Computer generated transcript
Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.
Hello, everyone. Can you just confirm if you can see me? And can you confirm if you can hear me? Someone can just type on the chat? Perfect. Thank you. Bear with me just loading my slides. It's ok. Can anyone just confirm you can see my slides if that's? OK. Can you see a slideshow? Mhm. Ok. How about now? Can anyone see my sort of desktop screen with powerpoint? Ok, guys. Really? Sorry, just bear with me. We're just struggling here to share my slides. Millie's helping me and we'll try and get this sorted ASAP and get this started. Apologies. Oh, ok. What we're gonna do is we're just going to upload my slides onto medal again. Apologies for this. Ok, so hey, sorry about this. What a pain in the ass. OK. How do I how do I add these slides to me? Do you know can you, are you sure cos I've turned off my camera and my microphone, the turn off. So I don't think you can. I hope so. Yeah. Yeah. Yeah. Oh whoops. OK. So OK. Well, I'll export these slides as a PDF and then do it that way. Thank you. Kids. I'm sorry about this. Ok. It's processing. I'm gonna click present now. Oh, wow. Ok. You can see it. Ok, thank you. Bye. Ok, guys. Sorry about that. I've a, I've added it now as a Oh, perfect. Amazing. Ok. Right. Disaster sorted. Um Hi, everyone. Thanks for joining this evening. My name is Sid. I'm a core surgical trainee in Southeast London and I'm head of the surgical team in mind. The bleep. This is our first webinar in our series on the core surgical training interview. We did this series last year when I was applying and Millie and a couple of the others who did the series with me were also applying and we found it really useful. So we wanted to try and run it again this year. Uh I just wanted to start by saying an apology for anyone who tried to join our event on Monday night. I think it was, we've been trying to get dates sorted for this and it's been hard, sort of getting people, you know, everyone's got work, Rotas and stuff. So trying to nail down exact date and times has been difficult. So we set up an event on metal on Monday and then had to cancel it, but I forgot to take it off metal. So I think people joined and nothing happened. So if that was any of you, I'm very sorry. OK. So what we're gonna do today in this one is a introduction to the interview. I want to talk a lot about um the process of the interview each stage, what I use to revise and my exact revision strategy for each of these. So I hope this is helpful after this one, the the following webinars will be more focused on each individual aspect. So you might, you'll get one next week on the clinical station and Andrew who's doing it will give you a few scenarios here. I'm gonna talk more about overall technique for the interview. OK? So this is the contents and yeah, quick disclaimer. This is all my opinion. OK. This is what, this is what I learned from doing the interview last year. This is what people told me. This is what reddit told me. And this is what my mates also did and we all, we all got jobs. So I hope this is useful to you. If you have questions during this, just ask and I'll stop and I'll answer them and there'll be time at the end to answer any questions as well. OK? I want to start this a bit strangely, but with my take home messages and then we'll go into each bit of the interview. So the first one is you have to treat this if you like an exam. Now, I think this is huge really because this interview is not really like an interview, right? You know, they're gonna ask you one clinical station which is split into 25 minute scenarios, one atl S and one crisp or two crisp. And then they'll ask you a management station, which is your professional di dilemmas and then you'll do your leadership speech. There's about, let's say 10 or 15 crisp scenarios. They could ask you another 10 ATS scenarios. They can ask you and about another 10 to 15 per like personal dilemmas, professional dilemmas scenarios they can ask you. So in total, there's about 40 scenarios and they just keep coming up year after year. So you can learn every single one of those scenarios and you can prep answers for every single one of those scenarios. So it's not like an interview where you might prep a little bit, but you'll get questions where you have to think on your feet. In this case, you can prep for everything. And this goes nicely into point number two is which you should know the answer to all questions they're gonna ask you. And I put almost all because there may be the occasional curveball, but generally you should know the answers to everything they're gonna ask you. And then the final one is to revise with someone else because it's, it's, I mean, it's like a medical school os, right? You can read the book. But unless you actual actually do the practical task, you, you're not gonna do that. Well, it's the same thing here. You need to practice speaking your answers. And the biggest thing for practicing. Speaking, your answers is time, time in this interview is so key. I mean, if I could summarize the clinical stations in how to pass it in just like a few phrases, it's just that you need to be able to say your a to eat in two minutes and 30 seconds. Once you've got that, then it's the rest of it's icing on the cake. OK. So let's talk about the structure. So II copied and pasted this direct from hee. So this is how it's gonna be, it's gonna be a 20 minute interview er to 10 minutes for management. 10 minutes for clinical, the management is split across two things. So the first thing is your leadership speech, which we'll talk about a bit more towards the end of this presentation. So you give your three minute speech and then you'll have two minutes where they'll ask you questions about leadership and then you've got your professional dilemmas situation, which can be like a colleague, turning up to work drunk, a colleague coming in late something to do about consent or capacity, that sort of stuff. And then you've got your clinical, which is two scenarios, five minutes each and they're generally one ATL S and one crisp. But like I said, you may have two crisp. I had two crisp. OK. So let's go on and talk about the clinical station. So the first thing I want to talk about is the resources I use for the clinical station. So, Medi Buddy Question Bank, this was the resource I use the most. I'm not affiliated with them. I don't think mind the bleep is affiliated with them. It's just an excellent resources what everyone told me to use. And it's, it's just brilliant, really, like, it's well worth the money. I think it was, it was 75 quid last year. I think it's 80 quid this year. It could be 100 and 50 quid and it would still be worth it. Definitely worth getting the green book, which is the book on the right of this slide is also really worth getting. So this book just has loads of clinical scenarios, loads of professional dilemma scenarios. And there are some things that don't come up in medi body that you'll then learn from the Green book. So an example of the top of my head is there is no acutely ischemic limb scenario in medi body, but there is in the Green book. So you'll use the Green book for that one. So those two are definitely my top two resources. Everything else in this list are just adjuncts basically which you can use as much as you like. So the ATL S book I hadn't done at LSI, don't think a lot of people will have done ATL S by the time you're sitting your CST interview, but you can get the PDF online and this is useful for a couple of things. So the for the first thing, it's to get a better understanding of certain topics that might come up in ATL S that maybe don't know much about. For me it was head injuries, neurosurgical trauma and look and the fact that the things you do in your at e and the interventions you can do will try to prevent a secondary brain injury. I didn't really know much about that. So I had to read the ATL S paragraph, not paragraph, chapter on it. The other thing it's really good for is making sure, you know, the up to date management for ATL S scenarios. So I think when I was doing it, it was the 10th edition. I don't know if there's an 11th edition, I don't think there is, but just check that. So make sure you've got the latest PDF, you'll get it free online. That's what I did. Um So an example I can give you about up to date management is burns and the Parkland formula. So, you know, it's like it's your timing, total body surface area burn times something times either two mils, three mils or four mils depending on the type of burn. The most recent ATL S guidelines had said it was three mils for all burns except a certain type of burn, which I think was electrical burns, right? So that, that was kind of a little bit different to what was in Medi body or the green book, but it was the most up to date guideline of how you need to manage burns. Another example is for tension pneumothorax and needle thoracocentesis, we'll know it's sort of what is it the fifth intercostal space, mid axillary line in the up to date A TL S, you can actually put it, put the needle in the second intercostal space. So that's the most up to date guideline. So again, really worth just making sure that what you're saying in the management of your scenarios is up to date. And just, I'd like to go back to the point before about the green book. The green book is excellent, but it's dated now. I think it came out in 2015. So really worth making sure that your management is up to date, use the green book to understand the scenario and then look at the other things I've listed there to make sure that your management is up to date. OK? Crisp. The Crisp Textbook. So I hadn't sat Chris, neither had any of my friends. And I, again, I don't think a lot of people will have done before the interview. Crisp is a bit more self explanatory than ATL S it is, you know, it's basically doing the A two E and then doing a chart review. Um I use the Crisp book only for to make sure I had a good understanding of the Crisp algorithm. So IE once you do the A two E then moving on to what is known as the full patient assessment, which includes a more detailed history and examination, a more detailed chart review, especially the op note, by the way, which we'll come on to later and then also looking at the available results. So this is what you need to say in your crisp scenario. Teach me surgery again, useful adjunct if you want to learn a bit more about certain things. Um One of the things that might come up in the pancreatitis scenario is why in pancreatitis, do you get hypocalcemia and hypoglycemia? Um I didn't know that but teach me surgery has a good little bit about them. So it's a g you know, it's a sorry hyperglycemia. So that's also a useful resource. And then finally I put am E learning which might see, seem an odd one and nobody told me about to use this and I don't think many people had used it, but I used it and it's really good for trauma. So me learning is free and it's quite easy to read, simple summaries and it's really good for a lot of the trauma stuff which is very relevant to. A&E OK. That's good guys. Like I said, any questions just, just put them in the chart. OK. Now I'm gonna talk about what was my revision strategy for the clinical scenarios. So when I was thinking about this, I actually could just make it a full step process which is having a generalized like monologue or spiel for crisp and ATL S and having that time to perfection, then adapting your monologue to specific scenarios. So for example, if it's a compartment syndrome scenario, you might not mention sepsis six, but you will say that you need, you will say over the phone, I would ask the nurse to please take off any casts or bandages on the infected leg, right? But you're not gonna say that if it's an anastomotic leak. So this is where you tweak your, your spiel depending on what the scenario is. 0.3 is known, the answer to the probable questions in the above scenario. So if you use anybody and you use the green book, it gives you questions that they could ask after the scenario. If you know all the answers to all those questions, it's unlikely that there's much else gonna come up and then finally repeat this enough times that you don't have to think about it. This is key really because you have such little time in the interview that you want to be able to just bang out your 2.5 minute crisp or atl s spiel dependent on the scenario. And you don't even wanna have to think about it because to say it in 2.5 minutes or two minutes, 15 seconds around that time, you have to speak quite quickly. So you don't wanna be thinking too much about the next step. You, you want to have it well, rehearsed. So you can just get it out if that makes sense. OK. So we're gonna do an example. And basically, I'm, I'm not gonna make this interactive because I don't think it really, I don't think it works that well on this format. So I'm gonna go through how I would answer this question and how I would approach revising or preparing for this scenario. And if anyone's got any questions, just put them in and we could stop at any point. So in our example, we have a 40 year old patient with Crohn's who is a few days POSTOP having a subtotal colectomy with an ileorectal anastomosis. So bowel resection plus anastomosis, the nurses called you because they have deranged physiology. So they're tachycardic, they're febrile and they're hypotensive and they're complaining about abdominal pain, right? So you need to now answer this question. You got 2.5 minutes to do your monologue. Oh, sorry. So I'm gonna kind of gi I'm gonna give you an example of how I would approach this, what my monologue would be. So I'd start by saying this patient sounds critically unwell and I would want to see them as in a, this patient sounds critically unwell and I'd want to see them urgently on arrival. I'd escalate the crisp protocol and be begin my assessment in an A two E fashion as well. As making sure to initiate the sepsis. Six early on. I'd start with the patient's airway. If the patient was talking to me, I'd be happy the airway is clear and I'd move on to breathing here. I'd recheck the respiratory rate and the oxygen saturations. I'd palpate percuss, auscultate their chest and I'd start them on 15 L of oxygen via a non rebreath mask, moving on to circulation. I checked the heart rate, the BP and the capillary refill time. I'd asked for an ECG at this point, I'd insert two large bore IV cannulae into both antecubital fossa, ensuring to take bloods for the following an FBC A EA CRP and FTS A VBG for a quick assessment of the HP, the lactate and the electrolytes as well as ensuring bloods for cultures. I'd also at this point make sure that I had two group and saves in case this patient needed theater. As I'm considering an anastomotic leak as a differential, I'd start them on IV fluids, normal saline 500 mL bolus and I'd start them on IV uh broad spectrum antibiotics as per the trust guidelines. I'd also make sure to take a lactate with the bloods and I would insert a urinary catheter here for um for urine and insert a urinary catheter here to monitor their urine output as per the sepsis. Six guideline, moving on to D I checked their GCS, their pupils and their BMS going on to E I'd want to fully expose the patient, making sure to examine their abdomen. I would take down any dressings to look at the operative wound site and I'd look at any drains. Ok. So that's my A to B spiel. It's, that was probably not 2.5 minutes and that's, it's felt a bit longer, but you can see how with practice, you could condense that, condense that down. So, what are the key points here in my A two E number one signposting early? So you should do this with every scenario, right? They ask you a scenario, don't go straight into. OK. So I'm gonna escalate the cris protocol and begin in an A two E fashion. They want to know that you are thinking about what the possible differentials are and that you're aware that this patient is unwell. So it's nice to signpost early. This patient sounds critically unwell. I would want to see them as a matter of urgency. I'm worried about this patient. I would see them as a matter of urgency. I would call my reg straight away because I'm extremely worried about this patient et cetera. You, there's a number of ways that you could do this and then give differentials, I think give at least three here. So what I could say is let's go going back to going back to this 40 year old patient. I'd start by saying I'm worried about this patient. I'm concerned this patient could be critically unwell. I'd want to see them as a matter of urgency. My top differentials here would be intraabdominal sepsis secondary to an ANAs tic leak, um intraabdominal sepsis secondary to an underlying collection or sepsis secondary to a peripheral source such as such as chest urine or lyme infection, something like that. Cool. OK. Next thing saying sepsis six. So if it's a sort of febrile infection type scenario, you just need to say sepsis six. Ok. Say it. You can say it at the start like I did, you could say it when you get to see, just say it. And also it's not enough just to say it. You actually have to say every step of the bundle, you know the take three, give three, you need to make sure you're actually putting that in your eight week. Um Other key things looking at the operative site and any drains. So I put this in here because I always forgot it last year when I was revising. But I think it's so important because right, this is a crisp scenario. This is care of the critically unwell surgical patient. So of course, you need to look at the operative site, you need to look at the site of the operation, the incision you need to look at for any drains as well. What's coming out of those drains? And then my fifth point I've given you there is when doing, you know, ABCD E it's easy to forget little bits like, you know, you get a, you get to breathing and you might say 15 L, but you forget to say that you'll examine their chest. So the way I would condition myself to say everything is I would use the approach ob S examination intervention. So let's take breathing again. Ab s respiratory rate and oxygen saturations, examination, um inspect palpate, percuss, auscultate their lungs, their chest and intervention, 15 L of oxygen via non rebreathe mask, ABG chest X ray. OK. Or if it's an ATL S might be needle thoracocentesis, chest drain. OK. And then the next thing that will come up once you've done your A three E is what do you do after? And the reason I've kind of dedicated a slide to this like this is because one of the big questions I had last year and I got a lot of conflicting advice on is once you've done your A to E, do you continue talking or do you stop talking and let them speak, let them sort of prompt you. And people would s was sort of a split between what people would say my approach and my suggestion is you keep going. OK. Don't let them prompt you just keep going and follow. Follow what I'm saying on this line, follow this approach. So you've done your opening statement, that's your signposting. This patient is sick. These are the differentials I need to see them then you've done your A two E and then you can go on to the rest of crisp before patient assessment investigations of management. Ok. So let's look at what we're gonna say next after our eight week. So going back to that scenario, uh, we've got the guy with the possible leak. We've done our A two E and then, then I get to the end of E and I'll say if the patient is stable enough, then I would want to do a full patient assessment. I would review the patient n news charts, their fluid input and output chart, their drug chart and their operative notes. I'd also take a more detailed history as well as an ample history. And I would look at any available results such as bloods and radiology. You can say ample history or you could even mention just I'd asked them when their last meal was when they last ate and drank because I'm cons I'm considering that this patient is going to need a reoperation because they've got a leak, right? So then going back to this. So we've done, we've done our, he, we've done our full patient assessment. Now again, we just keep talking investigations in this case would be the following the bedside. I would do the stuff on the, on the screen. Bloods would include X and you can give a reason why you're doing the bloods or you can just say the bloods. It depends on how well, you can time your A two E and then radio er, radiology examinations would include the following and then I just wanna take you back to that. So we've done, we've done opening statement A to e full patient assessment investigations and now we own to management. So informing. So management you can split into the informing and the pre, uh, pre prepared for theater. What you don't need to talk about is the, is the steps in a, in a, in a laparotomy and wash out or something like that. That's you just need to think about info who you're gonna tell and how you're gonna prepare the patient. So informing, you're going to, I'm going to speak to my registrar and the oncle. So the oncle surgical registrar on call surgical consultant, I will also discuss with um on call anesthetics. Um plus minus ICU. If you think this patient may need an ICU bed POSTOP as well as speaking to the theater coordinator. I'd also want to ensure that I'd fully prepared the patient for theater. I'd reassess them in an a to e manner ensuring sepsis. Six bundle had been put in place. I'd book the case on theater. I'd prepare the consent form. I'd mark the site. I would check that cross match blood is available and I'd give the patient analgesia and antiemetics. Just going back to one point I may here preparing the consent. So can you at, at our level we can't really consent a patient for a laparotomy and wash out and Hartman's because of a anastomotic leak. Right? We, but we can prepare the consent for them. Do you see what I mean? That's the difference there. Ok. Now, let's talk about the management. I hope uh just a little pause here. So I hope that was clear what I wanted to do with that was kind of show you exactly how I would prepare for that scenario and how I would do it was making sure I had AAA blurb a speech ready for every bit of the answer and just practicing what I've said to you now. Um over and over again and just getting it down to the point that I don't even have to think about it. I'll just say it. OK. So let's talk about the management station. OK? So resources I use for this Medi buddy again, green book again, but Oliver Picard's medical interview book, that's a new one. So that's again, the one on the right, this book is a more of a generic medical interviews book, but it is absolutely excellent for this part of the CST interview. It's got so much stuff about professional dilemmas, leadership. It's got lots of nitty gritty stuff about consent, capacity, all that sort of jazz. So it's really worth getting this book and using it to supplement your answers for this management station. And in GMC, good medical practice you, you can look into it and you can even quote or use GMC good medical practice in your prepared answers for each management scenario. If you like. That's an ex extra addition to it. So now revision strategy, how do you approach management scenarios? So you may have seen this, I think you probably will have seen this um acronym. Now, spies are so spies seek information, patient, a patient safety initiative, escalate support and reflect. So that's the framework that you should prepare all your answers with. OK. So make sure you've got a line or two for each of those things, for every possible scenario that you've seen in me body and the green book. And if you do that, that's, that's pretty great. Actually, that should cover you. The thing on the right is from our last year's management station wear and unfortunately, this one isn't on youtube, we can't upload it. But this was the approach that our speaker had suggested, which is basically SPI R but with a little bit more and that's what I used. And I think it's excellent because it just goes a little bit deeper and I think everyone will do SPI R. So having just a little extra, you know, a a little extra line or two probably will go a long way. So he, you know, he mentioned summarizing the scenario so you can do this. It's just a very quick, it's just like a quick couple of words to say you understood what the examiners meant and then identifying the key problems and any challenging issues. Again, that looks really nice shows that you're able to pick apart the scenario and identify the bits that are important. Then you go into spies are sorry, then you go into spies, then you go into reflect. So now similar to what I did with the clinical station, I want to show you how I would use that sort of framework algorithm to then uh to then base an answer for a scenario on. OK. So this is my example, you're the general surgical sho you're on call, you're about to finish your day shift. Um And you're at handover and your evening counterpart has not arrived. So internally, you're very annoyed because you want to go home, but you've not heard from them. You don't know whether they're gonna be late or whether they're actually not gonna turn up at all. So what do you do? So let's go through each step in the framework. First step is identifying the key issues and recognizing the challenges. So this is what you can say, you can say. OK, so I understand, I recognize that this is this is a difficult situation to be in. And I think there are a number of key issues that this situation raises. The key issues for me. Here are patient safety professionalism and potentially support for my colleague who may be going through something I don't yet know, do you see what I mean? Just like a line like that when you're saying key issues, patient safety is 99% of the time going to be a key issue. If you're not saying patient safety in it, you might miss the boat here. Ok. So patient safety is always really gonna be a big key issue. The only, the only scenario I remember where patient safety was not a direct key issue is the scenario and you'll read this in anybody or the green book where you leave confidential patient notes on a bus. And that's the scenario. How do you handle that? But in my answer to that, what I said was although not a direct key issue, patient safety here could still be compromised as you may have broken the trust between doctor and patient. And as a result that patient may be less likely to seek help from medical professionals in the future, you can say that if you want, I don't know, someone told me that it was a bit a bit over the top, but II liked it. I put it in there but I didn't get out that in the interview. So you know, take that with a pinch of salt challenges again, adding that in. So what are the challenges here? Putting the patient first, making sure you you're respectful with your colleague. Um patient safety. So making sure that um making sure the shift is covered, thinking about staying late versus your knowing, your tiredness can compromise patient safety. And then here I've also put plus minus, it is frustrating. And the reason I put plus minus is I think whether you want to say something like that is up to you, I always think it's nice in an interview to um to have a, a bit of a personal anecdote or a sign of humility or just something that makes you sound a little bit different from everyone else. And what I would say here is I know from personal experience that this can be a frustrating scenario to deal with, but it is important to consider patient safety and also that my colleague may be going through something that I'm not aware of. So I must make sure to stay calm and be respectful towards my colleague if you, if you get me. OK. So carrying on our example. So we've done the identifying the key issues. Now we'll go on to our spies. So first thing in spies is we're gonna seek information and this is a, this is, this stuff is actually pretty self explanatory and I don't think there's no like hard and fast, right, right and wrong for each scenario. Whereas like in the clinical scenarios that there are basically, but as long as you have a coup couple of reasonable points for each one, that would be fine. All right. So how, what would you seek information on here? Step one what is your colleague running late or are they absent? Give them a call. The other thing you could seek information on is what is actually going on in general surgery at that moment. So considering the urgency of the referrals and the ward patients and making sure that these, you've got a list prioritizing these patient safety. So you can say this I must, it's very important here to consider patient safety. If my colleague is late or the shift is not covered, this can compromise patient safety. Um On the other hand, if I stay late to try and cover my colleague, my tiredness may also lead to me making a mistake which can, which can also compromise patient safety. Next step in our spy algorithm. We've done S and P now we've got to I taking the initiative to contact the colleague. You, I mean, it's almost laughable how it's just just very obvious this bit, right? If you just call you call your colleague, um you could take the initiative to make a jobs list in the order of urgency and managing any emergencies. And you can make sure that you have all relevant information on any incoming referrals and then escalate. Who are you gonna tell your reg your consultant and the site manager? Why the site manager, your consultant may have, uh your colleague may have contacted them and if your colleague isn't coming, you need to get the site manager involved in regards to who's gonna cover that shift and in support. Uh I like to break down support. This is not something I learned from anyone else. This is just how I used to approach it where I would think about person X and then myself or whatever the situation was and then myself. So for the colleague support them by, is there a reason they're late? Is there something going on? Can you help for yourself? Speaking to friends and family? It's a frustrating situation being at work after you, you're meant to leave discussing it with your colleagues. And then reflecting again, I like to break this down into short and long term reflections. It was just my personal way of doing it short is you could reflect on how you manage the situation. Is there anything you could do differently? You could speak to trusted friends, colleagues, seniors to get their input on how you acted long term? Is this a recurring issue? Is this a problem in your department? Is there something going on with burnout and stress? Do we need a departmental teaching for it? Something like that? OK. So I hope that I hope that's clear. So what I would do for each scenario then is I would through the framework we did earlier on the slide and I would make sure they had an answer for everything that could come up. And we're gonna now talk about the leadership speech. So I have to say I think the leadership speech is a gift in this interview because you can prepare for it really well. And you know, you, you, the question that's ca came up last year was, was the one on the side. So reflect on your leadership, er, a, a reflect on your experience of leadership within a team or organization. How will this be useful as a core trainee? I think that's come up basically the last four or five years, but don't quote me on that just in case you get something different. But from my recollection, this is the thing that keeps coming up. What resources did I use? So Green book and Oliver Picard book, we've talked about the Oliver Picard book is fantastic. It's got lots of stuff on leadership. So it's well worth reading and um it will really help you for questions that could come up after your three minute speech about leadership, you know, things about good leadership, bad leadership, leadership stars, all that sort of stuff. Um You can read about in the Oliver Picard book and then finally, the Holy Grail of Resources for this is the R CS Surgical leadership document. Um This is fantastic. You just have to Google it. It's a PDF how I use. This is basically, I would come, I came up with my examples, you know, what my experience of leadership was. I um and what resulted from them and then I would use the R CF surgical leader document um to, to kind of, to what let me try and explain that again. Sorry for whatever my example of leadership was, my leadership qualities that I highlighted um were from the R CS Surgical Leadership document basically. So how would I suggest you approach the speech? So use the star method to structure your answer. OK. I think one of the uh the other big things to take away from this is every answer needs to have a framework and a structure behind it. So you don't end up just babbling basically, which can happen if you're nervous and you get asked a question, you don't really know. So the star method is the situation, task action result. It's a really nice way to structure your answers. Um Using the R CS document as I've said before. And then I use two leadership examples and I gave 2 to 3 reflections about leadership for each one. And I use a one clinical one nonclinical. That's what people had suggested. I don't think whether it matters, whether you use one clinical and both of them are clinical or not. I don't know. I think one clinical non, one nonclinical can show is a nice way of showing that you're well rounded. You've got nonclinical interests and then get the speech down and nailed to two minutes of 45 seconds or two minutes and 50 seconds. And it is because on the day you'll be more nervous, you'll trip over your words, you'll be a bit slower. So you need to have your speech timed to perfection. You don't want to finish at three minutes. And what you definitely don't want to happen is for the alarm to go off before you finish. That's a disaster. Ok. So really time your speech? Well, ok, so I want to kind of, I'm gonna kind of read my speech or not or give you an example. And on the slide, there is that same example. But in my sort of note format, in my star format that I then then turned into my proper speech monologue. So I'll give you the monologue, but on the slide is my notes. OK. So I'm just gonna give you the first half of my speech, which is this nonclinical example. So I started by saying strong leadership is a fundamental aspect to ensure safe and effective patient care. I'd like to give two examples of my leadership experience, one in the nonclinical and one in the clinical setting. I successfully gained the national leadership position as head of the surgical team for the online medical education organization by the bleep. My aims were to implement my vision for the organization and to utilize the strengths and qualities of my team members to work towards shared goals. I recruited new members, increasing the team from 14 to 30 people. I create an environment for my team members to to develop, launching new roles of responsibility within the organization and encouraging my team members to apply for them. I have formed relationships with those in the wider organization, pushing for collaboration between different teams to deliver new projects. Under my leadership, the surgical team has ran 11 new webinar series. We've expanded into multiple new areas with our resources receiving excellent feedback. Our viewership on the website has increased to 30,000 per month. Reflecting my experience, I've learned a couple of things to be a good leader. One must be task orientated, focusing on goals that are important recruiting team members, providing clear direction to achieve these a core trainee must also be able to focus on the task at hand, prioritize and delegate effectively. And at the same time, knowing when senior support is required, one of the most rewarding parts of my role is building strong working relationships with my team. My leadership style to facilitate this is being approachable and encouraging, seeking input from my team members and inspiring them to come forward with their ideas and suggestions. As a core surgical trainee, I want to be supportive of my colleagues, encouraging team based decision making. OK. So I, um so I hope that kind of spiel made sense. So this was this was kind of how I made my notes and then that was how I turned it into the sort of actual monologue. Um I've got a question if reflecting in your E PO portfolio, do you avoid giving details that could risk further to anonymization to your board. Human details that could risk identifying colleagues. Um I'm not quite sure what you're getting at. I wouldn't I, when you, when you are using examples, sorry doctor, I if you are using examples, I yeah, I wouldn't n name any names or the hospital or anything like that. Just keep it broad if you know my clinical example, I talked about being an F one on a care of the elderly ward. I didn't say I was an F one on this ward at North Park Hospital. I hope that answers your question, please. Um Tell me if it doesn't. Ok, final tips, make sure that on the day you have an optimum set up and plan this beforehand. You need a nice white background, you know, don't have anything in the back, make sure there's no noise, make sure you're in an area where there's good wifi. Um You know, if you're doing it at home, make sure no, you know, if you can ask no one else to be in, that would be ideal. You don't want to get distracted by any noise, talking door banging something like that. Dress smart so fully, you know, make sure you dress up properly for this interview, even though it's online, they're only gonna see this, this part of you, make sure you dress up, smile. Um This one's obvious but they're gonna make a decision. Oh, and they're going to, er, judge your score very early, very quickly. It doesn't take long to form a good impression. Equally. It doesn't take long to form a bad impression. So, smile, speak clearly, you know, look excited to be there, even though inside you're extremely nervous. Um, you know, fake it, try and do that. Next one. Do not assign sex gender to the nurse or the senior in the scenario. I put this in there cos I've seen it so many times. The nurse is not a she and the and your reg is not a he so just don't make that mistake basically. And when you're revising people with people, if any, you know, if people do this, let them know, you know, be, be friendly and make sure they know cos it's, it's, it's not a good mistake to make, I don't think, oh I missed one which was do not say the word obviously. And I put this in there because of a friend of mine who I won't name but who loved saying the word. Obviously, when they were answering these interview questions, they would say something. Obviously, this patient is unwell or obviously, I would do the following things and it's such a grating word. I mean, it's not obvious because you need to just be explicitly clear. So if you say I just don't think it comes across very well, if you end up saying obviously at, at the start of each sentence or before something that is clear. But you need to specifically say if that makes sense. So for example, do not say um obviously in this patient, I would start the seps 66, just say I would start the sepsis six. It's not obvious you're getting tested on whether you would do it or not. And then my last point is although it doesn't seem like it because there's so much competition and we all know how much of a nightmare getting a job is. Um You are in this together and it is so it is so much better revising with people revising with friends than it is doing it by yourself. I don't think you can do it by yourself. Um because you need to practice saying things out loud and I would say one of the best things I did was revise and do sessions with people who I actually didn't know very well. So I did a couple of courses. I think the Ace Medicine one and the Doctors Academy one and we'd form whatsapp groups between delegates and a course. And I, you know, I messaged on there or someone else messaged on there and just the two of us who didn't know each other would just sit for an hour one evening and do interview practice together. And that was fantastic because you, you know, you're not as comfortable as you are with your friend. You have to take it a bit more seriously and it, and for that reason, it kind of simulates the actual interview much better than if you're just doing it with your mate and you end up having a laugh. Cool. That is everything. Does anyone have any questions? Thank you for listening and sorry for the hiccup at the start. Yes. Um, ok, so, so I has asked, did you get follow up questions after your A two E I didn't, but I just kept going. So I think whatever they were gonna follow up on, I already said, er, so, you know, I had an upper gi bleed scenario. I went through my A two ei went through my investigations and I talked about getting them prepared for an O GDI. Think that follow up scenario was gonna be how you follow up questions were gonna be, how do you manage this? So I'd already said that, um, on another in. So I did the Northern Ireland and the rest of the UK interview. So for, so I had four, if you, you know, I had four clinical stations on three of them, I got through everything without them saying a word on one of them. I got like halfway through my A two E and then I got interrupted with questions and I think it's because I was doing my A two E. Well, I was doing my sort of rehearsed monologue so they knew I already, I could do the A two E so they were like, let's just move on to the next thing so that could happen. Anyone else goes, could we have dates for the next couple of sessions? Of course, er, Salma, the next one is on the second of February and I want to give you the dates for the ones after that, but I can't because we're still in the middle of trying to get them finalized with our speakers. I do apologize for that. But if you follow mind the bleep on basically anything Facebook, Twitter, Instagram, etcetera, they will pop up. OK? And the other things, we have a whatsapp group which um which you can join again through one of our social medias about core surgical training and it's got loads of people in and people will ask questions and the mo I'm one of the moderators, although I'm not very active on that. So, but there are some more active people who may be able to answer you, answer questions and I will try and answer any questions that come up on that as well. Uh So if you look at any of our social media pages, there should be a link to join that and we will make sure that these events are highlighted in those whatsapp groups. I'll give it another minute guys just cos I'm just because when I was at this stage, I had loads of questions. So if there is stuff, please feel free to ask me this is a good time now to ask any questions. Yes, they will, they will be recorded and they'll go on youtube. How many interviews did I have? I had two, two interviews for each of, uh, for each of them? Ok. Right. Oh, thank you very much. I'm glad it was useful. I do hopeful. Hope it was useful to everyone. I was coming kind of um, and eyeing about doing this particular session because it's not as sort of clear cut as some of the others where they'll go through specific scenarios with you. This one is just a bit more broad. So, thanks very much, guys. I would also appreciate if you could leave some feedback, it'll take a couple of minutes of your time. It would just be nice to have feedback for this event. So if you can do that, I would really, really appreciate it. So, um thank you, Farmer. Thank you Salma. Thank you. Ok, guys, I will um I'll close this. Perfect. Um Do the results actually go on all on to these couple? So is each c scenario five minutes? Yes. Do the resources you shared? Good at outlining how to structure your base cancer. Me, anybody is good at that. I uh I don't think the others are as good. I would also look at, oh, I'm sorry, you know, one of the things I've not mentioned is go on youtube and look and Google the mind and youtube, the mind the bleep page and watch the core surgical training interview, webinars from last year. OK. I, I'm biased cos obviously I'm a part of this organization, but I used those so much when I was revising. There's one on crisp where the, where our speaker goes through structuring your basic answer really nicely. And that's I used his template and his basic answer to then structure mine. So I would highly recommend those videos and you can find them youtube Mind the bleep course, surgical training, Suzanna. Thank you. II think we went to the same medical school. So I if that's you. Thank you very much and good luck on your interview. Ok, cool. I'm gonna sign off. Thanks everyone. Have a good rest of your evening. Good luck on your interviews and I will see you in the next sessions.