Computer generated transcript

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

Thanks for joining this evening. My name is said I'm one of the leads from one of the and I'm here to share this session of careers talks. Thanks everyone for joining tonight. We've got Kim. Kim has kindly agreed to give up the time to give us a talk on, uh, surgical training course surgery and further training pathway. I'm just going to invite you to stage. Now. It's an option to come up on your screen to join you guys just to say during this talk, if anyone's got any questions, just put Yeah, you can all the questions. Okay, guys. Sorry. Just better than two seconds. Skin is just having an issue with the connection. No, no, they're not going to be any sound yet. I'm just waiting for him. Rejoin talk. And that should be able to share just two seconds. Antonio has. Does it sound like a robot voice? I'm not too sure I can. Hello. Hi. Like everybody for the first time. Nice to meet you. Thank you so much for doing this. No problem and pleasure. And it still sounds and like a vulnerable voice from my end. I don't really hear you very well. Yes. I don't know whether it's smart computer. Just my computer. Yes. Okay. It's just me. That sounds good. Can everybody hear me? All right. Just me. Okay. Cool. All right. That's not an issue, then. Okay, Kim, if you see at the bottom of your screen, that would be an option to present now. Yes. I just get my slide on. Let's see. Yeah. Sorry. I think that's my computer, which is acting up perfect. Okay, I'm gonna I'm gonna turn my microphone camera off and I'll come back on at the end for questions and start showing on full screen. Okay. Good stuff. Well, tonight's mindedly career bad business series. My name is Kim, and I will be talking about courses. Good training or, um, the latest and known improving surgical training for the last few years. Um, just for the content tonight. And we'll be talking about why, considering surgical training and why not? Your good day and bad day in surgical training for the first two years and the training structure, the application and selection process is and how to prepare my apologies, how to prepare a medical student or a junior doctor before entering your specialty training. Then we will have a Q and A anybody's got any questions? So, uh, famous quote from And, sir, um, especially with a surgeon, must have hopes I alliance heart and a woman's hand. So true, until you enter first year of your surgical training. Um, Then again, my supervisor once told me that anybody can be a surgeon. You can train a monkey to do surgery. So which the quote is true? I don't know. Um, why do the surgical training and why not? So this is a few points to consider. And my personal experiences, um, training will look going into outpatient clinic shadowing your supervisor or your consultancy surgeon on a Monday, then going to theater either elective list or emergency list on a Tuesday or Wednesday and then going on call and in some of these days to see patients in a any GP referral or referrals, depending on who Which part of the job between your registrars. So you're basically a House officer. Um, what they traditionally called um, or a junior eligible trainee. You might be expected to attend trauma close as well, going down to A and B and C some exciting trauma cases, or you might be called by your f y doctors to attend some really unwell on the ward. Um, walk around is your bread and butter and your slide and we're just seeing in the first slide. Right? Okay, so there you go. I can do the second slide. Now, Are you seeing the second slide so I can see the y c s t uh, no content The second side, shall I? So, letting you just do a slideshow, then you may have to keep it as such. Yeah. Is that is that better? At least you can see the content. Okay. Yeah. So and spoken about. So basically, these are the content that will be going through in this one hour. And then this was the cool was mentioning about. And then, um, a typical of how surgical training is like for the first two years, depending on your department, you might be asked to attend, um MG T and chip in on certain patients that you've seen throughout the week. And so it's a pretty exciting rotor if you if you look at it, but it varies between different trust, you know, how much training in each aspect get in the first two years? Um, interest in and they told me, is obviously a huge topic. You can't have a surgeon who wouldn't appreciate. And they told me because, you know, that's what you are working with, mostly in theater. Um, then, um, I put this next point just because there was once when I was in theater, assisting in an above the invitation. Then there was this, um, nursing student who went faintish looking at, you know, the leg coming off the patient. And then I realized that, you know, it's not for granted that every everybody can weakness. You know, all the gruesome things that we do in theater. So this is, uh, an aspect that somebody who is interested or considering surgery should be thinking about before going into training. How much among the spectrum can you tolerate, or are you willing to undergo to see, um, in theater for you to become a a surgeon? Um, demand for physical and mental strength in theater is something that has been on my mind for a while. I'm not by any means a person, but I picked up some strength strengthening training. Um, recently. Just because I don't want to be, You know, somebody who's, um, end up with really achy muscles by the end of my training. And imagine you have to do this day by day until you are age 55. 60. And it is a huge demand for both mental and physical strength. I have had really experienced surgeon who went in theater at 10 and came up four AM in the morning for one huge case, Um, basically a marathon and fearful unknown. And adversity is something that you know s constantly our bread and butter, as you know, medicine generally, but especially so in surgery. Because everything that we do is based on our decision on the spot in that moment with the available information that we, um and you know, it's it's stressful. It's just, um, inevitably stressful on, you know, days that you are in theater making decisions and whether to take patients in the theater or even when you're seeing patients with, you know, complications post surgery in your outpatient clinic. Um, it's it's something that you have to be mentally prepared for before you even consider being a surgical training or eventually a consultant. So, um, what is a good day life or a surgical training? And basically, one of the best days for me would be, um, if I were given the opportunity to go into theater and to work on. You know, simple case is not overly complex cancer cases that are big shot consultants work on. But you know, something like appendicectomy or even skin lesions? Um, you know, amputations, amputation of the tool that I get to do most of the procedures and two or three of this procedure a day would make you know my day. Um and, you know, outside theater, good learning opportunities. Some consultants who is willing to spend their time on you teaching rather than, you know, focusing most of their attention to the patient. And this would definitely make you know your day really fruitful and productive learning experience. A bad day. To be honest, I would look like some you know, you'd be stranded on the world not doing much, because, you know, all your colleagues is out in theater somewhere, and there's no more slots for you to go or and there's no clinic ongoing. Not enough cases for you to see, and you just feel like, you know, you're wasting space there, um, throughout the whole day. So that would be, um, sort of my bad day. Um, occasionally, you get really busy days that you have to go home an hour later than you know your designated working our, um, But, you know, sometimes, um, um, control intuitively, you feel really, um, you feel the sense of achievement when you make a difference in somebody's life. So I wouldn't call that a bad day. It would just be a stressful day. But you learn something out of this on cold days, Mostly, this happens during the encore days when you're seeing patients and really unwell patients. Um, going to the next point, uh, physical training structure, um, and application and selection processes. So in the UK, after you finished of your foundation training, then you would apply for basic surgical training is call either the C S T or the I S T. So I s t is something that it's an action, um, to improve course surgical training. Because go. We've identified certain limitations to the conventional traditional way of, um, mainly because there were too many times dedicated to service provision, not enough supervision. And you end up with a bunch of trainees who complain that they're not making their competencies in the first two years of their basic surgical training and then the gap. All this, you know, Gap training gap when they are meant to be registered in their third year or, you know, subsequent years of surgical training. So I s t has certain criteria where they adjust your working pattern or working in a location so that you get more training and more monitoring, Uh, two year program. Um, so you got two years of basic surgical training and, um, it can include either four or six or 12 months of placement in one specialty. So it's like your foundation placement. You get to choose different program or different tracks. Um, in either of the specialties that you're interested in. Um, there are general surgery, um, upper GI I lower gi I and hepatobiliary your orthopedic sometimes, and and urology plastic e N t. So on so forth. And sometimes you get, um, I see you or cardiothoracic in the program itself as well. It depends on which trust and which programs that you pick, and it can be couple and uncoupled. Unfortunately, I think last year and they took out most of the couple training program. When I say a couple, it means that you get the full seven or eight years of college track where you are destined to commit to one specialty already by your first year. So it's around through program. That means that if you want a general surgery, um, and you know, throughout the whole year, the whole eight year, your training would be designed to cater you to your, um, to general surgery. Um, uncouple means that you will have to go through selection process again to get the national training number after two years of your, um, core or improving surgical training. And and it's more or less the same thing that you have to go through, um, to obtain the C S t o v I S t. Um, it's just more competitive this time. So just a brief introduction to ST three selection. After you finish your surgical training, you would be expected to us and, you know, portfolio An interview for the national training number. Um, and then after you finish your higher surgical training, then you will have your certificate of completion of training or sometimes and people go down the pathway pathway, which is the season pathway where you get less supervision and know routine a r C E p. But instead you get like, an appraisal every year to make sure that you need the competency as your what you meant to achieve in CCT. I will answer further questions if there's anybody who is interested in knowing the details about this application process for classical training. Oh, I s t and it starts, um, in November every year. So this year it'll be November 2022 you apply it to all real. Like how you apply through your matching and foundation training. Um, you will be asked to give a self assessment school According to certain criterias, all the documents are available on all real Or if you google it, I'm sure it will be out there. Um, and the application, um, that line would be start of December every year and then from December to January, you will be asked to submit and portfolio evidence is in the form of soft copy letter certificates, too. Backed up your self assessment score. So and assessor, which is normally a consultant surgeon, will be going through your pdf uploads or in a designated website, and they will verify your score and then give you either a new score or the same score that you've given yourself, um, and thereby you going through long listing and short listing in the process. Um, and if you need, if the verified school needs the benchmark for invitation to interview, then you get a linked Um, sorry. You get a slot to pick for your interview, which normally happens between January and March. Um, that is, if you need the benchmark school for the interview and then the interview will happen. And then if you happen to be eligible for appointment and, um, then you'll be invited to rank and different programs and the matching process will happen, and if you get the job, then congratulations. You will know it by April. Normally, um, in 2021 they were 607 posts, and the competition ratio was 4.16, which was rather high as compared to the previous year. Um, and recently getting more competitive for now, um, selection for, um C s t n i S t So what do they look at for portfolio or self assessment scoring. So the this is the latest one last year, and they look at your commitment to the specialty where you have to complete your and passed your MRCS part A. To get the ball mark, attend a few surgical courses, and it has evidence for it and then go on to a lot a lot dot org It's a free registration process where you just get a credited, um, lot online that you can lodge or your theater experiences where you scrub in, either as a medical student or a junior doctor or a fellow. Um, you can attend surgical conferences and it gets you parts for last year, so there might be a big changes every year, but more or less, the out frame is, um, as follow. Um, surgical. Elective emplacement gets you a few months as well, whether you're a medical student or an F Y one. But I think they take into consideration. Over the past few years, there were lack of opportunity to do elective so they have been a bit and flexible with that, um, post graduate degrees or qualification or additional degrees gets you and some score as well. Um, if you have prices or award from your medical school or, you know, regional international conferences, then those will get you some march as well. Um, quality improvement or clinical audit project? Um, it's mainly you just need one. But I would suggest to go for a surgical thing and a good one if you can during your f y one or f y two year, because you will have to do one as part of your ERCP assessment anyways and teaching experiences, you will need feedback for that. You will need, um, committed teaching, I think for at least a few months time, rather than just occasional teaching without any evidence is, um, training in teaching. Um, it looks at a short term or, uh, Post graduate diploma course. Um, in teaching, um, that will turn you, um, some marks in that aspect and presentations regional local nationally, um, publication as well, and last but not least, some medical or normal medical leadership post for at least six months, and you have to demonstrate that you make an impact. And normally you get this evidence is through a letter signed by your consultant. Um, So the tip here is to gather your evidence early rather than by November or December, just so that you have everything ready to board rather than scrapping through the last minute. It can be a bit annoying going back to your consultant when you've worked, um, a project with him or her a few years back because some of them won't be able to remember. So always gather your evidence as you go, even when you started out. First year medical student. If you're keen on surgery, so and this is for interview. And so the interview format is a 20 minute online virtual interview for the past two years. It used to be face to face. But nowadays I think they appreciate virtual interview more just so that they can get more capacity so more people can go through the interview stations. Um, so the format is very similar over the past few years. Um, get a management station, which is 10 minutes, and you get the clinical station, which is 10 minutes as well. So in the management station, you are expected to deliver a three minutes uninterrupted presentation, normally on the leadership topic. So they want you to talk about how you demonstrate leadership and how you can apply leadership in course surgical training or I s t, um, in three minutes, and then they will follow this up with two minutes of Q and a session. After that, you will be given a question. Um and, um, the whole station is five minutes. Mini station is five minutes where they will give you a pretty difficult scenario that there's no right or wrong answer to the station about, you know, management leadership, ethical problems sometimes. And you are expected to answer, and they will have a question that follows up to see how you react and how you present yourself. Um, clinical stations are pretty similar to, uh, hospitalizations, but just verbally. So basically, these are mainly acutely surgically unwell patient or a TRS station, or sometimes just simple A B, C. D. E stations. So these are the ones that we are more used to, um, answering, you know, just five minutes very similar follow up questions, and they just want to see how you manage in those sort of an emergency scenario. So all together for the management and clinical stations, you will gather 144 marks all together for the full marks. And, um, that will add up with the 72 marks from your self assessment or your portfolio station score and then all together, and you will get the score to rank and match to your desired and programs nationally. So normally you get two ranked, um, the post nationally to Wells, Scotland, um England and, um, North Northern Ireland. Um, Ireland itself has a separate system, so it's a different matching system. So how to prepare as a medical student or junior doctor? Um, so there are a few suggestions. So when you are a medical student, take advantage of your surgical placement. Um, ideally, expose yourself, introduce yourself to everybody on the world and then attached to you know your favorite senior or consultant even better, and then try to get some projects out of the placement because it will be very helpful. It can be as simple as an a simple audit, one cycle audit, or you can go for you know. Q. I projects and collaborate with seniors. If there's opportunities, Proactive, being proactive is key. Um, when you are an f Y one, it's not. It's always, you know, there's always opportunity to opt for surgical placement and you can work, you know, with your surgical trainees. You know, of course, is your training I s t or your registrar on some projects as well. Um, study for MRCS, part A and part B. Um, it's always, um, not too early to start your MRCS revision. Obviously, your finals take priority. But, you know, if you finish your finals, you passed your finals and you have some time. It's always recommendable to start revising for MRCS because my personal experience, um, there is very little overlap between undergraduate teaching and MRCS, and it is a challenging and for some So, um, you can take It's recommended out that you take at least 4 to 6 months to study. But I feel like that's intense studying, and it's even more difficult when you start working. So use your time well as a student and you can start revising for your part A. When you are in your you know, like 4, 4/5 year, depending on your universities commitment. Um, it's not too early to start your part B once you've done your part A, um and I feel like the continuity of studying from part a two part B gives you an advantage. If you know you're you're committed to surgery. And I do know people who pass their part B and even before starting surgical training. And that's possible. And that would give you much more time, um, to do something else during your condensed two year of surgical training, Um, find a supervisor shadow a supervisor. The idea is to train yourself as a consultant and you can do even when you are. You know, like in your foundation training if you have time. But normally surgical department. Um, yeah, it's a It's very busy as a foundation doctor working in the surgical department, so I could understand that, um, audits to our projects, research general clubs and anything academic, um, you know, expose yourself. Go and see how people do their project. Listen, talk to people when I started out, you know, as a medical student, I didn't know how to start this project, but it's very helpful to 10 conferences Because you see how people do and in their own ways, and you can learn from that. And you can sometimes, you know, get a feedback yourself, manage some simple project in your students selected components as a see programmes. Um, and then you just find opportunities to present them. Um, courses can be helpful. There are certain courses that are mandatory in your surgical training, that being your basic surgical skills and you're a TLS um, the critically ill surgical patient course uhm is not technically mandatory, but it's recommended. But that's a latest stage. So just clear off your basic surgical skills. And also you're 80 us first and you can do it right after graduation. I think maybe not a TRS, but basic surgical skills. You can do it right after graduation. Um, it is a lot of money. You can ask around your foundation trust whether they have studied budget for it. Because I did get I did got mine, um, sponsored from my foundation trust So some of them do sponsor. But if you haven't got it, um, take off by the time you enter course surgical training or I ST it's fine because they normally sponsor for this mandatory courses as well. So, um, it's up to you. The timing and it can be difficult to put on two courses during, you know, a few months before just because of the pandemic. But nowadays it's it shouldn't be too hard to book on to. This popular course is, um, surgical clubs and society. So if your university has one join it just so that you get more exposure and practice on surgical skills, how to hold a needle holder, how to hold the forceps. Um, and this can be very helpful in terms of boosting your confidence once you're in theater. So you know that you're not doing something that is not right. Um, start early, be proactive. I couldn't have to emphasize that more. Um, if you want a surgical carrier, that's no other way. You have to be proactive. I can't do any of my colleagues in the surgical field who are not proactive. And that's how we got that in the first place. Um, prepare for interview. Obviously it, um it stands for two thirds of your march and that will determine your ranking to a matching process. Obviously, you have to take priority of your interview so you can prepare it by. The best way is to get a colleague who's also attending the interview and then just practice with the colleague, um, as frequent as possible. If not, if you have a very supportive senior, get them to give you feedback. Um, and if anything, it all feels just practice in front of a mirror or record yourself, especially, you know the three minute presentation. By the time that you will attend the interview, you need to make sure that you can remember memorize your speech back to back by heart because you know you want to allow margin of error just in case you're panicking. So essentially, that's all I have for this presentation. And these are the references out there. Most of the documents, most outdated, updated documents and would be on oral once they release and the they open the application. And, um, you can check up some information online as well. So, um, I welcome if there's any questions, Thank you. Yes. Has any questions? Just put them in the chat box and we'll go through them. Thank you so much for your talk. I actually have a question. Um, do you think by the time you get into your surgical training, you should have a good idea of what specialty you want to do? And if you don't have a very good question? Sorry. Is there a way of now that I couldn't hear the last part of your question? Okay, right. And that that's a really good question. Should we have a clear idea of what we want to do before entering course surgical training? Uh, I think there is good and bad, to be honest. Um, so the good side is it gives you time to prepare and target your portfolio and your training, Um, towards a specialty that you're committed to that you see yourself doing for the next 30 years. Let's say if you want to do general surgery, um, you know all your courses or your your academic achievement and everything it will be tailored to general surgery, and you're not wasting time exploring around. But the risk of that is putting all eggs in the basket. So what happens if you go into course surgical training and realize that I might not want to do all their own course. I might want not want to be called in in the middle of the night most of the night. Um, just to attend some general surgical emergencies, um, I might be able to do it at the age of 30. I might not be able to do it at the age of 55. So is that a lifestyle life lifestyle that is suitable for you? Long term? So a lot of the problems with the run through programs they have realized it is. And some of the training is pulled out from the program from the training from the eight years training program in the first or second year. Just because they realize that, you know, bad specialty is not for them. And they see the good in, you know, other specialties like E, N. T or plastics, which has less demand for encore long term. So there is good and at, However, on the other side of the argument is if you go into course surgical training, not knowing what you want to do, you might be stopped in the lingual after the two years of your surgical training whereby you couldn't get the number then you have to get non training post or take a gap here. And then some specialties do penalize you for taking more year out of training. Um, and the most reasonable with the general surgery and also so far so there is a risk whichever way you go. But essentially, I think you want to stay through yourself to yourself. And if you feel like you're not committed to any of the surgery, you need to explore around. You need to use your taste of weeks, um, to go to different specialties and see how a consultant working life is like, You want to see the consultants working like not as a trainee as a trainee. Because if you can't see yourself as a consultant, don't don't do don't be a consultant. Don't waste eight or eight years of your life training to be a consultant. Absolutely. We've got another question in the comments from Melissa. Who's asking you, How is your work Life balance. So work like balance as a trainee is, um, not as, um, optimistic as, um, some of my friends in other specialty, I would have to say you are expected to cover on calls and you're expected to do service provision even though they have introduced the I s t um, pilot program a few years back. Um, my rotor depending on the department. So I so far I have been on 100%. I'm working in Scotland, so I've been on 100% bending so far. That means that we are working exceeding what's recommended. Um, and it's a busy, busy and department. To be honest, I would have a period of time where I'm working nights every two weeks and then every night shift would be 12 hours shifts. And then most of the time, if I'm not working nights, I'm working 12 hour shift daytime as well during the encore six weeks period, Then you will have another six weeks period where you would just focus on your training and you're working. You know, my personal trust words. We work 10 hour shifts on a short day, so those are the training of opportunities, so it is quite vigorous, and it doesn't get better when you're registered. The registrar's covers their own cool, and the demands for them are even higher than as it shows. So the coming eight years would be gruesome lack of work, life balance If I'm being completely honest as a surgical training and but I would know somebody who would, you know, say otherwise. So this is just my person know, uh, opinion. So we've got another question. Can you please explain the concept of uncoupled aspect of the surgical training structure? Slide again? Um, the uncoupled, um, aspect of surgical training. It's basically just the difference between couple and uncoupled. Training is mainly just whether you get a two year contract or a 7 to 8 year contract for your surgical training. So, um, the C S t o i n ST itself is a two year program. Um, if it's uncoupled, it means that you will have to undergo selection progress. Meaning, you know, the whole selection going through Oreo again and then showing your portfolio going through the interview again by the time you are in the middle of your second year course. Surgical training or I S T. So you will have to go through a selection process again. Whereas a couple program means that you don't have to go through the interview or the portfolio a second time, you have a number. Already, it's a run through program. So once you get the first year, it's a contract for you to train, um, seven years or eight years until you are consultant. Um, but unfortunately, last year they pulled out most of the run through programs from England, and the only ones remain the run true ones that remains are the ones in Scotland. And then I think there were only 10 around 10 run through post last year. I don't know what will happen this year, but I would imagine it's very similar. Um, this year, time your average number of working out in public so it varies. So when I'm on a training rotor for the six weeks, um, I would work 10 hours, five days, so Monday to Friday, 10 hours. So that's around 50 hours per week. And, um, you know, get two o'clock and outgoing at eight and then come up at six. And so life is good. You get the weekends off when I'm on an encore rotor. Then it would be, uh, sometimes I do work, um, 70 to 80 hours a week. Unfortunately, you do get a very cruel they working Rota, where you have to work seven days continuously. Um and you know, you can shift into day and night the next day. Um, it can be very, very tiring. And during those period, um, And like I said, it doesn't get better when you're registered, it only gets worse. The last question is, um, is your experience from a general surgery theme? Uh, PST. So, um, my, uh, program, um, is kind of, um it's not a typical general surgical team placement. So I spent my first six months in vascular surgery, then going into general surgery and then going to also and then general surgery again. So it's not a typical, um, general surgery team, Um, placement. But, um, it is what I opted for, uh, and the placement in Scotland and England varies. I do know in England you get to do you know, it's very normal. It's common for you to get general surgical placement and then going to or so and then going to, uh, other unrelated, less related specialties. But, um, some of the program is very nicely designed where you get, you know, if you are interested in plastics, then they would give you like e n t placement and plastics and then something very relevant to your interests. Um, so my main interest is general surgery, so I would say yes. But it's not just general surgery. It's a bit trauma. A bit, you know, vascular. So it's a pretty exciting program, in my opinion. Thank you. Until you've got another question. Do we rank nationally nationally, or do we have to choose in Scotland? Yeah. Um, it's a list. You rent everything together. You rent the jobs between England, Scotland and Northern Ireland. Wales. So you rank them. Um, you ran all 600 jobs and in a goal. I think that's all the questions. Thank you very much. No, thank you. Thank you. Thank you. Thank you for attending, uh, and made you. You get an email asking you can feed back, and then you get a certificate as well. Um, if there are any issues with that, just drop on fire and on Facebook or something. Thanks, everyone. I'm going to shut off the presentation. Yeah. Thank you.