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Hello and welcome to uh interview skills masterclass. My name is Mara Batty. I'm a consultant cardiac surgeon and a council member and trustee, the College of Surgeons of England. It's my real pleasure to welcome you all to this interview Skills Masterclass. It's fantastic to see so many of you who are interested in embarking on a career in surgery. Tonight, we're focusing on the interview section, not the rest of the process, but we will put the website uh with all the details of the actual recruitment process in the chat for you. There's some key dates that I'd really like you to remember the invitations to interview, start coming out on Thursday the eighth of February and the interview dates you really must keep this window clear, er, begin on the Monday, the ninth of Feb and run on until Wednesday, the 28th of February. As I said, the process is on the website already in the NHS England and I'm gonna say a little bit about the interview, but again, the information is all on the website, the interview format uh will be online as you're aware and there are 2 10 minute sessions, one focusing on management and ethics. The other, which will include a presentation, some questions and a management scenario and then a 10 minute clinical station which include 25 minute sessions each. As you know, we're focusing on the interview here and we're really lucky to have a number of experts from across the UK who are going to share their thoughts and their expertise. So without further ado, it's my pleasure to hand over to Mr Shabaz Malik, who's a consultant orthopedic surgeon. He's on call. So thank you for your time and he may have to scoot up. He's also the TPD for co surgical training in the West. So I'm going to hand over to Mr Bannock. Thank you. Thank you, prof um I hope every, everyone can hear me clearly. So, um again, congratulations to um everyone uh for putting this event together. Um It's pretty daunting when uh be you mentioned 700 plus delegates listening to this. So, um you know, well done to all of you for making the effort. And I remember going back to when I was uh you know, signing up for these kind of events and I was told that if you turn out to any of these events, you will always be a step ahead compared to your peers. So I'm sure you will pick up useful tips and it's great to have so many speakers joining this event. So as prof about to introduce, I'm Shabaz Malik I'm a consultant orthopedic surgeon with interest in shoulders, elbows and knees. And I'm based in Worcester Royal Hospital and currently in Deb two of my own call and still standing. Um, I'm in a CPD uh for the last uh couple of years and uh my job role is pretty much holding the portfolio for education along with my other uh partner. Uh So there's a dual role and uh we here at the West Midlands, which is a specialty I hope you would be choosing as your number one choice. Uh run a very good educational program and run lots of free courses for our, for our core trainees. Um So my job is to take you through some scenarios uh based on my experience and interviewing a number of candidates over the last couple of years. So next slide please sean. So I want to just set the scene. Um I think it's quite important to ensure that nowadays the interviews have changed from face to face to being um online. Uh Even the consultant in interviews are taking place online from across the globe, from, from, from those who are doing fellowships. So it's important to have a um a a environment which is conducive to your um interviews. Uh next slide, please. So here's an example of my room when I gave my first uh online interview and probably the only one so far. Um And most of it has been teaching now, but this is a room in Perth. I pinched the keys from my fellowship director to go and give the interview in a open wide room with lots of lighting and obviously drop in that. I'm in a nice place to the interviewee, uh interviewers. Um to ensure that, you know, there's uh good internet access. Uh There's uh, lots of light and every, everyone can see me clearly, everyone can hear me uh clearly and uh the things I went and did uh above and beyond other than just turning up on the day to make sure I practice with another friend of mine on the same platform that I was using for the interview to ensure there was no trouble even just before signing up for this uh talk. I, you know, made sure that my presentation was up and running. II could be heard. And these are some of the basic things that I think you need to make sure that you nip in the bud. It is a simple thing. But if you're not in the right place, poor network, your computer is not working, the battery is dead. It can just lead to problems and more stress when you are already under a lot of pressure. Next slide, please. The other thing is that you're in a stressful situation. It's important to remember to smile. This is me trying to scuba dive, having never done it and never even entertained the idea. I've never left the swimming pool more than 2 m height. So jumping into Indian Ocean was quite scary. But whether it was a nervous smile or a smile with enthusiasm. Next slightly, when I did look at what I was about to do, it was pretty daunting and quite well scary, so to speak. And I'm sure we'll all go through those emotions, but having a smile, having a calm face with everything exploding inside you. Is this still still a good way of conducting uh uh through stressful situations. Next slide? This, so for me, this is one of the two posts that II had in university. One is this one and II really like this, this quote very much because all the things that we do in life are ha are happening or happened because we are preparing for them and we do a lot of prep behind the scenes. So for you starting now. Well, no, actually, now you've been doing it since your G CSE S, you've been preparing hard for this career. You've been doing your exams. This is something you are so used to and same with surgery or any discipline within uh medicine you have to prepare before the actual event. Now that is interviews, that's exams, that's surge surgeries. Even I up to now prepare for cer certain operations beforehand. And I always think about the steps and I do all the homework and I discuss beforehand. And as what some of my uh most of my colleagues would do um so that we are prepared on the day for all eventualities. And that's where all your training is based. Not now, not on the day. And likewise, you know, for us preparing for anything we do it beforehand. So when you're on the stage, you're ready next slide, please. So do pro far has already alluded to the format briefly and I'm going to run through, there will be some repetition. There is no harm in repeating ourselves because those who you are attending late and those who may not be uh listening attentively. So it will help you just uh uh pick up all these points by, by repetition. So there's 10 minutes per station. Uh time will start one, the uh admin staff from the NHS England uh will confirm that you're the right candidate and take you to the interview room and you will be told that interval of 5, 10 and 15 minutes move on to the next section and then you will release promptly and we'll go on to the next um a candidate. Next slide, please. Again, just reiterating what uh A prof said here that your two stations, one is management 10 minutes per station leadership presentation is three minutes followed by Q and A for two minutes. We won't disturb you and your presentation time starts when your presentation starts. Station two is 10 minutes. Again, two clinical scenarios which I'll talk about now and they are five minutes each. Ok. I'm not sure why that come out blank if you go to the next one. So here's an example of a scenario. Um, you are, um, been given a pre uh a case of a 68 year old female with a fracture of the tibia. It doesn't matter the configuration of it. In this case, it's oblique and she's been having pain for the last 3 to 4 hours and the pain is getting worse. Um You've been asked to see the patient because there is uh well reduced sensation and the foot feels cold. So how would you manage this patient? So I want you to just take a moment to read this and take it in and think about the possibilities of differential diagnosis that you're going to encounter on in a scenario like this. And this is very typical scenario um in orthopedic ward, uh shall I say, and if you take away the fracture part of it, then you probably will see this on a vascular ward or, or any other ward next slide, please. So I wanna take you back to this thing called persons uh specification something that I didn't quite appreciate at the time. But this is something that uh it'll be worthwhile spending time looking through it. This is what we assess you on all the criteria for il on it. The entry criteria who was shortlisted long listed, short listed and then how we assess different elements of it. And this goes on for your registrar numbers and your consultant numbers, um consultant posts as well next slide based. So I want to draw your attention and you can, you can easily search this for those of you who may not come across it or may have seen it. Um But briefly, you can go to the um the oral website and look for the person's specification for any job uh for co surgical, medical or any other subspecialty. So what we will be testing in the interviews is your clinical skills knowledge and expertise. And we do that uh partly with the application, partly with the interview. And we are looking at the ability to apply sound clinical knowledge and judgment to problems, um recognition of and ability to undertake the initial management of an acutely ill patient. Someone like I presented earlier next slide. And again, um I've, I've just pasted a big page on it, but this is looking at your personal skills. So we will be judging your uh communication skills, problem solving and decision making, empathy and uh sensitivity, managing and uh team involvement and organization and planning. So these are the things we are testing in your applications and in your interviews. Next slide, please. So, coming back to this clinical scenario, 68 year old female with this fracture, complaining of severe pain uh for the last few hours with the co cold foot and reduced sensation. Um how do we expect you to manage this patient? Well, um we want you to be able to show that you will assess the patient and the limb, not just the limb, we want you to be able to pick up that this fracture has significance. And I will go in detail later on. Um you should be, you should be able to tell us who are you going to involve in the care of this patient? Further management? OK. Cause there will be a number of different people who need to be involved. And as you get more experienced, you will need to be able to decide what is urgent and what, what is emergent. One of the things that I was taught earlier doing my own call in my foundation training. And was that in order before you get really overwhelmed by a number of phone calls that you uh referrals that you get, decide what is urgent, what is emergent and what can wait. And that's one of the skills you will get good at. And this is what we do as consultants, we pick the patients that need the attention the most and then go through in order of in in a way of triaging in a way of least priority. So the next slide please. So we hope that you would approach this patient in a to E format. You will recognize this is a an ischemic limb or will be an ischemic limb. If you don't act quickly. You will show that you will. After the A two E approach, we will look at the leg uh assess the pulses. You may want to use the Doppler, you're worried about compartment syndrome. And the fact that there is a fracture will lead to bleeding and these can bleed significantly. And because it's a tight compartment, the there's no way for blood to uh go, the compartment pressure increases, which will then uh lead to a compartment syndrome. Um And you can throw in to show your knowledge that there are four compartments. You don't need to tell us what they are if you don't know. And the fact that this patient needs urgent or emergency surgery, in this case for a fixation of a fracture plus or minus fasciotomy, that is not for you to decide. But that is something that you are thinking about straight away. So you need to tell the seniors your registrar who will escalate to the consultant. Um You need to let the theater team, the CBO team know you need to know, you need to inform the anesthetist and in some places, the plastic surgeon may need to be involved because these patients often require a graft if we cannot close the wound uh later on. So you do need to let all the parties involved and that you need to demonstrate that you understand that uh next slide, please. Ok. What some of you will end up doing that those who haven't practiced unfortunately. But what we don't want you to do is jump straight to the leg and start looking through the leg and start examining the leg and start reaching a conclusion without looking at the rest of the patient. Because the patients need resuscitation, you know, the leg needs surgery, but the patient needs resuscitation. You need to be able to make the patient optimize them for the, they may need grip and save. They may need, uh, the kidneys may be going down, the, the, the, the kidney function may be going down. Um, they need hydration, they need pain relief, um, that you need to look at what medication they're on, how they call me, call morbid state because the anesthetist may not be the person who's already aware of the patient. Even though the patient is listed for surgery the following day may be ac uh, anesthetist who needs to know more about the patient and be ready, um, to, um, well, do further, well, ask for further investigations or, um, to, uh, discuss whether they seen as if it's a registrar. You also need to let your registrar know or the consultant and, uh, what we don't want you to come across is not knowing your options. We want you to be able to tell what are the different options. We don't expect you to know how to do them or you should be able to verbalize them and you shouldn't just say uh more analgesia and more analgesia because that's how you would miss compartment syndrome by just trying to manage their pain but not actually treating it the underlying cause for it. So these other way kind of red flags of a no, no what we what we uh uh don't want you to do in the interview and in real life, of course, um Next slide please. So that's one scenario. So this is I'm just going to leave this scenario here. So this is another patient, 85 year old, uh 85 year old male, five days, POSTOP hemiarthroplasty for a fracture, neck of feur. You can tell I'm an Ortho part because I'm only bringing in fractures and is complaining of shortness of breath uh with tachycardia and a 5 L of oxygen. How would you manage this patient? Now, take a deep breath, read the question again and think of what, what is the first thing that comes to your head? Now, imagine a non orthopod and change that to a hemicolectomy for a colon. Ca exactly the same scenario. Five days complaining of shortness of breath like guarding and five oxygen. How would you manage these patients? So, things that should be going through everyone's head in not any specific order is, is it chest infection? Is it pulmonary embolism? Cause? That's the first thing that I'm thinking of. But if you think of chest infection, yes, but your pe should be there, Taia, yes, but not so much. They need 5 L of oxygen. But this is a classic patient, 345 days down the road bedbound and may have other risk factors. But that's what we would expect you to start thinking about. So we want you to be able to apply the sound knowledge and judgment to this problem. Uh If this is the patient who's going off on the ward, then you need to prioritize this patient based on the clinical findings, um you need to be able to undertake the initial management because this patient is unwell. So that may require getting an ABG making sure this patient is non non breathable mask with high flow oxygen. Um starting on um treatment dose of Clexane while you get urgent C TPA or getting further help from medical colleagues. If you need to, what we don't want you to do is jump to the other side of things and not doing the very basic assessment of A to e next slide, please. Um And the next one, please. So I'm gonna, I'm gonna leave those clinical scenarios there for you to think about because you're unwell patient and you've been doing this for the last couple of years or if you've taken a year out and you've been loing or you've been doing something different, you've been managing these patients. So there's nothing new that you would be saying in reality. So I'm going to finish off with a couple of slides of saying to you that surgery is, is, is a graft is hard work. There's nothing magical about succeeding in surgery. It doesn't matter who you are. It doesn't matter what gender you are, how tall, small, short white, what background religion you are. Anyone can be a surgeon. As long as you are hardworking, you're determined, you're dedicated and you've got perseverance. I've got an F one who started earlier last year, within a week, volunteered to come into theater because they were already kind of surgical minded and put their hands up while their colleagues were happy for them to go. And they came in and assisted in theater. Within the first week, I had enough two in the last couple of weeks who decided while doing their surgical rotation that they wanted to know more about orthopedics and on their own back, on their own days off at the weekend while they were doing twilight during daytime, they came in and explored what orthopedics was about and I made sure that they've got a good taste of it um so that they can take it back and convince them to do orthopedics. And likewise, if you feel there is a surgical specialty that you're interested in, you should go and taste it and persevere and speak to colleagues and should be able to do that. So there is nothing, nothing magical about being a surgeon other than these few tapes that I've said next slide please. And this is another favorite quote of mine. I mean, at the end, when you see someone senior, when I was a foundation year doctor and I was seeing someone close to retirement, everything was just everything just so majestic. It just flowed, it happened, it was just effortless. And my day one of consultant was awful, terrible. It took me ages to do the same case I did yesterday as a fellow and it took forever and I just felt I could never do this again. And I have I picked the right specialty. Am I the right person imposter syndrome? And a few years down the line, I'm still feeling the same, but I am getting better at it. I am getting good at it because you know what I'm doing the same thing. The staff know me, the ans know me. Um everyone knows me and I know them and it's becoming a routine, it's becoming a habit and I'm getting good at it and that's exactly what we are as surgeons, as an athlete. Ronaldo Messi, your whatever your team is, formula one, we are just practicing this thing for years and years and we be you're just becoming excellent just by just repeatedly doing what we do um uh neck slightly. And this is my second, my second poster poster on the wall that I had in medical school. Not this particular one because I have to be careful. Now what you choose from Google because um you can get done if you, if you take a stock image and don't reference it. So I ended up taking my own picture. This is again from Perth um almost perfect. I love this picture. I took this picture. Um um and this was around the time of pandemic with mayhem all around the world, but it seemed like a perfect evening with the sunset and the boat and this er bird flying around. Um and, and, and if today was perfect, there would be no need for tomorrow. It, it reassures me that there is a need for tomorrow because my day just was short of being just perfect day. So maybe tomorrow uh I'll, I'll do better and II wanna say this because not all of you will be successful. Some of you will need second attempt and there's nothing wrong with that failure doesn't define uh who you are. It kind of describes who you are. Ok. So if some of you are not successful, you shouldn't give up on the dream. You should try harder, you should be prepared. Um You know, you should prepare more. Maybe you were unlucky for whatever reason. Maybe the question was difficult to understand. Maybe you didn't get enough points. That is not to say you cannot come and try it again. Ok. So do not be worried if you're not shortlisted, do not be worried if your interview doesn't go but make sure you give it everything and do your best. And if at the end of the day, it doesn't happen, don't be put off, come and try again. We want you to try it. We want, if you've got passion, if you've got a dream, we want you to come and apply for it and be our colleagues next slide this. So I hope that was useful. I just kept it very simple with those scenarios because that's the kind of situation you will come across. You can practice this um with your colleagues practice with your CT S co trainees. Um They've been through this and your registrars and they will talk you through and give you a bit of practice. But the main thing is, which is down to all of you is practicing yourself. This is uh different ways of getting in touch. Um Please please do get in touch. Um I will reply to your email because I do get, you know, 1020 emails um in a day. So I will reply to you if you've got any questions, even if it's not straight away. But um welcome for attending and thank you uh to my faculty colleagues um for, for putting it together and Becky at the Royal College. Um I hope it was useful. Thank you so much Mr Mali for that really interesting talk, not just about clinical scenarios but also the wisdom along the way. Um I guess um paraphrasing Aristotle's practice makes perfect, isn't it? And on the day be the best you can. And that's why you're attending sessions like this. And we're lucky enough to um, be able to hold these sessions do your best. You cannot do ask any more of yourself. So, thank you very much. II, as I said, Mr MAOs on call, so he is going to have to leave us at some point. So I don't know if there were any specific questions for uh Mr Mali in the chat. I've not seen any, um, oh, somebody's asked about how to end the interview. Um I'm guessing you're sort of guided um to the end by the interviews, sort of making it known that you've come to the end. Any, any comments for that question, please. Um Yeah, I mean, that's a fair, fair, fair question. Um To be honest, inter interview comes to a national end by the time you've answered all the questions and that you're always saved by the bell most of the time. So, you know, if you answered everything, um then yeah, it will come to a national end and, and the, the interviewer will say thank you. Um, or may I ask you if there's anything else you wish to add? And that'll be that five minutes is not a very long time and you will, you will know you won't even know it's gone. So, yeah, you don't need to worry about that. Thanks very much. I'll try, I'll try to go through, I'll try to go through the comments quickly and see if I can reply to it while you move on to your next talk. But thank you for having me again. Pleasure to have you and thank you for being generous. We're sharing your um these contact details as well. So hopefully you won't be mobbed too much by um colleagues now. Um It's my pleasure to move on to the next two speakers. Um It's a, a real personal pleasure to introduce to you, Miss Lily Cooper, who's a post t plastic surgeon based in London and Miss Catherine Ford, who's also post CT pediatric surgeon currently at G OS. And the reason I'm particularly pleased that they're here is they are the architects of this event. They set it up, I think in 2012, having gone through the process and really wanted to share with colleagues and it's gone from strength to strength and they're going to tell us all about tips for online interviewing and um optimizing performance skills. So, over to you, cat and Lily, I can't hear you cat. So just while cat's connecting to her audio, I will start just by introducing ourselves. So as far as said, we are both now post CCT um and both trained in London and really have noticed that particularly when we were starting out, there was very little support for um foundation into co er and cat and I felt very passionate about this and we set up initially three initiatives, two of which are still running today. Um So the aim for this interview skills competition was er, sorry, er, interview skills masterclass was to have something that was open for everyone that was free. And we're so pleased um with how it's developed over the years and particularly Becky's idea of having this as a, a freely accessible lecture event, er, which has meant that so many more people can attend. And it's amazing the number of you who are here tonight say welcome. Um And you'll hear more about the workshop sessions which we'll be running um preview as well. Cat jump in whenever you're ready, just talk over me. So this talk is in two sections. Um K will be taking over in the first half and I'll be delivering the second half and we will be first of all talking about an approach to online interview. Now, some of this will repeat the last talk a little bit, but it's just generic interview tips. And we're conscious that a lot of you are already pretty familiar now with online interviews, but in case there's anything that you can glean, we'll just whip through a few of the basics around that. And then in the second half, I will be talking a bit about performance. So in addition to being post CT in plastics, I'm also a life coach and I'm really interested in what we know from professional sport, professional music and the performing arts in terms of supporting performance generally and how that can apply to surgeons. So I'll be talking a bit about that in a second bit in case that can support you too. So we've divided this talk into personal and technical before the morning of Good for it. Um Thank you Lily for standing in. Um So as Lily said, which I've missed some of we're going through the interview for sort of personal tips and tricks and then technical. Um so before the interview, I don't know where you got up to Lily with the slide, but I'll start at the beginning. Um We need, we all need to approach interviews like it's an exam in a way and that's how I, how I've always been taught and how I've approached interviews. Um because you feel the most prepared having sat and thought about your answers at home quietly and talking with colleagues, et cetera. Um So somewhere to start is know your CV, back to front inside out and have prepared examples um with which you can um summarize your audit for example. Um And, and be able to give examples about what your best one is and why um we've already been through the exact um stations of the, of the interview, but, and we'll be having talks this evening for um the management and ethics side of things and you've already had the talk on clinical scenarios. So we won't go into that in more detail. Now, um it's already been alluded to that, the best part of practice is also to learn what you can from others. So that's both those that have gone through it recently, but also more senior colleagues who have gone through registrar interviews, for example, and also consultant colleagues. Um and it can't be said enough that we need to practice practice, practice. So that on the day of the interview, things just roll off your back and you appear really prepared. Um And as part of your prep, please book your study leave. Um It doesn't, it doesn't look good. If you're uh mid ward round, you're jotting off the interview quickly and you're frantic and you're in a corridor next side, please. 66. Um So again, we're all old hats really at um doing online interviews, courses, et cetera. But some things we picked up along the way, obviously don't wear your pajamas, even if it's tempting to wear your shirt and your pajamas on your bottom half, just don't do it. Um Same rules for real life, nothing sheer, nothing see through. And there's a few tips here about what, what certain um patterns look like on screen. So stripes, for example, can sometimes blur um and certain colors don't look as good as others, but essentially keep your clothes plain smart just as you would um in real life and plan these in advance. Um The technical set up again is it's, it's straightforward and, and, and common sense, but think about your internet strength, think about where in your house you've got the best connectivity um and have a contingency plan. If your um connection drops out, think about what device you're going to use. Does it work? Um What's the sound quality like? And it may be worth also if you've got a busy household with, you know, dependent Children, et cetera, book a slot in your household diary for a quiet time so that the house is as undisturbed as possible. Um And also try and familiarize yourself with the program slash platform that the interview is using. So it's the platform that the interview use is something that we were not familiar familiar with and we were looking at the interview process ahead of tonight's preparations. So it's worth downloading in advance practicing logging on if possible or at least making yourself familiar with where the various mute, et cetera camera buttons are before the actual interview, if, if that's possible. Um Thinking about your real life setting is really important. So for this interview again, there are instructions that you have to show your um camera to the room before the interview starts. So don't just tidy the immediate space around you, you should make sure your whole room is tidy. Um Because you're gonna have to show it to the interview panel before you start. So have your neutral tidy space prepared, remove those incriminating photos or embarrassing objects. Um And also we would say don't bother with a novel background. Nobody really wants to see a, a moving sea Seascape behind you. It's really distracting. So just have something that's plain um and not novel and we've already had some, some thoughts about lighting but just be aware of sitting in front of a window um as another warning cos that can er fade your profile out. Um So now moving to the day of said interview, um again, strongly advise you to have a day off work. Um Pretend you were going to it in, in, in in real time. Um Get yourself as smart and professional as possible, do your ablutions. So you're not distracted again, mid interview and think about your your environment delay deliveries. Um Turn you off your washing machine, your dishwasher, just have things as quiet and professional as possible. Think again about your technical set up in advance. So get yourself seated down, seated down, sorry, a good 30 minutes before you're due to start your interview, ensure your connectivity um as as good and as fast as possible. Have a drink close by and double check. You've got all the documents and checks that you need to provide the interviewers at the start of interview, have your charger plugged in and think about your camera position um in that you don't want it coming in too high or coming in too low. No one wants to see up your nostrils or at your double chin. Um So have yourself aiming to look directly at the camera and then during the into itself, Lily will talk in a bit more detail shortly about um ensuring you have the best presence personally as possible. But briefly, to mention it's really important even though things are online that you use non verbal interactive cues, again, pretending it's as in a real life scenario as possible, have quite pregnant pauses. So allow the interviewers time to finish, allow yourself time when you finish before the next statement is made to avoid repe, avoid repetitions and fade outs and if possible hide your the camera screen of yourself so that you're not tempted to look at it um during the interview and just focus on the interviewer faces and not your own. Also be really tempted not to have your paper notes either on the screen or physically in front of you. Cos it's really obvious if you're referring to something when you're delivering an answer and it's so important, you're as natural as possible. Um And the final point is the the technical things during the interview. So just it's, it's the most sort of salient point really we wanted to hammer through today is just to follow the instructions and be natural. Um You could use the mute button when you're not being asked to speak, but be mindful, you know where the button is and how to activate it, deactivate it quickly. Um Have your phone available in case you need to troubleshoot tech with anyone um and have a have a game plan if an unexpected event happens, um these things do happen, it's fine. Just be professional. If something happens, apologize and then carry on as normal. So in summary, um be yourself, be prepared, be professional. Leave lots of pauses, take your time and don't rush when answering the questions and have a contingency for the unexpected. Um Cos something will happen, just be prepared for it and respond naturally. Thanks Lily, I'll hand over to you. Great. So you've done all your prep, you've set up your technical bit. What do you have when you start your interview and you sit down, well, you have three things, your knowledge. So that is all the facts you've learned, but it's also your surgical experience, your technique. So this is your presentation, your patter, the types of answers that you have prepared. So I'm sure you've all got that book um which in our day had a white front with all the colored squares on and you will have learnt lots of patterns of how to answer certain scenarios and have certain um examples of those. And then you have this third bit, which is basically your ability to string it together, your ability to access your executive function and judgment, access those facts, get your points across and have the impact that you want to have. However, the way we tend to prepare for interviews and also exams, by the way, like the like the Fr CS looks more like this, we spend a huge amount of time on facts, a bit of time on templates and most people don't even think about their mindset, managing their autonomic state, their impact, which looks very disproportionate to me. So this is just a nod to a few aspects that you might want to think about. And we both cat and I will leave our contact details, very happy to talk more about them. So your total score looks like this. There's the test, there's your evidence, so your portfolio evidence and then there's the interview, the interview is really important. And as you know, it is a face to face remote interview when you look at the scores, which are all out of six for each of these sections, presentation skills, judgment, communication, prioritization, working under pressure are really heavily weighted. These are all to do with mindset and impact. So a few points, we you have a limited quantity of attention. People talk about bandwidth. This is why we talk about paying attention because we only have a certain amount. It's like you have a wallet full of money and you get to choose what you're going to pay your attention to. The first thing is to maximize your budget, your budget can be eaten away. If your brain isn't working properly because you haven't slept enough, you haven't drunk enough water or because you've got an unstable blood glucose. We all know that right. We're all doctors. Once you have your budget, you need to think about how you're spending it. So people talk about divided attention because you can literally end up spending half of your attention elsewhere and only half on your task or in this case on your answer, things like external distractions can take some of your bandwidth, some of your attention. And so can internal distractions like self criticism, this can really eat away at your attention and distract you to the point that you may not even hear a question you might have to ask again or get the wrong end of the stick. It's really important to become skillful and aware of your internal distractions as well as manage the external ones. Like K said already, you also have different qualities of attention and this is like back to med school stuff. So bear with me. You'll remember you have a parasympathetic and sympathetic nervous system and we're always somewhere in between the two, but they actually both exist in safe or regulated and unsafe or dysregulated states. And this is something I didn't really understand from med school when you are feeling safe and you're in a parasympathetic mindset. Your cognitive function is very big expansive broad, creative. You can even think about what you're thinking about which is something called metacognition. And when you're feeling safe and you're sympathetic, that is where you can become very focused. It's even where you can access flow. And this is interestingly a sympathetic state. People talk about tunnel vision and that's what I've tried to represent here. So you can become hyper focused on a task and you can perform out of your socks when you're in this state. The reason is that it's very slightly hypofrontal. So the amount of function in your prefrontal cortex very slightly reduces, which means that you become less self conscious, your sense of ego decreases, which is how sometimes in theater, you can have spent four hours and not realized the time has passed when that goes too far and you start to feel unsafe. We tip down into our exclusively human most evolutionarily recent survival behavior, which is to try and charm or persuade or prattle or fall on your way out of a situation through fight flight. And if you can't run or fight, freeze and or dissociate to reduce the pain, and this is something we share with reptiles and ancient mammals, it's essentially playing dead. Now, wherever you go. And we all have our patterns of where we tend to go. All of these states are linked by a reduced function in the prefrontal cortex. That is where your judgment and your executive function are, that is where you need to be able to access to get those sixes. So the key in any interview, any exam, any performance is to remain in the top half of the algorithm. And you can do that through feeling more safe or feeling less unsafe. But why would an interview make you feel unsafe? Well, the key point here is we are closer to our ancestors than we think we are. So we feel like we've moved so far from our cave dwelling ancestors. But actually, we all know evolution is a very, very, very slow process. 85% of us still have Palmaris, longus forearm muscles, which we used to use. When we swung around in trees. It takes a very long time to evolve and the way that we currently live in this weird sort of disparate massive cities, very little social communication has really only happened in about the last six generations. There is no way we've evolved for it. So if we want to understand our brains, we need to go back several 100s of years to where we did live in small communities and think why would an interview make you feel unsafe? Well, in a small community, your social status literally is a matter of life and death. You need to be part of the gang to live efficiently and live safely, protect yourself from predators from natural disasters to gather and forage and cook food, child rear effectively and so on. So if you were in any way, judged and your status dropped that really was something to panic about. Our brains remain wired like that and interviews are very judgmental. We're sitting there in front of a panel of people who are basically judging how good we are. That is a very vulnerable state. And at a subcortical level, our social status monitor, which is broadly the Amygdala, but the limbic system um and is colloquially known as the in Ari the saboteur. The committee is busy telling us all sorts of things which are very distracting. It uses our attention budget, telling us it's all going wrong, what we should do about it and it affects the quality of our attention because it makes us feel more unsafe. So it's very important to be aware of that, to know it's completely normal and to develop skill around recognizing it and disconnecting yourself from your inner critic. So techniques you can consider maximize your budget. This is so simple, but it's unbelievably common that people would stay up late cramming before an interview or an exam. Get enough sleep. Make sure you've had lots of water and eat sensibly to maintain a stable blood glucose and then spend your attention very carefully. So you have as much as you possibly can for the task or the question that you're answering, minimize external distractions and then get skillful with the internal ones. Get to know you a acri and notice it disconnect from it and that will reduce your rumination around it. The level of, of distraction, trust your process. So you cannot control things that are out of your control. It sounds like a stupid thing to say. You can't control whether your answer is going to be perfect for the examiner because you don't actually know exactly what they're looking for. What you can control is the process by which you perform best. So we will all have a state that we perform really well. For me, it's when I'm relaxed, the tenser, I get the worse I do. It doesn't matter if it's a practical task or if I'm thinking. So I know that if I stay relaxed, I'm most likely to give my best answer. So I can just focus on staying relaxed knowing that I've done all this prework and that is the most the my best process to do well in an interviewer and a talk like this, you will all have your version of that. You might be relaxed. You might be fired up. There might be any number of permutations on the theme but work out your process and stick to it and finally have a strategy for being thrown, you will be thrown. You don't need to be perfect. You just need to be able to recover, reflect, get back on track. So figure all that out before and it will be time very well spent. Now your impact, it won't surprise you to know that your interviewers are also closer to their ancestors than they think. So, take yourself back to your small community. You need to be able to judge how safe someone is from 50 paces. Because if they are an unsafe edition, if they're threatening aggressive or in some way, you can't trust them, you need to get them out of your tribe as soon as possible. There is debate around how much of what we say is part of our communication, but it is the minority. Most of what we say, most of what we communicate is not the words we use. It's the prody the way we say them and our body language. Remember that when you are trying to communicate and answer where you're being interviewed on how competent you are. The words you say are very, very low on the priority list. Have an open posture, smile, breathe slowly. These are all signs of regulation, by the way, they also all directly stimulate your parasympathetic nerve or modulate your cortisol levels. So they will calm you down to and humans co regulate the commonest example of this, of course, or the most famous one is a parent regulating a child, but adults do it too. You'll know people that calm you down, you'll know people that stress you out. You want to be someone in the interview that calms down. The interviewers don't wake them up, regulate yourself. You will regulate them and finish deliberately. Good luck. Thank you so much, Lily A and cat. Both of you for your joint presentation, particularly in, um, enjoyed the bits that we don't think about. We, you know, you worry about the scenario, we're going to hear about the management, we're worried about the rules et cetera, but it's actually making the best of yourself and being the best you can and paying attention to that. So I think that's a fantastic place to, um, as I said, Q and A at the end. So this is fantastic time to take a short comfort break, I guess. So we're going to all go away and regroup at um 830. Um Sorry, 1830 sharp. So you've got nine minutes uh of break. So see you in nine minutes. Thank you. My pleasure to introduce Miss Yasmin Auganum, who's a consultant urological surgeon at guys and Thomas and she's gonna focus on the management and ethics part of the interview. So M Ganem, thank you for joining us and over to you. Thank you. Um Next slide slide, please. First of all, it's a pleasure um to be here and try to give some feedback, some uh understanding about the interview itself. And Catherine Lilly touched a lot of things that I might, might sound familiar, but I'm going to focus on basic things and that might come up in the interview. So the topics we're gonna talk about briefly, you probably saw when you were practicing for the interview, these things like ethical dilemmas and we always talk about the soft skills and communication skills as well as, um, how do you learn from mistakes and also basic stuff like the wh O checklist. And I'm gonna touch all of these topics a bit, but just to give you an understanding and when you do get asked about it in an interview, you wouldn't freak and think, OK, I don't know how to deal with that. Uh, next slide, please. So just a bit of background that would, um touched it already. Appearances is very important and I know that many of the interviews are going back to being face to face, but it's very important. You think about it? The first impression is they all know you're nervous. We're all nervous. Every interview we do, um makes us a bit anxious and we, we it's very hard to smile but try just to look relaxed as much as you can. Some of you um might really struggle with that. But if you dress nicely and you feel confident, just come in, take a deep breath and try to smile and say nice to meet you to everyone in a very respectful way. One of the things that I struggle with is to stop before you talk personally. The minute I feel like there's something I wanna say. If they ask me something that sounds familiar or practice with my friends, I immediately start answering. Don't if they ask you a question, just stop. Even if you need to. Sometimes when I started interviewing, I used to count until 3123 and then answer the question. It shows that you listen, it shows that you're attentive, but it also shows that you didn't memorize the questions and you didn't memorize your answers. You're actually ask, thinking about what they're asking. You. Also, it's very important to have a structure. I'll touch a couple of things like the ethics things or um the ethical dilemmas, et cetera have a structure of how you want to answer the question. If they ask you about personal experience, don't jump from. It's very tempting to jump to an experience and then go back in the end what I've learned and I'm not sure. And then you get nervous and stressed. Think about how you want to answer it. For example, if you don't have experience in something, I don't have experience but or I do have experience and I would like to share with you, even if it sounds silly to you, these tricks will help you from today until your FRC S. It's a way of thinking. But also it's a way of speaking. Now also, it's, it sounds a bit silly when I'm talking about structure. One of the things is having an ending to the story or ending to your answer. Don't leave them hanging. Thinking is that's it. Are you done? Make sure that you make very, you make sense and I know all everything that I'm saying so far sounds very obvious, but it's not practice with someone who's going to the interview or had an interview before or, or registrar or trainee um that you trust and you feel confident with just try practicing how to speak and how to end a story or an answer. Now, I'm, I'm a big fan of neonics when it comes to medicine or anything else. I really like it and I love this stars and spies. And the reason is, is because sometimes when I'm trying to answer a um a question, especially about um my own experience, I like to think about the star. For example, I think, OK, of such a situation, I'll explain it. I said the task, what they asked me, it doesn't have to be task. But in your brain, you can say, OK, the, the, the thing that happened, whether it was the dilemma II experienced, whether it was the situation that I dealt with, then what have I done? And what was the outcome? If you remember these four bits? You can answer any certain every possible question in a way that makes sense. Just like the structure. What was the situation? What have, what, what was the dilemma? What was the issue? What have I done? And what was the outcome? It's very simple when it comes to spies as well, you will get asked and I'll show you in the next couple of slides, for example. And difficult situations you dealt with. How did you escalate and, and these kind of little things like initiative, escalation and support, meaning that you understand all the different bits and pieces of dealing with a complicated situation and you set in a second next slide, please. Oh, yes. OK. So uh the presentations are scenarios of three minutes and I'm sure uh you already know how it's doing and if you don't, I think it's a good idea before your interview to know the structure. So you wouldn't be surprised during the exam. Uh The management problem solving is about five minutes case. So that means no one expects you to um deal with the COVID in um you know, in Paris Johnson's house, it's supposed to be something very simple and straightforward. And when we talk about when you talk about the situation, trying to reflect what's your experience when it comes to leadership or how did you work as part of a team? But the words, leadership, this is something very important because I was practicing with some of some of the registrars or some of the people who are applying. And there's this tendency to try and show that you're the leader and you held it and you, you took responsibility and you took control. It's not just about being the leader, being a leader comes across also when you work as a team and you can be a leader, but also we're looking more team members and I think you have touched it before. You wanna be part of a team and you wanna be, you want someone to work with you as opposed to someone to boss you around. You will see what I mean in one of my examples. Next slide, please. So I'll start with EDA dilemma. Everyone I know that everyone dreading. And when I was asked about EDA dilemmas the first couple of years, I was always dreading. What will I answer? First of all? Don't lie. OK. Don't lie. Don't make it up. Don't try to memorize a scenario. It's fine. Also, you're all juniors. It's fine to say I never came across an ethical, a significant ethical dilemma. But if you think about it, many things can be, I think a dilemma and you must have, you might have for example, experience one of the following that I gave example for you taking credit. Someone gave a brilliant idea, someone did some work with and then someone else takes credit for it. That's quite an ethical dilemma. Should I say something? Should I find out? I don't really know, blaming someone uh for your mistake or even just, you know, not flagging a mistake is an ethical dilemma, doing something wrong and never come, you know, upfront and say, OK, I made a mistake. Is that an ethical dilemma? Someone who's who says I can do that. I wanna take a response. I wanna put the catheter in. I wanna do this, I can do the uh the cystoscopy I'm just taking for my world and you know, for sure that they have no idea how to do that. So you go to the consultant and say something here is not right. Uh, doctor and patient confidentiality, gossiping about patient. That's something that we see quite often. Is it appropriate? Is it not these kind of circumstances, these kind of situations you can come across quite often. And one of the most common things that we all see that you can use if you ever dealt with that is a colleague that is being a bit lazy and a bit, you know, cutting corners a bit and not really doing his job or leaving everything for the night team, these kind of situations that you might have come across, you can just think about it. You don't have to lie, you don't have to make up a story. Just think. How did I deal with that? Did it bother me? Did I go to my consultant and say I'm not happy with that? Did I talk to that person that I have a challenge, these kind of things we want you to see if you can deal with it because one day you also gonna be a consultant and you need to learn throughout your journey how to deal with people who are more junior to you as a junior registrar, as a senior registrar, as a consultant. This is what they wanna hear, they don't wanna hear, you know, amazing stories that you've done in your young age. Next slide, please. So the communication skills, I think it comes um I II tailor it with the e dilemma quite. Um I because I always say that it has to do with each other because for example, look, I'm always using my hands, especially when I don't like giving talks in front of people and I am very conscious so you can see my movements. And when I'm, when I'm nervous or when I'm moving a lot in the, in the, in the interview, you might have the same problem, especially if you're talking about something that makes you a bit uncomfortable. You're not really sure if the people who interview you believe you or maybe they're not interested or maybe they just looked on their phone for a second and you think that you're boring them, it's normal, it's all normal, but try to focus on your answer. And this is why I said before. Don't lie and don't make it up. It's OK. Focus on discussing things because what we read from the way you answer us is actually something completely different. If I'm asking you a question and you answer me nicely and you and you have very clear verbal communication. What I hear. He knows how to talk. He can explain to a patient the way he explains to me, he can talk to a patient. He can talk to a colleague. He can be absolutely coherent and clear. That's what we hear. This is what communication skills are about. It's not just about how you dealt with something, not verbal communication. Don't sit on your hands or sit like this. Don't lean on your chair and do this. I actually, um, practiced with a junior that I didn't know when he was sitting like this on his chair. I thought he was a bit disrespectful. Trying to see. I'm sure he was just because he was nervous, but trying to imagine what would happen if someone would behave like this in front of you, you would feel a bit uncomfortable. There's other communication skills that may not come as across as, as good in the interview but are very important for us as doctors, which is the written communications and the letters that we write to the patients and the GPS. But also the being team leader and a part of a team are for me are equivalent and I'm sure the team will agree with me. You don't have to also a always be the team leader. You also have to remember that 90% of the time you are part of a team, you have to be a team player because at some point, at some point, people will notice that you're trying to always take over and people will not enjoy working with you. And it's not in our type of work, not necessarily as surgeons, but as doctors, it's not longstanding, you have to be a part of a team and I'll touch it when I touch one of the next slides, please. Next slide, please. Now, and apart from the ethical dilemma, one of the common questions is how do you learn from mistakes and people love it and everyone starts freaking out. How deep should I go? Should I actually admit the mistake I've done? Should I actually be that honest? Do they want to hear that? I made a terrible mistake once or maybe I'll just try to say something stupid and then you start really getting nervous, relax. First of all, you know what they're gonna ask you, most of the questions, repeat themselves for specific reason. But what, what is a mistake? Some of us think that a mistake is, for example, I had a registrar who accidentally um switched the stickers on a patient's consent form and consented the wrong patient. Obviously, in the last minute we found out because we had loads and loads of checks which I'll touch in a minute. But it was a terrible mistake. He owned it. He said I made a mistake. I wanted to rush and consent all the patients. That's a big mistake. It's a mistake. Some mistakes are smaller than that. I told the patient um accidentally that he doesn't need follow up, but then I called him 40 minutes later and I said, I apologize. So you need to come in three months for another follow up or another scan. There's many, many types of mistakes and we're human just again, don't try to minimize it and make it as if you never made a mistake. If you never made something that you can think of, you can say I can't, I'm sure I made many mistakes or I'm sure I've made mistakes with all humans, but there's nothing comes to mind, but it's good to have something in the drawer in the back of your head. In the case. They ask you because there's a very good chance of asking. Now, we all know the audits and we all know that the NHS and the GMC and everyone really likes to talk about mistakes. And the reason is, is because the only point of talking about mistakes is what you learn from them. We don't admit our mistakes because we want to embarrass each other. We admit it because we can learn something from that. So for example, this chap, my registrar, he is very junior. He made this mistake. I didn't embarrass him. I didn't humiliate him. I didn't escalate it. I just said, ok, we have many checks. Why was that wrong? What have you done wrong? He was rushing to consent to patients at a time. What have you learned? I've learned that I shouldn't do. I should focus on one patient, finish with this patient and move on it. Seems silly because it's obvious. But we all make mistakes, especially if we're trying to rush, what did you learn? Work in? Never work in parallel, especially when it comes to patients. These kind of things are extremely important. Next slide, please. Now I struggle with this. I used to struggle with this question and I'll explain because no one wants to admit that we're stressed, especially surgeons, most of us who have type a personality, we're strong, we're resilient, we don't have stress and we deal with that. And our generation, I'm sure Lily and agree with me was even more embarrassed to talk about stress and, and emotional Lily as a coach will tell you that people really struggle, especially in our job to say that they're stressed and that they're overwhelmed and sometimes just too much. And it's a problem. We, we, we acknowledge that well being is, has been frowned upon un until the last couple of years. But we're acknowledging that this is part of our life and we need to be able to talk about it. And this is why you might be asked in the exam. How do you deal with stress? Do you have stress? Are you do you? It's ok to say yes, I'm in a new relationship and a new job. And this interview, we all experience stress, but sometimes when you experience stress at work, it comes across and it can actually reflect on our own job. And this is where it gets scary. This is why we want you to be honest. So, do you cope with stress? Yes, I have stress in life. How do you cope with stress? I prioritize things. I make prioritizing when comes to work. I'm a junior doctor A&E is calling, I'm gonna go back to urology. I'm sorry, my world is very narrow. Um uh they, they're calling me from A&E because of a patient with bladder outlet obstruction. You can't, we, the ward is calling me because the patient is tachycardic and they're worried they want me to do an E CG and, and it is not working. They're calling me also from downstairs because they want help. Um They're trying to get the reg is trying to get a stent and the nurse is new and she can't help and I don't know what to do. I'm freaking out. How do you, what do you do? You prioritize? OK. A&E they need a catheter. Ok. Fine. I'll, I'll start, I'll start with a patient that is unstable in pain. You have logic in your head, you're doing it every single day, think how you cope in real life. And then it's not a difficult question. Yes, I get stressed. Don't lie and say I don't get stressed. I'm fine because that's wrong. But you can say yes, I get stressed but I prioritize, I prioritize by how stable the patient is. I prioritize. Um for example, um how symptomatic the patient is et cetera. Next slide, please. Sorry, I, what I didn't say, I'm sorry. Before I go to double O checklist. Also, when it comes to stress, you might be asked like I said about your well being. How do you cope with stress at work? You can say I prioritize every weekend when I'm not on call. I take some time out, just time out. It's ok. That's what I do. I mean, we all have stressful lives. I take time out time to myself. I take Saturday or Sunday and I just do nothing. I watch television. I go for a walk. I do something for my mental health. I just relax and it's OK. Actually, I think if I would interview you and you tell me yes, the job is stressful but I find time once a week to just relax and unwind. I would say, ok, this person can hold on for many, many years because they understand that their wellbeing is as important as their hard work in the hospital. And no one expects you anymore to work 26 hours and deliberately saying 26 and then, you know, come the next day very, very strong because it's not, we know it's not sustainable. So just be honest. Now, the reason uh wh o checklist I put it is because first of all, it's often a common question and you wouldn't understand why because I just told you that one of my artists made a mistake. And the last minute you do the wh O checklist and you find out that you made a mistake and it happens, know the checklist, know the questions and know why we do the checklist. And you, I just gave you an example of why it's super important. It's a critical thing and it's one of the things that stops the never event. And it has been proven statistically proven to reduce mortality and morbidity, which is why we're doing it. Next slide, please. The next thing that you have to know um is the pillars of clinical governance. There are seven of them. No one is expecting you to give a long talk about all seven and no one cares the reason people think about the reason people want you to say things. This is why I give you all the examples of why you get asked every question. The reason is, is because you want, they want you to touch it for example. And one of the um one II heard on an interview, someone says that this is the best answer you've ever heard. And I thought I love it. I think that all the trainees should do that. There are seven pillars, ones that I'm involved in. I love it because that means you know the you know, there's seven check, you should know the seven because you might get asked about one of them. So please do. No. But if you say there's seven, but I'm involved in two or three or these are the ones that I'm actually involved in like clinical care. These are the jobs I've done research. These are the papers that I've been involved in audits, et cetera that shows that you're not just memorizing. We all know you're good in remembering. You finished med school. Well done. We want to show that you're taking all these things that have been built for you like these pillars of governance and you're using them in your real life. You understand what the pillars are all about and why are they there? So if you answer me this way, there are seven pillars, but I'm involved in these pillars, that means OK, they know they have pillars but they also know how to make these pillars from a line online to something real to something that they're actually practicing and that gives you loads of lots of credit. Next slide, please. Never events. I touched it. II said it as a word. At the end of wh o you might be asked what are never events. Um It's quite straightforward but no, no, the common ones, the wrong side, et cetera. Um you know, ob leaving object inside. Um This is a, a question that my read last year that got a job has been asked last year. They asked her, have you ever heard a witness case? You were involved in it? And she called me after an interview and she was really nervous because she said no, I've never watched never. There's nothing wrong. Why should you lie? No, never had the experience. Thank God. It's supposed to be a never event. So if you're never exposed to it, it's fantastic. But what you need to know is if it happens, who do you need to talk to? Who do you need? Ok. So something happened, um, you removed the wrong kidney, you gave blood to the wrong patient, you gave me II, these are the common ones who do you talk to? Who do you inform? What do you do afterwards? And one of the questions that you can ask, how do you stop in every event? How do you stop it? If the scans are now open in theater, you can quietly, you don't have, we know you're young and you know that some consultants are a bit grumpier than other. It's fine. You can gently quietly open the scans in theater and just say I will open the scan and make sure that they're visible in theater. This is part of the wh o anyway, but some surgeons are quick fine, open the scans and make sure that we're all aware of the side. Make sure that everyone heard in theater that the right side is correct. Sorry, the correct side is marked and that these kind of things make us know that you actually understand and you've been in theater more than just observing as a medical student because it means you get it next slide, please. Management and problem solving. Um It's, it's very similar to the other questions in terms of how do you deal with things and how do you cope and how, what would you do in this episode or if you have this dilemma, et cetera? The oh, sorry. Can you press again this um first again as if there's no accidentally did. Um Yeah, another press, please. Sorry. Yes, thank you. Accidentally did the thing. So the problem solving can be many options. For example, did you ever have an issue to solve? And it's very similar to the ethical dilemmas or the other questions you might be asked specific about a scenario. They're gonna give you a scenario that you have a difficult colleagues and it's hard to work with or they're gonna give you someone who was drinking a specific, not something that you experienced. But what would you do if be ready to answer? But again, it's extremely important. I can't emphasize it enough. Be honest. Be yourself. What would you actually think about it? You've been working with colleagues for a long time. What would you do if someone is untrained says it gets the job or someone who is absolutely a nightmare to work with or what do you do if someone is doing something wrong? Just think about it. Don't stress out in the exam as I said before, stop listen, stop think and answer what you actually would do. And it's ok to say I'll speak to the person. I'll speak to my um um, my, my, one of the consultants that I get along with one of the more senior registers, I try to cope with that. If it's your consultant, who would you speak to? I go to another consultant. I go to clinical lead. Just think. What did you actually do? Lift? Conversation is another example. Would you make a comment? Be honest? Don't lie and say, oh, every time I on a lift and I'm saying I go just be honest, I feel very uncomfortable. I might make a noise or I might make a comment and say guys, there's, it's not appropriate on the lift. Just be honest. Other things you need to know is what is proms. Uh proms is patient reported, outcome measures. It's extremely important. Read about proms. It's very, you can find it online. Uh different targets, not too much, but at least just basic ones because it means that you understand in daily practice next slide, please. Now examples. Um I'm sorry, I don't know why it does this and again. Yes, thank you. Examples from the previous years, colleague leaves uh you on call believe so they can go to theater and they do it again and again, it's very annoying. We all wanna be surgeons and we all want to operate. What do you do? How do you deal with that. Think about the answers. I'm sure that all of us from far to be and cat and Lily, everyone will answer differently because we all cope with it a bit differently. I for example, will go to the colleague and say, not fair, not cool. I want to be a surgeon too. You need to hold the bleep. It's ok. I might take it once or twice or I'll say let's split. Let's make sure that we all operate at the same, that we all get the same volume of operations and if not not cool these kind of things. Uh Next, please you see a calling being bullied at work. I've seen it once. It's not nice. It's not easy to watch it. It's very difficult. What do you do? How do you cope with it? Would you complain? Would you not again, all of us will answer differently and it's ok to answer a bit different as long as you understand the issue. But I'm sure you know that saying, ignoring it is not an appropriate answer. Yeah, you can't ignore if someone is being bullied because tomorrow it can be you. And it's horrible. Next slide give an example of when you had to prioritize. I touched it a bit when I said about the stress. Ok. How do you deal with that? We all do that? Stop overthinking about the questions. Just think normal daily scenarios, A&E the bleed. What do you do. How do you prioritize and think about normal life, unstable if it's A&E ok. There's other, there's other doctors, there's other support. I need to deal with my patients on the wards because I'm the only doctor I need to do this. I need to do. This is a patient in pain. It's a patient that the minute you actually know how to answer that, we know that you worked and you know what you're doing next slide, are you asked to consent? A patient procedure? You're not familiar with. What do you do? Are you? Are you, we all get embarrassed when we say we never seen it, especially if we just got a number and we're really excited and we're working in urology boards for the last two or three years. We, we interviewed a few times it didn't work and now it finally it worked and now you're extremely embarrassed. What do you do? Do you google it? What do you do? Do you look online? The answer is no, if you're not familiar and you've never seen this operation, I'm just telling you now, I personally think and I hope my colleagues agree with me. If you're not familiar, you can't ask someone to sign something because you're guessing how it looks like stop and say I go to the consultant. It's my first time I wanna watch you do it, but I would be grateful if you can help me consent and I'll listen while you're explaining, that means you wanna learn and you can do it next time after you heard it and you watched it and now you're happy. The answer is not youtube. But now you give, this is another example. And next one, this is a very important question. What makes the consent valid? This is extremely important. We all know about consent for consent four form. It's extremely important. Does the does learn, this, does the patient understand what you're saying? It's not just a patient that has the capacity, it's not just capacity. It's understanding if a patient tells you, for example, um I don't wanna hear, don't wanna hear. I'm just gonna sign, don't care what you're doing. Is that a valid consent or let my wife sign? I II don't wanna hear about it. I don't want to hear, I'm sure um a cat, for example, if, if you're dealing with Children as well, what m what makes it valid if mummy and daddy are divorced and it, they're not gonna ask you this specific but you need to, to it. I want to provoke your mind thinking about things. I want to challenge you thinking. OK. Actually, it's a good question. What makes it valid? It, they're not gonna ask for a specific question. Mummy and daddy are divorced and not talking. But just to understand that there are so many scenarios and so many things in our world and if I'm asking you this question. Not because I want you to see that you read it is actually that you practice and you think about it. Yeah. Actually I consented the guy the other day and he was so nervous, he didn't even listen to me. Is that valid? Should I just maybe go back, come back, give him something to read. Maybe a reschedule if I, if it's cancer, how do I deal with it? These kind of things we want you to think and if you come to the interview, when you're thinking and you and give an answer, that is honest, that's enough. And last one, that's a genuine question who can consent. And I think that when it comes to Children, for example, um capacity, even the age of 14, a kid can consent if he has the capacity to do things just read about it. There's beautiful on um leaflets online and explanations online that you can find and just get a rough understanding of who can consent. It's extremely important next line, please. So uh press again please. And again, um last things that you might get a asked about is dangers of social media, for example, again, press uh patient data protection. Sorry, I thought I have control myself. I apologize. Um Patient da data protection. Am I allowed to send, are you allowed to send on whatsapp patients details? Is that OK? Uh Can you just sa save, you know, on your memor stick? Um You know images from packs with patients details. Um um photos on your phone, especially in my job when it comes to urology and we deal with privates or with CS jobs that you're dealing with Children. Is that ok to just snapshot Children and take and save it on your phone, you need to know these things. Um know the general targets. Um Two weeks wait pathway is the most common one. You need to know what it means. What does it mean? Two weeks, um, the 18 weeks target. Um, the and just general questions that I put in, you can get the slides of a PDF. What makes it safe? Um For example, what do you do if this is more current? There's a train strike like any other day in London for those of you who work outside of London, it's a nightmare getting into London. So what do you do? Your colleague keeps getting late to the night shift or there's a train strike and it, it can come these kind of things you might be asked and just be honest, I have three. Thank you so much. Um Yasmin, it's been really great. You've covered so much in this, in this presentation and I know that the, um, we'll be able to sort of scroll through some of the extra slides at the end. I would like to, if I'm able to, um, move on to a couple of polls that the team behind the scenes have got for us. So I don't know if Jane, if you want to run a couple of the polls. Um, so that, um, and these are anonymous. So it's not gonna flash up whether you've applied before to your name. This is just for us to get an idea of, um, where our, you know, our attendees are up to in their sort of journey. And we'd also like to know where about you're phoning in from and, or, or logging in from. And I might say I'd get in trouble if I'd say there's a prize for someone who's the furthest away. But I do, if you do, if you come from somewhere further up, do let us know. So, OK, moving on from the polls then and um apologies, Yasmin for sort of um you know, I was really enjoying that. Actually, um I'm going to introduce our last but not least speaker who's Mr Bella Amina, who's a current core surgical training in the case. Um I think Egypt is winning at the moment in the chat. So um a colleague from Egypt back to Mr be, I mean, he's recently been through the process. So, although we're talking and sharing our knowledge about things, he's actually been through it and he's going to kindly share some of his thoughts about the recruitment process and his journey and hopefully the ultimate success. Ok, over to you bau thank you. Thank you all for having me this season. All right. So my name is Bilal. Um I'm a current core surgical trainee in the KS scenery. I'm also the current surgical education lead for the GBI Academy as well. And today I'm going to tell you a bit more about the recruitment process and the journey that I've taken and share with you my ups and downs. Are you all able to see my flight at all or it's not moving? Yeah. Yes, it's just moved forward fine. So first and foremost, well done to all of you to actually joining this event, essentially, you are here to make the jump foundation year training. The core surgical training isn't easy and you're, and by being here, we're able to help you take those hurdles in order to overcome the certain challenges that you may meet. Uh next flight, please. Uh I think you may have jumped. Uh Sorry. Yeah. Right. So going through the CSE recruitment timeline. So it's a long process. So starting out all the way in November by the submission of your oral application all the way through to an office of release at the end of March and start of April. It is a marathon. It isn't a sprint, but there are moments of ups and downs that you will experience. Um if you may start uh doing some quick, please. Yeah. Um and again, next slide please when the flight. So we've also uh at this particular moment in time, you would have all submitted your or your application in the next slide come December time. As long as you've met the eligibility criteria, you, you would have been long listed and an invitation to book the M sri exam will be sent to you. Next slide in January, you would all be able all be sitting the M SRA exam next, right in February and February, as you can see, popped up a few times on this timeline is an important month. You'll be asked to upload your evidence from your self assessment when you actually applied back in November. Next flight, February is also when your MSRA results come out and the invitation for the interview will be sent to you next slide in February following the interview invitation, you will then undertake the CT interview. Next slide. You will at this particular moment in time you prior to the the release of your results, you will be asked to preference all of the choices that are offered to you for CT in that particular year. Next slide in March at the end of March, the initial offers will be released and explode depending on how this goes. Further offers and upgrades will then be offered to you in the next slide. And currently you would have jumped over the first hurdle, but there are many more to go next. So do not underestimate the M SRA. The M SRA is a new introduction that was introduced in my year. Last year, an MSRA essentially holds the key about how whether or not you progress in this process or not. Uh Next flight, approximately everyone who is long listed will be uh or sit the M SRA exam. However, the top 1200 will only be invited to interview. You also need to meet a certain threshold to be part of our top 1200. Next, right. So typically the pathway into coord trading as you're all aware is explodes completion of your medical school years, next slide into foundation program and next slide and intercore surgical training. Next slide for many of you, this will be very straightforward and you'll be able to overcome each hurdle. However, they're far from the case in most instances, the next slide and Nick please, the jump from foundation program to quarter of surgical training can be bigger than what can expect. Next slide. And there may be a hurdle or two that you have to overcome in order to get to it in the float, do not underestimate the process. It is competitive. There are many of you or all of you today that would like to apply for the surgical training. However, there are a finite number of uh posts available last year, 2539 African supplied to early 609 posts. So a competition ratio of 4.17. This data from the hee competition ratio website, next live face. However, progress is not linear. Next Friday. So you may make a personal decision not to apply for co surgical training straight after FD. You may locum, you might decide to travel before taking the that that jump. Some individuals may want to return to academia. They may do a masters, they may do a third degree. You may have some health issues or recent bereavement. In order for you to take some time out before you end up undertaking the journey, you may have done really well actually in your interview and you may have been offered the post, however, not the post that you wanted and certain geographical limitations may prevent you from actually taking that post off. You may just had a bad day at uh at the office, you the the interview and the exam is a one stop shop. So you, you come in, you do the exam and you go home and you may just had a bad one on that particular day. It doesn't mean you're, that's the end of your journey. It just means that you had a bad day. That's all. However, at each juncture, you wouldn't realize that you are actually making progress along your journey next life. And so this picture on the left actually represents my journey into the CD and it's not been a straightforward one makes like this. So I completed my uh foundation program between 2019 to 2021 in the next slide. Now I'm sure you're well aware, those particular years were heavily impacted by the pandemic. It was the first year that the whole interview process had changed from a face to face format to a virtual format. Many people tend to have gone abroad or taken some time out to locum no longer opt to do so. Those who were abroad or returned, the competition was fifth. And ultimately, my portfolio did not meet the shortlisting criteria that are um limited be invited to interview. Back then, the MF RA was not the ticket to interview and it was all down to your portfolio score. So I ended up taking atn O educational and clinical fellow post at UCL H for that particular year and then opted to reapply after my FDA within that year. Next f please. Now this time my portfolio was significantly better. I met the uh the level to be invited to interview. However, on, on the whole I my score I achieved following my interview did not meet the threshold or, and I was ultimately out competed for the desired job and location that I was willing to take and accept. And ultimately, I had a very slim outside chance of receiving an upgrade, but that never came. So what did I do next slide, please? I took on an orthopedic research fellowship at uh Saint George's Hospital. This is the year that the and this is the last year I was in your position and the M SRA was introduced and I'm and I'm here thinking, oh my gosh, it's a new hurdle. What do I do now? However, at this particular point, my portfolio had improved significantly but I made sure in order to get that uh to interview and in and make sure that my portfolio was actually assessed and scored, I had to ensure that my M SRA was on point. And overall, I had a significant improvement to my overall score and scoring really well in my interview as well as my uh portfolio, as well as the MSR and successful. Finally. So now just a next please and I've now just started atn O program in KF. So no matter how difficult your journey is, you will always end up on top and perseverance ultimately does pay off the next ride within my time that I took other roles. My, my experience has really shaped who I am today. It's improved my overall knowledge and my skill set on top of this, I've achieved additional accomplishment including research clarifications presentations and ultimately strengthening my portfolio for the future. Not just for the next step, it's also helped me to um gain, sorry, can you just go back one slide? And ultimately, just to kind of go back on that last point was um I've gained lots of mentors uh throughout the process. And ultimately, these are people that I can always go to. But a word of caution fly, please you may be considered to be too experienced and ineligible if you've taken time out after the foundation here too. You have an 18 month clinical limit before you are considered to be too experienced to apply for co surgical training. However, there are ways to go around this and, and other roles to explore. You could do a teaching fellowship, a research fellowship, which is what I did in my second year. So I'd already done 12 months, but I made sure that I did not rule myself ineligible and therefore took on a research fellowship. You become an anatomy demonstrator. You could have a non surgical role for ie work in A&E for a period of time. You could do some local work and you can also return back for a master's or another degree next supply, please. But do bear in mind depending on the number of years that you've taken out between foundation year and going into school training. Uh And by the time you apply for specialty training, you, you may be penalized at the T three application. So it's worthwhile uh to look into this further just to make sure you do not um give yourself any disadvantages next life. And thank you for listening. Thank you very much for, for showing us um what um our colleagues, what we all know that everyone's journey is individual. We all take different routes and there's more than one way to get there to end sort of game and there was a couple of questions in the chat about, um, not over, um, going over your 18 months. But I think you already answered that and you're saying that you took a, a research fellow job and, you know, you were so you need to pay attention to, I guess all the rules at the different stages so that you don't accidentally sort of, um, uh, sort of make yourself, um, ineligible. So, so I think we'll open it out now to questions. Um We've answered some along the way, but we really, this is a safe space. Uh Please feel free to um mention stuff in the chat and we'll try and feel them um amongst all of us. So, but before we go to that, I just want to summarize what I think I've taken from this because I'm always learning. So I think we've um focused on all the separate areas of the interview process. We've talked about clinical scenarios and how really they are very straightforward in that you have your ABC, then you home into what, what the actual issue is, resuscitation is important, managing the patient and creating appropriately. That sort of the the important thing we've been, we've had a talk about familiarizing itself both with the interview um platform, but also your setting, you need to show um the your room as part of the process is quite detailed, as said, detailed information about the process of the interview. Um, you need to prepare yourself as well as your setting and that means, you know, how you dress. I used to give a talk about how to dress, which is really very silly because my sister would think that I was the least person, um, um, sort of able to talk about that, but you need to make sure you're in a comfortable environment we've heard about. I've had an excellent talk about management and all the things that can come up in management and ethics. And I really think you need to think about those answers. Don't fib don't lie. You will have either experienced or seen other people experiencing some of these, but, you know, don't, don't, I would suggest don't use a mistake that ended with a fatal outcome. Um And, you know, you don't want to come across as blase and don't tell people that the way you relax is having 10 pints of in the pub after every operating list because although you might do that, you probably need some help, but you need to sort of balance out what your answers are and just be sensible and what a good colleague is. You've had a couple of links to BMA work. I mean, there's plenty on the GMC website, the BMA website on ethics and consent and Montgomery and, and all the things that you need to know. So I'm going to start looking at the questions. Um So uh do, do this and, and it, Cat Lily if you want to come in. Um, so does local work, um, in surgical specialties count for the 18 month limit. I would have thought if you're doing a, a surgical stint, um, that it would count as surgery. So, um, so that was, and we've got a question now from minging, who's asking and maybe below, you might be able to talk to this. What do you, what do you mean by upgrading offers? What can you talk a little bit about that process? Um or Yasmin, right. So at the end of the whole process, having done the MSR, once your scores are self verified uh and released and as well as um you get an interview score, what normally happens is based on all of that. Once you have preferenced all your jobs, you get a ranking nationally amongst the 1200 people that applied based on that ranking, you then get allocated your job of choice following that. Um Essentially they go down the number. So bank number two will get the next pre the job, number three, et cetera and all the way and so on and so forth. There will be people who do not want to accept a certain job that they have preferenced the moment they have opted not to accept that job, it then gets offered to the next candidate in line that had ranked one below that individual. And ultimately, if that, if that happens, then you can then be upgraded and take someone who is technically ranked lower, is then upgraded and then get to the next uh job offer on their preference list. Ok, thank you. Well, there's another question that um came up for you which was um you shared your journey, you were unsuccessful um twice and he, you know, but now successful, but which is great. Uh What do you think changed in that? Was it something in you that changed for or, or was it just that you gain more experience in the process? So can you, can you speak to that? I don't want to put you on the spot, but people were interested in the talk about. So it's mind you, you know, this um not getting a place first time around. I, you know, I went back, I reflected where was, where did I go wrong? I realized gap in my portfolio, that particular incident went back the following year. Um and then worked on that prior to the next application stage. I was doing all these extra things. I gained more experience at the same time and I was more determined than ever having gone through interview on uh for the first time in my second attempt. That's when I realized that actually, um you know, I am disclose from getting it and I was even more determined. I just was, I had, you know, I wasn't able to go too far away from where I, um, in the certain area of the country. And ultimately, I felt that I wasn't, I wasn't willing to take a job that I may not have enjoyed at all or it being too far away and not really contributed to what I wanted. Ultimately, I want to go and see, you know, I wasn't willing to take an, an ent the job, say, for example, so those sort of decisions need to be made quite early on. Thanks very much be II can see there's a lot coming in the chat about the timings and what counts and what doesn't count towards your 18 months since surgery. You've actually said Bell, I'm looking at you again that in fact, your research post didn't count towards it so that you were within the rules. So I guess, and I, the 18 months of course, doesn't include, please correct me if I'm wrong, doesn't include surgery you did in your foundation jobs. It is post F two. So you've got your year and a half of, um, other jobs or 36 months jobs or however you're doing it before you are then discounted from, um, not sure that's the right word before you make yourself ineligible to do and you can do other things, but there are certain time limits, uh, which not just for that process, but for later on, you know, getting into your next hurdles. I don't know if you ask me if you want to say anything because there's obviously lots of questions. Yeah, I agree. I struggle a bit answering some of the questions because a lot of people are asking what does count and what doesn't count. And I'm not that, I mean, I'm not, I know that the limit of the 18 months. But Bilal, you, you mentioned that and I II wasn't aware that if you do research, it doesn't count. I thought that it's in the block of the 18 months that it does, it care to explain what you meant in terms of it didn't count in your experience. So ultimately, it's primarily it is an academic post more so than a clinical post. Oh, I see. So you've done a pure academic post more or less, it's, it's a good way to do that because basically it doesn't pass the limit but you still gain the academic experience. And I really like what you said about the fact that for the long run, it's not just now to get the numbers, but actually it gives you a lot of knowledge and experience in academia and then you can do it again when you're more experienced and you have more time again. So um so II II completely agree. So I hope it helps because everyone asked about the 18 months limit. So it just means that the um the pure academic jobs do not count. Um Thanks Phil all and Yasmin, there's another, obviously, there's lots of individual, um, questions coming through and I don't want to be ignoring them, but there are, there is sort of generic information and everyone's circumstances are unique. But I noticed there was a question from Sri Lanka and I do know if you're training outside of this system, you, one of your years, you can't count more than one of your years in surgery as part of your foundation, you know, equivalent. So you could discount, you could say that a year up to a year was done in your foundation years or equivalent. And then the rest would count as your 18 months. So um that's uh that's it a few questions about the M SRA and you know, its relevance, et cetera. Um It is um I don't know whether the cut you have to do it. It's part of the process. So um we need to, you know, get, get over that hurdle. But um my understanding is that the top 1200 people who, who are ranked will go through um to have their portfolios reviewed and then interview and that sort of. So there may be other people above whatever the cut off score is, but it takes the top 1200. So hopefully that answers one of the questions. Um There's questions about how to, how you're very popular, how you applied for fellows programs. You just have to look at all the websites, the um you know, the MJ NHS jobs ask around um, ask your peers and seniors so that, um, you know, when these do come up, they, um, you'll be aware of them. So, um, so, yeah, so the, that's, I just started that I'm sort of looking at more chat things. So I think that is probably, um, covering a lot. There's some, somebody's asked about whether your, um, allowed pieces of paper to take notes during the interview. I think you need to double check. I was reviewing that earlier and I do think that you're not supposed to have any devices, et cetera. So I would err on the side of no, but it the rules. Um I was and I can't absolutely remember what the answer to that is. So please double check. There is detailed um information on that website about the process and the platform and what you need to do um in terms of, you know, verification, et cetera at the beginning. So um there's a couple of comments in the chat about what you need um If you are going to work uh if you're coming from abroad to work. So I think we are, if there's any other comments or questions in the, please do put them in the chat. But otherwise I think we have covered most of the threads. Um Yeah, and somebody saying that last year they weren't allowed retirement. That's my understanding. But please do double check. Um So that um but thank you for that and I did say that I was, this is just a personal thing. I was keen to see where everyone was from and we've got people as far away as Nigeria from Egypt. Um I'm in Sunny Wales, so, so I don't, and I'm obviously jealous of the person who is in the Maldives. So there we are, we can't have it all. So I really appreciate everyone tuning in. So I think that I'm going to um I don't know if any, I'm gonna ask each of our colleagues to just say a final sentence. Um So I'm gonna go around my screen. So Yasmin, final thoughts, keep calm, be yourself, smile. It'll be OK, whatever happens, it'll be OK. Even if you don't pass this year, learn from Bilal, you can try again and make a wonderful year out of it. Absolutely. Um Bilal, your, your next story. I think I, OK. II think there's a issue with your connection. So I'll go on to cat. Um um I would say prepare hard be yourself. And also if you haven't already signed up for the interview mock um session in February, it'd be great to practice with you all. The Thank you cat. That was a, a reminder I should have mentioned that there are going to be some interview workshops um uh early next year. And if you're an affiliate of college, you get first dibs and they're all usually sold out. So if you're not an affiliate member. I don't get any uh a bonus for recruiting people, but please become an affiliate of the English College. And then when the interview workshops are open up, I think it's, it's very, you know, it's not very expensive at all. Um And you get access to all, all this sort of college um um resources, but you will get first um opportunity to actually join the actual workshops where you will get some practice with colleagues. So bear that in mind, Lily. Final word to you. Good luck to you all. It is completely normal to be nervous. As we've all said, it would be really weird if you weren't um learn to recover rather than trying to be perfect and maybe think about how you can repackage your experience of nerves, what you consider to be anxiety. There's a really classic switch you can make from being anxious about something to being excited. And a lot of people use visualizations like imagining that big wave surfers are about to surf massive wave or really good skiers at the top of a really tricky black run, imagine the same sensation, but frame it in a different way and that can really help um and see you all. Hopefully, maybe not all of you cos we may not have quite enough spots but lots of you at the workshops. Um Yeah, and all the best. Great. Thank. Thank you Lily and from me. Good luck. Um Thank you for joining us. Thank you for our faculty and the whole team behind the scenes who've been holding through the questions and, and navigating the chat. Um Best of luck, be the best you can. And um hopefully we'll see some of you um sign up to an affiliate and you'll get um the option of joining the interview skills um sessions, the workshops and have a lovely evening. We're gonna sign.