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daniel.foran@cardiov.ox.ac.uk The SFP Interview A MedED LECTURESESSION STRUCTURE General Academic Questions Critical Appraisal Interview Format The Clinical Station The Academic Station Personal Questions ‘Off the wall’ QuestionsDo I need to Interview? Interview Format • All online • Typically, 1 panel (?except North-West England) • Varying numbers and types of stations: • 2 total (1x clinical, 1x academic) • 1 longer station including both clinical and academic • ?Norwich: 3 total (1x clinical, 1x critical appraisal, 1x research plans) • Typically, 20 mins total interview time • No longer than 40 mins • May have 14 mins abstract pre-reading time • Interview slot may be bookable or pre-allocated How to prepare? • PrepareA-E assessments for all acute clinical scenarios (good for finals) • Prepare bullet points for some academic questions • PRACTICE WITH FRIENDS • Mock Interviews (personal tutor, SFP doctors, academic supervisors, anyone willing to give you a mock…) • DO NOT SPEND EXTORTIONATE AMOUNTS OF MONEY ON COURSES!!! How to prepare? START PREPARING ONCEYOU’VE SUBMITTEDYOUR APPLICATION Will be helpful for future interviews (core training,ACFs, etc) The Clinical Station • Essentially the same as the finals acute care station… • Between 1 and 3 acute cases • If multiple cases, usually will include: • Critically unwell patient • Patient who will soon be unwell • Non-urgent patient but with ethical componentClinical Station Example Clinical Station Breakdown 1. Prioritise! 2. Safety net non-priority patients • Gather more information • Ask for basic interventions whilst you are busy with priority patient • Alert senior 3. Assess the acutely unwell patientHow to prepare? A - Airway Assessment • Look, listen, feel Interventions • Suction • Manoeuvres • Adjuncts • Airways B - Breathing Assessment • Look, listen, feel • RR, SaO2 Interventions • Oxygen • CXR • ABG • Ventilation C - Circulation Assessment • HR, BP, Cap Refill, Pulse character, Heart sounds, Urine Output • ECG, Bloods Interventions • IV Cannula • Fluids • BloodTx • Catheterisation D - Disability Assessment A VPU / GCS, Capillary Glucose, Pupillary reflexes, neuro exam Interventions • Oral/IV glucose (or IM glucagon) • Consider ITU escalation for airway management if low GCS E - Exposure Assessment • Temperature, top-to-toe examination (looking for scars, rashes, bleeding, trauma, swelling, surgical sites etc…) Interventions • So many things… Post A-E Assessment Alert Senior Take History 1. SBAR Handover A – allergies 2. Further management M – medications 3. Have a clear question P – PMHx / PSHx 4. Need to call other L – last meal seniors? E – events leading up to illness Demonstrates that you are a safe FY1 What could come up? Cardiology Respiratory Gastroenterology/Surgery Other • Acute coronary syndrome • Acute severe asthma • Acute GI bleeding • Sepsis • Acute heart failure / severe • Acute exacerbation of COPD • Acute appendicitis • Hyponatraemia pulmonary oedema • Pneumothorax • Acute cholecystitis • Hyperkalaemia • Arrhythmia • Pneumonia • Acute diverticulitis • Hypokalaemia • Atrial fibrillation • Pleural effusion • Acute pancreatitis • Blood transfusion • Cardiac arrest • Pulmonary embolism • Intestinal ischemia reactions • Aortic dissection • Deep vein thrombosis • Post op complications: • Poisoning • Ruptured aortic aneurysm anastomotic leak etc • Alcohol • Infective endocarditis Neurology • Bowel obstruction • Confusion • Head injury • Anaphylaxis Endocrinology • Meningitis Renal • Fall • DKA • Subarachnoid haemorrhage • Acute kidney injury • HHS • Stroke • Renal / ureteric colic • Adrenal crisis • Status epilepticus • UTI • Thyrotoxic crisis / • Delirium thyroid storm • Syncope/ collapse • Myxoedema Types of questions? • GeneralAcademic / Education / Leadership Knowledge • CriticalAppraisal • Personal Questions • ‘Off the wall’ Questions General Academic Knowledge • The easy marks! • This is the stuff they will expect you to get right • Think broadly • Risk / Odds / Hazard Ratios • H Index • Type 1 / type 2 errors • Power • P value • Types of bias • Study designs Critical Appraisal • ‘ell us about a paper you read recently’ • What are they actually asking? • Should probably have an answer to this question… • May be a pre-selected abstract / paper • Looking for a thorough and STRUCTURED analysisAND probably an opinion on what it means for clinical practice in the area of interestAbstract Example Appraisal Structure 1. PICOK 2. InternalValidity 3. ExternalValidity • Population • AKA Bias, Confounding, • Important Question? • Intervention and Chance • Analyses (intention to • Control • Study Design treat vs per protocol) • Outcome • Population • Intervention effective • Key Findings • Intervention and safe? • Blinding • Economics of • Outcome Measures implementation • Statistics 4. Ethics 5. Conclusion • What is the utility of this study to your practice? Personal Questions Links back to the whitespace questions Structure your answers • Have three reasons for any ‘why’ question • Make them personal to you and the SFP you are applying to! Off-the-wall Questions Typical of Oxford and Cambridge Example: “How can we get more patients involved in research?” Key thing is that you want to stand out from the crowdTHANKYOU FOR COMING! PLEASE FILL IN THE FEEDBACK FORM!