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I'll hand over to George Os who will kindly speak about the portfolio interview section. Um, and I'll type in all the rest of the answers just to save time. I'm so sorry for running over George. Um, how are you doing today? No worries at all. No, that was brilliant. And, uh, for everybody listening to your presentation, it was brilliant for me as well. Thank you for the years that I was applying. Uh a very detailed. Everybody needs to listen to what you said because literally the examiners, they do have 10 minutes. They do do not have more, they don't need more information than they once requested. Do not put extra information. Just put the, the one requested. Don't make it too complicated, put yourselves into their position and make sure if you were in a government, what you would like to hear 100% whenever you're ready. You're more than welcome to share your slides and we'll go from there. Fabulous. So, can you also see my presentation? Yeah. Fabulous. Ok. So, uh, morning everybody. Uh my name is George. I'm a General surgery, uh, registrar and clinical research fellow at Imperial College, London. Um, I'm going to take you through the new uh interview portfolio station uh which is new for everybody. Uh Since um 2024 the portfolio will be assessed um Before your interview, the examiners will have 10 minutes with your uh submitted evidence to go through it. So uh the CST recruitment, as we already said, has a dedicated portfolio interviews uh station uh which is part of the three stations of your interview. The this presentation is going to show you how to answer specific questions, uh how to structure them, uh what to say, what to meet and how to stand your, your during your interview. So, uh as you know, uh this is the first time that this station is introduced into uh an interview, especially after COVID before COVID. When it was a face to face interview, this uh the port of station was included and you will have to carry your own portfolio with multiple pages and the examiners were going through it in front of you. Nowadays, the examiners will have 10 minutes to go through your portfolio and ask questions for two of the domains. So the this year you do not have to self assess your portfolio. There were a lot of uh complaints the previous years regarding the self assessment because the self assessment uh it was the p practically, it was one of the indicators for you to get a CST uh interview with the M SRA included. Which wasn't very fair because a lot of people were uh underscoring or over scoring themselves. So as you can uh see on my screen, uh the M SRA uh accounts for 10% portfolio. The first station counts for 30 as well as the the other station. So M SRA is very important to get you to an interview. But after that, all the points are in the interview stations and portfolio interview and how you structure it and how you answer the question of your portfolio station counts 30%. So be extremely cautious about it. So uh the candidates will have to uh submit an index page. I'm pretty sure all of you applying this year will have seen the index pages and uh you have to score themselves based on the evidence you submitted A to D the uh uh it is very detailed on uh online when you apply. There is a an index page on how to fully submit it. Jono went through it uh in a lot of details. So I'm not going to go through it again. So the final score as we said are based on evidence quality and your interview answer. So be very, very cautious how you structure your questions, be calm, concentrate on your uh camera, smile, take deep breath. This is what they're going to say. They're going to see a colleague and they can trust for the next few years. So it is a te 10 minute review before you actually join them, they go through your portfolio and then a 10 minute interview uh with you guys, they will be choosing randomly two domains or two domains that either they are most impressive or they lack of quality and evidence. So they can uh critique you how you did it, why you did it, what you learned from it. So uh focus on key evidence. It's very important to um what you say to be evidence based. All your answers needs to be uh very specific and to the point, don't fuck around. Don't forget these people are either very senior trainees or consultants. They, the same day, they're gonna hear multiple uh trainees and you need to stand out, make yourself to look as the best candidate they've seen so far. It doesn't matter if you are first in the day, lasting day in the middle, make yourself stand out with how you say things and this is a key after a good preparation. So before I apply for course, surgical training, people used to tell me you need to know your portfolio inside out. Even though it wasn't a station when I applied, it's very important. Every detail you have in your portfolio, you need to know by heart, you need to know exact dates, the specific details, how long you deliver the teaching, even though they're not going to ask you these specific questions, but mentioning specific details make you stand out make them aware that you know what you're talking about, make them aware that you did it, you delivered it, you organize it, you were the lead in every step of your portfolio structure. Your answers, your answers needs to be prepared. The answers needs to have a specific structure. It doesn't matter if it's Star pro I will, will cover how you'll answer uh the portfolio Q questions uh the later stage, but make sure you have a structure. They don't want to hear disorganized answers. They're going to hear very specific, detailed and structured answer that they will cover them. Don't talk too much because you need to give them time to ask questions. At the end of the day, you have 10 minutes, pace yourself, take a deep breath and I'm pretty sure you will all do fine. So some of the questions from the past. So everybody, especially for course, training is very interested about your electives. Why did you want to go into that specific speciality? What's your long term plan? Where do you see yourself in 10 years? What, what did you learn from your elective? Did it give you motivation to apply for surgery? Did you go to theater? What did you learn in theater? What impressed you in theater? Did it change your mindset regarding surgery? What would you do different quality improvement project? Very important. They will ask you why you did this? What prompt you to perform the specific Q IP. What was the aim of you conducting the Q IP if you were the lead to it, if you were organizing and how you were, if you were the lead, how were you coordinating your team publication wise? You need to find the reason you did the publication. I know most of u most of us initially, our first publication was because we wanted the extra point for our applications. But this and say, I want uh I found this specific topic very interesting. Uh I worked in a specific team that uh we proved that this topic could change and uh the management of uh XYZ pathology and we're going to publish in the make aware the scientific community presentations. You need to let them know where you present, why you present that? Why did you attend a meeting in UK? Why did you attend a meeting in America? Why did you attend a meeting in Europe? Why this specific meeting? Was it, was it a meeting for junior doctors? Was it a meeting for uh general surgery? Was it a meeting for internal medicine? What kind of meeting it was? They need to know everything, just be detailed, making them aware why you did something specific? It gives an insight and gives them a target to score you higher. You didn't just go to a meeting because you were accepted that. But you targeted specific meetings to go and present. And of course, you need to tell them if it was an oral or positive presentation, teaching initiative, a lot of people ask about it. So teaching initiative and what is defined to work with uh local educators? A I guess they mean people from your own hospital. So you could say that you identified a gap in surgical teaching in uh cardiothoracic teaching in neurosurgical teaching. And you need to have a specific to a specific target group. Did you perform this teaching to medical students? You perform this teaching to foundation doctors. And you could say then I then II conducted the survey. I found out that uh there was a gap in the understanding of specific neurosurgical pathologies or uh general surgical pathologies. And we work with local educators and we organized uh 1012 or 15 weeks teaching which I conducted 456, 10 sessions with uh XYZ title and the rest of the sessions were delivered by my colleagues. But I was there making sure that a room was available or I conducted online and make sure that the link were sent to all the candidates before the actual day of the presentation. Everything was set up logbook wise. They may ask you how many cases have you performed? You need to know the exact number you can't say oh performed around 35 around 40 around 50. You need to be specific, you need to know your logic inside out how many cases did you perform uh in a general surgery rotation. How many surgeries you performed in the trauma and orthopedics rotation? What was the most cases you performed? And did you actually assist? Did you hold the camera? Did you observe from the side? They may ask a question, why be honest if you haven't performed a lot of surgeries yourself or you didn't assist in a lot of them be on, say it was um uh a registrar l uh teaching session uh with a consultant in theater or, and there were too many trainees, the, oh, I didn't have time to go to a lot of sessions, but I II was trying to go into my free time on my days off and there was always not when I was on call. So other trainees were prioritized, be honest to what you say, make sure you have evidence for every information you feed the examiners questions like what is an audit? I think all of you should know the definition, what is an audit. And as I was told in the past, make sure you understand what is noted before. You try to create a definition, make sure that and no de a auditing against standard guidelines. So you identify, you think you identify a problem and then you're auditing against standard guidelines. And this is the difference between a research and an audit. And noted also at the end of the first cycle needs to show that you could, that you identify the problem and that you're trying to resolve it at your second cycle. So you need to suggest a solution and this solution can be delivering a teaching session, creating a workflow which will be introducing your department. So the teams will be based the assessments on it. And then after a specific time frame, you're re auditing your practice against your set guidelines. Research, it's mm it's not against specific guidelines, not against specific standards. It's a new study trying to look something new and innovative. So structure your questions very, very specific to what you say. You cannot mix research and audit audit. As we said, it's against fixed standards and guidelines. Research is something new and innovative. Let's go to questions, exams. So commitment to surgery, as I already said, they will ask you, what were you doing that? Were you assisting? Were you holding a camera where you did you put some stas did you manage to do some dissection? You could say an example that of something that impressed you. I did a very difficult robotic case and I placed the ports and everything was really stuck. Uh a lot of adhesions intraoperatively or I came across um a dislocated hip and uh we spent uh two hours in the to try to relocate the patient was under a general anesthetic. Very challenging cases because of patient's comorbidities. Tell us something that really impressed you make something that is really sincere to all all the examples you you give to them. So what exams have you taken to ensure you get sufficient surgical exposure? So they want to see that you, you, you went the extra step. So you could say I was going there uh every day after I was finishing my ward round or I stayed after my normal shift in a normal weekday past five o'clock, I was staying, I was going to seaport, uh do uh an appendix. Uh find out if there is an ace for me to do with the supervision of a consultant or a registrar, I was going there during my weekends on my time off, on my days off, I was uh constantly trying to get as much experience as I as I could. I did uh I did placements. Um I was taking annual leave to uh go to theater. Um I did taste or taste in another speciality that was interesting with specifics placement in theater and clinic to get more and more experience, quality improvement for a clinical audit. I'm pretty sure this will be all of your questions. Um They want to know why did you pick the specific topic? And if you were the lead for your project, did you actually lead the project? Did you do, did you perform only the data collection? Um How did you co if you were the lead? How did you coordinate your team? How did you ensure the communication was sufficent? How did you make sure that you delegated the tasks as a lead, you need to delegate the task, make sure that everybody in your team is aware of their role, that everybody gets the feeling. They get something back. It's not only from the lead to get a letter from a consultant for the presentation, it's from the whole team to receive the benefits of the of the audit eight. Everybody needs to go and pretend get something back, learn from it and then advance to the for the audit. Even the people who do just the data collection need to progress. After that, you may as the lead, you need to make sure that everybody understands their roles and get something back, explain the audit cycle and how you applied in the project. You need to say that uh you identify specific standards. What were these standards? Where did I, did you identify them? Were they through specific surgical societies? Were they through uh nice guidelines standards? We identify that, let's say the imaging for early diagnosis of this condition. Uh it was not sufficient as per the nice guidelines. So we made sure we created a flow chart. Uh We delivered Friday morning teaching. So everybody was aware uh of the uh problem and the flow chart was uh introduced uh as part of our clerking approach to patients. And we re audited our practice in three months, six months time. And we found out that we have improved our practice. The imaging techniques we use was increased to increased by 5% and we will continue uh with the same flow or delivering the same teaching sessions to our colleagues and the new fy doctors coming into our department. So everybody is aware about it. So this has increased. Uh This has decreased the patients waiting uh for the proper treatment and this has improved facing care. Tell us about what the time your project did not go as expected. How did you address the challenges? So as a lead for a clinical audit or Q IP, you'll come across difficulties and these, these difficulties will be not, everybody will uh do the data collection as appropriate. Uh There will be questions as a lead, you need to be able to address them. You could say that uh II set up a whatsapp uh group. Everybody I was always available on my phone or face to face to address uh the concerns, the questions I went through with my colleagues uh with all the necessary requirements for the data collection or the presentations we had to do to deliver this project. I was in constant communication with a consultant uh supervising this project, asking questions that I wasn't sure and I was uh giving feedback to the rest of my oh to the rest of my team. I was the delegating the task appropriate based on everybody's capabilities and I made sure everybody was satisfied at the end of the project what are the key elements of a successful Q IP? The key elements of the successful Q IP is you identify a problem and at the end of the project, you need to show improvement. So you need to show that I identify a problem. I audited against specific standards. I introduced a solution, a proposed solution. And these after a specific time frame manage to improve patients care because patient should be at the center and patient center should be at the center of your thinking. You do, you do this to improve patients care, research and presentations. What were the finest? And why did they contribute to the field? This is what I was saying before. So why did, why did you do this? Why, why were you involved in a research project? Because you wanted to come to the, you thought that you want to improve patients care, you were involved into a research project uh that there are no specific standards against it. Uh You had to start it from the beginning. You ha you had to start from scratch and that's one of the main challenges you will face conducting research. How did you face, how did you overcome this? You could say I did a literature review, I did a systematic review and out what is of uh what it is published. I had regular meetings with my supervisor, with my colleagues trying to uh identify the actual problem and how we can um address it. I had regular meetings with uh specialized colleagues in the field. We worked all together for it, research methodology and analysis. What exactly did you do? How, what was your inclusion and exclusion criteria? Where did you find your data? Uh What was the general idea that you want to inform? And how did you do your analysis? Did you um did you conduct a statistician? Did you do the analysis yourself? What uh type of um software you used if you haven't done it before? Just be sincere, say, I wasn't aware of how to do it. I conducted colleagues who have done it before I conducted statistician. I went through, attended courses and learned how to do it. What do you believe is the important of research and surgical training. Research drives evolution drives improvement in patients care. Everybody needs to be involved in research, everybody needs to improve the well known standards as we know them because this is how we improve care for our patients teaching experience. What methods did you use to engage your audience? So you could say uh I conducted the survey uh uh with my local colleagues, uh colleagues and we found out there is a XYZ problem in the surgical teaching. So uh we organized the testing based on their needs. And how did you approach this? You could say either it is online or face to face. Uh If it was a face to face that you made sure there is always a room available specific time you were communicated via email or via whatsapp group, um or Facebook, Instagram, whatever social media you use that everybody was aware about the where the teaching takes place. What was the topic? How many people are going to present? Talk about your feedback. Feedback is important even though it's negative, even though not everybody got what they wanted. Tell that, oh, we covered most of the people's needs. We got excellent feedback for a few colleagues. Uh A lot of colleagues didn't find it satisfying or they didn't get whatever they want from the session. So we uh II made sure that I addressed this specific feedback. I made sure that we delivered more detailed session the next time. How did you improve it teaching experience? You say I took uh its feedback um uh and read it carefully. I tried to improve based on the feedback I received what exactly I had to do pace my teaching. Uh May uh add more pictures, more example, more, more case studies in my teaching. So everybody is aware what I'm talking about depending of the level of uh surgical exposure. What do you think that makes an effective teacher and surgical teaching? Uh You need to say that you always have to adapt based on your audience. Different kind of presentation will be delivered in medical student foundation, doctors, co trainees and registrars. So you always have to adapt. You always have to gauge how much response the these people are to your teaching. So these are the structures. Uh as I said, Star Prom and Iran, there are different type of structures you need to use, irrespective of what you use. Make sure you, you know what you are talking about, make sure there is a flow. Don't, don't, don't have a disorganized talk. This is very important. The day of your presentation practice with colleagues, practice with your family practice, with practice with consultants practice is what it matters before your interview. So a is a very sufficient method. This is what I used during my interview. Uh You can briefly describe uh the context of um your uh elective or your placement, what you learned about it. Uh What was the role that you did those specific days? You could say I was attending the teaching, I was assisting in future. I was doing the ward round and then assisting in future. And then I was attending the teaching the the clinic in the afternoon. How did you do this? You could say that I was following a consultant during the morning ward round. Uh I was making sure con um uh consulting the patient with the registrar or with the consultant and then make sure that I was informing the anesthetic colleagues uh that the patient was ready. I was attending the uh um theater, make sure that the patient is ready. I was going through the who tech list uh for preop interop and POSTOP. After the operation, I was going to talk to the patient explain how the procedure go and discharge them. Afterwards, I went to clinic. Uh I went to an upper G clinic or colorectal clinic or um the wrist orthopedic clinic. I learned this and the other at the end of my place in and I learned about this specific speciality which changed my mindset. And in the future, I would like to apply for it, reflect what you learned, how you developed and how the specific placement improved you, why you did an audit and how you did your research. So state why you did it? You identified the problem? You thought there is uh a lack in patients care, you specify your role. What did you do exactly? Did you lead it? Did you design it? Did you do the data collection? Did you do the analysis? Did you do all? Did you coordinate? How did you coordinate? How did you speak with your colleagues? How did you delegate the tasks describing methado? Make sure you're specific about it? Inclusion exclusion criteria. Uh Why did you exclude some of your patients? How do you think that the methodology will impact? Was it a prospective, a retrospective study? What's the difference retrospective are, is when you look in the back perspectives, when you have a specific set point and you started collecting in the future, you, you need to have a specific time frame for rate study to complete it. Main finding, summarize your main findings. What was the significance of it, what you learned from it? So the other uh the other uh methodology where you can follow uh is I Mr with your introduction methods, results and discussion. This is actually how we write a paper. So you can follow this, you can briefly state the your research question is what was the problem is? What was your methodology summarize the main findings and what you learned from it? And what was uh the if you could manage to uh solve the problem of further research needs in the area? And what you're planning to do with this piece of paper? Are you planning to publish it? Are you planning to present it? What's the next step and teaching initiative again? Star what was the situation? What you learned from it? What you did? I think I went through it uh previously. But this is a, a very good example. I will give you uh 30 seconds to go through quickly. It just says how you did it. Um I was, I noticed a gap in the medical students of of foundation doctor in this department or this medical school that I was teaching in at my local hospital. Then I discussed with local colleagues, what we want to do and cover this gap. We created a face to face or online teaching sessions uh twice weekly. Or once weekly at after five o'clock when everybody could attend. Um the teaching was conducted based on uh medical students needs and what they want to hear it was based, it wasn't long teaching. So uh everybody was overwhelmed after a long day. And so uh finally, uh success in your portfolio station depends on your preparation, be honest and be clear to what you say. There are a lot of resources asset, these events we do. Um uh I would would at any point if you go and practice before your interview, my personal will be more than happy to help you. Uh drop me an email and I will post my email into the group. Uh speak with your colleagues, speak with your consultants and practice. Practice, practice. That's the only solution to success. Thank you. Wow. Thank you so much for going through that. I cannot hear you. Sorry. No, I can't just give me a second.