, which is really good. So things can come out of audits other than just the change that you have implemented know publications. I think this is probably one of the harder ones to score on and to get points on as it does take quite a while to get a piece of work to the stage of getting it published. Um, score Maximum points would be to been an author on two or more papers and then for the next lot would be the first author, co author of one paper that has been published. I would definitely recommend, as with everything, getting trying to get involved with something early on so that you do have that time to allow for it to get the stage of being published prior to applying. So for all of you, at the moment, it's a great opportunity. You still got a long time before, so you definitely have a lot of time to try and get involved with research and try to get some publications out of that with in Edinburgh. There's always a lot going on, and people kind of think of it as a research hub, so lots of consultants would be very keen for you to approach them. If you're interested and see if there's anything going on or if there's any research ideas you have yourself, and to look into that you could start doing and and then work through that. It's really interesting. You learn definitely a lot about it as well as the world of research, so I would recommend it to everyone. But as I said, it's something to definitely start early with this as well as I mentioned audits, It is a really good opportunity to then be able to go on further and present your work. For example, presenting them at conferences is a really good way to kind of tell people about your work, um, and disseminate it through the kind of people who would be working with that kind of thing each day. So it is a really good thing if you do get a publication to also try and get it out there to the world and promote it as well through presenting it various things and that leads me nicely on to presentations and posters. So this, as it says on the tin, is how many kind of presentations you've done. I personally feel that if you've got something like a paper that you've done or an audit that you've done that is a good quality, always aim high, Um, and try and present at either national or international conference, and the one that you score most points for is if it's an oral presentation over a poster presentation. But everything that you're able to present is amazing, and you always get points for it. But if it was personally me trying to score most points in this, what I would advise is to do try and get an oral presentation and just put it in for a national or international meeting, um, and conference. And if you don't get it, that's nothing to worry about because you can then try other places or even a regional meeting is good. So I would definitely recommend trying to get anything that you do work on presented at either a national, international or regional meeting. Yeah, now, this section here is something that I think is one of the more tricky ones to get points for and try and get on your CV. It's something that I personally didn't have any points on. Whenever I was applying but basically it's just showing out with the kind of normal presentations, publications and audits that you've done. What other kind of research? Things that you have on your CV. No to score. Maximum point. It would be if you've ever written and submitted a successful application to Elrich or Emerick. You know what I'll record Emerick. I hadn't even heard of these until about a year ago and what they stand for is Elrich is the local research ethics Committee, and Emerick is your multi center research ethics committee. And effectively, what this would be is if you come up with this research idea for either a trial or some form of research that you then had to go through the ethics process to get it, um approved for you to be able to carry out the trial through either of these committees. So if you've written and submitted one that has been successful, you'd be scoring four points straight away. Um, but it also would be very good if you were doing that, because hopefully what your research would be doing would be leading to publications and presentations. So if you are able to get that, that's amazing you'll get lots of points on the application. As I said, it wouldn't be essential. Other things here would be if you've had a formal royal in a training collaborative or if you've initiated a trial project or screened and consented patients into an NIH are funded trial. Now, A lot of people may have heard of some of these kind of things, like Scott Storm or or search star as well, so I would definitely try and get involved in these kind of things that are going on. There's a great, um, society called Asset that you might be aware of. And they have a whole list of these kind of audits that you can be involved with and trials that are going on. And you could be a regional person to try and screening consent patients into these effectively. Um, so I would definitely recommend trying to get involved with these. As with everything, a lot of this kind of research and projects take time. So I would definitely recommend thinking about it now and trying to set something like this up early and as well, the last one that you can get points for our your academic f my rotation, and that is something that either have it or you don't have. If you're applying to do an academic F. Y, actually, one more point on this as well. So with the application process as I mentioned, you have kind of a blank area of space where you lay out your writing and your points for what you've done within that to try and get the maximum amount of points that you're scoring in something like this section, Um, even if you don't score any points, I definitely recommend that you put something down there of what you've been involved with because the person marking your application isn't going to know what you have done or the things you've been involved with. And sometimes you may have done a whole host of things throughout your medical school time as well as your foundation years that are very useful and have taught you a lot. And they're very good to have in your CV. But they don't fit any of these boxes, so I definitely recommend trying to get them in in an approved great place, if possible. So, for example, whenever I was filling out this one I wasn't able to score any points on this section. However I had within S S. C s at University been involved in different things corresponding to orthopedics. Also things that weren't orthopedics that I put down here that we're involved with research. I also put down things like anatomy dissections that I had done and we preserved in the museum that were other research indicators. They didn't score me points because they didn't fit into any of these boxes, but I felt were very important and showed my interest and surgery early on. So I put them down here in a a nice layout to just highlight the fact that I had actually also been in all these things as well. And the people at the interview stage will have your application. So I'll actually be able to see all these extra things that you may have been involved with that might not have scored your points. And it's also a talking point whenever they are asking you the questions. So I definitely would recommend that you try for everything, put as much information down as you can all be it not overloading for the person marking your application as they have to go through a lot and you want to be clear and concise for them to see all the things you've done. But definitely if you've got any extra things or awards or any society's and things that you've been involved with, definitely try and get them down somewhere. And so the person working it knows all the things you've done. So where to start? I feel probably giving you quite a lot of information there with all of the things that we have just gone through. But I thought I would talk. I've probably already said some of this stuff, but just off the kind of places of where to start, whenever you're trying to navigate this mind field of all these different things, as it can be a lot to take in and it can be a lot to try and do it once, definitely not something that you'd be able to do all these things at once, which is why I recommend starting early. So I thought I'd just give a few pointers of where I feel it would be a good place to start. So, as I said, consultants and registrars, everyone is always very happy to get you involved in things and point you in the right direction. So any placements come and find us and ask to be involved with research audits going on. Everyone loves you to get involved with them. Just ask anyone, and sometimes you might get on well with someone. And it's good to have someone as a mentor to ask these kind of questions of what I do. Hear what I do there with regards to the application process or projects. So if you find someone like a mentor, it's quite nice to have, and they can help guide you through the process of everything going on. Seek out a surgical rotations. Be that with your SSC and surgical projects doing your integrated degree in, uh, surgical kind of specialty. Um, your elective is very important. I think people are starting to be able to do electively when I so doing a surgical elective is definitely, really handy to have done, um, your F Y rotations for me. As I mentioned previously, I was quite lucky to have done a few surgical rotations, the first one being in pediatric surgery where I got exposure to orthopedics there as well as trying to orthopedics in general surgery With regards to when you do them, I think you can be quite strategic in it. And I tried to be as best as I could, and I tried to save most of my surgical rotations for the end of F Y one, but also if I, too, because I felt that if I was to do a lot of the medical rotations first, I'd be able to find my feet, understand how the war's work have that kind of good, basic understanding of medicine and managing patients. Um, and then that meant that whenever it came to the surgical side of things, I was able to do that very efficiently and well. That meant that I would then have more time to be able to spend trying to go to the theater or clinics and getting those experience. So I definitely do think that doing the surgical rotations if you're interested in surgery, you might get a bit more out of them further on That being said, on the other hand of the coin, it might be nice to have your surgical rotations earlier on in your training to definitely know if that's something that you want to do or to get experience off them. But I definitely personally found that it was quite nice to have my kind of final year of f Y to mainly based in surgery. I would also on that note recommend trying to do your trauma. Orthopedics one. No, it's not essential to have done, uh, orthopedics rotation within your junior doctor years before applying, but it definitely helps, and it's really useful to do it to know. Definitely this is the career that you want to do, but also to get that experience of working in an orthopedic ward and the common presentations and operations that get done. So I definitely think it's a good one to try and get it, but it's not essential. And then, finally, a tester week Taster Weeks are really good. I love mine, and I think it's a really good thing to do. It gets you a lot more operating time and see operations as well as good at clinics with consultant, so I definitely recommend doing a test a week. If you're able to in orthopedics now, it's also not essential, but it shows your interest and throughout the application process and all those points that we're talking about. They're all indicators of your commitment to the specialty. And that's essentially what the Examiner's are looking for is they're wanting to see someone who's committed and really wants to do that, especially as their career. So that is why it is good to get involved in all this stuff early. What I was going to say something someone told me whenever I was a medical student, which I find really useful was that obviously, if you're applying for orthopedics, it's really good to have these projects and audits in orthopedics. But it's not essential. For example, you may happen to have done a proge that's based on the ent or plastic surgery. Definitely every piece of work you do is really useful and really good, because you're learning the process of research and how to carry these things out, and you will be able to potentially get things from them, like doing presentations or publishing your work so they're really useful to have, and it shows that you understand the process of research and you may start off thinking that you want to, for example, be a plastic surgeon, and we're working towards doing things involved with that. But then down the line you realize that actually, it's not what you want to do, and then you have experience in orthopedics, and that is what you want to do. So you will have a lot of plastic surgery on your CB That is all transferable skills, so whatever you do and get involved with will be useful and good. Um, but obviously, if you do do in, especially, like trauma orthopedics that you're interested in, it is, um, slightly more adventitious and make the most of any opportunity. You will come across lots of opportunities, and I think that they present themselves to you, and they're very useful to do so. If anyone comes to you with an opportunity to definitely take it and get stuck in and get involved. And it's always handy to have a friend who's also so interested in a similar especially um to talk about it with also to do projects with and also guide each other through the thing because it is hard and it is long, so it's nice to be able to do it with someone who's also interested in it. Start building, you see, Be now, as I've already said and collect evidence being organized. Is Sochi here? And being prepared is Sochi is something that I cannot stress enough. Um, I think what I found really useful was for everything that I had done in medical school. I would ask the consultant or whoever I was working with, um, if I could get a letter and signed the evidence, everything I've done, for example, that medical feedback. So I showed you getting evidence of the feedback you've had all of these things you need to be able to prove that you've done them and have evidence that you've done them signed off by a consultant or by getting the certificate for the course or the program and certificate for presenting something at a conference is so essential. And you don't want to get to the point where you've done all this amazing work and you haven't got that evidence for it. So technically you can't prove that it was there, so I can't put it down. So, having all this get a box, I found that I just either a box put all this in or what I found was I just created folders on my computer, one for audits, one for presentations, one for publications, etcetera, etcetera and put it all there as soon as I had it. And it meant that when it came to uploading the evidence for the application, it was all there in front of me. And it took that little bit of stress of trying to collect it at a later date and back dating it for a year or two years. So much easier. The last thing I want to say at this point is, Don't take too much on it can be overwhelming and try and do this all once you have time, enjoy everything that you do. It is so much fun. And I personally love it. Everything that I've got involved with, it takes time, and it is long, but I've enjoyed doing it, and the result at the end is so good whenever you've got it there and you can see all the hard work you've done. And surgery is such a fun career. I'm able to go into work each day and do something that I love and get involved with it and do these operations and learn about them all. So I definitely think it's such a rewarding career. So don't be put off by how hard it is being organized, and starting now it will definitely take that stress off and will be definitely worth it. In the end, with regards to the application itself, I find that because you're at the CT are now you've got lots of opportunities to collect the points. But whenever it comes down to it, don't stress. If you don't have some things to identify the things that you do have, which is great and then identify the things that you don't have and could get. For example, you may not have any audits, and that's something that you could do, um, in a period of time. So then just identify the things you need to do and go out and do them. There's some things you may not be able to get in the time frame, so don't stress or worry about them. Just do what you can get the maximum one points within the time frame that you do have. As I said, the application takes time, Um, so definitely start early when it comes down to it in a few years' time. If you are applying, I definitely recommend starting to put the application together really early with regards to writing it. It's not something that can be done overnight, and it's something that I think there's a lot of skill and art to, um and how you present it. So I definitely think whenever the application is released, be aware it takes time to start writing it early. Revise it, get other people to read it, read, draft it. Um, you want to make it perfect for your applying, so you give yourself the best chance. So I've probably bombarded your brain's with so much random information there that I hope has been useful. So to finish off, I'm just gonna go through quickly. The timeline off the application process, not something you'll need to worry about at the moment. But just good, I felt, if you know about it, it's good to be aware. So for the run through program, as well as the core surgery you normally apply by the end of November, applications probably open at the start of November, so you've got about a month to write them and get them submitted. You then get long listed in December, and at this point, you then need to upload your evidence to back up the application. Now, whenever you were doing the application, you need to score yourself on each section of what you think you should be given points for. And then, if you're long listed based on those points, you need to upload the evidence to back up what you're scoring for. And then someone will go through all of those scores and say whether or not they agree and either give you that mark or if they disagree, and either mark you up because I think you should be getting more or mark it down. If they think you overshot now, I think it's try to be as realistic as possible. Um, with regards to your scoring, do not underscore yourself. If you think that you may not have it. I always think that, for example, if you, um, I think that you deserve those points, definitely put them down for myself. I had attended quite a lot of courses and scored myself full marks for them, and then it came to it. I think I was scored on one point because they didn't count a few of the courses, but you are able to peel it if you feel that you deserve those points and state why you feel it is, and they could be upgraded or downgraded based on that. So definitely score yourself for what you believe. But also don't be going ridiculous and giving yourself a lot more points. You do need to have done the work and have evidence to back it up. And then based on that, after your evidence has been ranked and gone through and verified, you will be short listed in February and then will be given an interview if you've been successful, which will sit in February and offered to come out at the end of March following the interview with regards to the interview. I didn't want to go into too much detail because it's quite a while away, but I thought I'd just give a brief overview of what it involves. So you're aware of the kind of things that they ask. Your portfolio is one section which is effectively everything that you have marked yourself on with regards to that matrix. We've just talked through, and this is yours. Time to shine. This is where you're able to sell yourself and tell the Examiner's like how great you are and why you believe that you should be on the training programs. Use this time to get in all these extra bit of work that you've done that may not have been on your application of portfolio or, for example, things that you might have completed since your application went in. This is your time to tell them all about yourself and show all the hard work that you have done. The next station is a clinical station, which you're asked to clinical scenarios. So, for example, this could be something like compartment syndrome. This could be something like a hot, swollen joint, and you're just ask to go through what you would do in the management and then ask some specific questions on that. Another station is the handover station, where you're given a list of patients at the start and some information about them as if you're about to take over on an on call and then you have to talk through that station on all of the patients. The order you would see them in what's urgent, what you're going to do in their management and what can be delegated. What can be wait for later and how you're going to address each of these patients and manage them. And that station is just showing that you're able to prioritize. You're able to judge quickly which patients and cases are urgent or which things can wait and be dealt with at a different time. So that is actually quite a fun station to do, I found. And then one of the last ones is communication. So this is a quick station where you will be asked to communicate with, for example, uh, patient, to explain that they've broken their hip or to talk with a family member about, uh, the management plan for a patient or something a bit more tricky. Like go through a D E n a c p. Our conversation or consenting a patient, which is quite a good station I found as well. And then finally you'll be asked to do a presentation, which is normally three minutes long. When we got asked last year is how will trauma orthopedics recover from the coated pandemic, which is very topical. Um, so that one is something that you will get the title of early in advance and have some time to prepare for. So that is the interview now, almost finished. Um, sorry I rattled through all this. Um, I just thought these are to interview books that I found very useful for going through just for interview techniques but also practicing questions, so I would definitely recommend looking through them. As I said previously, it's always nice if you have a friend or someone who's interested going through the same thing as you're able to practice with them speaking out loud and practice definitely does make perfect. So I would recommend doing that. And then some societies These are some very useful societies that I found were helpful whenever I was at your stage, but also progressing through foundation years for not only courses but information about things, advice, webinars as well as being able to get involved in things. You've got asset, which is very good and aimed at junior doctors and surgeons in Training Royal College, the British Orthopedic Association, as well as one of the new societies. The foundation trainees Surgical Society of Scotland and all of these kind of places run events and webinars like this where you can get lots more information and get involved in different courses and things that are going on. They're a very good source of information. So thank you. I'm sorry for going on for so long. I hope I didn't talk too fast. And if you've got any questions now, pleased to ask. Or I'm more than happy for you to contact me any other time. And I can talk through anything more in detail.