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Summary

The on-demand teaching session by Isabelle and Rohit offers an in-depth look into the Acute Care Common Stem (ACCS) program, with a specific focus on the application process. The session primarily aims to guide medical professionals interested in joining the ACCS program. Rohit, who is an ST3 at Briley Park Hospital, discusses his personal experiences and shares valuable advice on approaching ACCS applications. Topics covered include the program details, interview preparation, key dates, and specification of the application. Rohit underlines the importance of meeting the selection criteria, updating A list, participation in audit, teaching experience, and showcasing achievements both inside and outside of medicine. The session encourages medical professionals to be aware of how to gain additional application points and ensure they make the most of any opportunities to stand out and enhance their applications.
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Description

We are excited to present our applying to training webinar series aimed at junior doctors who will be applying in the near future to speciality training. In each webinar, our speaker will guide us through the application process of their speciality including some top tips for success! We hope you can join us.

Speaker:

Dr Rohit Punj

Graduated from Liverpool in 2015F. Foundation training on the Isle of Man.ST3 in EM currently.

Learning objectives

1. By the end of this session, participants will understand the structure and key components of the Acute Care Common Stem program. 2. Participants will be able to explain the relevance and application of the Person Specifications for the ACCS application. 3. Participants will acquire an understanding of the M SRA and interview preparation strategies. 4. Participants will be familiar with key dates and deadlines in the ACCS application process. 5. Participants will understand the career implications, benefits, and drawbacks of choosing run-through or core training, as well as the skill sets necessary for each.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

I think it's just loading. Ok. Hi, everyone. Um I'm Isabelle. Welcome to um, the first um in our apply to ST series. Um I'll let our speaker introduce themselves, but I just wanted to remind you all if you want to ask questions because we'll be doing AQ and A, just pop them in the chart and we'll go through them at the end. Um, and also please fill in the feedback forms. So, um I'll hand over um, to rot. Ok. Thank you. Hi guys. My name is Rohit. I'm uh currently in ST three at Briley Park Hospital. Um, just a bit about myself before we start. So I graduated in 2015. I have worked in A&E since 2016 when I was an F two. I think it was my first rotation. Um, but I only started training three years ago but we'll go through that uh in a bit. Um, but I've done a bit of prehospital work. Um, and uh now I'm, er, involved with teaching and other things like that, but we'll go through that as we go along right next slide, please. Ok. So it's just a little bit about what we'll be going through. So most of you probably already have an idea but just what exactly the A CCS program entails um Aureol if you're not familiar with it, um The most relevant thing probably is the person specifications for the A CCS application a little bit about the M SRA and then um interview prep and preparation and what came up at my interview and then some key dates to be aware of. Uh next slide, please. Thank you. Er, right. So just briefly about what A CCS is acute care common stem uh encompasses emergency medicine, mainly that's why it was created, but also the other acute specialities, um internal medicine, ICU and um anesthetics, but they all have a longer er, training program. Theirs is four years compared to our EDS, three years. Um You do one year of ed and acute med, one of anesthetics I to you and then one back in A&E unless your A&E is not your parent's speciality. Um just in terms of when it actually comes to preferencing, it's probably better in my opinion to have itu and anesthetics in your second year of training rather than your first because those skills aren't very often used in A&E. Um And if you only have the men ST one, you're, I think you as you because you're still a junior when you go back into A&E and ST two, it's probably better to hang on to have those skills more fresh when you're heading back to A&E as ST three likely on the um reg rota. So it just makes you a bit more confident, I think compared to I based on what I've seen and my own personal experience, um, you can have co or run through. Um, my, my thinking is unless you have a very specific reason for wanting to do only the first three years, like you're gonna move, you're not sure about A&E I don't see any reason not to do run through because you can change. After the three years, you can switch specialities, you can apply for. Um So rather than going through that headache of interviews again, um I would just go run through um some alternatives to A CCS if you do have some previous ed experience. Um is the ST three entry. If you've got your competency signed off in it and anesthetics, er mainly your IOC your initial assessment of competencies so that, you know, they're happy that you can intubate independently um or the dream pathway which is a year shorter A C CSB. Um ed training being six years in total, the dream is five years um or then direct entry into ST four. If you've got your other specialties signed off, particularly P ES plus the ITU and anesthetics. Um but particularly for IM GS. If you're new to the UK, I would recommend going through it and anesthetics here. So, you know what the difference is So, you know how referrals work and you know what to expect of the other specialities. Uh Next time, please. Two, so all applications are on oral. Um If you guys haven't already signed up or had a look, this is what it looks like. This is the application you would be applying to, er, for a CCS. It's run by case, er, there's a couple of different ones on there that don't get caught out, um, when you are replying. Um, next slide, please. So applications are open until the 23rd of November 4 p.m. and they close automatically and there won't be any applications after that, the day on the day that any application closes, it does get quite busy and quite laggy. So make sure you try and complete it beforehand and I double triple check beforehand. So these are the different areas that you'll be um, er, filling in on the application form. Um, it looks very long, most of it's quite straightforward. The bits where you'd spend the most amount of time is employment history, which is, er, more laborious than anything else. And that's because basically you have to put all your, every single F one rotation independently f to anything you've done since then. Um So that's the most time consuming the next being. And the third section supporting information, er, which is where you put in everything that, that's basically selling us up and why you're A&E and why you, why you're doing what you're doing. Uh The next slide, please. Um So person specifications, as I said, this is probably the most important bit about your A application um or your A CCS application and it's split into two separate, separate sections. Um It's the essential entry criteria and the selection criteria. Now, this is updated yearly. It's basically the same every year. Um But they change little things like the quest form if you haven't completed your, if you complete your F two, more than 3.5 years ago, or you haven't done an F two in the UK, for example, you've come from abroad, you need to get a quest form signed off and it needs to be the latest one, which is the 2024 1 at the moment. And that needs to be signed up by a consultant. It's a very long form. Uh So I suggest making friends with someone. Um They don't have to do a great deal of writing. It's just they have to sign about 1012 times to say that you're competent at F two level. Um Obviously, if you've done F two here in the last 3.5 years, you'll have your foundation program certificate of completion, which is adequate and that's all you need. Um All the essential intra criteria are basically assessed at the application stage. So if you don't meet any of them, you won't get through. But the rest of it's all very simple, such as qualifications, fitness to practice health. Um, the only other one that might be a sticking point for some people is career progression, which is where if you've had a gap in your service for whatever reason of more than four weeks, they might pull you up on it. Um, but most people can, can wing it, they're on a bank or something. So, normally people don't have gaps. The next one is the selection criteria, er, or just go back a second. Sorry. Um And that is where they're looking at very specific points of what you need to be meeting the criteria to be entering A&E training or A CCS training. Um And so there's an essential side and a desirable side, sorry, the essential side is very basic. Um and you'll all meet that regardless the desirable one is what you're using to sell yourself. Um And I'll go through it on the next slide, please. Mineira. So there's lots of different categories in the desirable section. Um It looks at um additional degrees. Now, if any of you have intercalated intercalation doesn't count for some reason. Um It counts degrees before medicine and after qualifying. Um which is a, which is very irritating but it is what it is. Um, they like you to have resuscitation um courses. It's listed as an as a desirable, er, characteristic, but when I applied, they made me do my, a list before starting training because they said it was mandatory and they still not listed it as mandatory. So I'd recommend you have your, a list up to date, audit, having some sort of, um, participation audit, however minor is on the desirable and it can be something that they bring up in your interview, er, posters, presentations, publications, obviously, er, slightly less obviously is teaching. Um, and that's because lots of people do teaching but lots of people don't collect feedback. Um and some may not be aware that you can actually do courses to help your teaching skills. Uh That's what the Oxford Medical is there for. They do a teacher to teacher course. Um And that can go list on your application as relevant courses and bolster your teaching experience and your inclination towards teaching, cos everyone values that very highly at the moment um evidence of management. And we um that can be both within medicine and outside of medicine. So if you've ever done anything like this, if you run a, a program, if you helped um organize a sport event, uh anything like that, any little thing that you can humble brag about essentially to emphasize your management skills, um achievements outside medicine, including altruism. Um I'll go through this a bit later but it's really easy to show that you have something outside of medicine. Um And it can actually give you points on your application and then relevant courses obviously, next slide please. Right. So now we're just gonna go through bits of the, the actual oral application where you may be able to easily score points if you don't currently have them. So this is the bit about posters, presentations and prizes and these are essentially relevant to all applications, not just A CCS. Um So obviously at the bottom, there's no presentations, posters or publications, but now it is lots of er, conferences of virtual. Um and you can submit, II looked at one last week where you could submit your application, your poster for a course that was gonna be in a week and it essentially gets automatically uploaded to the presentation and that gives you one point and that was a national level, sorry, that gives you two points because that was a national level meeting. Um Some of them are obviously much stricter depends on what kind of uh what society you're going with and how prestigious it is. Um When I did my application I submitted to, to the er Royal College of Radiologists W conference in Vienna. Um So I got free holiday, I had to not free holiday, but I got some, some payment towards that, but I then got an international conference and actually all the presentations were virtual. So I didn't talk to anyone. Um I didn't have to do anything. I went there, I had lunch and I came home. Um So that's how easy it can be. Basically next slide, please. It kind of feels like I'm teaching you to cut corners but sometimes in medicine you have to be savvy. Um and there are so many people applying it. A CCS is one of the not one of the most competitive specialities. Um still more so than like I MT and GP. Er, but it's still good to be able to stand out. Um, so teaching, um as I said, lots of people don't collect feedback. So if you do have some feedback, you can say you've taught mainly students, but we've still got about three weeks till your applications are due. Um So there's still time to create a form of a teaching program um for medical students if you think um you want to implement something in your department, something that we do in my A&E is uh called 10 at 10, which is every Tuesday. We do 10 minutes of teaching on a quick topic or a quick teaching on something. Um And it happens once a week. Um So you could organize something as simple as that and you've, you've then got an extra point. Um You're not gonna be able to do the top one in three weeks unless you've already got it, which is great. Um But that's something that's uh that's very easily achievable next time, please. Mm Audit. Um So again, most of you probably have audits if you've done f one here. Um But this one is uh again, really easy because you just have to start an audit in three weeks and you've already got a point. They don't really tell you how many points everything gives you. They did it one year. I remember, I think it was a year or two before I applied. They sh showed you how many points you would get for each thing, but they don't do that anymore. Um, so we don't know exactly how much this is all weighted. Um, but you, you can easily start an audit project in three weeks. Uh, you won't be able to complete it but you can easily start it. Um, next slide, please. No. Sorry. My very elderly granddaughter's in the background. Er, going to the loo um, so achievement specific to A CCS. Er, so if any of you wanted to do A&E for a while, you might have already done your M RM, which is great. You'll get point. Um, but it's, this is how easy it can be to score points. If you're not already a member, you can become a member of the um, of ar chem. And you'd get a pointer as in that middle point there. So you remember of a specialist society, it doesn't have to be a chem. It can be a pre hospital emergency medicine group. Um because some of them are a little bit cheaper. But um, I believe as an R chem, like associate member it's like 59 lb a year or something. And you've got a point. Um And if not, you can apply for conferences. So, within the next three weeks, I think there is a, another uh r chem conference or an emergency medicine conference of some sort. You just have to go to that and get your certificate and that can be on your, on your application. Um And that's something you can do in the next three weeks. Next side, please don't cheat. Don't lie, by the way, um I'm just teaching you how to work the system. Um Don't put anything on there that's not false, obviously. Um So outstanding achievements outside of medicine, lots of us do lots of interesting things outside of medicine and I think we often underplay this. So most of us aren't national or international level athletes or musicians or anything like that. But if you play an instrument to a reasonable level, I don't mean if you started, you know, a month ago, but if you play to a reasonable level, that's an outstanding achievement at a personal level. Um So that, that can easily give you an extra point on your application. Um If you've ever played in a group, um again, something like that, it can be absolutely anything. There's another bit about um charity work. Um We all do some form of charity worker, whether it was donating and things like that. But you've got three weeks to do something even if you did a, something that I used to do and occasionally still do is like cook at the, um, uh, what's that place called? Now, I can't remember. Um, the, uh, the, the homeless shelter, um, the, um, Samaritans, er, and that's, you can do that once and they always need people to cook. Um, and you're, you're contributing charity. So that's another bit of the application, but you still, you get extra points. Uh, next slide, please. So after all that's completed and they've looked at your eil eligibility criteria. So long as you meet those, which most the vast majority of you will, you'll get recruited for the M SRA er applications by the end of December. And you take it in mid January and that's been quite consistent for the past few years. Um Now this has weighted 40% of your entire application. So even if you didn't do very well on your interview, but you prepared well for the M SRA which I would consider starting to do now and it's valid for many other um, specialty applications. Um You can do quite well um regardless of, of interview performance. Um I use past medicine and a bit of past test. I also bought you Medicare because I got frustrated two days before the exam. Um, but it's uh the, the past me I think was the one that most people use and most people got on with quite well and it's the one I think that best reflected the exams. So my grandad's coming out to um uh Right. OK. Um So total of 100 and 70 minutes with two sections, professional dilemmas. Um which is S JT, if any of you have done S GTs before, it's exactly the same. It's as confusing as it always is. Um And I'll go through a couple of examples er after this slide and then the next is your clinical problem solving. So E MQ S SBA S, we're all very used to them. Hopefully. So I haven't put examples in. Um But one thing I would suggest for those is um look at nice guidelines, common things like hypertension. Um you know, the pediatric red flags, the pediatric er traffic light system, things like that. So that things that come up very commonly. Um and some other things relative to, to A&E like subarachnoid hemorrhages just knowing which um antihypertensive you would start first line how you diagnose preeclampsia. Just very simple things like that that are very common to A&E just back to the um professional dilemmas. A second. Um It's very much a mix of logic and what you would do, which out of the best, which out of the options they've given you is the best or you would rank the best. Um It doesn't necessarily mean what you would do in real life. Um It's more what do they want you to, what do they want you to do? How do they want you to think? And if you're new to the NHS. It might be a bit, um, alien to you. Um, but it, it comes with practice and I think you soon get into the swing of actually, what do they want from me? So if we go to the next slide, please, um, this is an example of one of the rankings. So there's five options. Um, they've given you this scenario about, um, a junior doctor who had made lots of mistakes and then was very emotional. Um And they've given you five options and you're basically scco scored on, they've got their, how they would rank it and you're scored how close to your ranking, how close to their ranking is your ranking. Um And I think this is a really easy one actually compared to some of the ones that I got, um when I did it for foundation and then in the M sra including writing a note in there, um on their handover sheet rather than converting them directly silly things like that, but they will put curveballs in there. Um But on past medicine, there's, there's quite a few of these. Um And you, like I said, you quickly get into the swing of them. Uh Next slide, please. This is the other element of the professional dilemmas where you have to choose three best options. Um On the contrary, I think this one's quite a hard one. uh and it's the one they give you the example they give you on the website and there's a free, er, a test, like paper on the website as well. So it's worth doing that. Um, but just trying to understand that, yes, you know, you might want uh feedback from your f two colleagues. Um, but in this instance, is that exactly what you need? Probably not. Do you need work on presentation skills from the IT department? No. Um that would be greater but that's not what, that's not what they want you to say. Uh neck side, please. So if you pass the M SRA, you then get shortlisted for interview, they don't tell you what the cut off is. Um So you, you won't, it, you won't entirely know, but you'll get an idea when they release your, your scores um later on, but it's not relevant to when you do get your interview. Um, interviews happen, er, end of Feb mid to mid March. Um And these obviously wait more than the um M Sra all booked and, or all online, the way the structure works is you enter into the, the, the virtual room. There's a co, I think I had four other candidates with me and then a moderator. Um and then you all just basically wait your turn. Um And you're in essentially exam conditions until you've been interviewed. Um And you might have to wait for someone else to come out of their room before you get to go in. But you have to stay on that screen in front of it. Um You go in, there's two panel members and there's often a like an it person there as well. So there'll be four of you in the room and sometimes there's another person who's kind of invigilating the examiners. Um so it can be a daunting, but normally the other people have their cameras off. Um 20 minutes of them asking you questions and then 10 minutes of them looking through your portfolio, there used to be a portfolio station uh before I think it was 2020 where you would go in with this massive file and you'd go, they'd ask you questions and you'd go through. Um But that doesn't happen anymore. They'll look at your application basically and see what, what have you put down, how would they score you compared to what evidence you can provide to them and they might underscore you, they might, they might give you less than what you would have given yourself or they might give you more. Um But that's essentially your time to, to highlight what you think are your selling points and your, what your shows your commitment to speciality and why you'd be good at that speciality cos they might overlook things that you think hang on. No, this, this shows me in a very good light so you can bring their attention to that very casually. But if they're very resistant, don't push them cos they do get pissed off. Um Next slide, please. Uh So, um interview prep, er, this is a book that basically everyone uses. There are other ones, this is the second edition I've shown a picture of, but there is a third edition now. Um and, er, it's, it's really good and it gives you structures for different types of questions. Er, basically whether you're giving an example of something, er, whether you're describing yourself or whether you're dealing with colleagues that are difficult to deal with. Um And there's a certain amount of overlap for all of these. Um So one prepared answer can be used for different questions because it's nearly impossible to prepare for every single eventuality. Um So what I would suggest is don't just learn, there's these three acronyms that they give you. Er, but much like when you use sbar, um don't just learn the acronym, understand what the acronym is trying to show you. Um Because when you do our, in this, the, the interview and they ask you a question that you haven't prepared for. You can then adapt your previous answer to um to your, to the question that they're asking you. Um I would highly suggest saying your things out loud. Are you sounding natural? Do you sound like a robot? Do you sound very unnatural? Because when we write things, we often sound very different to how we would say things normally. So if you've written an answer, that's not in line with how you would normally express yourself. You can change the answer even if it doesn't entirely fit their, the acronym they're giving, you just make sure you don't. So, you sound like a, you know, a real human being. Um, find a partner to practice with. Um, they don't have to be medical. It does help. Um, but when you find, especially when they're medical, I think it's much better because they can tell you when you're waffling. Um, and because they'll know that, that what you're saying is not what the examiner is asking you, but you might have gone off track. Um, so it don't have to be medical. It's probably better to have a little bit of both, but I would definitely practice with a partner and it does really help, um, essentially interviewed they're not looking for. Um, you know, they're not looking for an, an em consultant or consultant of any specialty. The main things they're looking for are, it's a, it's like a, like it's almost like a liability test. So can they work with you? Can they train you? Um, and are you an employable person? Do you seem like you, you, you would fit in naturally? Um So they just want to see a real human being with who has some sort of passion for the speciality and the ability to understand what the speciality um demands. Uh next slide, please. So just a couple of final things. So this is what I was asked at my interview. Er, the first was why emergency medicine, very standard question, er, very easy to answer. Um, you'll all have your own, your own, um, reasons. Um, so make them as, as real as possible. Um, and draw on real examples. Um, cos that's, that's all I did. My thing was I love being able to deal with a sick child to a, a cardiac arrest, to a trauma to, you know, pulling a splinter out of the nail and you do that all in one day. Um, or the fact that every day I see something new and I know that's true of many specialties but it's just, it's, um, particularly relevant to emergency medicine, I think. Um, why would I be good at emergency medicine again? Very standard question. Um, and in this answer, I remember waffling a lot and so the follow up question was what makes a good emergency medicine consultant? And looking back, I think they were, they were very similar questions. Um, because essentially they're asking me to say why I would be why I would be good. And if I can't say that then to kind of recognize what is good. Um, but again, I waffled, er, so don't do that. So just l I would say try and have a, a, a way to rein yourself in when you feel like you're not, you're not, you're going off track. But if they repeat themselves or if they sound like they're um they're asking you the same thing, but in a different way, it's because you're not hitting the, what they, what they want to mark you on. So to see if you can bring in a different angle, just mention any other random quality that you think is good of a consultant, of any speciality and try and bring in a real example of your day to day that that might, you know, be evidenced by um what have I done outside of emergency medicine that would make me suited to the speciality again, employability? Um Are you a real person? Do you have real interest outside of medicine? Do you, are you someone who, who's obsessed with, with guidelines in reading the E MJ or do you actually have a personality in your life? Um I think it's a bit of a bit of both. Oh, can you go back, please? Thanks. Um What skills have I picked up outside of medicine? That would make me better as an em specialist um about self explanatory, try and bring in uh a, an example from real life outside of medicine that shows why you, what, what skill have you learnt that can be applied to this and whether it's teamwork in sports or leading an orchestra or something like that? Um And then how has my experience outside the NHS affected my approach to patient management? So I did my foundation training in the isle of man, which is not the NHS very similar but slightly different um with its own geographical um s so if you've come from other healthcare systems, they may bring that in. Um, and that's a good opportunity for you to say how you're adaptable and um how you can think outside the box, er, blah, blah, blah, blah, things like that. Nar, please. Um, so one thing, er, that often comes up, it didn't come up in my interview but I have heard it come up in other people's is hot topics um and something relevant to emergency medicine as it is now. So when I did my interview, um we'd moved away from the four hour target and we were doing six and 12 hour targets. Uh so I think it was a week or so before the R chem, our chem released a uh a statement about how we're working just 12 hour targets and we think it might be better, obviously didn't work out because we're now back to four hour targets. Um But understanding why we've gone back is important. Um volume pressures is just, that's part and parcel of a recruitment and retention of staff. Um If you're from abroad, play on that. Um And so you understand why they've recruited you and, and then try why you know you might think about recruiting other people, how we keep, you know, doctors trained here here as well. Um If you're, if you're not from abroad and you're, you know, you're trained here and I've done all your work here, play on that as well. But from the other angle, um big thing at the moment obviously is about physicians associates. Um And there's this whole big backlash. Um So I wouldn't be surprised if that came up in an interview by allied Health professionals. A and PSE NPS are very well established in A&E. Um But to bring Pa S in is a completely different ball game because they don't have that same background that A NPS have. Um So they may ask on that, all I would say is keep everything however stronger you may be um keep everything very politically correct and balanced. Don't feel like I hate PA S um and they're doing my jobs um or that we should have more PA S and no doctors just keep it very balanced. Um And finally resuscitating em is this new mandate that er our chem have launched and they've got some really nice and clear posters. So have a look at those er, and you can use that, you can use those points that they've brought out in some of your prepared answers uh for interview questions. Um Next slide please. These, I just summarized the key dates here. Uh So if you wanna take a picture or something uh of this, it's sometimes easier to uh have it all in one place. Um But essentially, once you've had your once you've been given an interview date, uh you'll be able to preference your, um, your jobs and then you'll have your offers by the end of March. Um, so I wish you all the best of luck. I hope that was somewhat helpful. Um And if you have any questions, then I'm perfectly happy to answer them. See, I have any questions, either. Put your mics, I don't know if you can put your mics on or write it in the chart. It was that informative? You see? OK, he's about gone. So are you taking over? Hello, everyone. Thank you for attending uh this webinar. Thanks for the talk with. Uh it was very informative and very precise. Um wondering if uh anyone has any questions? Oh, I think someone's typing. Yeah, we'll give a couple of minutes for the questions. And meanwhile, we also um added the feedback form to the chart so you could uh kindly fill in the feedback for a session. Yeah. Uh if you have any further questions, you could also email us and we can get it. Um So we have a question. Would training outside the UK be a disadvantage. Er er, I don't think so. II know lots of er, trainees who have come from abroad, done emergency medicine abroad. I know one who did emergency medicine abroad for seven years. Um and he went to ST four obviously lots of people. So all my training in emergency, all my work in emergency medicine before starting training was not itu in anesthetics. Er, so I wanted to start from the very bottom. Um, even though it would mean being an EDS ho for another six months, which is painful when you're basically working at registrar level. Even though you're not technically a registrar. Er, but I don't think there's any disadvantage from training outside. Um, and lot, lots and lots of people have done it. We have another question. Um, so, uh Pata had to resign due to personal circumstances. Is the 3.5 year criteria still valid or does she need to re a crest form? I think I read on the eligibility. I have it open on the eligibility wei um section of the website that if you've a training program within the last couple of years, um, that is perfectly fine. So, uh, have you been able to? Oh, no, that was current employment. Um I think I would when, um, both the, when was your F two? So, uh, she did an F two in 2020 went to GP training in 2021 F two in 2020. We're, we're coming to the end of 2023. You're like borderline. Um I would, the problem is it's, it depends on when they're gonna look at your, they should essentially look at your eligibility from when you submit the application. However, if it comes up again later, it might just be safer to get the crest form signed, especially as you're just on the borderline. And as I said, it just requires someone who you've got a decent rapport with to um sign like 10 or 12 times. But I got mine done as the consultant was leaving the department. Um and it was very quick and he asked no questions. So it's quite easily done. And um the next line of questions is more about uh the personal achievement. So how to show proof for personal level achievement, for playing music instruments or any other personal sport. So on a personal level, it it can be very difficult unless you've got evidence that you've been in, you've played on a, even if you had a picture on a stage, for example, I think this was more relevant when you um uh when they had an actual portfolio because they could look and you could say, you know, look, that's me in an orchestra playing the clarinet, for example. Um in this situation, I think it may come up when they go through your portfolio in the last 10 minutes to say, what have you done outside of medicine? And I think which is then when you say I do this, even if you play sport at a county level or you play instruments to a very high level where you actually teach other people, um that's the time to bring that in. Remember, the whole thing about bringing that in is not just, I'm so good at this. Look how good I am. It's that I'm good at this and that's why I'll be good at any or good at any other specialty. Ok. That's, uh, that makes sense. Last question. Um, please, can you go over what you said about doing something outside medicine with this, uh, short three weeks? Oh, yeah. And the charity group, um, I would say the charity group. Yes, it counts outside in medicine. Um, there are so many ways you can volunteer for charity. Um, lots of them require like DBS checks and things like that. But if you go to a homeless shelter, um, you can, you can serve food and this sounds like cheating. But if you do it a couple of times you can do it, you can technically do it once and you're, you're altruistic. The idea is that you should be doing it regularly. Um, but you can certainly start and then it comes towards your application. Um, and it's, it, you can even ask them to say, give you proof that you have volunteered here. Um, I don't think it will ever come up. Uh, to be honest. Um, but there was when I applied, there was a section on the application which said documents, um, which isn't there at the moment, maybe because the application is not closed. Er, but at that stage you might be able to upload supporting evidence. Um, so, so something very simple Um I think in a, in a charity setting is quite easily achievable. Yeah. So thanks, thanks for answering all the questions. Uh Thanks everyone for attending the session. So, uh now we've ended with this webinar and of course surgical training webinar is ongoing. Another link if anyone would like to join. Thank you. Thank you, everyone for attending. Yeah. Bye bye bye.