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Careers Series - ENT

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Summary

In this session, medical professionals (doctors, medical students, etc) will have the opportunity to experience a conversation between Christian Grimes, a core trainee with a job in E N. T., and Rohana, a new F one interested in surgery. Christian and Rohana will discuss why looking into a career in E.N.T. could be beneficial and useful, as well as share their own experiences and tips on succeeding in the field. They will also talk about what it's like to work in E.N.T. in terms of work/life balance and getting points in leadership and management on regional levels. Don't miss out on this insightful and invaluable opportunity to learn more about the field and ask any questions you may have at the end!

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Learning objectives

Learning objectives

  1. Understand why ENT is an attractive career choice.
  2. Be aware of the scope of ENT procedures (open, endoscopic, robotic and microscopic surgery).
  3. Gain knowledge of ENT specialty training in the Southwest region.
  4. Understand how to apply for a specialty trainee position in ENT and the points available in your portfolio.
  5. Come away with a better knowledge of plans for F2 and F3 in ENT.
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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.

Hi, everyone. Welcome to another mind the bleep careers talk. We've just got Christian Grimes today, who is a core trainee with a job in E N. T. And we've also got Rohana, who is a new F one interested in surgery. So take it away, guys. I'll just put the links for the feedback in the chat at the end. And don't forget to fill those out because you'll get your certificates of attendance via that group and just ask any questions you want in the chat. We'll ask at the end. Brilliant. Hello, everyone. Thank you. Thank you for introducing me and marijuana. Um, so I'm a course surgical trainee with an e n t themes job, and I thought I wanted to do ent roughly since final year, um, and sort of have learned along the way. I asked a lot of people about how to get into it and made a couple mistakes along the way as well, and have ended up with my dream job. An ent theme job in course, surgical training, and we'll be looking into applying for S t three n e N t. At the end of this year round, I would like to also introduce herself and hi, everyone. Yeah, I'm Joanna, and I've just started as an F one in the pool. Um, I first came Interesting ent. Sort of halfway through medical school. Um, I'm kind of hoping to apply, um, to be in question position in a few years' time. So, um yeah, that's why I'm at the moment, and hopefully it's sort of up from here. A wise decision, Rana. Well done. You can't go wrong. Okay, I'm going to load up the presentation, Uh, which we've done before, but I'm also going to start a pole. We want to get an idea of where you guys are all from, so that we can adjust the presentation appropriately. Because if you all call trainees, that's going to be different If your medical students, uh and this will help us direct the questions and answers specifically to you guys. So I'm going to try this. I've never used mental before, but I have, um, created a pole. You may be able to see it. You may not. I don't know, but hopefully something has flown up on your screen under polls, and we'll just start to get a bit of an idea of where you guys are all from. I'm going to give you a second to do that, because once I load up the presentation, I can't see it very easily. Um, and then we'll crack on now. I kind of I don't think there's too many good at the moment. In total, we're gonna have about 50 of us, which is amazing. A lot of interesting ent. But what we're seeing already is that the majority are either foundation doctors or medical students. And I'm not sure if the one c t is me that I could I put that down or whether there's I don't know whether I represent 11% or not. But but by far, most of you are foundation doctors and then secondly, medical students. Great. So this talk is perfect for you guys. If you're telling me that you're sort of specialty doctors or something, um, I don't think I'm gonna be able to add much, but we should do with you dot So let me share my screen and we're going to work on. Okay, Rwanda, Can you just let me know if you can see the slides? So I know. If anyone else can see, you can see them. Brilliant. Okay, so a course surgical trainees guide to getting into E N T. My name's Kristen Grimes. I've already said we've got Rohana with us. And I also wanted to mention one of my consultants. Mr David, older son. He's a consultant ent surgeon in Torbay Hospital where I've been working for the last year and he's had a look through invented this presentation as well. I'd also like to thank mind the bleak for giving me the opportunity to do this talk with Rohana. Um and I would also like to thank the SFO UK. Okay, so this is point number one Learning Point number one guy's join the S F O u K. And also, of course, you're in mind the sleep if you haven't already. Why joint S f o u K? Well, it's the student foundation for otolaryngology in the UK so Joanna and I are both representatives of this society, and that actually gives us a point in leadership and management at a regional level. So we'll we'll talk about Korean portfolio stuff later, but that's that's one reason why to join them if you're interested in that those sorts of career points, Um, but even better than that, they have lots of different topics about how to get into TI. They're on all the social handles as well, and they inform you about events that are going on. They got competitions. We'll link back to it later on. But basically these guys are good to have on your side to be aware of what's going on as a student and as a doctor. I didn't know about them until I was a court trainee, and I feel very much like I was left out at the start. So don't be a Christian and join this early. Okay, so what are we going to talk about today? We're going to talk about Korea's an ent. Why bother looking at a career in Ent? That's what you guys want to name. I'll have a chat about what it's like being called training the Southwest, and then we'll have a chat about. Actually, she is from the Southwest as well. Aren't you from exercise? So she'll also talk to you about what it's like being a medical student, going and thinking about the ENT in the Southwest. We'll talk about applications and port photos as well. This is even useful as medical students because you even get points only get points. In fact, if you've done it before medical before being a doctor. So at medical school, so really useful information across the board gives you an idea of what? To aim for what? To apply for what? To start doing it, even in your early years, Uh, going forward And what we're going to talk about Plans for f y three years. Okay, that's quite a popular topic. There's a couple of two is among you will be useful as well. And then we're gonna leave it to the floor for you guys to ask all your questions at the end. Okay? Okay. So we've already talked about this, and actually, we've got an idea of what you guys basically are. So we're going to move on, So y e n t. Uh, well, let's crack off with a couple of them. I really enjoyed ent partly because I felt like I was treating people across the spectrum. Okay. You had the very young you have pediatrics, otolaryngology. Kids with glue were requiring tonsillectomy adenoidectomy etcetera all the way through to elderly patients and things like head and neck cancers or reconstructive surgery. Um, and everyone in between. A variety. It's very hands on. Okay. So as a surgical specialties goes, you can do open surgery. You can do endoscopic surgery. You can do robotic surgery, you can do microscopic surgery. And so there are lots of different options available. I'll give you an example of each open surgery head and neck dissection. Okay, so you get to open up the whole neck, get to see all the lovely anatomy, get stuck in really fun as an assistant as well, because you get to see what's going on the other end of the spectrum endoscopic. Okay, we do a lot of surgery and noses, that's all. I'm using endoscopes. Very difficult to learn from that. Sometimes when you're trying to look down and nostril with the surgeon who's got the head in the way. But But there is obviously with endoscopy. You also have the camera as well. So you get to see things on the screen that's really enjoyable. Robotics. That's really fun. Okay, that's new. Coming through like the DaVinci machine. So that's really exciting. And e n t. Is a recognized specialty that uses the robot. You might. You might get to use that as well. Um, E N t is often quite a satisfying specialty as well. It's a mixture of surgery and medicine, which is, quite, um, is quite satisfying. You do a lot of clinics as well as theater, and often patients are quite well coming to you, or you find that you often have a solution for them. And often treatment is curative. So when you think about some specialties like Upper Gi I where you know, if you were sort of a pancreas surgeon, for example, and everyone came to you with pancreatic cancer, uh, the majority of 20% die from pancreatic cancer over a five year period. So you know that is very different to the patient that comes to you with their daughter, who's got, you know, bilateral give you and you're going to give them some grommets to make them all better. A couple of things to think about that you also the day of the 80 algorithm, which is quite exciting. You're up there with the anesthetist managing the airway. Okay, When a patient does go south, they go south very quickly because you know, when we think about managing patients on a two, e airway is the most important one. And it's very satisfying, I suppose. One, after the initial scary episode to have come in and save the day, helping manage a from 80 algorithm, something that I think is appealing to a lot of people now as well. It's got a good work. Life balance. I say this in caveats among surgeons. I'm sure my wife would tell me and you guys as well that we still have to commit a lot of time to, you know, the port, failure of surgery and the conferences and the, uh, teaching sessions and evenings like this, for example. You know, all of this is sort of contributing towards being a surgeon. Um, but along with that, E. N. T s sort of on call schedules, for example, uh, tend to be nonresidential. So if you're the registrar's a consultant, you don't have to be in hospital to be on call, and you're not often called in unless there is an airway emergency, so you can see how that would work with with with your work life balance and the date today ent as well doesn't tend to be as busy as some of our other surgical colleagues like general surgeons. My consultant, Mr Edison, maybe he's biased has wanted me to put in as well that why Working ent? Well, he wants to work in the ENT because he finds the colleagues are generally quite normal and nice and supportive people possibly compared to some of the stereotypes that you may see in other surgical specialties. So that's a lot of different examples. But, Rana, why don't you share your thoughts on that? Just these representatives for you and why you're interested in the n t. Or do you have any other thoughts about what pulled you into the idea of the ent? Uh, I think the work life balance is probably the biggest one for me. I think it's just because I rotated around quite a bit of the cervical special to you, and, um, I will, um, see, they just seem to have a lot more like they were leaving on time. There wasn't. You get some sort of airway emergencies and things, but generally it's a bit more elective surgery. Um, and they all just seemed really happy and really like their job, so that was quite inspiring. Really? Um, yeah, that's the biggest one, I would say. I mean, there's there's quite similar reasons that you just said, Really, Um, I like the variety of patients, which you don't get a lot of specialties. Um and yeah, I like the medical and surgical mixture that comes with it. Yeah, absolutely. And there's a lot of variety you can do is you can do nose is you could do throat. Hence the Ent Pediatrics facial plastic I've listed in red. Those are all the different subspecialties that you can choose to go into as a ent surgeon consultant. So you have to kind of pick one of those and demonstrate that you're interested to go into some of those some specialties. So a huge wide range and it's interesting, really. I mean, I'm very honored as part of the sort of ent that we've got so many people that want to come to tonight session because I don't know about all of you guys, but for me, I only had one official week of ent at medical school, and then I did a taster for a month. But up to that point, I only had one official weakening to run. What about you? How much ent did you actually get? As you know, a standard, Uh, in the next two. Unique. Yeah, I was really lucky, because we do like, a one standard week, but then in 50 you can choose a bit more. Um, so I chose to do six weeks in the in the in tears part of, like, my surgical rotation. 50 years. So I've actually I've done seven weeks in total, which is more than anyone else I've heard of doing as a med student. So, um, that's been really useful, especially because even if you don't end up doing, um t I think a lot of what you learn about an ent comes in useful and GP and e d. Um, So when I did those rotations, I was sort of a lot more confident as well with it. Very good point Ent plays a lot in a and A and in GP medical practice, they say up to 25% of GDP appointments have an e n t issue. Uh, so that sort of demonstrates how much e. N. T. Actually invades into our GP colleagues. Specialties. Maybe this is a good point now to touch on as a medical student, you know, if you're thinking about E N T. But you only get that one standard weekend ent. How could you broaden your experience there So you're on a had a brilliant opportunity to be able to pick a specialty. If you don't get that opportunity, most medical schools should be able to allow you some time to devote to a specialty of interest for a couple of weeks, maybe up to a month. I got a four week allowance, which I could divide as I wished, and I divided into two weeks in Salisbury Hospital in two weeks at Portsmouth Hospital because I was in the West region from Southampton University and I had an amazing time there and that really sort of help consolidate whether ent was what I wanted to do, uh, again, medical students, you know, I really worried that medical school what I was going to do. And, you know, when we go into becoming a doctor, you know, going to medical school, we have to decide that we want to do medicine at the age of 16. For a lot of us, Uh, and and so we're kind of used to the idea of knowing what we're going to do, and it's quite insistent when we don't know. So if you don't know what you want to do, my first advice is, Do you want to do something with a bit of surgery and yes or no? Do you want to do something that's in hospital, out of medicine, out of hospital, yes or no? And you can also say, if you want to do a bit of both, you know you can work with that, but if you want to do a bit of surgery, but you also like a bit of medicine, but you want to be a hospital specialty, then seriously consider ent and think about adding that to your your experience. Maybe. And finally, if you get the choice, E N t. Very friendly will be happy to have you along. Certainly. Okay, so I'm going to talk about the ent training pathway. So we talked a little bit about getting a bit of experience in the ent at medical school. Another one as well is join the SFO. There are medical student and foundation doctor society. You can become the medical rep in your, uh, university if you so wish, or you can just sort of tag along and get some interesting, um, and some information from the ENT Society. So let's say you're starting to think about the ent. Well, what's the pathway? Well, everyone's going to be going through the foundation years one and two, and then, depending on what you want to do, you could either go into an f Y three plus Okay, so that's like a fellowship year or working abroad. I've done both, by the way, so very happy to answer. Questions on both of those have worked in New Zealand, and I worked as an F Y three in medical education as a fellow, Um and then once you've done that or not, do that to you, then apply for core training. And that's quite interesting. You actually do it quite early. So even if your day one F one well done today, getting through your first is F one, probably all induction stuff and no real medicine, but you're you're doing great. Um, but if your day one f one you know, you've got 18 months now until applications for core training, if you want to go straight through, um and and so you kind of get used to this idea that actually you do have to sort of crack on and get through things because 18 months, we'll go go by pretty quickly not to stress you out. You've still got plenty of time, but it's something to bear in mind. You do core training years. I've just finished ct one. I'm about to go into C t two and I'm also thinking about the fact that I've got to apply for S t three in November, December this year. So all through the last year, I've been kind of planning doing stuff to get prepared for that. And then once you get into, uh, specialty training an ent, it's all plain sailing. Right? Okay. You got 60 years in total. It's quite a long process. Um, you when you apply for something like ENT because he's not in every hospital, what happens is you apply to a region. So let's take my region. For example, peninsula and peninsulas got four hospitals that provide Ent. It's got Torbay, Truro Extra and Plymouth. And each year I would rotate around each of the hospitals and the two of them I would rotate around again. Okay, so it's going to bear in mind a couple of areas in the country like Glasgow and Birmingham. They've got a lot of ent hospitals and experience in a smaller areas. You don't have to move out of those cities, but in other place this is like six or seven degree. You can tell I've been looking at the ones down the South bit more, but in all of those, you do have to move around a bit more. So that is something to bear in mind as well. That being said, I have to say the majority of the registrar's in peninsula are female, which hopefully demonstrates that E N. T is an accessible specialty for both sexes, as it should be. Okay, s t eight. So it s t eight. That's the last year until you decide what sort of specialty you want to go into your subspecialty. Rather, um, so you may end up doing a fellowship here after ST A to gain more experience in your interested subspecialty. There used to be a run program. Okay, that was trial for three years. That is no longer available. So if you've heard from your colleagues that there is a run through program for ENT, which you can apply for the training level, But you can do all your years and one go that no longer exists. There was only a couple of sites in the country, mainly in London and Manchester. Unfortunately, those are no longer available just to make you aware. Okay, Romana, why don't you have a I won't be here a bit more about you, and then I'll I guess I'll talk more about myself in a minute. So my slides just have you got a side up? Because it's just gone off my screen? Yeah. I don't know if that's just my That's it. It's back. Um, so, yeah, I said I just graduated from X to, you know, any, um, just moved school to start as an F on and had my first day today, as some of you might have done. I've always been interested in surgery throughout medical school, being involved in the surgical society quite a bit, Um, and as president, this last year, which is a good opportunity. Um, and then it was sort of half way through medical school and my rotation in third year. I did a week of ent, and I just really enjoyed it. The team? It was in Cornwall, actually, Um, the team were really lovely and got me really involved. The surgery that I went to see it was all really interesting. Um, they sort of talked me through the head and neck anatomy a bit, which I hadn't really learned much about before. Um, and following on from that, I asked them if I could do a bit of research with them, find out a bit more about ent, um, and then did a regional presentation with them from that, um, and then I went on after my fourth year extra, I did an interpretation in anatomy at Bristol. Um, and I chose to do an e n t theme dissertation while I was there. Um, and also sort of talked some anatomy. Um, while I was there as well just to get some teaching experience. Um, And then I returned to extra for my final year. Um, which is when I managed to do my six week e n t block, which I enjoy more than I had in third year. So that was a positive sign. Um, and that's when I applied to be an e N T u K rep. So if anyone is interested in that, I think I applied like November, December a year ago. So you're probably coming again? Sort of End of 2022. Um, but that was a really good opportunity to get involved in the N. T. Um and, yeah, I don't have any anti placed position, but an F two My last job will be on E N t a four month ent rotation then. So I'll hopefully sort of build up some more ent things for my portfolio, then, um, and go on to apply for surgical training from there. Really brilliant. And what Rihanna hasn't said is she's also presented some of her stuff at National, uh, international conference is, which is just ridiculous. Really. I don't remember doing that at your level, so I was very impressed hearing about your your stuff. Amazing. It really is. And I called like I've worked with the Corn Ball team. They're really friendly. And I think I'm working with the third year actually did some experience in Cornwall and we're doing some research together and we're trying to get a, um, an article published and stuff. So, um, that's a really good sort of story in how to get involved in some you know, both some portfolio stuff. Yes, we have to do for the portfolio, but also some stuff that actually you reflect on and go. Wow, I had a really good time. Actually, I really enjoyed that. It was very fulfilling. It was kind of a type two fun situation, but it was really enjoyable. And I've gained something from that and actually become more engaged in in a in a specialty. That's a great idea. I never really approached any seniors as a medical student to ask to do any research I never really thought to do that. I don't even know if I want to do in tea At that stage are points that you get only if you've done things at medical school, which are then close to you when you're a doctor. Um, so if you're still a medical student, you can start now. You have our permission to start now, if you're interested, um, and ask around to do these sorts of things. An inter collation as well is great. I also did an integration, and that's a really great year to sort of test the water. It takes some time out of the normal program to give you an idea of whether you're interested in something particularly. Yeah, I found that really, really useful. I did mine up in leads, and mine also was studying advanced head and neck anatomy and your anatomy that also introduced me to and two from that point of view. So this condition can be useful to to sort of test the water and gain something from it, you know, including on your port failure. But also just life skills and and an interest. Okay, so from my point of view, I was a student at the University of Southampton Medical School in Wessex. Um, I gained. I think I did a week in fourth years how it worked out for us. And then after that, I decided to inter collate doing A B S C in clinical anatomy and leads. I picked leaves because all dissection based. So we got to dissect lots of heads and necks, um, and brains and I probably should have used that year better from a research point of view. Uh, they did give us a project, and I dissected out the head and neck region to look at different surgical approaches to the threat to treating thoracic outlet syndrome, but never, never sort of sent it off to be published or anything like that. I didn't really know what I was doing, And, um, I just thought, Oh, no one's going to be interested in that 10,000 word essay, so I didn't really get around to that. But it was a systemic review, a systematic review and looking back at it now with my more surgical importantly minded brain, I would have gone. Actually, we could have turned that into something. But the key is, is having a mentor or in and having guidance as well. You know, you're not expected to know everything straight away, and it's really good that you're here tonight. This is, you know, this is the best thing that you're doing. It's also good to try and have a chat two colleagues above you to sort of get a bit of a mentor bit of advice on what you can and can't do because I'm still learning now about publishing stuff and certainly a medical school. That wasn't something I was thinking about, but the B S C in clinic anatomy got me really interested in the end. I loved it. And then when I went back into phone a year, I did the four weeks in the ENT, and by that point I started to look at you know what, what was required down the line. And I started thinking about opportunities that I could take out there and and then finally, you actually identified doing a couple of competitions because I thought, Right, I need to start doing stuff and I like surgery. Let's do it. And the competitions I did there was one by the Royal College Surgeons of Edinburgh, which you can be a member of. You can be a member of any of the colleges. It's fairly cheap for students, and it gives you, for example, uh, and you can also it's also cheap as foundation doctors. You don't get points at the portfolio but they introduce you to lots of information and prizes and competitions and events and things like that. I did the surgical skills competition one regional winner for that in the Southampton region and did the final in Edinburgh, which I didn't get it. But it was a great experience and I got a regional prize for that. And I also went to a summer school because I was feeling really nerdy that summer. And, um, it was a international summer school and it was talking. It's by I'll have to think about it at the end. Um, I forget who it was, but it's in Manchester. It was a painful course. It was a whole week, and you got to choose what sort of specialties you were interested in. And then those of doctors came to the conference and talk to you about these different specialties. So I thought, Gosh, I need this to the work out what I want to do. And then they sprung an international anatomy challenge, Uh, and people there from all around the world. And it just happened. I came second in that because I've just done a year in clinical anatomy, you know, so it was all fortuitous. It wasn't like I planned to do that. But then I could say an interview that I've done an international have one, an international prize, the second place, which does count. So you don't have to just be first, which is something I didn't realize anyway. I did foundation and picked by this point, I was stuck on E N T. And so when I ranked all my jobs in foundation years, I picked one which had e n t in it. I hastened to add those foundation doctors if you're going. Oh, I like ent, but I haven't got any anti job. Don't panic, OK? To get into court training, you don't have to have any ent experience, and I've just spoken to my core set trainee year. One guy who's taking over my job. He's done no ent experience coming into an 18 month ent job, so it's not a requirement you can get into doing e N T. A core training without any experience as a foundation doctor. What you do need is surgical experience. Next, I'm going to move on and I'm chatting nodes. Um, and I anticipate a lot of questions at the end. But I did my two years in F one there and I said, Yeah, my advice is say yes. Two things. Okay, just say yes to anything. The photo on the top right here with me and a couple of my wonderful friends. Um, that's just us on the TV show Did a quiz. We did a show called Britain's Best Junior Doctors for the BBC, and we were one of eight teams that got through these sort of stages and got into the live rounds on live TV, not live TV. I live, but it was on TV. It was a couple of years ago and you can't find any clips now if you're gonna try and search for it, they're not available. Um, although I have got it on CD at home, of course. But we did that and we came second overall in the country as pool house, representing pool hospital with the cleverest F ones in the region that you don't have to do that. Okay? And I was terrified saying yes to this opportunity. But I said yes, nonetheless, driven by a fear that I wanted to get into E n T. And I didn't know what else I wanted to do. And we end up coming second. So you don't have to be this rearing ready to go surgeon since year, one medical school to get into this. But my advice is, say yes to lots of things. Look out for these opportunities and try and take them and doing them what you can. That's one of the Christians. Life lessons. Okay, so after that, I didn't want to go straight into court training, So I went to New Zealand, and I started working out there. Okay, uh, traveled across America for four weeks, travel across New Zealand, then worked out in there doing Austin Gynie. Why Christian, did you choose Abdelghani? Well, Optima doesn't count his surgery. Okay, Doesn't counter surgical experience. Uh, and that was useful because there's only so much experience you can do in surgery before applying for core training. Okay, which is 18 months, so make sure you look at that now. You don't want to exceed 18 months of surgical experience. Um, going into core training. If you do, then you can't apply, but it doesn't count. So I still wanted to do surgery But instead I ended up doing the gynecology and C sections and stuff like that still get experience. Then Covert hit. Had to come back early. Had to cancel our wedding. Had to be delayed by a year. Um, I applied course surgical training didn't get in. Why is that? Well, the portfolio is okay. I got an interview, which in unto itself these days is actually a challenge. But I had no one to practice with the New Zealand. No one knew what I was applying for. Um, I didn't really have any colleagues in the UK that I could sort of drop in on and do calls across the world to do Is you practice? And I just I just wasn't as prepared. And when I flew back to the UK, did the interview the management station, particularly which you don't need to worry about today. But the management station through me a bit and I didn't get in was absolutely gutted. First time I failed anything. Uh, that's not true. But first time that I felt like I wasn't going to progress in life, you know, I was doomed. And so what I do instead. Well, my wife was going to Cornwall. So I went to Cornwall and did an educational fellowship over there. And I educated students teaching them anatomy, teaching them Jim Basic Sciences. I taught extra students actually, in the 2nd and 3rd years and did practical skills with the final years. And I got to do ent I got to You got to do then So you got lots of experience build up my log book. And most importantly, I have people around me that we're going to ent and we practice like hell to get through the interview and the happy. You know, the happy ending is that I got a course of training job and I got it in E N T. Which was my dream job is about 70 jobs in the country that has some ent experience in them. So I drank them all first, based on geography, basically, and I got my second choice. So that sort of goes to show that you don't have to be, you know, awesome from day dot You can learn as you go. Say yes to everything as you go. And overall, you know, if you look keen, say yes to things try and get involved. Stay persistent. You will get the job that you want to go into. Okay. Sorry. That's a lot about me. Um, a lot about sort of anecdotal evidence and stuff. I'm not that old but already started talking about the old days and what I did. So we'll go on to other things. I'm going to talk a little bit about getting into course surgical training, because as you guys are medical students and F one F two, this is something that you're going to be approaching within the next couple of years. And that amount of time is is key, actually, to develop your portfolio so that you have a good chance to get into court training. Um, this is the schedule that was last year. And basically, it runs in a similar format every year. Okay, So applications start around November. You have to submit your portfolio around December. You end up doing finding out whether you get an interview in January, February time, and then you end up doing your interview in February to march time. That's that's roughly how it works over that schedule. And then after the interview, you find out if you've got a job in sort of march April time and by May you get your results of your interview and you you Most people end up knowing where they're going to be. So again, that means that if you are an f I one now, you've got about 18 months before you need to submit everything for going into course surgical training if you want to go straight through. So it gives you an idea that in 18 months, you know, that's that's what that's what your goal is. I'm going to go through a lot of sort of data heavy slides, but I'm going to try and breeze over it and give some anecdotal stories, um, to sort of try and make it more interesting and demonstrate how you can do these things. Run A If there's any of these slides that you particularly resonate with, and you just stop me and interrupt and say, Oh, you know, I've got, you know, story about this, or this is how I This is how I got points for this. I think that would be really useful as well. Um, so MRCs party. So this this is the surgical exam that you get to do. There are two parts to it. Party, everyone does. And Part B. You only need to do part B of the normal MRCS exam when your core trainee and there's a special one for Ent that you do separately to everyone else but the MRCS part. A. Anyone who's interested in surgery does the party. It's a written paper. If you pass, it used to be different. It used to be that if you just sat it, you get a point. But now you have to have passed it by December of F two to have got the point. So I did it in, I think, January of F two. Um so I didn't get it. And I think the previous diet is October time. So you're gonna have to be pretty keen to already get points doing the MRCS if you're going straight through. But that's it's worthwhile doing if you think ent. If you think surgery is something you want to go into courses, there's loads and those different courses I've given a list here, of course, is particularly recognized and particularly useful for anyone interested in surgery. Uh, the basic surgical skills courses. A great course that I wish I did. Enough one. Okay, I didn't do it today for basically for points, and by that point, I kind of knew the basic surgical skills because I've just been in theater enough. But, um, at the at an F one level would be key. Really, really useful. It's a lot of money. I know you guys don't get studied budgets an F one and which is rough, but it was a really good course of doing the foundation training because it teaches you all those things that you sort of on the back foot on going into the theater. If you can suit if you know how to repair rooms, make excisions those sorts of things you're going to, you know, excel going through. If you do that course first, Crispin alert. They're basically surgical versions of a less courses and 80 s is a trauma version of a less, which is the advanced life support course, which everyone gets to do in their foundation training. There's other courses as well. I don't know whether there's any surgical specific courses apart from those that are as important, but those ones are the ones I would recommend that costly, if you can get on the study budget, do book early because a lot of other people are trying to get on to them because Cove it has made it difficult and to get onto these courses operative experience. So this is the thing that gets everyone interested. So if you're a medical student and you don't know if you want to do ent, try and get some experience in theater because that's my That's half the reason why everyone wants to do surgery. Okay, they want to operate and operating. And surgery is not about ward work. It's not about it is, to a degree, the clinics. But you know, being in theater and getting to, like, put some gloves on and actually do something that's when it gets your heart going. That's when you get excited. Um, and that's that's something that I recommend in terms of points on the portfolio. For that, you basically just have to demonstrate that you have done, um, a certain number of, uh of cases assisting so you can't be observing so you can't be in the back of the room, not scrubbed. You have to be observing it. Um, but it's worth trying to get some assistance. Get a senior colleague to show you how to do a little bit of sitting at the end. You know, closure of the wings, that sort of thing. Um, and you'll get those points. Just do as many as you can start right away. You can. Even as a medical student. How do you like this? Go to the logbook research on Google and create an account today. Anyone can do it. I think I created a foundation. Is because they needed a GMC number, actually, Um, so I don't know if the medical students, whether it's as accessible but marijuana if you haven't done it already, creating the logbook account as along with everyone else who's an F one F two and start logging. Your case is straightaway. I did it from F one and I got about 20 good cases, and that was flux for the interview. So, you know, that's all that was required. Um, it also says about experience. This is slightly different. Um, you know, we talked about some cases, but it's also talking about how much elective time have you spent in a specialty. So I could say I could get four marks because I did four weeks of added in the ent Uh, and that's something that you guys can do to. So if you think you want to do surgery still not sure yet, but you want to see what it's like. Do that taste in some surgical specialty like Ent, you'll still get the marks for it. Okay, degrees and prices. Well, the degrees we're gonna gloss over that. Basically, if you've done a interrelated year, you get a point or two points, depending on how well you did that year. If you've done a masters of PhD, you guys probably already know that you get extra points for the mass majority of us. We can't reach those higher point because doing a PhD or doing a masters requires a significant time out of training, which that might be you and a friend. A very good friend of mine is doctor doctor, because she's a PhD student first and then doctor. Amazing girl, Um, but for the majority of us, that that wouldn't apply, So I'll gloss over that, but considered interrelated year. If you are considering you know if you if you're not sure what to do. There is no rush going through training. Hopefully, I've demonstrated with my story that you don't have to go straight through everything if you don't. If you're not in a rush and an insulated year was an amazing year and in fact, I would argue my best year was the interrelated year prizes. Um, surprises could be at medical school if you're really, really clever in medical school. Unlike me, uh, you may be getting distinctions and things like that, and that gives you prizes already. If you're not as clever if you're not in the top 10% as the rest of the cohort, that's fine as well. You can do other prizes. Um, the SFO Ent has an undergraduate s a prize, the Royal College of Surgeons. There's a surgical skills prize. You can go to conferences that ends up having prizes. You can do other s. A prize is there's loads and loads availability out there. You just kind of have to look for it and go into it to another one. I'll advertise the neurosurgery, the competition, the national undergrad, that neurosurgical competition, which I used to write the paper for, and that's in Southampton. And that's the national prize as well. And you get You don't have to come top, either. If you come in the top 10% you get a prize as well. So if you are particularly good at your your anatomy, that could be something you want to do as well. But the real model of the story there is, say yes, give it a go. That's not often those are people that actually go into these things, and you'd be surprised what you could win. Quality improvement audits. This is bread and butter. It's expected that everyone basically gets these points, and it's not too difficult to get what is an audit? What is quality improvement? Well, I'm not going to go into that into detail because that's an interview answer question, which you learn for interview and then you forget immediately afterwards. But basically as many students, if you're not aware of what quality improvement is an audit, Um, it's basically where you measure current practice against the standard. That's with an audit, and then you see how well you do against the standard. Uh, if you're not doing well against the standard you put in an implementation and then you reorder it to see whether your implementation is made a difference compared to the standard and quality improvement project is basically the same thing. But you don't have a national or local standard to compare it against. So you're just comparing it against sort of anecdotal evidence of the fact that maybe something isn't going well and you want to try and improve that. But you haven't got something to a standard to compare that with. Most F one F two, I believe, have to complete one of these during their training. So I was forced to do one of one of these in F one F two and pull Hospital is actually very good at supporting you through that whole process. So even though I wasn't really sure what to do, and I did a quality improvement on, I think urine dipstick recording, which is not the most cutting edge or thrilling of audits of quality improvements. But as a result of that, I could demonstrate that I led all aspects of the surgical themed clinical audit, which is the top points there, and I presented it at the local meeting because we all had to present at the local meeting to pass F one, but that actually, you know, without really realizing it, gave me top points for that. So just make sure that you're involved in all aspects of a quality improvement project. Make sure it's surgically things. They changed that now, so make sure you do the surgery. I would have got through with my urine dip one, um, and also make sure that you presented at something. It's very easy, actually to present orders and quantity. I did one today. I didn't think it was even going to get in, but I submitted an abstract. I thought it was a bit now, and they accepted it, and I did it earlier today. That was a regional presentation. So don't be afraid to get stuck into these audits and quality improvement. You don't have to do it alone. You can do it with other people. You all benefit as a result of that because it's a lot of work to do on your own. Don't do you do with other people and then look around to see what sort of undergraduate compasses or post Graduate foundation compasses you can do my top tip of foundation doctor is definitely, definitely definitely put something into the foundation National Conference in Bristol. Okay, that's in January, I think each year and they pretty much except anything. It's only for foundation doctors. So you've already got a smaller group to apply. And they have so much capacity that they will accept anything. I did a poster, Um, and it was It's a national poster, technically, so that gives me the top points for a poster. Easy peasy, teaching experience and training. Uh, and when you have a chat about teaching experience because you did a bit of that with your interrelated year, Yeah, So I think I first saw this sort of structure. Actually, during my integration year, I saw this portfolio thing, Um and I thought, Oh, I've got a bit of time this year compared to some, like many years. Um, and I thought I'm learning a lot of that, and I've been kind of pass it on to the younger years. So because you do a lot of your learning at Medical School of Anatomy 1st 2nd year, So I sort of got together with some groups of first years. I think it was and just sort of run through a lot of, like a limb anatomy and your anatomy, et cetera. Um and yeah, it's really it's really good for a portfolio. You can get sort of feedback forms, um, and things from them, and it actually was quite helpful. Well, some of the topics I did in detail with them actually came up in my anatomy exams anyway. So it's It's the kind of thing I don't like to take time out to do when they're busy. But like actually, teaching a subject can really help you in your force anyway. So I would definitely recommend um, teaching out of all of the things on the portfolio. I'd say teaching is quite an easy one You can do, Um, because there's always going to be younger students that are gonna want to come along, um, to sort of anything you can make like Ent for finals. Like anything like that. I'd say that students will always be keen for So yeah, I definitely recommend that exactly, just as I said, and I'll just add a couple of finicky details to that as well for the actual portfolio. Um, it's what's really annoying is that they're very particular. And so you have to really read the small print here. So I did that year in Truro doing an educational fellow where I taught sessions every week. I'm sure I did this as well. But I taught sessions every week for the whole year, and I was basically part of the Exeter teaching syllabus. So I felt, you know, you know, like I was doing a really good job, and this is going to be amazing. I was gonna get top marks. I didn't get top marks. Why? Because I technically didn't work with local educators to design teaching program. I organized it, but they didn't give me the point because I didn't design it because it was part of the university standard curriculum. The university designed it, and I provided and organized it. And that was enough for them not to give me those top points. So, do you read the small print? You will get called out otherwise, So you have to demonstrate that you basically spoken to someone senior ideally a consultant and and said I want to create this teaching program you only have to do four sessions a year. It's not that many. It used to be that you have to do regular sessions for six months, but it had to be more regular than that. So four sessions over a year. But you have to have a senior back you up and say you designed all of this and they kind of supervise you doing it actually do that. And then you have to have evidence of formal feedback, feedback, feedback, feedback really, really important. I overloaded my portfolio with the feedback stuff just to make sure. I mean, I probably don't need to. We're getting feedback from this from you guys as well today. Even now, it's important. Any teaching that you do always designed feedback doesn't take very long. You could do something like surveymonkey or physical feedback form. If you're old school and and the participants are in with you in the room and the feet, if you haven't done feedback, then it didn't exist. It's as simple as that makes you get your feedback. Make sure you can demonstrate you've designed it yourself with the supervisor to say yes, very well done. You're doing an excellent job and also make sure that you do regular sessions throughout the year. If you do that, and that's not that difficult. Once you now know that, that's what you have to do. You get full marks, training and teaching training and teaching is a bit of a funny one. You've basically either done it or you haven't, um, and they're really picky about this. If you want to do an F Y three year and you want some extra points both in teaching and training and teaching, then you could do an educational fellow year that also pays for you to do a PG certificate postgraduate certificate in medical education. One of my colleagues did that. She got three points of this automatically for doing that over the year, and she also designed a teaching schedule over the years with the educational supervisor. So she got four were always four marks. Here again, if you've been, not many people have a master's level qualifications, so just skip that. I thought I had done training and teaching, but actually I've only had training and teaching that lasted less than two days or was two days. That includes the training and teachers course, which is something that was worth doing. If you're not going to do anything else, try and get on the training, the teachers course. Um, but I wasn't able to get any more points than one point because of that. But if you can demonstrate that you've done five days of training in teaching, then you get points. And actually there are courses out there that have looked at this portfolio and just go on back. We'll just add an extra couple of days. So that applies. And my colleagues who did those courses did get through. So it's about being savvy about it as well. Presentations. Well, presentation's basically any work that you do. This is what I've been told, and I'm not always amazing at doing this myself. But this is what I've been told. Any work that you do, uh, let's say you do an audit, Okay? I'll give you an example. Uh, okay, let's see, today I presented a tonsillitis order, So let's say we do an order and tonsillitis. Okay, So how do you manage tonsillitis in the acute setting compared to national guidelines? So I audit that I do two cycles and I demonstrate that I've done all the work, and I presented at my local department meeting for Mark to audit. Then I submit it to a regional ent conference, which anyone can do, including med students that get accepted. I do a poster on that, and I present as a poster. Then I get marks on the poster. Maybe this is a particular project. That's quite interesting. And I start writing an abstract and an article to get it published. Send the abstract off to a journal, which accepts it and then also get a publication as a result of it. For one piece of work, I've managed to get points in all sorts of different areas. It's the same with presentations. Presentations come into three forms, basically local or departmental, regional, national or international like I say, apply for the Foundation Training National Conference. Easy to get into give you maximum points. You can do an oral presentation that you get more points. If you do a poster, you get less points but still worthwhile. And this is basically that divided up in different categories. If you can do an oral presentation at a national meeting, full marks if you can do a couple of posters where you've been the primary author and let's be honest, if you've worked just as hard as someone else, I'm doing a poster. But you just switch the number of names around for first author when you present it, then you'll get the points. Where do you get those points there? So that's fine as well. Um, and it goes down as such. There's a couple of examples of where you could send these through that E N T emulated doesn't even have to be interrelated. You can just do general surgical conferences. Assets is a good example of a general surgical conference that's regional meetings. There's national international meetings. All sorts we have to do basically is Look for it and go for it. Okay, we're coming to the interest guys, and I realize this is quite heavy. I know we've got 10 minutes left, and I do want to answer your questions. But if anyone is finding that this is kind of starting to become irrelevant, you want me to see through the last bit so we can answer your questions about the ent? Just let me know in the chat, I'll happily skim over the last few bits. Um, but I'll crack on. Nonetheless, publications and publications are hard to get. I currently don't have any publications. I've got three or four in the pipeline, but they're really hard to sort of go through. And they made some of you. I'm sure he'll have already gone. Oh, I've already got a publication or two or three. Uh, and I bow down to you know, I would love to hear your experience of that, but you don't have to have publications to get to my stage. Um, but they are something that you do have to sort of go into and submit and and think about doing because they do take a long time to go from the idea and conception to fully published in the journal. That being said, you have to just demonstrate that it's been accepted in the journal to get the marks not actually have it published in the journal. Okay, so you do have more time than you think. Um, and this is basically saying Are you a first author? Are you a co author, or have you been involved in a collaborative effort to do applications, and you can find these are different stages. Now if you're interested about trying to get some collaborative authorship, which is the easiest way of getting into publications, and you particularly want to do it in the N. T. There is a site called Integrate, which is what I use quite a lot to get collaborative work research publications, an ENT because it's a group of ent registrars that put out different national, um, sort of audits or research proposals that then departments will take up. If there's someone interested in taking it up and do the work and submit it to them and then down the line, they'll publish that. And because you've been involved with it with the with the local data collection, you'll get your name as a collaborator on the publication. So that's something that's worth doing if you want to dip your toe into publication, but you're not sure about doing something yourself that being said. Like I said, there's a colleague of mine who's a third year medical student in Truro. You just asked a consultant, I want to be involved in research, and I said the same thing to the consult and he said, Well, I've got this project, Don't you do that? And now we're at the other end of it, looking at Publix, uh, publishing that so asking around for projects is absolutely acceptable. And if there's a surgeon or someone who's actually keen and interested, then you know they will help you and mental you and get you that publication down the line. But it takes a long time. Don't worry if it takes a year or two. Okay, you just need to sort of start doing it now. I have it in the back of your mind, but don't stress about it. Leadership leaderships, a really fun one. I you know, I didn't go into leadership stuff on my own sort of tuition on necessarily I kind of partly to take the boxes of the portfolio. But now, looking back retrospectively, I've had the most fun being involved in all these societies and meeting people that are passionate about things that I'm passionate about, and and it's been the most fun. A good example is, you know, being part of the mess I was the social sec for pool. I got to organize the water sports for the pool. Ms. Society Brilliant. Really fun. Um, I've been a exam writer for a national undergraduate. Your anatomy competition. That was really fun, really interesting and different experience. I was the teaching coordinator for my academic society at university. That was really fun just to sort of get to know people and develop some some teaching and that sort of thing. Uh, and I'm part of SFO, as is Rana, part of the committee. And I'm going to talk to you guys basically because, you know, I saw something on Facebook from mind the belief saying, Hey, do you want to talk about your specialty? If you like it. And I thought, Oh, I like my specialty And I do talk, you know? So it's actually something that's quite enjoyable to do. Ideally, you want to aim for something that is sort of regional, but you know, or national. But it's very easy to get something local. You know, you can be part of your own committee at your university, or you could be part of your message if you want to or you can be. I was also the chair of the Guardians of Safe Working Hours Committee So we used to talk about how to accept report, and, uh, if you're not aware of what that is yet, don't worry. But basically we have support the junior doctor's report when they were over working but not being paid for it. And I was the junior doctor chair for that. So I ended up hosting those meetings and that, you know, that was another local leadership thing. So it's very, you know, if you look for it, if you say yes, you actually can end up falling into lots of fun, different roles, and as a result of that, you probably have an enriched and sort of experience life. Really. You can tell maybe that I'm quite passionate, and I've really enjoyed my time doing these experiences. And I never set out going into medical school thinking I would do all of this. Say yes, give it a go And yeah, and the roles in leadership are probably the most enjoyable that I've that I've gone through. Okay, this is a fun one. So, guys, if you are an F one and you don't want to run through straight into course surgical training or F F two and you Probably at this stage. If you're an F two, you just finished it or you just started. Um, and you're thinking I don't want to go straight into core training. Oh, but won't surgery, like, discriminate me for that? No, they won't. And they won't discriminate you if you apply for surgical training in F one and you don't get in. Uh, and then you go again the next year. Okay, So my advice would be Do you want to go into surgery? Yes, I do. Quite, You know, want to give it a go? My portfolio is up. Scratch. It could be better, but I'll give it a go. Do give it a go. If you get an interview, you don't get in like the first time. Doesn't matter. Okay? You can do another year round. You gain that crucial experience of of interviewing already. You know what to expect next time and then the next time around. It's so much less stressful. And you know exactly what you need to do. So my advice is you know, if you think about surgery, do apply for it. Do go for it. If you don't get in first time around. Do you consider doing it again? But what could you do it? Every three weeks? The anatomy demonstrator, like your ana was in interrelated year. You could do what I did, which was being an educational fellow. Make sure that you get one extra perks. Okay? You want time off to be able to do those educational rolls or academic rolls? Don't do a job, which is 100%. And they don't give you any time to do those extra roles, but still expect you to do it. Okay, You need something like 50 50 or 80 20 which is what I had. Junior clinical fellow. This is a very popular thing to do, right? Because especially with cove ID, people couldn't travel a board so much and work aboard. So they found jobs in the UK There are tons of them. And if you want a year out in the countryside, you want to learn how to surf. May I recommend Cornwall, which is where I did mine. They've got 43 or 40 for clinical fellow jobs down there, and you can just spend a year there and have the best time of your life and also gained some academic experience, but of course you can do that any of the country. One of my colleagues made very good use of it and went to London for a year to do it 20 there and got a load of publications as a result of that. So that's another good example as, well, additional degrees. Probably the most useful at your stage is either an integrated degree, a post graduate degree in education, something like that that you can do just for a year. You can actually do a masters if you do a full time for a year, but then you're gonna have to start thinking about how you're going to fund it as well. Um, but an option for that, if two is you could locum um, and then do your masters, which was only, like, two days a week. So if you work two days a week doing your masters and then Loken other day, other shifts, uh, to keep up, you know enough money so that you can survive and get by. You will end up with a master's this experience and having broken for a year. So food for thought we could talk about that more if you guys want to talk about that. But my message there is Don't be afraid. If you want to do it, don't feel rushed into things. Do you make sure that you have some sort of plan in that year, though, don't have it as a complete dossier without doing anything, because, um, that's a missed opportunity. But do feel free to branch out and take your time and do things to get experience, get points and apply again. Okay, this slide at the end, this is just some useful links. I'm sure we can share these slides to you guys where you can find this. These are all useful documents that I've, uh, used to try and look at careers in E N t. And I've found it very helpful in giving me an idea about whether ent is what I want to do, how to get into it and where to take it. And that is it. That is I'm sorry that it was a whole hour just talking to you guys. I hope that was useful. It was slightly more heavy on the how to get into court training because, um, you know, there's a lot of detail there, and a lot of people will be looking at how to get into court training. So we'll open up to the floor now, and Frankie will hopefully help us. Um, hear about your questions. But if you have more questions about the ent as opposed to specifically getting into surgery, well, that will do that. But whatever you want, we can have a chat about that. I'd be very happy. Thank you so much, guys. That was That was so, so interesting and comprehensive. I feel like I have so many questions. Just myself. Um, we haven't got any on the chat. Just at the moment, I have encouraged people to put any if they have any. Um, but to be honest, you did do very good explanation. So maybe that's why would it be helpful to talk through the average day of an S h ent doctor? Would that be interesting? Yeah, definitely. Yeah. Okay, I'll do that. And if you guys have questions, please just send them through now. But an average days and I was an s h a doctor. We'll talk about that first, and we can go up to consultant stuff, but as an S h o. Uh, you get in at eight because surgeons like to get in at eight. Not before. Okay, we like to start early. Why, you ask? Well, that's because we have to start theater. And so that's why we all have to get in early. But we get in at eight o'clock, we do the wart around between eight and nine, hopefully finish by nine. Okay, Ent is a quick specialty as invasive surgery, most surgeries at doing the ward round number done by nine and then as an essay. So you're either on call for the day and ent, depending on where you work. Maybe varied, but there's opportunities. You just do it as a resident or nonresidential. So currently I'm working nonresident, where I have a 24 hour on call shift. But after basically 9 30 it's unlikely I get called in. I do. Sometimes I don't always. I'm allowed to go home. I have the mobile on me and and they get called back so but I'm on call for that day, so if you're the person on call, you may spend the day being on call and you get called about anyone that comes into a and the or the surgical receiving unit, uh, with an ent problem, and that might be your day. But if you're not on call, then you could be either running an emergency ent clinic. This is one of the amazing things with the ENT is when you tend to be a job, you do an f two, which is good, actually, because if when you're just trying to find your feet and learn what on earth is being a doctor by f two, you start to develop a bit of understanding of what you're doing. You start to develop a bit of your own practice, and then the emergency clinics and ent give you the autonomy to start doing things yourself. You get to learn lots of practical skills, feels like micro suctioning, manage epistaxis, which are nosebleeds taking foreign bodies out of the ears and nose is resetting. Broken nose is all sorts. You get to do things and they make a real difference. And you feel like an absolute god among men and women, you know, because you can actually do something and make someone better. Um, and that can feel really good as well. And you start to feel like you're a proper doctor. So you might do that for half a day and the other half a day. If you're not doing clinic and you're not on call, then you're not actually expected in most places to be doing anything, you know? So you have this free time now that free time is usually set for you to either attend consultant or red clinics or go to theater. So how many jobs on the daily on the regular do you get to have, you know, daily or every other day planned experience to go and do clinical or go to theater? You know, not not loads, you know, when you're a general surgical, uh, admin monkey in in as an F Y one, which is what I was, Um, I learned a lot of skills, but it was harder to get into theater, and I definitely didn't see many consultant general surgical clinics. But with the ENT, that does tend to be more available because because the job is generally, I suppose, maybe less busy or it requires less people on court to be able to manage it. And there's less ward work, you know? Uh, obviously a big trust. It's going to be different if you're in London. It's obviously going to be different compared to if you're in pool, for example. But in pool, I would say, If you've got more than seven or eight patients on your ward list, then it's a busy day. And that's not bad, is it? We compare against general surgery, which would be 20 patient or more. So, uh, that's sort of the standard day in some trust E n t finishes early, guys, you can finish at four o'clock or 4. 30. I think in the fall it was 4 30 in true, it was four o'clock. Unfortunately, in Plymouth, we're about to go to it's 5. 30 at the other end of the spectrum. But yeah, sometimes you finish early as well, but hopefully that gives you an idea as an S h o. What? What? You're sort of experiences as you progress to a registrar. Then you don't run the EKG clinics, the emergency clinics, But you start running registrar clinics that are joined as an adjunct to consultant clinics and then you can talk to the consultants about the patients and ask for advice and things like that, and you get more dedicated time in theater. You should have at least 3 to 4 sessions of theater a week. A session is a half day, so you should have 3 to 4 half days a week. So 2.5 days of pure surgical experience and you rotate around different subspecialties. You might be the head and neck registrar, and you do all the head and neck with the head and neck surgeon around the week, or you're the audiology or the gynecology registrar and you follow them. Uh, the calls as a registrar tends to be less intense than an S H O. Actually, because of my experience, I have been on the registrar rates for ent for the last five months. A mixture of they wanted to give me the opportunity, and this ought to be good at it. And also coated meant there was no one else to do it, so please could do it. But that was a really good experience, and the intensity has been less generally speaking. Um, and I've actually been covering two hospitals, Exeter and Torbay so that can happen as well. So that's what it's like as a registrar over those years. From what Year? 32 years? Six, uh, years. Seven year eight. You start to sort of decide what you want to go into and by year rate. You have done your other exam consultant exams and you'll be starting to look at doing a fellowship, which means, uh, you don't have to, but most people do. Um, fellowship is where you then do an extra year, even the UK Abroad, in your subspecialty of ent, to demonstrate an interview for a consultant job that you've got more experience than other people in that subspecialty and then as a consultant. I'm sure it's all golf and surgery, but I'm sure it's not. But, uh, you know, that sort of gives you an idea as an S h o. You know what your day will be like and then going into a registrar what your time would be like as well, because I had a bit of experience with both brilliance. Great, because I asked a question question, um, when you touched on the MRC s and they're being I've seen before about living apart before E N t. And then like a general Part B. If you want to do ent, are better off doing the special ent one Or can you do the generic part B? I don't really just not really sure how it works. Sure, um, and I'll add in in for about part as well, because that's just changed this year. So, uh, part a. You do everyone does that wants to do surgery. It used to be that you could do it to play with otolaryngology called Don's Party, and that was an E n t only multiple choice paper. And then you can do don't Part B, which is the diploma of ent basically. And that's the MRCS part D that you're talking about. Any ent they've now scratch the don't party. So if you thought that you could do an ent paper party and then an entire paper part B, that's now incorrect from this year, uh, one of the most part. Once you pass that, you do part B. If you do the standard part B, then you're going to get questions about all other surgical specialties. Uh, and, uh, it means that if you pass that, then you can apply for all the other surgical specialties. Uh, so if you're not sure, it's definitely the one for you or you're not sure if you're going to get into the ent and you would be happy to go for something else. You could decide to do the MRCS part B, but unfortunately, don't cross over. So if you did the M S C s part B, not ENT and went to the ENT, they wouldn't accept that equally if you did the M S C s part B e n t. And then try to go into another surgical specialty, they wouldn't accept that. So you have to do both papers, which people do do. But you have to do both papers to be able to get both things weirdly. The MRCS party. Sorry, but weirdly, the M s part B. You think it's all practical stuff, but there's actually a lot of ent theory in that as well. Okay, because I've heard the story because the part A it's more like a medical school kind of, isn't it? And then part of it is a bit more don't bit more maybe kind of experience but that that study later, Yeah, apart A is like doing finals again in terms of the physiology, the anatomy, the pathology. But then it throws in some more surgical related stuff, like so you know what is this Not not What is the sister? A procedure. But, you know, how do you manage this patient? I do a sister, a procedure. But I've never heard of that before going in learning about it. So there is some surgical specific stuff that they talk about as well. But yes, I think that when people struggle to get through, part of it is usually by the downfall of not doing enough revision or physiology or anatomy. Is it? Is it absolutely necessary to have done the MRCS part to get into see ST No, no. It just gives you an extra four points. Um, now, I don't know if you're not interested in points data itself, but I think last year the number of points to get in was 37 was the cutoff, which is pretty high. So if you were on 30 you know, three points and you just need that for more to get in or whatever you know that makes a difference. And then everyone you can look at the portfolio requirements and you can see that actually, everyone gets kind of similar points, and then people break away with publications or presentations or extra degrees. And so a lot of people, and also a lot of people didn't get in the previous year. And I've taken a year out and gone again. So a lot of people, if you can do the M s part, I basically do do it because there will be a lot of people that have done it. Not by no means have that because one of my friends has only just passed it, and another friend just passed it as well. You have to is basically compulsory to have passed it by the end of CT one called training year one. But even then, I'll see you, Uh, if you don't Yeah, exactly. Yeah, you have to at some point. Anyway, some people say the sooner you do it after medical school, the better. Because you've kind of learned that stuff. Anyway, to a degree. Sorry. Carry on a bit of a lag. No, I was just No, no, that's fine. I'm just saying that, uh, that, you know, having done medical school, you just come out to be done finals. You've got a lot of the information that you can then take on to MRCs part A and also, you're still in that kind of mindset of I know what it's you know what to do. Like revising. I'm kind of used to that once you're a doctor and you're being paid and you have an actual, normal life to a degree, Um, it can be hard, I think, to get back into that kind of exam treadmill. And it feels more novel as well. It feels odd going from, you know, no longer do I have to work in the evenings understand today because I don't have to revise or, you know, all that stuff in medical school trying to go from that back into I got to spend the evenings. Revising is a bit hard. So maybe you could argue Doing it sooner is also good for your mental point of view. How much in advance do you need to book it If you want to sit it, You know, whenever you want to sit it, they have a deadline for applications. I think of late It's back in back face to face now as well. Um, I don't I haven't heard many people saying that they've been struggling to get a place to do it. It's not like you run out of places to say, but there have been a couple of cancellations in Coated, and they were trying it on online as well. Um, but I think it was back to face to face. And, uh, usually, if you apply for it by the deadline, you get a place. That being said, you do also want to kind of mentally be in the zone that you're going to go for this exam, and that can be hard to get your head around as well. Because once you put that money down, you've committed and you know you also want to give yourself a good amount of time to be able to revise. You know how to revise frankly, like you've done it already. You've gone to university. You've passed everything. Um, So you do know what to do to revise for an MCQ paper? Just make sure you give yourself enough time to be able to go through that rigmarole. Not doing it. Yeah, well, what What is? The key thing is, um it was really good talk. Thank you so much for doing. I think it was a different part as well. Breakfast. Okay, You use it for chat wise, and you can get your diet under there and do the back. Uh huh. Everything. Uh huh. Brilliant. Frank is doing a slight robot impression, but I think she's rounding things up and saying Thank you. Thank you, everyone. Thank you very much. I hope that was useful. Let's get the feedback. If we can change things in any way, do you consider joining mindedly? Do you consider joining S f o e N t. And I hope to be working with you guys An ent in the future. All right, Take care. And I think that's it. We'll wrap things up. Take care. Bye bye.