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Right. Ty, everybody. Can everybody hear me? Yes, Carl, thank you so much for joining and thank you so much everyone for joining myself and Carl, my name is Anna and I am the VP of UK Plastics Research Collaborative. Welcome to our first webinar um to help you guys apply to for surgical training. Um So we'll just give five minutes for everyone to come in and then Carl will take it away and she cool. Thanks, Anna. I'll wait and then we can start when there's a few Carl. Just so, you know, we're able to see the whole screen that you're sharing rather than the slide show. So I don't know if you want to maximize or yeah, I'll switch it. I'm just um I'm just waiting in case any more people join, but I'm gonna switch to the um the slide and then we can maximize it. I think we're probably ready now. It looks like it's plateaued fine. OK. I'm gonna make a start guys. Let me know if you can't hear me well or if there's any questions. Um I assume you guys actually can't unmute yourselves on here, but you can just drop something in the chat. Um, or if you can unmute yourselves, unmute yourselves. So let me go on to the slide show. Fine. So, can everyone see the slides? I'm gonna take it as a Yes, Anna, let me know if there's anything that comes up or if there's any problems. Um, so I'm gonna give a quick talk on preparing for the M SRA, it's one part of the preparing for CST series and it's an important part, but also a small part and I'm gonna keep it relatively brief. So we're just gonna focus on the key bits. What is the M SRA? What are the things you can do for it? And how is it important for CST? So I split it up into pretty much these four points. 0.1 is just gonna be a brief overview. Just summarizing what you might already know two is why is it relevant? And there's two parts to it. One is it gets you to the interview and the second part is it actually counts towards your overall score as well. And we're just gonna discuss what the importance of each of those is. Third part is gonna be preparation, just some tips and advice and then I'm just gonna share my experience cos I think sometimes that's the most insightful in these er circumstances. So on the right, I've just summarized again, the three components for your core surgical training application. One is the M SRA the second bit is gonna be the portfolio and the third is gonna be the interview on the right in the brackets. What I've put is actually how much it contributes to the overall score that you get at the end. And at the end, once you've passed the M SRA if you get to interview, you have the interview and then you've had your portfolio validated, you're gonna get a composite score, which is basically 10% M sra 30% portfolio and 60% interview. And they compute it all together together, give you a number and then rank you with all the other candidates. Um So that is basically the rough summary. The M SRA has a special role obviously because it gets you to the interview. So it's important and it's kind of the most important bit to focus on for now, the MSR stands for a more specialty recruitment assessment. It's computer based. So you're gonna go to a test center at some point early January and you, it's usually a Pearson test center and you spend kind of the morning or afternoon there and you get the, you, you click your way through, it's pretty straightforward and it's split in 22 parts. So the first part is the professional dilemmas. And the second part is the clinical problem solving. They are equally weighted. So they count for 50% each. The professional dilemmas has got 50 items, whereas the clinical problem solving has got 97 anyway. So all interesting things you can actually just look up and you probably know yourself. Um, from my point of view, I think the two things to stress are, they are quite different exam papers. The professional dilemmas and the clinical problem solving. Um the professional dilemmas, you've got a bit more time for your questions. So you've got almost two minutes to think it through and answer it. Whereas the clinical problem solving is much more rapid fire. So you can see you've got about 46 seconds per question, which is actually less than you get for most med school exams. So it's a bit more fast paced and you really have to push to get through everything at a time. So those are my two take homes. Um The other thing that's important for the for this exam is the clinical problem solving is one that you can prepare for a bit more reliably just cos it's a bit more multiple choice focused. So you can actually have a right and the wrong answer. And I think you can actually feel your progress. Whereas the professional dilemmas is a bit more difficult because there's some nuance and there's not always a logic that carries over from one exam to the next. We'll do some practice questions in a minute and then you guys can, can see how you feel about it. I don't know what the timeline is gonna be yet for this cycle. They release it a bit later once they start releasing your actual application, Windows and Aures. So you can actually apply for the program in terms of what we had last year. And I think that's a good thing to go off. The test window was January 4th to 16th and you just had to select the time and book it in at some point in December. The weird thing, like all of the, I feel like NHS recruitment things is it's a bit random. So they will email you at some day in December. But I remember you sometimes know the day but you're not exactly sure of the time and they will release the slots and then you have to book yourself in pretty quickly. Um What else do I remember about that? I also remember that you book in the slots. You don't quite know what time it comes out. So it's good to have like a group chat maybe where you let each other know when it's gonna come out and sometimes not all of the test slots come out at the same time. So if they release the first batch at like 9 a.m. sometimes they release the next batch at 11 a.m. So just be mindful that you can rebook your test slot. But I think you have to cancel the existing one anyway. So the long and short of it is you have to book it in December. They don't tell you when it's gonna be released. You just have to be kind of on it with your friends. Um And then you just have to pick the best time and location. The main thing is location uh for you to take it good. So you take it at some point in that test window. I don't think it makes a huge difference when you take it. Just get it done. Yeah, the results, you're gonna get them at some point in February, early February. And on the same day you get the results or your score, you also figure out if you've got an interview or not, sometimes it turns green and tells you if you've got the interview before, you actually know about the um result good. So on the right, I've put a little rubric of what they've got from the test site, which is um which is actually how they score your exam. So in GP programs and other programs that use the M SRA as well, they actually give you the split score. So on oral, you'll get a result for the clinical problem solving test and you'll get one for the professional dilemmas. And based on it, you can actually figure out how well you did in each, if you only apply to course surgical training, you just get the total result. So that's what I did and I got my total result at the end of it. So I couldn't actually figure out how well I did in each of them, it doesn't matter. But I did have friends who also applied to GP for example, and they actually had that breakdown. The composite score you're gonna get is gonna be those two scores put together, each one of those scores is scaled on a bell curve. And 250 looks to be roughly the average. So if you get 250 you're gonna be in the top 48% of candidates roughly and you can see that roughly here in this chart that I've marked it. Um Yeah, so yeah, so that's pretty much what we can take away from it if you can see if you get something above 310. And if you manage to do that in both exams, that would give you a score of something like 620 total. You are in the real, you know, if you got it in both exams, you must be in the top 1% cos it doesn't really score, it doesn't add, it's not sort of a summative thing. Um Yeah, so bearing in mind the score range is 600 would be an amazing score. Um If you got 500 that's sort of two at times an average score. Yeah. What does this actually mean for you guys? So I've told you what the exam is like what the structure is gonna be. It's a progression to interviews. So that's really important. It's actually the most important part of your application in a way because you could be great at interviews and you could be um have the best portfolio, but you're not gonna be able to make that count. If you don't progress progression, they have a fixed number of interview slots. It's about 1200 but I'm sure they'll change it a bit if there was suddenly a lot more applicants. And in terms of applicant numbers, I think it was about 404,500 that applied last year. That basically means that about half the people that apply are gonna get an interview. That means for you to get an interview, you have to score above average as the sum score compared to the average CST applicant. That doesn't mean it's gonna be. And yeah. And so that depends a bit on what the average CST applicant is. Like having looked at reddit, the score for last cycle was about 531. So that was the cut off score. It means that you've basically scored above average, significantly one paper or a bit above average in both, which makes sense. The second thing it's gonna have an impact on is your overall score for CST. So this is the score that they add together with the portfolio in the interview to give you the total score, they scale whatever score you've got is 531 or you know, whatever number you've got, they're gonna scale it and they're gonna put it into something between one and 10 and it's gonna come to your total score. It doesn't make a huge difference. I'm basing that off my experience, which I'll tell you about in a bit and also that with my friends, some people with a lower score, um, the scale score doesn't seem to vary a huge amount. The long and short of it is if you have a school that's high enough to, to interview, it's probably not gonna make a huge difference for your overall school. Good. So I'm just gonna pause there quickly. Does anybody have any questions? Let me see. I can actually see it on the charts. Yes. Yes. Yes. Ok. Nothing good. I'll carry on then. Um Yeah, so good. So the summary of those two points was two parts of the exam. It's really important that you try and get an above average score compared to the other CST applicants, which is a tricky ask because it means it's not about how good you are overall. It's about having to be a bit better than your peers, which is always a bit of a tricky one to be in because it makes it, you know, it, it makes it a competitive exam at the end of the day. What can you do for it? I think preparation wise, I've got two tips passed. They've got a brilliant question bank and you can use that for all of the clinical knowledge. Pretty much. You've got a couple of 1000 questions and if you've got the time to go through it and just think about the questions, you'll be pretty well prepared. The second thing is gonna be some of the past papers they have online for the M SRA um and they are good to just get you into the flavor of what is it gonna be like on test? So I'd save those for a bit later and I'd start with pass med, but they're actually pretty good. And you can literally just find that by Googling Hee and then M sra past papers or practice exams. The ones they're particularly good for is the professional dilemmas because they have a very particular way of phrasing these professional dilemmas. And I think the values that they assign to some of the questions, they're very specific to some of the people that are writing it. And you can see that best on these online pass papers. Um Good. So those are things I think you do need to prepare. Well, what do you not need to prepare so well for. So I'm gonna show you some past paper questions in a second. In my experience, I've taken a lot of exams just because I didn't actually go to tell you about my background. But I'm um starting CT one in plastic surgery themed in London. I got my second choice for CST. So it went well for me. Um I graduated from Cambridge and I did, I've also done the U SME S and I've done the MRC SA and B and M RCP part one. So I've done a lot of exams basically and can kind of have a bit of judgment about what kind of an exam this is in terms of how does it fit in, in terms of difficulty in needs of preparation. The clinical problem solving part is easy. The questions are super simplistic. There's almost nothing in terms of actual problem solving that you have to do. You basically get single step questions and answers. You will see that as you start practicing for it. So it's not like some of the other exams you might have had in med school where you've got complicated things, you have to solve something, you have to do some maths, there's um multiple steps, you have to be really thinking in your feet. There's none of that. So I think the moral is you really have to try and get through as many questions as possible because it's examining the breadth of your knowledge and not necessarily very complicated depth if that makes sense. Um If you think about it when they designed this exam, it was originally for GPS and people applying to that sort of specialty group. So there's actually a lot of questions that are themed in that sort of way. Um That's what I wanted to say about preparation. Let's do some questions. So we're gonna start with some of the professional dilemma ones just to get you in the flavor. I'll give you, let's say like a minute, just read through it and then just think to yourself, what is the sequence that I might rank these in? And this is one of the two styles of questions they've got for professional dilemmas. This style is a ranking style. So you've got five options and you have to rank them from most to least appropriate. I'm gonna go through the second style in the next slide. And if anybody wants to, you can, I'm gonna minimize this again in a second just so I can see the chat and if you wanna put a suggestion into the chat, you're more than welcome to. OK. Um This pole might be tricky with the pole because it's gonna be a ranking. Um Fine. So yeah, we'll, we'll think through it quickly. So I hope everyone's had a chance to look at it. It's basically, yeah, it's a question surrounding basically how you approach a patient who's a bit dissatisfied with their care and how you'd approach it with all of these questions. There's a basic logic to it which is generally exploring opinions and exploring ideas is the most appropriate thing to do. The least appropriate thing to do is to be rude or go straight towards complaints. So the answer option that they've gone for here is CAD B EC because it's actually exploring the concerns and is the best option. E is actually dismissing kind of the concern that she's got by not solving it. And you're actually directing towards complaint. We all know it's not really, not really something that um the ent consultant has say over, it's kind of a national policy so it would be a bit inappropriate to shove them under the bus. So that's why it's the least appropriate. And then the middle ones um ad and B um A is good because you're explaining, which is she's kind of raised it as a concern, but you're not exploring if there's anything additional. Um And then it's between D and B um and these ones start to get a bit trickier because it's sort of like, you know, you're referring her for a second opinion to suggest it to discuss with her usual GP when you can actually just discuss it yourself. Um Yeah, it makes sense. It's, it's not appropriate for them to have a tonsillectomy. So that's why you wouldn't refer for a second opinion. That's why it's the, you know, second to last option. The tricky thing that you're gonna have with these professional dilemma questions and why it's hard to get 100% ever is that sometimes the options, they're not always in a hierarchy. So, referring for a second opinion and suggesting that she makes an appointment with her usual GP, they're not, they're kind of different strategies. They're both a bit wrong and it's a bit weird to sort of weigh out what's more or what's less wrong. So, yeah, these are tricky if you go through past med and if you go through the past papers, try and pick up the basic principles. So, for example, you'll find that there's certain principles about escalation. You go to your senior, you go to your registrar, then your consultant, then maybe to the manager. Does that make sense? Just try and pick those patterns out and learn them and that's gonna set you up the best for this part. Let's try. Uh This one, this one here is the second style of question here. You get a list of options and you have to select the three most appropriate actions to take in this situation. This one's a bit different also because for the other one, you're ranking it. So they're like individual events and you're thinking this is the best. This is the second best here. You can almost think of them a bit in combination. Not quite but, but um if the explanation sometimes eludes the fact that you could be doing these three things, you're picking three things to do, give you guys a bit more time to read about it. But 30 seconds, let's say, um OK, that's probably enough time to have had some thoughts about it. So, again, the patient is a bit unhappy with how they've been treated. The answers are CD and G. Generally DC. Always good exploring how the patient feels, especially when they're unhappy is in these situations. Always a good one. They seem to always default to this one. The second one is tell them that you're feeling sorry they're feeling this way. It's nice. It's empathic. And then I was also struggling a bit thinking about what the third one would be. In this case. It's asking Mr Davies what he'd like you to do. It probably makes the most sense because actually the other ones, the way that they're phrased, they're a bit, they're a bit off h for example, you're trying to reassure them because, you know, the registrar, but actually you weren't there in that situation and you don't know exactly what happened. So it's tricky for you to reassure somebody when you weren't there. The advisor, the consultant doesn't really make sense because they're speaking to you about it and you'd be kind of, you know, it's wasting a consultant's time at the end of the day. Um B is missing the point. Somebody's unhappy and to share your opinion about how great you think they are, it's probably not gonna help. Nobody wants to hear that. Um E bit heavy handed formal complaints when you haven't tried to resolve it locally within your powers. And then f is at the end of the day making an excuse. So g although it doesn't seem completely optimal because you're a bit like, you know, what do you wanna do? Um It's probably the best option that we've got here. K um we're gonna do one from the clinical problem solving that. Um So give this one a read. The thing that you'll probably find with this question is it's very simple and they're all like this, they're one step questions and you'll read it and you either know or you don't give you another 10 seconds, right? So the answer is simple, it's Ciprofloxacin. I'm sure you guys all knew that fluoroquinolones, they can cause tendon rupture, especially if they're taken with steroids that increases the risk. This is as hard as it gets in this exam. So, um the other thing you'll find is the questions, they're very trivia like questions. So it's usually those side effects that you've seen in med school at some point before Ciprofloxacin obviously actually has lots of other side effects. Um They're very rarely examined, like you're never gonna get something, you know, completely out of the ordinary because they're very, they're just very trivial like questions. So stick to pass me, go through that and I think you'll be in safe hands sometimes, then they change the stem and they keep the answers the same. So this is an example of a, like a follow on question. You could sort of pretend it's a two step question. But actually, if you've done these enough, you know, you know, side effects acne antibiotic. How many antibiotics do we use to treat acne? Not that many. Um, and on this list, you know, pretty much none. So there's one that stands out and that's the tetracycline which gives you some sensitivity. So the answer to this is Minocycline. Um, yeah, go through it again and it will quickly, you'll quickly get the hang of it. Um, we'll do one more and this one I chose, I'll tell you in a second because it highlights one of the difficulties of this exam, which is sometimes actually, it's not that you have so much problem solving to do as rather the, the information they're giving you is really brief and it's, you know, in real life, you never make a diagnosis on, you know, three bullet points. But here we are, that's the exam. So we're thinking it through. So 63 difficult to turn over in bed me to help to do up a sh buttons. There's not a lot to go on here, but you've got a few, you've got some epidemiology. 63 male difficulty turning and shirt buttons. What's the most likely? It's slowness. It's bradykinesia, um maybe a bit of rigidity, but basically bradykinesia. And that's kind of one of the key diagnostic markers of Parkinson's disease. So that would be Parkinson's disease. I think that's one of the things you're gonna have to get used to with this exam is sometimes it makes it forces you to make a diagnosis on really limited information. And so you just have to be well versed with that med school trivia stuff, which is what do these three bullet points mean? Another classic is, you know, you're having a hot bath and they are flushed, they get flushed right after having a hot bath and you're looking for a hematological condition and it's, you know, polycythemia vera, it's not common and I've, you know, it would be more if it was a real problem solving, you might just put like a blood count and you could do something that's actually difficult, but they don't do that. They just do these trigger words and then make a diagnosis. Um cool. So I'll tell you now what my experience is. So I got my second choice for CST and it was a London program. I told you. So about 2400 people apply. You have to get that threshold score to get to interview. That's about 1200 people. Everybody then gets their portfolio score validated, which we'll talk about in a different session. But basically you have to get that validation of that log book ready. And that is challenging and you have to do it long in advance because you have to submit it just after, you know, if you're gonna go to interview or not. Um So M sra fits in at the start and then the interview score is actually what makes the biggest difference to your performance the weird thing is you then have to rank all the programs and you only find out the result of your interview um at and the sort of overall score at the very on sort of results day. So yeah, it's, it was always a bit sort of a shock to figure out what program am I gonna get? What rank have? I actually got, I put my score here. So I got 585. So do you remember the cut off was about 531. The average for one section will be 250. That's sort of 50% or better, 50% or worse. The to get something like 600 it's not as simple as saying you were, you know, top 25% in both papers because you know, people don't score the same percentile in each paper. So what I'm trying to say is a score like 600 is pretty rare like I know next to nobody who got one. some people do, they give it 600 a bit above. It doesn't make a huge difference to your scale scores. So my friend, I have a friend who's got 554 scale to 4.5 and mine scale to 6.4. That's two points that's um compared to sort of an interview that's like one or two points in the interview. So just bear that in mind to give you context as well. My friend who got that school, got a London themed plastics training post as well. My flatmate who topped the year in CST or you know, came first for CST got pretty much the same score as me. It was 587 or 590 but it wasn't much more. So the long and short of it is the person who got the top of the E didn't need to have the top CST score. So I think just bear that in mind the CST score, er, the M SRA score, sorry, is really to get you to the interview stage and then you can prove yourself um, good performance. Yeah, based on breadth rather than depth. What else would I say? Everybody knows how to prepare for exams themselves. You've done a lot of exams, think back, you know, how do you normally do? Are you normally a lot below average? Are you normally above average? Use that as your basis point? You know, I've done a lot of exams. I know I'm normally above average so it's unlikely I'm gonna suddenly be below average because it's the same stuff again and again and again, bear that in mind when you're making a training plan because you wanna think about where did you sit before and where do you wanna come now? And that might dictate a bit how much time and effort you're gonna expend for me. For example, I'd done the U SME S before I felt quite prepped with my like detailed knowledge, but I still needed this sort of NH sgp breadth of knowledge. So I did do pass med quite a bit before. I don't think I even went through one whole cycle. But, you know, my flatmate and somebody else they went through, you know, two times, they went through the question bank. There's no sort of right and wrong, there's no sort of right and wrong. Um What else have I got for a tip? Um I think it was something on the description that said group sessions, you can, you can use them for like the professional dilemmas and I think it's good to sometimes talk it through because they're so, you know, they're so silly sometimes the answers. It's nice to just have somebody to be like who agrees with you and it is like this is just the, the most annoying answer key. It doesn't make sense. Yeah, that's sort of what I would recommend. I think for the clinical problem solving, it doesn't make a huge difference. I think just try and get as much done as you can. The peer to peer group is really useful for the rest of the application process to guide you through how to submit your evidence for interview um for portfolio and to prepare for the interview. Um Yes. So I think that's it. I think there's no one er model that fits all. I think if you can get to the interview you can kind of relax about the MSR. And I think the key thing is um yeah, just try, try your absolute best to get past that threshold stage to get past that threshold stage. Yeah. Um And the only other thing I'd say about CST is, you know, obviously a lot of people apply, there's a lot of multiple stages, they're quite time consuming and tiring. And then at the end of the day, the outcome you get is still has an element of randomness. So don't be, you know, whatever happens, don't be disheartened and you know, it's more important, think about also whilst you're doing CST also just planning your mind. What's important to me, where do I wanna be? Where do I wanna work? And just think about some like J CF applications in parallel. That is the end of my wisdom because there's not much more to say about CST. Er II. Sorry. So do you guys have any questions? And if so just shoot in my weight, I'm gonna stop sharing. That's good. OK. So I've got a question. So what was the most challenging, unexpected about the exam? The time pressure. So I didn't think the time pressure on the clinical problem questions was a lot because as you probably could tell when you were doing them, you know it or you don't know it. The only thing you have to be disciplined with is if you don't know it just, you know, flag it and come back at the end. But don't, you only have 45 seconds. So don't spend a lot of time if you don't know, just flag it and then come back. I personally, if I actually had enough time, I think, to loop through and do it again. So I did answered everything in the clinical problem solving and then I had enough time to go through all of the flag ones because it was quite quick. Um, time pressure and then what was challenging about it? I think the pro professional dilemmas is the most challenging because they are so random. Like you will walk out and you've got absolutely no clue. Um You'll have absolutely no clue. Um You know how that went, how to build an E log book for Non UK grads. Um It's tricky. I mean, if you're working in the UK II guess non UK grants and not working in the UK that, I don't know, I don't know if you can get your log book and you can add your cases as you would um in the UK. Um That's something I'm not actually familiar with. I think if you're in the UK, you can build it, I think just like as a regular UK grant. Yeah, if you can get it in other countries and every time you do an operation, you just have to add what you're doing bearing in mind the procedures that count for your portfolio. Are ones that you are assisting in, not just observing to try and assisting is literally just you're scrubbing, you're suturing a bit or you're retracting. So just try and get those cases in um how my score roughly compared to pass mid. I'm gonna be honest, I don't, I have to let me see if I can check my scores on password. Normally, don't actually reflect how I do. Let me see. I don't remember. I'm gonna be honest, I'm the kind of person I never, um, I never used to pay that much attention to my pass med scores because I usually just n I think, um, I don't know why, but I just, I never look at it that much. I would have been a bit above average but it, I think I did better on the actual exam than pass med. Um Yeah, that's me with most question banks. So anything else anything anyone's got on the top of their head? What else is useful to know? Maybe I think basically it's a long challenge, the CST application, it's pretty tiring. Um, the M sra you know, it's literally just like the first step, you know, put some time into it, but don't get, yeah, put, I think, look, if you wanna get, if you really want to get a CST program and you have one in mind that you wanna get, put, you know, as much effort as you can try and get through each other. And even once you've done the MSI already start thinking forward to interviews, what I'd say. So, just treat it all as like you wanna try and do as best you can in every single station. Inevitably you won't, but you know, you wanna try but it hinges inevitably it calm down fun enough to the interview. Mostly. Let me see it as a message. How can you start preparing as a medical student for C SS T? Um Oh, interesting one. I, well, how would you prefer to see act applications? I would and I wouldn't because you're gonna, you might go crazy because the thing is they change it and um they change it so often that sometimes I remember when I was in medical school, they had the um mrcs was part of it. It was, there was like distinction, there was your intercalated degree, you know, now a variety and it's like, you know, it's M sra which we've never heard of, which is a stupid exam actually, sorry to say it. But you know, it's like not very a, it's not very intellectually challenging, it's just a bit of a, an annoying exam. And then you've got this portfolio which changed completely as well. In the interview, you might lose your, you know, lover for surgery. The only thing I would say, which is always gonna be useful. My only advice is what will always be useful like long term as a medical student. Is probably log the procedures you're in. There's no harm with that just like log them. Um because it adds up and all you need is about 50. And the second thing is um if you can do something like a publication or first or the publication or what, that will always be useful in your career, so that I'd also recommend. Oh, and then the final thing is actually probably just like um learn to know like some people in the application process, some of the specialists that you wanna do. I say that because the other funny thing that you get, when you, when you get through this whole process and you have to rank all of the programs and I want, so I wanna do plastic surgery. So that's what I've got plastic themes. But I actually, I didn't know I was gonna do it until like a year before, um, before I applied pretty much in the year that I applied. I kind of decided it. And the funny thing is actually when I learnt everyone in the plastic surgery, but when I met them, you get some really good insights about where is a good hospital to do it because you can get a great score. But if you don't know anything about the department, even in London, there's some really ones, there's some ones that you really want to avoid and there are ones that are really good. So, you know, for your purposes so you kind of um you know, you kind of have to just make some friends who are gonna help you, I guess from that. Can you guys hear me? Yes. Following on from that I am one year um younger academically than Carl cause I'm just an F two and I am in the process of applying and I found myself at multiple stages looking at things I had done to get into CST as a medical student that are now not counting anymore. Um For example, I did the PG cert and this year it's not um counted anymore in the portfolio um in the portfolio bit of things. But you know, as long as you approach something for the sake of learning and for the sake of experience, then it will never be a wasted opportunity. There's always a way to talk about projects or particular degrees that you've done um you know, in your interview or they will be helpful later on. Uh But at the same time, don't feel like, you know, you have to personally invest a lot of time and money if you're not sure that something is not necessarily gonna count. So if you're happy to do it, even though it wouldn't give you points, then I say go for it because you never know how the application system changes from what one thing to the other, from one year to the other. However, as Carl was saying, you know, operative experience surgical experience, whether that's a rotation in foundation year or a surgical elective. Um, you know, doing some teaching a form of audit and qi it's roughly always asking you uh similar things. Yeah, that's true. Can you take this exam in med school? No, you can't. It's a ranking exam. So they want you to all take it at the same time so they can cut you off. They do that on purpose because there's just too many people to interview. It's kind of annoying. Don't get too, you know, I know it's an exam but like, it's really, I've done a lot of exams and it's really not a challenging exam. So it's a bit of a frustrating one. You just have to get that. You have to do this, the bit the question banks. I personally didn't use any others. Um, how many months to revise? I, so I'm, I was working full time pretty much when I did it. I never really thought of it as a month. I just did it on and off for like, for a few weeks, I'd say, I think some people say two months and I think that's, it really depends a bit on your experience level with exams. And as I said, personalize it. Do you normally do above average? Do you do below average? It's the same content, like we've all seen it before this, you know, Ciprofloxacin. That's kind of how I felt about it. I've done enough exams that I knew. Actually I'm familiar with most of these questions by now. Weirdly enough. So I didn't feel the need that I have to lock myself in a room and do this again and again and again. Um, but yeah, like you have to sit down many, yeah, a couple of afternoons if you can start, you know, soonish, I think I'd get, you know, I'd get the pass but now I'd start doing some questions. Just get yourself in that zone. Take some time to build up the speed. I find you can't just get it. First of November, sit down and do it in a week, you know, you just need to start building it. So I think now is a good time to maybe get it and start doing a few just building that momentum as it takes a bit of time. Anything else? I can't see anything else in the chart, but I can do some public announcements just to see if anyone else uh answers any questions. So first of all, thank you so much guys for attending. Your feedback is really vital for us because it helps us to shape whatever content we deliver next. So I have sent it, sent an automatic reminder for everyone to do the feedback. It's also really important for our speakers. It's fundamental for us to keep this free. But at the same time, they should get something in return and your lovely feedback about how helpful they were and definitely goes a long way. And second of all, um we will be doing three more webinars and they all take place in October. You can find more information on, on, on our Instagram or on our link three. We will be talking to you about uh portfolio, how to accrue points for that and how to upload the evidence for that as well, the recent changes that impact our application cycle. So that's not necessarily too relevant for medical students, but it can still be helpful to know, you know, what you should get involved with. We will talk about interviews and we will also talk about how to rank jobs, accept jobs and upgrade your jobs all through the platform. So all of these will take place in October and take your IP O for that. And lastly, we will be recruiting for our own UK Plastics Research committee, which is a great way to show that you're committed to, you know, plastic surgery or surgical training in general in future applications. As some members of our team are now in ST three and you know, they're moving on to um on to more advanced um workshops or webinars for people at their stage. So if you're interested in that at all, do drop us a message on Instagram and we'll be able to share with you um our application form. Uh Let me just answer Brian's question. Sorry, unless you uh had something else. Anna. Um, yes, you, anyone, your last, your last supervisor surgeon usually can validate it. That's fine. And they can, they can validate things that you've done previously. They just put a signature on every page. If you have a nice person, they normally do that. Um And the, it, it won't work as well if you've never operated with them. So you kind of have to align it that you get kind of try and have done a surgical rotation ideally in F one or start of F two. So you've got somebody or no, a surgeon because you know, for med school because they need to sign you off. So you can't just never have done a surgical rotation. It's three years since med school. You're in London, I just won't walk up to a surgeon and be like, can you sign this? It's unlikely to work but almost everybody gets to know a surgeon at some point. Yeah, they can sign it off. Um What other question was there? Um, invited. OK. How does it happen? You're invited because you've applied to CST in October, November and you are then given the invite link. It's part of the process. So this just, it doesn't just happen. You have to apply for CST and then you get the invite. Um Is it worth doing a master's degree with the, do she? And no, if you, if you're asking it like that, then my feeling is no it only in the sense of if you wanna do a master's degree, definitely do a master's degree because it's gonna add something to you. But, um, gonna be honest, I feel like everything in the NHS takes way longer than it should. And sometimes, you know, you kind of have to find, in my opinion, you have to find that balance of, you just wanna be done and, you know, master's degree is not really gonna make you a better surgeon and they might add something. It's tricky. You know, you might also just implode because you know, master's degree. How fun is it? How expensive is it? That's my feeling. Yeah. Um So that's, that's one I would never say do it just for this. How does all set up a log book for this medication? Go to E book and that is you can use it for your entire surgical career. It's called E log book and just register and then you add the cases portfolio is just like a term for like all the things that you've done. You can see the portfolio requirements for the application and then you can kind of just like take note, you just kind of upload it all when the time comes. They ask that for you. Um Yeah, and I think the last thing to say just, you know, with all this preparation, the annoying thing about this system is I don't think it's the fairest system in the world. I don't think it's the most meritocratic. So you might just go crazy because, you know, I can imagine if I was in medical school and I was, you know, doing all these exams in publication, getting a masters, you know, all it came down to, I'm going to be honest with you was the interview and the interview had nothing to do with a masters or a phd or anything. So you can imagine how frustrating it must be, you know, if you've done all these things and you don't actually get a post, do you know what I mean? So don't do that is my feel. Do uh I'm not sure what the hub thing is that you just have to add them on to E book and then that's enough. Yeah, there's that link. Um Yeah, if they're on your logbook, it's, it's enough. They have to be assisted, not observed, assisted or more, right? Any questions? Good. Well, I hope this was useful. Um It will be more useful to people that are about to do the M sra um Yeah, last question is the ACF pass just completely different for this. Um Oh, I have to think, I don't, I can't tell you with a certainty, Brian. It's, it is and it isn't, I think ACF the general consensus of ACF is the more publications, the better then though I've heard of people who get into a academic post after they're in CT so sometimes there's an ST two entry but it's not like, um, but I think there is a separate acf pathway out. No. So, publication doesn't need to be surgically yet. Exactly. Um, if you have to pick a registered specialty, just choose whatever specialty you're doing most commonly at the moment, it just helps you add the stuff. It just defaults your procedure list. Ok. Yes. Join in for that on the 11th. That'll be good. Good. Um, yeah, that's probably it just, yeah, focus on, just do it one step at a time. Don't plan too many years in advance. Just do it, do kind of within reason because, you know, you might just end up hating what you're doing. So, that's what I found. At least I was, you know, I didn't, I didn't try and do it too much, um, in advance. Call them. Thanks. Good luck with the applications and, um, hopefully you guys can enjoy the next talk. Thanks for.