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Hi, everyone and welcome to our fourth and final webinar of our applying to core surgical training series by the UK Plastics Research Collaborative. Thank you so much for joining us uh this evening and for being participative throughout the course, we had, you know, an introduction to the M ss ra, how to uh get going with a good portfolio, how to prepare for interviews. And today we're sort of wrapping everything up and we'll actually have a two part webinar. The first part will be a General Q and A. And for that, we've asked our followers on social media to send us questions in advance, but not if you haven't, there's AQ and a function built in medal and you'll be able to send any queries or doubts in there. Whereas the second part will basically tell us how we can logistically apply as in how to fill our oral application, how to rank jobs, how to accept jobs and and what the different terms all mean, you know, accepting, accepting with upgrades and more. So for the first part of the webinar, the Q and A, we have Doctor Katrina Turnbull. Um she's a plastics team the CT one working in Edinburgh and she's also part of the educational um subcommittee of UK Plastics research collaborative. So, thank you so much for joining us cat. Um Myself and Faye will be able to give us the questions that the audience shares and you prefer uh you decide how to answer them. Fantastic. Thank you so much, Anna. Thank you for the lovely um introduction. Hello, everybody. I'm Katria. As Anna said, I'm a, a co trainee based in Edinburgh. And my rotations at plastic scenes. I'm doing breast ent uh and uh breast E and T and plastics here in Edinburgh. And I'm hopping on the first kind of 30 minutes, half an hour of the uh session to effectively answer any questions that you might have uh for core surgical training, the application process, the job, um anything at all. So if you've got any questions, feel free to put them in the chat, as um Emma said, and uh we will just make our way through them. So, um I think the first question that we've got, uh someone said, do I need a CST rotation in a specialty to then apply for it uh for ST three. So I think if you know, for sure what specialty you'd like to apply for this makes your life significantly easier, but it's not the end of the world. If you don't get a job in your desired specialty as a core trainee. Um For, please goodness, I'll be applying for a plastics ST three post uh as a core trainee next year. Uh And the plastics pathway is very procedural based. So you'll have to get lots of things signed off in order to be able to have a competitive portfolio for ST three applications. So, uh from a plastics point of view, if you have a plastics job as a core trainee, it makes your life a lot easier, but lots of people don't get a job that they like uh or special that they like in their core rotations. And that's ok too. It doesn't mean that you can't apply for your chosen rotation. Um It just depends on whether the subspecialty that you like to sort of pursue is procedure based or not. The other thing to, to think about if you're thinking about rotating and your jobs is where if you do get a, a job in your chosen specialty where it is with regards to what job it is and core training. So each job is listen to six months. So I'm doing four, lots of six month jobs and you apply for your registrar job before your last core training rotation. So before your last six month job. So um if let's say you wanted to do a breast surgery and your breast surgery job falls at the last rotation, you won't be able to get any of the procedures done because you would have already applied for ST three posts. So that's something to think about as well. So, uh, another question has, um, has anyone applied to the Northern Ireland? Has anyone applied to Northern Ireland? How does the selection process differ? I didn't apply to Northern Ireland. Um, so I, II don't know if the selection process differs, I would imagine, from my understanding, it's all done through oral and the process is pretty standard for whatever deanery you're applying for. So, I would imagine, um, it's probably, it's probably the same, probably the same, but I have to say I didn't apply to Northern Ireland. So I probably wouldn't be the best person uh to answer that to answer that. Um Any other questions? Yes, we had another question from the audience. How far in advance can we start recording cases in our E log book? Great question. So, um, effectively the sooner the better, it doesn't matter if you haven't started already, but it will make your life easier if you start uh as a student as an fy, I started my logbook as a, as a medical student and managed to get lots of things recorded before even starting as a, as a foundation year doctor. I had lots of surgical jobs is an fy, but I actually didn't really get any cutting time at any theater time just because the busines of the job. Um And you don't really go to theater as a junior doctor or as a foundation doctor. I should say. Um, so or I didn't anyway. So if you can start early, I think that just makes your life easier. Um And it also shows dedication to the specialty, um, which I think can look quite good for you. And from a portfolio point of view is, is always useful. So I think the sooner you get started the better, but don't panic if you haven't started already, I've got um friends who will be applying for core training and they've only just started this this year and they've only just started getting their logbook uh sorted. And I think to get top points for this year, you need 40 cases from my understanding. So, um you know, if you give yourself maybe a couple of months to try and get all of those uh logged, um that's a kind of doable. It's quite a big task, but it's a doable task. So the earlier the better. But if you haven't started, don't panic and use the E log book um uh kind of platform online. Um So the next question is criteria changing every year, what things do you think are unlikely to change in the CST application scoring criteria? So, um the core training criteria have changed a lot over the past few years, I probably started kind of very kind of sort of gently started collating a portfolio as a student. And uh the criteria had changed a lot from when I started to, when I applied last year. So, um, I think things that are unlikely to change would be things like your logbook, uh, because they like you to have recorded cases. Um, the number of cases might fluctuate. But I think the logbook is a pretty sure thing that they will keep, it's obviously difficult to say for sure. But I would imagine that they would keep the logbook and things like presentations and publications. I know sometimes these come in and come out. Um But I would imagine having things like posters and oral presentations will probably stay. Um And uh I think publications or they do, I don't know if they've now cut publications actually from this year or they've bunched into the same group. Um But I would imagine your kind of standard presentations, attending courses or conferences and that sort of thing will stay. It's also useful to think about. Um not just for core training but also for your registrar uh applications as well. Um That even if they're not counted for core training, it's, it's not time wasted and it's not uh time lost as such if it's not counted for CST things because it may well be counted for ST three applications as well. So don't fret if something like prizes was cut out of the application process a couple of years ago. Um And I think in some specialties, prizes still count for registrar jobs. So, um, don't fret if things are, if things are chopped out and you're not expecting it. Um, it's not time wasted or time lost. Um, so just to confirm, joint first author is accounted for the publication grade A, I, I'm not sure. I think they'll be very prescriptive about what counts and what doesn't count. And there's going to be very little wriggle room with regards to sort of, uh, maybe trying to get something into a higher grade or not. If they say joint first author is counted, then they will um they will allow it. But I think if, if it's not prescriptive and it doesn't say joint first author, then I might be a little bit cautious. The other thing to notice is that when you apply, um, you, you give yourself a self assessment score and if they then disagree with the score that you've given, so let's say you give yourself, I'm picking numbers out of thin out. Let's say you give yourself 10 points. And they think actually we only think you, uh you get eight points. Um You might land yourself in hot water because um if you over school yourself that can, you can run into problems there. So it's, it's very, very, uh you have to be very, very careful when it comes to scoring yourself and looking at the self assessment. So I think if they say joint first author is counted for a grade a, then that will be the case. But if it's not prescriptive like that. Um I'd be cautious just to follow up um from, um I'm applying this year. So I don't know, I have first hand experience, but I do see that on the, on the portfolio criteria, they have a bit about joint als, so you can definitely read that guys. Uh But at the same time, there is also a platform where you ask a question and they are able to get back to you, they got back to me within a day. So if you have any doubt whatsoever, you can sort of write about your evidence there and they would confirm for you, which I definitely recommend uh from that point of view because this is a very personal case. Yeah. Um So the next question is, is it still worth doing APG CERT considering it's cut out of this year's application and maybe in the future as well. I think um I think doing these extra things always has uh pros and cons. Uh I think for currently for registrar jobs, I think APG cert is counted or at least for, for, for plastics. I would be more familiar with that. Um It also gives you the time to do other things if you want to uh doing something like APG Cert. So maybe you could work on getting some presentations or publications or I know some colleagues have done APG Cert and then managed to increase their logbook and their surgical experience. So, um I think it's important not to do these things just for the certificate. I know it's very tempting sometimes, particularly if we're uh needing to kind of increase our, our points and, you know, we want to better our portfolio. But I think um making sure that we do it for the other reasons as well as just the kind of portfolio side of things is important. I um I did a master's which I think now I'm not entirely sure what I don't think. I'm not sure if it's going to be counted for registrar jobs, but doing the master's allowed me to do some publications and not supposed to and all of that sort of thing and that has been incredibly valuable. So um whilst I might not get the certificate for the extra degree, I was able to do lots of other things which has been really kind of beneficial, not just as a trainee, but also for portfolios. So I think if you want to, you have the time and you want to take some time out and that sort of thing. Um uh I would encourage it, but I think it's important to acknowledge that we, we do these things for the right reasons as opposed to adjusting it for this sort of certificate if you like. Um So do you think taking a year out to do teaching on F three F three to prepare for core training is a good idea. I think I think it's, it's a very good idea if you want to. I didn't take an f three year. I went straight from FY two to,, core training. Um, I wanted to go straight into core training if I could because it is quite a competitive, it can be quite a competitive process, particularly if you're specific about where you want to work and the jobs that you'd like. Um, so I sort of took the frame of mind that I would give it a go and if I got a job great and if I needed to take some time out, that's ok too. Um But equally, I think there's no rush and we learn a lot by doing other things and, you know, going away if you want to do some traveling, seeing the world, do some academic work, do some research or get maybe like a clinical fellow job to improve your portfolio and then apply for core training. Um These things are all uh valuable and worthy. I think the only thing to think about is that, um again, I can't speak for other specialties, but I know for plastics, if you've, if you've taken more than a certain number of years out of training, since you graduated, you then get you, you get penalized quite heavily um for your points for your registrar jobs for your registrar application. So, um that is potentially something to think about. Um But I think there's a couple of years of wiggle room. So I think if you want to take it a year out and do an F three or um do a clinical fellow or do an extra, doing that sort of thing, uh Is a very valuable thing to do. We learn a lot both within medicine and outside of medicine. And I, um I would definitely support it, which is ironic because I didn't take enough, but I think it can be a really good idea, a really good idea and it's also something to talk about at interview as well, which can sometimes make you stand out from your um peers. Yeah. Um So the next question is, how does one organize a taste a week in foundation training? So I think it probably varies deanery to deanery. Um I organized a couple of taste a weeks and the way I did it was um as a foundation doctor, I'm not sure um if your F Ys or medical students or who's in the audience. So, um as a, as an fy, you get allocated an educational supervisor and um a lot of these things need, need to be organized through them. Um But the way I organized a foundation um taste a week was uh emailing the consultant of the chosen specialty that I wanted to spend some time with um, and asking if I could join them for a taste a week and what maybe would be an appropriate week to join them. And then if you sort of get all the information and do all the, the leg work yourself, um And then you can present the idea that you're going to take a taste a week, you know, between the state and this date. Um, give the rotor team plenty of notice. Um Then, um, it makes it more likely that you'll be able to get your chosen week and your chosen specialty. Uh, but I organize everything through my educational supervisor. So the next question is, could you tell us about your experience sitting the M SRA? Uh how long is the exam? And what did you find hardest preparing for it? Sure. So um the M SRA, as I'm sure you'll all be aware is now quite a significant part of core training applications. You have to uh prepare for the exam and then set it. And then depending on when I did it last year, you had to get a score that was higher than the cut off score to get an interview. Um I think, and your portfolio was also included in that, I think now it's just done on your M SRA score. So the score is really important. There are lots of kind of uh lots of different sort of um a lots of different types of advice um online about sitting the M SRA I probably studied from about now, really so kind of October time and I started it at the end of, at the beginning of January, I think I said it set it in one of the last dates. So I probably did a good kind of two months of revision and I used um past medicine and I also used a, a kind of a question bank called E Medica because they had lots of different past papers if you like. Um I thought it was quite similar to um finals in terms of the breadth of knowledge that you needed. A lot of people, all GP trainees, uh all people applying to GP training have to sit the M SRA. So it's very, it's very much focused on a breadth of knowledge. Um and it split into both a clinical section. Um So like science based questions. Um and then a kind of ST type thing and I found the ST uh aspect of the exam very similar to the actual ST that I sat as a student. Um I think the hardest thing was knowing roughly where, where your knowledge level, your knowledge level needed to be. I think I probably presumed it needed to be quite a lot more in depth than it actually was. Um But then probably some things uh I maybe didn't quite get the mark right when it came to the breadth of knowledge that you need. So I would, I would take a focus of trying to know a reasonable about, about lots of different things as opposed to an awful lot about everything. And then, you know, naturally you then can't cover, cover everything. Uh I think timing can be quite difficult. So, um you can be quite short on time, particularly if you flag questions and then you need to get back to them and, or you're not sure and then you kind of sit there and think about it for a minute or two. So I think timing, it's, it's all about practice. Um uh and kind of nailing that from that side of things. And then I think it's all about practice when it comes to the sat and the ethical side of questions. So I just lots and lots of past papers and question banks. Um And whilst it's kind of difficult to know where you should be because, you know, you haven't, well, I had sat the exam before, so I wasn't entirely sure what to expect. Uh about two months worth of quite kind of good going revision, lots of past papers and past questions. Um I think prepare me relatively well. Um What would you recommend for? What would you recommend sitting MRC S? Would you recommend sitting MRC S part A and part B and foundation training? It doesn't matter. So, um you can sit the MRC S anytime from when you graduate. So you, so you can sit as a, as A, as an fy. Um There are pros and cons to sitting it as a sitting in foundation years and then sitting as a core trainee. Um I think the benefit of sitting as a foundation doctor is that um if your jobs are maybe a bit more amenable to studying, uh then you can kind of get an awful lot of studying done during foundation years if you want to. And then it takes quite a significant job off your to do list as a core trainee. Um But I think what you're studying, what you're learning for the mcs is actually incredibly relevant as a core trainee, particularly if you've got lots of, um kind of slightly more broader jobs. So, or if you're doing things like general surgery, orthopedics, that kind of thing, um, the anatomy and the physiology and the surgical side of things is very relevant. So, um, it's almost quite nice to be able to utilize the knowledge that you're learning when you're prepping for the MRC S as a core trainee as opposed to just having it as a foundation year. And then, I don't know, I can only speak for myself. But, um, if I'm sort of cramming for an exam, I remember most of it for the exam and then quite a lot sort of leaves my head after a few weeks. Whereas the knowledge you need for the MRC S actually, um you'll need throughout your training. Um Part A and part B, I'm sure you're probably aware already, but the MRC S is written to part A and part B, part A is the, uh, written papers that you get two papers and it takes about a day and then part B is like the clinical side of things. Um, I don't know of anyone who set both part A and part B as a foundation year. I know a few people who have done part A and I think from their point of view because they don't have to worry about it as a core trainee, it makes their life a lot easier. Uh But then I think when you're um, training as a core trainer, you'd kind of naturally get exposed to probably the level of knowledge that you need and, you know, things like for the anatomy, you know, you're seeing the anatomy in theater and it kind of makes it a lot more relevant and that sort of thing. So perhaps it's maybe a little bit easier to study for as a core training. So I think if you can sit it as a foundation doctor, you've got the time. Um, you can always give it a go, I don't know there's anything wrong with that. Um But don't stress if you um feel like you can't manage to sit it in years, that would be my advice anyway. Um So the next question between, between the time you get an offer and the start of qu how did you prepare? Did you purchase anything in particular like surgical loops or anything else? So, um, you get your offer. Uh, I got my offer during my last job, I think of Fy two. And with regards to preparing, I didn't really do very much. Actually. I, um, I practiced my suturing, uh, because I thought I'd like to turn up on the first day and have a rough idea of how to kind of simply close a skin wound. Um, but I didn't purchase any sort of specific equipment, so I didn't purchase any loops or go on any courses. Um, before starting core training, I think from what I've from when I've spoken to my supervisors and my consultants as a, as a CT one, um, they very much expect their core trainees who are doing their first job to effectively not really know very much at all. And they mean that in the, in the, in the nicest way and it's actually really helpful because they expect you to, to start from scratch and they want you to learn the basics in a really good way. So, um at least my consultants and my supervisors didn't expect me to know everything uh from when I started on day one. So I didn't really need to do an awful lot in order to repair. I think I probably brushed up on a little bit of anatomy and practiced my suturing. But apart from that didn't, and I did look at consent actually how to consent patients and that sort of thing. Um But I didn't do an awful lot in terms of preparing before I started co training. Let's see. Um, so the next question, do you need, uh, the basic surgical skills course from the Royal College of England for core training? So, I don't think you do. I think if you can do it, it's very good. Um, and it gives you a lot of information over quite a short period of time. Um, but it's not from my understanding, I don't think it's mandatory. Um, you've got a few mandatory courses that you have to do as part of core training. So these are things like a TLS and crisp and some other similar courses crisp is carried the critically on surgical patient. Um, but I don't think BSS is mandatory for core training, but if you have the opportunity to do it, um, uh it's a very good way of sort of learning the basics of practicing. Um And they've, they've got quite a high sort of delegate tutor ratio. So it is a very valuable thing to do if you can do it, but I don't think you have to do for training. So the next question is for crisp and ATL S, do you pay for it or does the deanery pay for it? So, I don't know if it, it might vary deanery on deanery. Um I'm based in the southeast of Scotland and for me, um I get ATL S and Crisp or its equivalent funded. Um, they're quite expensive. Well, they're very expensive. Um, ATLS is just under, I think just under 800 lbs and then Crisp is about the same. Um, and II get these funded. I think you get. So, a TLS is a bit like if you've done a S or BLS, you have the course, you have some mandatory MC QS that you have to do before the course. And then there's like a kind of exam on the day that you have to pass. And I think if you, um, fail the exam on the day, you can have another attempt. But if you, if you effectively fail, examine you to say a again, I don't think they'll pay for you to do it again. Um, but, uh, I think they'll cover it, uh, once, definitely. So it'll be funded. Um, but then I think you have to cover your own sort of travel costs and if you're staying over and that sort of thing, uh, so the next question is, what was the most difficult aspect of the interviews? How did you prepare? So, um, the interview, I think the most difficult thing I found about the interview was time. So you've got a, you've got a, a set number of minutes per station and it's very much, it's almost like I would imagine they have a tick sheet and, uh, you need to get through as many of the kind of, er, points on the piece of paper in order to scoop up as many of the marks. So you have to get through as much as you can. Um So I found the timing of that quite a challenge and you have to be incredibly slick at um recalling your A two E and what you do and what you do next and have things that sort of slip off the tongue, like referring back to um care of the critically unwell surgical patient or, um, guidelines, maybe, you know, if you're managing someone with a nasty femoral fracture, having the orthopedic guidelines and that sort of thing. Um, so the timing and knowing what to say or sort of buzzwords in order to get you the, um, the points, um I found challenging in the sense that you just needed to, uh, you just needed to practice this and learn this, um, for the preparation. I, uh, I had a couple of books that I prepared, um, that I used for preparation and then I also, um, subscribed to an online system. Um, I can't remember, I can't remember it off the top of my head, but I'll let faye know and perhaps we can email, um, email you all if you'd like to know, um, where they give you scenarios and um, they then give you kind of the perfect answer if you like. And, um, I found that really helpful and then the last thing I did probably for the last few weeks before I got the interview was practicing with other people. So if you've got um medic friends, probably they're super helpful in these situations um or equally non medic friends just to kind of put you through your paces and press the clock when they say go and you have to answer the questions. Um and just allows you to very much verbalize what's going on in your head and get it out um in sort of exam, perfect answer format. Um that was invaluable. So practice, practice, practice, practice um with other people if you can uh just kind of going through your very much standard answers because the questions were probably, or what I found was when I was doing the, the practice questions and then what I got an interview, they're actually relatively similar, they're pretty prescriptive. Um uh So just having that in your brain that you can kind of fall back on and you almost don't need to think about, you know, what you do next in your A two assessment um is invaluable. So I used a couple of resources but practice, practice, practice as much as you can. And I also attended a couple of webinars um and then had like a draft um not, not, not, not a draft, a kind of mock um ct interview. Uh and you got feedback and um it was very constructive and I also found that really, really useful. So if you've got the option to kind of practice with seniors who've maybe been there and done that quite recently. Um, I would, I would, I would advise that too. So, uh, one more question. Ok, we'll take one more question. Um, do we have, do we have one more question? Mhm. I currently can't see one more question in the chart, but if anyone from the audience would like to send one more question, uh, please feel free otherwise we got through a lot. And um if no one has anything else to ask, oh, there is one more question. Should interviews be practiced after getting shortlisted with I MSR Marks or earlier. So I think this is, this is really difficult. I initially didn't practice interviews. Um I was very much of the thought process of, I'll wait to see what my M Sra Mark would be. And then if I'm lucky enough to get an interview, I'll start preparing, but actually the window is quite small. Um And I was told by a senior very much to be like, give it a go practice for your interview and just um kind of move forward as if you know, almost that you're going to get an interview. And um I think giving yourself that wiggle room and that extra time to prepare uh is really useful. So I would suggest um focusing because I appreciate now the MSR is really important with regards to getting an interview um or getting shortlisted, focus on the M SRA, but then don't leave it until you get your M SRA mark to then start interview preparation. And it's also um your interview preparation because you, you ask clinical questions too in the interview. Um So that knowledge that you need to have on the tip of your tongue for your interviews will also be helpful for the M SRA. So II wouldn't leave it until you've got your MSM SRA Mark to start preparing for an interview. I do it concurrently. That would, that would be my advice. Great. Sounds good. Thank you so much, Katrina. You're very welcome. Uh We've really picked your brain. So things and it's been really, really helpful honestly as a prospective applicant. Great. Um So we'll now just um we'll now just invite Fran to the stage, but for everyone in the, for everyone in the audience, please remember that through Medal, you can we start a discussion thread and if cat today has said something that then you find yourself reflecting in a few days, you can always write it either on the Med app or uh on our social media channels and we'll find someone from the committee ready to answer um your questions. So, thank you so so much. Uh K again and thank you so much, everyone for engaging for the first part. Hello, everyone. Um Please just let me know that you can see and hear me because this is my first time doing a presentation on metal. So I just wanna check that everything is working. Um and then I will share my screen. Fran we can see and hear you very well. Excellent. Perfect. So um I'm just gonna share my screen. Give me one second. Can you guys see that? Yeah, perfect. Ok, so hi everyone. Nice to meet you. My name is Fran. Um I'm Act two and plastic surgery currently at Coventry Hospital and I'm going to be talking to you today about preferencing for um CST in 2024 2025 application round. Um, bit of a disclaimer. So this is now two years since I applied for CST. I have gone through the guidance for your year. But one thing I'll say throughout the presentation regularly is that it's super, super important while you're going through the application process to keep referring to the guidance. And obviously, we all know that the oral guidance and the guidance online is sometimes feels like it's a bit all over the place and is very wordy. Um But really that is the biggest way that you can kind of mess up your application if you don't keep referring to that. So that's something that we'll keep repeating throughout the presentation but is really, really important. Um In this talk, we're gonna go through an overview of the preferencing process. We'll go through the key timeline, we'll go through quickly the practical steps to preferencing and how you actually do that on a. Um However, this again is something that you'll probably completely forget when it comes to the preferencing process, but is relatively straightforward and easy to work out. The main kind of part of this talk is going to be talking about ranking posts and then going through some kind of tips and tricks in terms of ranking your rotations to try and make sure that you get the rotations that you want. And basically things I wish I knew at your stage when I was applying because I think it would have massively altered my decision making in terms of ranking. Um Finally, we're gonna go through some of the terminology about accepting and holding offers um which can be really confusing. But again, I think this is something where we'll go through it, you might forget it, but it's just the key point there is just to really make sure that you go through the guidance and understand when you're responding to an offer, what um you're actually kind of committing to and what you need to then commit to a diff by a different deadline. Um Very quickly, we'll go through the application timeline. So currently we're in the stage of the application window which is between the 24th of October and the 21st of November. Um You'll then have your M RSA window. The dates of that are not yet confirmed, but that's likely to be somewhere between December and January 2025 you'll then have a period of um evidence submission. So that will be between the seventh of Feb and the 19th of Feb. And then you'll have your interview window, which is between the 24th of Feb and the seventh of March. The preferencing window is between the first of February and the fourth of March. And this is corresponds with obviously probably the most stressful part of your application. Um and is something that's very easy to kind of put on a back burner while you're preparing for interviews, sorting out your evidence, obviously working full time alongside it. Um But it's a really, really important part of the application and something that you shouldn't leave to the last minute. So make sure that you're aware of the initial preferencing window, which will be between the first of Feb and fourth of March. And that again will happen right at the most stressful period of your application, which is when you're uploading evidence and when you're trying to prepare for your interviews, you then have following the interviews. If you're successful, you'll have your initial offers and then there are two other deadlines which we'll go through in more detail. And in this phase, you'll go through a stage of rerefer or upgrade cycling and we'll talk about that a bit later in the talk. So you will have some opportunity to preference between 25th of March and eighth of April. But to be honest, it's best if you get it right. First time, the job choices at this stage will be limited, preferencing can be a very complicated, overwhelming and challenging um process but has a massive impact on your satisfaction and core training. So making sure that you know the key dates and the timeline and understand all of the terminology is really crucial. So this is based on uh last year. So last year there were 645 posts in the UK. Um I've kind of split that up into different regions on this map. I'm sorry to everyone from Scotland and Wales because I couldn't actually find a map with the correct deaneries for core training on. Um but Scotland has 60 posts and Wales had 43. Um There are generally around 600 posts to preference um which when you initially see that spreadsheet of jobs, right in the middle of your interviews makes you feel incredibly stressed out. Um But don't worry, it is um quite a straightforward process once you get a hang of it and you kind of develop a system around it and we'll talk through that slightly later. So the basic overview of how you actually preference, so you'll get a notification when preferencing opens and this is in the form of a, an email from oral telling, reminding you that the date for preferencing has opened and you'll be able to see the preferences um on the oral website, the first thing you're gonna need to do is log in to oral and you'll have to navigate to the preferences section on the CST application profile. So on your dashboard, it will look something like this and you just click on the preferences button here. Once you've done that, um you will come to essentially a page of something like this on it. Um And you'll be able to see preferences in one column jobs that aren't wanted in another column. Uh One thing that's slightly confusing is that for some um programs, there is an additional column. Um That's a new thing that seems to have been added since I did this. Um But I think for core training, it's likely to be something like this. So it's likely to be laid out like this. I know obviously these are I MT jobs, but this is the only um template that I could find on Google images. The most important thing to do at this point is basically to download the jobs into an Excel file because this is where you're gonna be doing the majority of your preferencing. So you'll download it into Excel and you'll open your preferences in Excel, you'll see the 600 jobs in, in a big table with loads of information. Um And essentially it will look something like this. So this is from the year that I applied. Um It will, you, obviously, this is a column that I've added, but essentially you'll have the preferences listed here and then you'll have a description of the program giving you an outline of what jobs which hospitals um And here you'll be able to see which region um the jobs will be um present in. So you can kind of use this to kind of start your process of trying to rank once you've ranked your jobs on Excel, which does take quite a long period of time and deliberation and will also require you to kind of keep returning to it, keep going through it, do a little bit every day. Um Speak to people you can about, especially about the top section of your ranked jobs. Um and that will allow you to kind of make decisions. And then basically you take your Excel sheet and you put that into the column here. So you will upload in your search for the job here and each job will have a number associated with it or like a code associated with it. So you search that in this bar here and then you add that to your ranking. So you can essentially copy this into here and that's the basics of it. Um There is in the not wanted column, you can add any jobs that you wouldn't accept or you definitely don't want. Um I think in terms of your timeline when, when I applied, um you knew your ranking at the time that you preferenced your jobs, which was quite helpful because you had a good idea of how many jobs you needed to preference to be guaranteed a job. Um I'm not sure if that's the case for you guys because if you, if we go back to the timeline, which we will do in a second, it looks like your initial offers are after interview and your pre your initial preferencing is closed by that point. So I would advise that you rank a large number of jobs, obviously, nothing that you definitely definitely wouldn't want to do. Um But make sure you rank enough jobs. So you're not in a situation where you're not given an offer and off a day because there is always the option later on in the preferencing process to be able to upgrade your offer. So you want to make sure that you have a job to start with that you can then kind of opt to upgrade cycles with if it's not necessarily what you want initially, that's not the end of the world, things do change. Um So that's kind of an overview of how to preference. Um One thing I'll say is that I would speak to other people that are applying at the same time, make sure that you're all doing it correctly, make sure you're reading the guidance. Um There are some key steps in the guidance that are really helpful. Things like making sure you save your preferences every time, making sure you tick the box to say that you have reviewed all of the preferencing options every time they are things that are really, really easy to miss. And obviously you can get to a point where you think you've submitted your preferences and you actually haven't. So make sure that you check and make sure that you follow the guidance on oral while you're doing this process cos it is boring to read through. But at the end of the day, it makes a massive difference and it's really difficult to kind of get in contact with the uh recruitment office at the last minute um and be sending frantic emails asking them kind of, I thought I'd preference this and I haven't and the deadlines pass, you don't want to be in that situation. So just make sure you read the guidance while you're doing this. And I would also say, and this is slightly off topic, make sure you do that with your CST evidence as well. Make sure that every single thing you're uploading, you have exactly what they have asked for in the words that they have asked for. So you're not in a situation where they're docking points because they are really, really, they can be really, really um strict on the rules when it comes to that. And it's just something that you can completely avoid if you're organized and you um follow the guidance properly when you think about how to preference. So this is really the main part of this talk, there are several things that you're going to consider when you preference your jobs. Um And they're different for every person. But I think in general, most people will think about which rotations or which jobs they want, which region they'd like to live in, which hospitals they might want to work in and which opportunities. So um when you think about D GH hospitals, they sometimes are better in terms of theater experience. Whereas teaching hospitals can be and this is a massive generalization. But teaching hospitals can be more difficult to get theater experience better, better in terms of research opportunities. But then also thinking about opportunities outside of work. So think about the things you like doing, whether you're going to be able to do them um in the place you're considering moving to. And I think that's really, really important because to be honest, you need to make sure you're happy for the next two years. If you're not happy, you're not going to perform as well at work and you're going to end up in a situation where you feel really stressed and burnt out. Um The four kind of tips I would give you in terms of thinking about preferencing are understand all of the jobs and rotations available, make sure you've read through the whole sheet and you've systematically worked through all the jobs I would come up with a system that's going to be different for everyone but we go through my system after this, but come up with your own system to help you prioritize based on what things are most important to you. Um, take into account factors which are important to you, not only at work, but also in your everyday life and things you enjoy doing and what makes you happy and really put yourself in this situation, especially with the top kind of 100 at least of your jobs of how you would feel on off a day if you were given that job. Um That's something that I think is really easy to do when you have 645 options. It's really easy to think. Oh, I'll move to the other side of the country to do this rotation because it has all of the jobs I want. And then suddenly you're in a situation where you are moving away from your friends and family. You don't know where you're gonna live. You're feeling stressed out. You don't know anyone that's working there. So really try to put yourself in the situation of how you would feel if you were given that job on off a day. Um Human beings are quite complicated. So this isn't necessarily the only four things you need to think about. There are going to be other things that are more important to each individual and that's totally fine. It's just about really thinking about drink or training, what other things you want to achieve. Where do you want to live? Are you close to your friends and family? Are you well supported? Are you going to be happy? Are you going to be able to get out of core training? What you want? Um And I think just really thinking about your priorities for core training is a really good step in terms of then doing your preferencing. Um And really, really important, I've put this um figure here, I don't know if anyone knows what this is. I'll give the audience a second to respond. If anyone has seen this before or I'll just continue with the deafening silence. This is um a figure that's called Maslow's hierarchy of needs. So these are the, this is essentially a pyramid that demonstrates what human beings need to be able to reach kind of their full potential and their best self and their best, like, you know, your best efforts at work and how you're going to kind of be the best person you can be. And actually, it's underpinned by all of these other needs. And these are things I think, especially in the medical profession that we often put on a back burner, we often do 13 hour shifts without eating and drinking properly. Um We often sacrifice kind of weekends and time out to make sure that we kind of achieve different things in our portfolios. But actually two years is a really long time if you're unhappy and I think it's very, very important to make sure that you are prioritizing your family, your friends, your loved ones when you're undertaking this process. So each, I'm gonna break these down into kind of, um, each section. So when thinking about which jobs, um, I would start by thinking about what you need for ST three. Um, my top tip in this kind of area is if you're split between two specialties, I would focus on your top specialty for ST three. And I would make sure that you get um as much experience in that as early as you can rather than splitting your, splitting your different options between different rotations. Um I think it's very, very hard if you're trying to do everything to meet the requirements for different specialties, especially if your chosen specialty is something that's very competitive. I would try to get early jobs in that specialty so that you have built the connections and you've got the cases that you need to be able to apply for ST three in the November of CT two. Um And one of the mistakes I made was to put all of the um plastics jobs that I wanted late on in my core training. And that makes it really stressful and difficult to make sure that you have your numbers for ST three at the point that you are um applying. So I would try and prioritize your top specialty for ST three and I would try to maximize the amount of time in that specialty in CT one rather than CT two, which is kind of counterintuitive because you think I will have developed the surgical skills by CT two to be a lot better in that specialty. I would just go for it as early as you can. Um, don't rely on swaps throughout your rotations. Um, swaps are possible in most sceneries, but you can't really rely that you're going to be able to swap into a specialty, especially if it is a competitive specialty. And it's also difficult to know where that job will be. And if it will be in a geographically kind of convenient place for you to be able to commute. Um, the other kind of key point to add to that is you usually can't swap out of your first rotation in CT one. So I would try to make sure that your first rotation in CT one is something that is going to be beneficial to your career. Obviously, all four of your core training jobs or, um, all of your core training rotations usually aren't going to be the same specialty. There will be a bit of, um, chopping and changing and doing different specialties. But try and think about when you'd like to sit your mrcs exams if you haven't already, um, and kind of make the most out of that rotation in a different way if it's not necessarily, um, counted towards in your core procedures. Um The other thing to think about is that if you have that contact early on with the, um, top specialty that you're aiming for that department in your hospital, um, it makes it easier to then go back and do locums or go in on weekends to do weekend lists or kind of, you know, make connections that then allow you to do research in that rotation. It just gives you um more time. So those would be my top tips in terms of jobs. The other thing I would say is going back to the point about how the initial preferencing window opens, right at the point that you're most stressed out during your application period and you're trying to prep for interviews and it's really, really easy to just think I can't cope with preferencing 640 jobs. I'm gonna, you know, do it very roughly and hope that it all works out. Um If you rely on re preferencing, especially for really competitive specialties, it, it makes it more difficult to then get those jobs later on. So I would just aim to start your preferencing early, make sure you've got your jobs in the correct order, give yourself the best chance of getting the jobs that you want. Um There are specialties where the upgrade cycles work really well and you might move up kind of loads of points up from where you were initially. Um But II think especially for those competitive specialties, especially for London posts, rep preferencing can be very disappointing and I think it's important to know that early on and make sure that you um do it properly the first time. Um Sorry, just before I move on, does anyone have any questions about that part? I don't think anyone has written anything in the chart. Perfect. Thank you. Ok, so now we're gonna talk about which region. So the CST deaneries are different, the foundation um deaneries. And I think n understanding geographically, the size of the deanery that you are going to be working in is really important because um you might not always know the CT two jobs um of the rotation. So some um some core training programs don't actually list all of the CT two jobs or at least they didn't when I applied. So for example, Tes valued that you might be on a plastics the, but they might not tell you in CT two, what your jobs actually will be. Um So you need to think about the size of the deanery, whether you're going to have to relocate during the middle of your training, which I think is always something to factor in. Um thinking about obviously who you're living with, where you're living, your commute to work because all of those things are going to have a really big impact on you when you're working a really busy full on, on call rota and trying to achieve all these things in your free time. Um, again, and I'm sorry, I've said this so many times, but I would really, really prioritize your support system. Um I think it's really important to choose places where you have some support as your initial preferences. At the end of the day, there are pros and cons of every deanery. Um, if you want the opportunities, you will find them. And I think having support kind of massively trumps that because core training can be really, really hard and it's especially difficult if you're then trying to factor in driving kind of the other side of the country or getting a train, the other side of the country um every weekend to try and make sure you have some social connection. So I would really prioritize um being close to friends and family and making sure that you understand exactly where you might be working and how far your commute will be because all of those things are going to really impact your ability to keep going. Um throughout what is a really stressful kind of two years. Um It's not always possible to get your first choice region. So, um you know, obviously London is incredibly popular, but you can consider commuting to nearby deaneries or you can consider transport links if you live on the edge of the deanery. But again, that's why it's really important when you're looking at rotations, especially if they tell you all the hospitals to actually understand how far away is, is one side of this scenery to the other. Where is my teaching likely to be, how frequently am I going to have to commute? How far? Um, because all of those things are really important in understanding how your life is going to be for the next two years, which hospitals and opportunities. So I would say once you've kind of narrowed it down to a deanery and you're going through the jobs in that deanery. Um I would try and get a feel for which hospitals are the hospitals where you would like to work. And again, we've, we've spoken about the difference between D GH hospitals and university hospitals. Um But looking at the GMC survey feedback, so that gives you a really good idea of how trainees are reporting their experience in different departments. C QC reports. Give you a good idea of again, different departments within the hospital. Um There used to be a really useful website called Junior doctors.co.uk, where people would anonymously um rate hospitals and leave comments and that was really, really helpful. I think that now has been taken down, but there are still some links on Reddit which go through um different kind of hospitals and people's different experience of working in different hospitals. Um The biggest thing I would say is that if you know anyone who works in the department or works in the hospital that you would like to work in having a conversation with someone who actually works there, either currently or has recently worked. There is really helpful because things can change really quickly. Um you know, there can be massive shifts in rotors or systems within the hospital that can very, very quickly alter training. So kind of getting an up to date feel for how working in that particular hospital is. What, what the training opportunities are um is a very useful way of thinking about the different hospitals in the region. And then thinking about how long you're going to be working in each hospital. Um And how that all works. One thing that I would say is crucial and I know is not really in the nature of a lot of people including myself, but it's something that I've learned throughout core training is that when you get to CST, uh if there are issues with your training, if you're not getting enough there a time, if you're constantly being asked to kind of cover the ward because your colleagues sick, make sure you flag those issues early. Um and make sure you flag that with your educational supervisor and the TPD because that the end of the day, you are there to train, you're there to train to become a surgeon and they need to give you the opportunities to be able to do that. They get funding to be able to do that. So I would say if you have any issues with your training, it's really, really important that you flag that early. Um This is my personal system. So this completely might be different for every single individual. And the point of this slide is not to tell you, this is exactly how you should preference. The purpose of this slide is to kind of talk you through how I would develop my personal system based on what I would prioritize if I was to apply for core training. Again. Um Again, it's really important to kind of think about what your own priorities are. So my personal system would be to if I was gonna do this again, I would firstly rule out post without plastic surgery because that's the specialty I want to do. I would then identify the regions I would be happy to work in. So for me, that would be West Midlands or that would be London because those are the two places that my friends and family are. I would then identify jobs with 12 months in plastics. And I would prioritize jobs with plastics within CT one rather than CT two if given the opportunity, but I would rank all of those jobs. Um I would then look up the hospitals in the region and get a feeling for different centers, how the training is. I would try to speak to people in different hospitals and then I would form a system to rank jobs. So there's no right or wrong way of forming that system, I personally chose to do that based on points. So I allocated different points based on how I prioritize these different things. Um The, the things that were an absolute no go for me. So post which didn't have plastic surgery, I didn't rank because I didn't want to um do any other specialty. But I know that um for some people just getting a job and then being in the situation of being able to do upgrades, um it, it is useful to also rank those jobs because there is a chance at a later point, you might get offered something that you weren't initially um kind of expecting. Um So I would color code regions and jobs. That's because I'm, I love Excel, but I love highlighting things in different colors. So I just think it makes it easier to understand. Um I would also create a new sheet at each of these stages and I would try out different things. So if you find that once you've ruled out post without plastic surgery, there's not enough jobs for you to rank you, you can go back a step and kind of add in other posts that you might be interested in. You might add in, I don't know, post with TN O as a second choice or something like that. Um I would make sure you preference enough jobs. And again, I think that's harder for, for you guys because you might not necessarily know your ranking at the point that you are um trying to rank your jobs, but just make sure you have, you have gone through that stage because you might get lucky. And even if you don't get your first choice, there is a chance that you might get that at a later stage and I would start early. So I left my preferencing, I think I left it till the last week thinking I had plenty of time to rank this number of jobs. Um And I managed to do it, but it was incredibly stressful. Um And I wish that I had started earlier because to be honest, it's gonna take you the same amount of time either way it's better that you do it properly. Um It just relieves that anxiety of, did I do the right thing? Should I have spent more time preferencing? You just don't want to be that person. So I would start as soon as the um preferencing because the closer it gets to interviews, the more stressed you're gonna be and the less you're going to want to do your preferencing. And it also gives you a chance to kind of talk things through, reflect on things, think about. Um You know, actually I've decided that I want to be with my partner who lives the other side of the country. So I've decided to change everything and I've had a conversation with my parents or with my friends and I've managed to work out what I want to do. So I would just start early. Give it, give yourself time, make sure that you have time to think and reflect on uh the jobs that you're submitting, getting an offer and sorry, just before I move on any questions about any of that, we can go through everything at the end. But yes, yes. Ok. There have been questions. Ok. I know my, my voice is echoing. OK. Not echoing anymore. OK. So the first question would be what would be the a adequate number of preferences roughly? And I think you mentioned that, of course, in your year, it was different cause you knew you're ranking already. Yeah. And so I'm not sure if you could elaborate on that. So I think it really depends. I mean, to be honest, if you rank all of the jobs, you're not gonna be in a situation where you um if you rank all of the jobs, you're not gonna be in a situation where you could have got an offer, but you didn't take it and you haven't opened yourself up to the possibility of um upgrades. So I think what I would do in that, I think I would probably rank as many as I could, but I would focus on ranking the ones that ranking properly, the ones that you really, really want. And then following that, I would try and find a way of kind of maybe shortlisting like, to be honest, the more effort you put into this, the better job you're going to get. But whether it is possible to kind of sit down and actually rank 645 jobs, including jobs that you would never ever want is another question. It's, it, it does get quite difficult. So, what I did was I, um, ranked all of the jobs with plastics across the country and I did that section of my application uh very, very thoroughly. I then block grant jobs. So I kind of said, um, ok, TN O in atn O themed rotation in a Dery that I would, that I wouldn't necessarily want to work in. I'll just add those jobs and I might not necessarily spend so much time kind of going through them and um making sure that they're checking all the hospitals and things like that. So I prioritize the time you spend on the initial ranking section of it going through, at least I would say at least half of the jobs properly and making sure that you are writing them correctly. Um The ones that you don't want as much and that you're kind of just putting in, um, because you want to have a hand in the game if it comes to being able to up to um, increase your offer with upgrades, um I would spend less time on, but there is always a chance that you will be offered one of those jobs. So, I mean, it really is kind of down to how confident you feel about your interview, what you would be willing to accept. Um, how many specialties you would genuinely consider at ST three because II kind of knew that really, the only thing I would consider was plastics at that point. Um, and making sure that you, you know, if you're not gonna take the, the bottom 100 jobs anyway, that you've ranked, you absolutely wouldn't accept any of them, but you just want to have a hand in the game. It doesn't really matter where you've put them. If that makes sense. That makes sense. And I think just for our knowledge, roughly how many plastic themed jobs if you remember were there in your year, um I can check at the end of this cos I think I still have the Excel Sheet. So, um at the end of this talk, I'll stop sharing my screen and I'll see if I can find the um Excel Sheet and give you a number. Thank you. That sounds really great. And the next question I think you will be going into it soon anyway, Melissa is asking potentially you can preference everything and then be likely guaranteed a job and then upgraded to a job you wanted higher up. So we're gonna talk about, yeah, we're gonna talk about um upgrades, I would say. So you're more likely to be offered a job, but just so that. Um you guys all know there are 645 jobs. Sorry, I'm now going one second, I'm not going back for all of these. So there are 645 jobs. But actually if you look at the number of applicants um per post in each application year in 2022 there was 2302 applicants. And last year there was 3384 applicants for 645 posts. So, um it isn't a guarantee at any point, but obviously, if you get the 645th post, you would have wanted, you still have a situation where you're able to um kind of upgrade your offer. Um I think there is still a reserve list and if I'm completely honest with you, I'm not exactly sure how the reserve list works. That's something that is on the oral guidance. But um kind of ranking 645 posts gives you a better, better possibility of getting one of the jobs out of these 3384 people who are applying. Um The other thing I would say is that if this is your ob and obviously take a thing, have a think about it. But if this is um the first time you're applying and you don't necessarily get what you would want or you don't think that you would be happy in that post. I would really, really consider um whether it's the right thing to do to go ahead with uh two years of a rot of rotations that you definitely don't want to do for ST three. I think having a year out makes, um will make your application stronger and will give you time to focus on the interview. Focus on what you got wrong in the first round. Really. Think about your options, do your exams. Um And II mean, I took an F three and I didn't actually apply in the cycle of F two because I didn't want to have the stress of getting a post and not being sure I wanted to take it. But, um, I think having a year out, actually, I was in such a stronger position the following year than I would have been if I had applied in F two. Um because of the fact that just that extra year of knowledge, um really, really helps you, um ground your application, think about what you're lacking, get the things done that you haven't done the year before and then you can make that a really, really productive year. So II wouldn't be afraid of having to take a year out even though I know it's getting more and more competitive every year and it is very, very stressful. Um And I'm sure you guys are all feeling really stressed about it, but don't be kind of forced into taking something that you wouldn't be happy with because at the end of the day, um, if you don't want to do it at ST three, what are you working towards? It's not gonna make you happy in the long run. So I would, if it was me and obviously everyone is different, I would consider taking a year out if it's your first time, especially, um, get your exams done, you know, do something that you're interested in, build your portfolio for the following year and then come back in a much stronger position to reapply and potentially get the job that you want. Not everyone gets it on the first time and it is a hard process to go through. Is that OK? Have we finished the question? Yeah, we have finished the questions. OK. Sorry, I'm gonna go back to my other side but my computer's frozen. It's great. One sec. OK. Um Bye. OK. Um Right. We're gonna now go through getting an offer and rerefer. So again, read the questions. Um, make sure you understand the terminology. So I don't know who came up with this terminology on oral. Um It's so confusing and it catches people out all the time and I have worked with um people who have got this wrong and have lost the offer that, you know, they, they were going to accept because they didn't understand the terminology properly and hadn't read the guidance. So this is the point at which unfortunately some person has made this terminology which is incredibly similar and difficult to understand. But you really, really need, I would say read it every time that there is a re upgrade cycle, read the terminology about whether you're accepting or holding with upgrades. Cos it the difference is really confusing. I made this slide yesterday and I still can't tell you the difference is really confusing. Um Essentially when you get your offer, you have six different options as to how you want to respond to the offer you can accept, you can accept with upgrades you can hold and you can hold with upgrades or you can decline or you can withdraw. I'm not gonna talk about decline and withdrawal. Cos I think they're quite straightforward and I'm sure you guys can work those out. The top four are very similar terminology and are really confusing to understand the difference between. So accepting the offer means that you're excluded from any further offers and any other specialty within this recruitment round. Uh Aside from hierarchical upgrades, I don't know what hierarchical upgrade is. Um Essentially this means you're saying yes to entering that core training program, if you get your first choice offer and you're 100% sure that that's the job you want and you're 100% sure you want to start core training you would accept. Um You can also hold an offer which means you haven't committed to entering that training program, you still can make a decision up until the whole deadline and there is a date for the whole deadline, um which is slightly later on in the process. Um You can only hold one offer and before the deadline passes, you either need to accept accept with upgrades or decline. So when you're holding an offer, if you fail to accept that offer before the whole deadline, you will lose that offer. Does that make sense so far? I'm gonna say yes because no one's complaining. Um then we're gonna talk about accepting with upgrades and holding with upgrades and I'm gonna move that. So accepting with upgrades essentially means that you have said yes to the program that has been offered to you, ie you are going to do that core training job. But if one of your higher preference jobs becomes available, then your offer will automatically be upgraded to the new higher preferenced option. If you hold a hold with upgrades, it means that you are again in that like limbo state of you need to make a decision by the deadline. So you haven't accepted or declined the offer, but you can still be open to upgrade. So if you, if you are holding a job that you don't necessarily want and you don't necessarily want to start um that program, you can hold the offer. I you haven't committed to starting the post up until the offer until the hold deadline and before the whole deadline, you might be offered an upgrade in your list of preferences which um you would then take as your new held offer and you would then need to make a decision on. Does that make sense? Cos I know it is really, really confusing. Has anyone got any questions about that part of it? And I'll try my best to answer. So there's three questions from the audience, but we'll take the two that focus on this part. And then anything else that is general, we can maybe focus on later because I feel like this is already quite challenging. Hm So the first one is, do you get allocated to your top choice that is available via the upgrade or do you get or is it random? No, you get Alloa. So the way that the, the way that the job allocation works is that if you're the number one person in the Deanery, you will be given your number one choice if you're the number two person. Oh, sorry. If you're the number one applicant, you will get your number one choice. If you're the number two applicant, you will get your number one choice unless that is the choice of the top choice of the person who is the number one applicant. So you will be given the, your highest ranking job that is available as long as no one that is ranked higher than you has. Um wants that job basically. Um or hasn't been allocated that job. So if you are accepting with upgrades or holding with upgrades, you have the opportunity to rerefer in these upgrade cycles. So you can kind of add, you can change your preferences around and then the preferencing window will close and then there will be a cycle where they will again go through the list and they will allocate the top available preference job to each applicant in rank order. If that makes sense, I think, I think it's a bit more clear. There's another question from the audience, which is what's the difference between holding and holding with upgrades. So if you are holding an offer but you are not open to upgrades, you're saying I am still making a decision about the job that you have offered me, but I am not open to any of my higher ranked preferences for this job to be upgraded to one of those preferences if that makes sense. So the situation I think that might come into play is if say you're trying to coordinate your application with someone else or like, you know, a long term partner or a friend or family or something like that and you're offered a job and they're offered a job in the same area. You might then think actually, I don't want to be open to upgrades because I know that I want to be in this area. So holding a job basically means you haven't made a decision on the job opting into upgrades means that you're opening yourself up for your job to be um, relocated based on one of your higher preferences. Thank you. And I think with that, you also answered Melissa's question, which is why would you choose to hold, what would be, what would you be waiting for in the interim that would affect your decision? I guess if you were holding with upgrades, you'd be waiting for a higher preference. Hm But if you were just holding, you might just be happy with the job that you've been offered, but maybe not necessarily sure that you want to start core training or maybe not necessarily. Um you know, you might just want to put a pause on your job changing if your personal situation changes or um things like that, I think to be honest, it's so I find it so confusing. You guys probably very, I'm sure you all understand this immediately and are very happy. This I think is so confusing and I think it catches so many people out. So I would my biggest, biggest, biggest point is that when these upgrade cycles are going on, please please be clear about the deadline you need to accept your offer by, please be clear about the different terminology. And every time you go through one of these upgrade cycles, check what you are um doing in terms of the offer, check that you are, you know, either accepting and you understand what that means. You are going to go into that core training program with the option for that to be changed to a different preference. Um, I think, you know, it's the, it's really, really, um, unfortunately the words are really similar and it can be really confusing. Um, but just make sure each time you have checked and refreshed your memory and you can get so bored of reading except with upgrades and hold with upgrades. But that's fine because you're gonna make the right decisions and you're not gonna be in a situation where you're caught out by the deadline. So, um that is really my biggest point. Um But I hope I've kind of explained it a bit. I'm sorry that it's so blurry and unclear. That's ok. We have one more question that we'll take, which is do upgrades happen automatically or do you still need to accept the upgrade offer? Uh Upgrades, upgrades happen automatically. Um So if you accept with upgrades, it will happen automatically if you um yeah, so if an improved preference becomes available before the upgrade deadline, the current offer will automatically be upgraded. Um But after you've done that, you can't then go back to your previous post. So it's not like you then have the option to say actually, I wanted to be in this place with the with these jobs. So um it will happen automatically, holding with upgrades essentially means um the upgrade will happen automatically you can't revert to the previous offer that you were holding, but you are now holding the new offer. Ie you can make a decision as to whether you want to accept or decline the, um, the new job that has been offered to you. Ok, sounds good. I guess if we have any more questions, we'll take them up, we'll take them later just so we can get to France Sls. Sorry, when are you done? Um I know it's very boring. Um ok. God stop. Um Here we go preferencing time nine. So I'm hopeful that this will make it slightly more clear. So we've obviously talked about this part and the initial preferencing window, you then get your initial offers and I'm now gonna go through the upgrade cycle. So the hold deadline. So this is the deadline that you need to have made a decision as to whether you are going to accept or decline a post is the third of April 2025 forget third of April do like first of April 2nd of April, like you need to know um by this date, you need to have logged into oral and you need to have either accepted or declined your offer and made a decision on it because after this, if you're holding an offer and you haven't accepted it, you will lose that offer. Um There are you then the upgrades continue until the eighth of April. So we're now gonna talk about the upgrade cycles. So basically, the upgrade cycles are periods of time that I think in my year were around like 48 hours periods in between when you get the initial offer and the whole deadline you have in each one, a period of time where you can rerefer and you can reorder your preferences at that stage and then your preferences will open for a short period of time. They'll close again. They'll go through and allocate all the jobs again. You then um you know, if you're holding the offer, you can then choose to accept it. And that happens multiple times in between when you get your initial offer and the whole deadline. So the crucial, crucial thing to know is this deadline, which is that you can hold an offer the whole way through here, you can decide I'm not going to definitely accept, I'm going to hold, but you need to have made the decision by this date after the whole deadline. Anyone who is still holding a post um will lose that post and only people who have accepted the offer with upgrades will continue to have upgrades going on until the upgrade deadline which is the eighth of April. Um And at that point, that's when the posts are finalized. So if you are um continuing to accept with upgrades, if you, if your job here is you've accepted it, but with upgrades, it means that if you are not upgraded you will be going into core training, doing those jobs. So you need to be happy with your jobs around here and then whatever happens here is kind of extra. Does that make things slightly more clear? No, probably not. But it, it's unfortunately a very, very confusing process. Um But in this period of time I've known people have massive shifts in their jobs where they've kind of, their, their bank job has significantly changed and their jobs changed multiple times and they've ended up getting one of their top offers. So it's not completely kind of um redundant to go into this period of upgrade cycles. I think things can massively change. But as I've said, I've also had colleagues who have failed to accept that offer by the whole deadline and have been been in a very long winded conversation with the recruitment office to try and sort out um getting back the job that they'd lost and all of this stuff. So essentially being aware of the dates is absolutely key. Um Making sure you check the terminology every single time is absolutely key. Making sure you do the preferencing properly at the start is absolutely key. Um It's as important as your interview, which I'm sure it doesn't feel like at the time because you're really, really stressed out. But to be honest, you could have the best interview in the world and do the preferencing wrong and still end up with a job that you don't want. So just please please make sure that you follow the guidance, you check it every time and that you do your preferencing properly at the start. Those are really the key things in terms of getting it right. So I think people in the audience are saying that it is clearer, but I also wanted to remind everyone that this is recorded and will be posted on our med page together with all the other webinars. So closer to the time. If you want a refresher, please do make use of the recording. Thank you. Um I'm just gonna go through the key points and then we're done. So essentially make sure you understand that application timeline, make sure you're aware of the key deadlines, reread the guidance, start your preferencing early. Um Other things I'd say don't make choices that are gonna negatively impact your mental health because two years is a really long period of time and court training is really hard. Um I would my personal tips and I know people are split, but I would try and focus as much as you can on what you want to do for ST three and probably at this stage because your year is only gonna get more um busy and stressful as you come closer to interviews. Try and have a look at your ST three or ST three requirements for your specialty so that you can gear your core training rotations towards that set of requirements just so that you have a broad idea of how many, how many, like how many different operations you're going to need to have done. So you have an idea of, um, you know, how many audits you're gonna need to have done for plastics, especially thinking about things like, um, whether you're going to have any burns numbers. Um, and whether you're going to get any opportunity to, um, in the burns team or whether, you know, you're only going to be offered skin and hand numbers. So those type of things are really important um and will massively impact your ability to apply to ST three and CT two. So, um I would make sure you don't need to worry about kind of having it already, but just having an idea of where you're going to be looking at in sort of the next three years is really helpful when you're trying to do planning when it comes to core training rotations. I would also advise prioritizing CT one jobs in your chosen specialty at ST three because of the fact that you can't change your first rotation usually because it's too short notice. Um And then also you will set up good links in the department. You have the opportunity to go back. You've got yourself kind of on a good track in terms of your ST three application, but also, um you will have more time to be able to change things around in CT two and more opportunity to do that once you've worked in the Deanery for a period of time and you've done your exams. Um because at that point really, your core training should be good towards getting your S D3 number. So I would, I would advise that as kind of my major piece of advice for this talk and I hope it was helpful. I've put a link here that is um a link for the oral user guide that I found online. Um There's also the applicant handbook that I would advise looking at both for evidence upload, but also when you're going through the preferencing process. Um and I think Anna is gonna talk about this, so I'm just gonna move this. Hang on. Thank you so much ran. Um I think maybe uh we could just take one more question before we look at this. Um which is what are the ramifications if you accept a job and then later change your mind. For example, if you decide to take an f three years, that's actually a really good question. So I would refer to the guidance on that. But um I think there is a period of time that you have to give us notice. And also I think just make sure if you, I wouldn't plan to do that because um there is some sort of clause in the guidance and I'm not 100% clear on exactly how far into a training program. If you drop out of it, you then have to go through an administrative process um to be able to apply for another training program and it kind of counts against you and you have to get letters from the Deanery and things like that. And I'm not sure if that, I know that that's the case if you drop out of um the middle of core training um when you're applying for ST three, but I'm not 100% at what point that starts applying. So I firstly wouldn't advise doing that. I would advise, I think things don't really change very much by the time you get the um in between the whole deadline um and the finalized deadline. But um I would, I think being in the game up until that point is probably a good idea. But after that, I think, think very carefully before you do that and make sure you understand the implications of accepting an offer and then dropping out because there is some um there is something in there and I'm not 100% clear on exactly what it is. Um that if you drop out of a program, it then is harder to reapply and you have to go through kind of an administrative process um to do that. Thank you. So I think we've actually answered all questions. I was answering some stuff in the background, Francis and I'm trying to make it easier for you Uh But we have provided the feedback form on the chat. This will give you access to a certificate, but most importantly, help us to learn our content so that we create events that are always helpful for you guys. And apart from that, we are also sharing our link for our collaborative Inspire study um which is a study that basically looks at the knowledge gap and the obstacles and trainees that um and and the obstacles that students and trainees have faced when entering the a plastic surgery. So we're basically trying to look at these per years and create efforts that can tackle these per years to make it easier for students and junior doctors like us um to pursue surgery, particularly if they are from a diverse background. So we've got both an undergraduate and a postgraduate link. Um And again, this is done by ourselves UK Plastics Research Collaborative, which at the beginning was founded mostly for research purposes, but we've expanded to many different things and the results and you know, the answers you submit are completely ano anonymous, but we'll basically use these for publications, presentation purposes and hopefully to affect some policies that to, to comment on some policies and push some policies that can benefit all of us positively. So, thank you for doing both uh of those things and thank you for staying engaged until the end, I think as a prospective applicant, this was honestly the most useful thing. I of the year. So thank you so much. Ran for your kind time. Thank you all and thank you everyone. Once again, if you have any more questions, please always feel free to get in touch with us and feel free to watch the recordings. Ok? Thank you, everyone. Have a good night and thank you again for and Katrina. Thank you. Have a nice evening. Thank you very much for coordinating everything. Good night, everyone. Bye bye.