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Hi, everyone. And welcome to this talk. I'm learning to teach for medical students and junior doctors as part of a series by the Walter a dandy neurosurgical society. My name is Mariam Ali. I am a current GPS t one. So I'm in my first year of GP training, and I've had an interest in medical education since very early on in my own career. I'll be talking to you today about developing your own teaching skills and why this is important for medical students and doctors to actively learn to teach. Well, okay, just checking what? Our recording. That was the awkward. Okay. Oh, any good teachings have been off with learning effectives. And so these are asked today. So we want to consider what constitutes high quality teaching in a medical context. Um, we need to understand the importance of teaching skills of developing these for medical professionals, um, and to identify ways in which medical students can develop their teaching skills throughout their undergraduate and early post graduate careers. I'm hoping that I'm talking to a group of, um, you know, medical students and junior doctors very early on in their career. And so, you know, lots of things that I talk about will be applicable to all of you and in some way for some of you, especially, um, medical students, right at the start of your, uh, your your undergraduate careers, things might seem a little bit further ahead. But there are definitely ways to, um, implement everything that we talk about at some point, either now or in the coming years. But we'll start off with a little bit of background about my own journey. So I spent five years at Keele University. Um, study medicine, obviously, before graduating in 2019. Um, you may ask, where on earth is keel? Um, I definitely ask that myself when I was deciding where to apply. Um, so it's a very, very rare oral campus university in Staffordshire, somewhere between Manchester and Birmingham. And I had a great time there. Um, maybe there's some people from keel in the audience Shut up to them. Um, I think came back up north, Uh, kind of where I'm from, um, to do my foundation training, um, at Warrington Hospital, which is somewhere between Manchester and Liverpool. Um, to this bit of a theme here, um, had a bit of a funny two years. Um, here, because covid hit us about eight months into my f one year. Um, so that was a strange time for everyone, wasn't it? I then took enough three year, which I'd always wanted to do, and I'd always wanted to spend it in a teaching role of some kind. Um, of which there are plenty. And we'll talk about that later. So I headed, um, to the University of Manchester to teach and asked me to Pre clinical, medical and dental students realized I forgot my little one nations. They're, um so, So spending that year at the University of Manchester, Um, it was probably more of an educational experience for me than for the students, because, as some of you know, uh, as time goes on, all of the basic science that you learn before you hit the wards and sort of disappears doesn't quite, uh, So I had to hit more and Ali quite hard. Um, for the first few months, um, I also use this time to do a postgraduate certificate in medical education. So I got the opportunity to learn about teaching theory. Um, and the evidence based behind the way we teach and assess medical education because it does exist. Um, you know, as medics, a lot of what we do with evidence based and teaching and assessment are are the same. I've now gone back clinical practice, and I'm in the midst of an emergency medicine rotation at Bolton Hospital was part of my first year of GP training. Um, I'm actually recording this after a stint of nights, which you might be able to tell from the from the eye bags. And but, yeah, that's the same. Okay, so let's start off thinking about how medical education is structured and delivered at, um, undergraduate level. The word doctor actually comes from the Latin. Sorry, which means to teach, um, you know, we work in teams of varying seniority and we will all inevitably have the responsibility to teach someone junior to ourselves, and that's whether we like teaching or not. Um, we're also learning to be able to communicate well with patient's, um, and part of that is, you know, teaching them about their own health conditions, especially chronic ones, because knowledge is power and as the chronic disease burden increases as the population gets older and sicker. Um, not just not just in this country, Pretty much globally. Um, in most developing developed countries, um, we need to empower patient's to take control of their own health. More being where possible. And there is a certain element of education and transfer of knowledge there. The classic image of medical education is the the rightful humiliation model. Um, of many, many medical students carrying around a patient, um, being grilled mercilessly by a scary surgeon, often often in a bowtie. Um, I've definitely experienced that myself, but we are moving away from that approach. Um, and teaching usually occurs in a more holistic and ethical way. Nowadays, um, you know, more patient empowerment, etcetera. And there's more of an emphasis on experiential learning. I e. Doing things, you know in a supervised setting and then doing it again and again with increasing levels of supervision until you're competent at doing that skill. And at that point, you can probably supervise someone else doing it and help to improve their skills. Finally, especially at pre clinical level, and PBL is really heavily utilized. Um, so PBL is problem based learning. For those of you that aren't familiar with it. I'm sure most of you are because it is used in in most medical schools. Now, Um, um U b l is used to trigger sort of higher order cognitive functions, things like critical analysis and problem solving. Um, to help, help students consider lots of aspects of the patient's health journey. And that's been a really key development in the last few decades. And medical education. Um, yeah. So hopefully hopefully, most of you, if not all of you have some experience of PPL. Um, it's definitely a drug to get used to. And, you know, I know that, uh, talk from my own experience and and people that I know when you start PPL you think that you're just teaching yourselves. Really? Um, but when you get a group that works really cohesively, um, and works really well together and knows how to do PPL Well, um, it can be really, really valuable learning tool because you're you're not just considering the scientific versus is that happening in the patient's body, but you also considering the psychological and the social factors or consequences of that. Um, and when you get to the practice, you really see the benefit of considering those things before you actually meet. The patient's going through these problems. Um, yeah, I'm not gonna bore you to death with a litany of learning and teaching theory in this talk, because that would just be dead boring, wouldn't it? Um, but I think Constructivism is a really key theory that we use heavily in my dad without realizing it. Um, and actually, you know, when I talk to you about this theory, you're all going to think, Well, that that's really obvious. Um, but I'm just giving a name to a phenomenon that we all know exists. That happens. Um, so Constructivism It was developed by by court P O. J. Um, in about 20th century, Um, and a lot of his work centered around preschool Children and early years education. Um, essentially, it just refers to building on what an individual already knows and using that to create a threat of significance to something else. Okay, so it's a kind of a way of reinforcing knowledge, um, and solidifying and edifying it. Most medical schools will follow a spiral curriculum, so you revisit topics at different stages of the course. So for instance, you might learn about how blood glucose levels are controlled in the first couple of years of med school. Later on, you'll learn about how that system gets dysregulated. Maybe by an autoimmune process like Type one diabetes, um, or by sticky secretions in cystic fibrosis. And you'll then consider how we can address that pharmacologically at the same time, especially if you're doing something like PBL or PBL based, um, you'll probably also consider what the toll of that chronic health condition might be, Um, and and that might be reinforced by talking to patient's on the ward about their own life experiences. And and then finally, your then going to be directed to learn the complete management of diabetes. Um, including the pharmacological approach for type two patient. So, um, imagine having to go straight to those awful my skylines and learn that step wise approach off by heart without associating any meaning to it. Um, and those of you that have seen, uh, you know that have seen that kind of, uh, that wise approach on the on the nice guidelines. You'll you'll know what I mean. It just wouldn't make any sense, and it wouldn't have any any importance to you if you just went to it in its raw form, it's not going to stick. So as you know, the the human brain needs to attach significance to things and understand them to retain them. And that's what PJs theory really focuses on. Um, so let's think a little bit more practically, um, about the teaching that you will may experience or deliver either now or in the future. So I based the next few slides around some important questions to consider. Okay, the first leg. Wife. Why should doctors learn peach? So, uh, they've already alluded you. Teaching is an immensely important part of medical practice. Um, you may decide to to do teaching as a central part of your weekly or monthly schedule once you reach a really senior level. Um, you know, maybe probably as a consultant. But even if you absolutely despise teaching, you will at some point, if it's not really happened to you, you will end up with a flock of brand new third years in September and who are following you while you're struggling to get through your solo morning ward round one day. And you know It's a nightmare, and you don't want to make their day a nightmare as well. But it's going to happen to all of you. You might be the medical student in that situation, and you, you you really value good quality teaching, don't you? And and you know when it's It's not been a good learning encounter, and it's part of the doctor's duty to teach junior colleagues. So it's really it's really sensible to learn how to do it well, and in a way that's interesting and useful for both parties. Teaching is not just talking at someone and kind of path on everything you know about topic in 10 minutes. Um, I'm sure we've We've all been on the receiving end of a session like that, but an effective teaching session should be individualized and should stimulate some active participation from learners. Um, I'm telling you how important is to teach, but we really aren't thought healthy at all in medical school. Um, there are definitely course is that you know that that you can do and things, but I don't really think that, um, there's any formalized, um, curriculum focusing on learning to teach in many medical schools in the UK, and for some people it it comes naturally. You know, if you if you like to teach, you might have a natural flair for it. And but it's definitely not, um, instinctive or natural to everyone. Um, we spend years learning how to diagnose and treat disease so it would make sense that we need to learn how to teach as well. Um, and finally, taking up duties can really support your TV and your specialty applications thinking forward, um, over the next few years, especially if you're looking enough to have the opportunity to deliver teaching in a lot more long term capacity. So, you know, over a few weeks or a few months, um, it can really, really help on your applications going forward. Okay, we'll move on to our next question now. So what are the qualities of a good teacher? If this was a live teaching session, then I would would pause, and I'll get you all to take a minute to to think about what qualities and characteristics you think that a good teacher should have, um, feel free to pause the talk. Now if you want to, you know that's the luxury of a prerecorded talk. You can hit the pause button, go and get a cupper. Think about this on your way to the cattle if you wish. It's probably a good time to have a break if you need it. Um, about maybe a third of the way through. Um, so, yeah, here is the list that I came up with and, you know, by myself with a few colleagues. And it's definitely not an exhaustive, you know, by any any active imagination, and everyone's got their own style. But I think the ability to build comfortable interactions with learners and maintain an approachable demeanor is really, really important. It's absolutely key, um, to having a positive learning encounter. Um, you obviously you also need to to know something to to share with your learners. And you need to be able to communicate that and get that across effectively to them. Um, hopefully, you'll notice that a lot of these qualities do overlap with those of a good doctor. And so, you know, if we've all got these these skills to to some degree already by just being medical students or doctors, um, then we can just direct are resisting skills and to be able to excel as as educators on the ward or otherwise. Okay, what makes a good teaching session? Um, first of all, you need to find someone deep. Um, you then need to figure out who they are and what they already know that you can try and and and what they need or what they want to learn at this moment in time. And that's going to allow you to make a plan for your session and set clear objectives. Um, for instance, you know, if they want to gain confidence in performing an abdominal exam or, you know, if they're a little bit further along in their studies, they might want to get used to assessing hernias or stoma is and, you know, want to apply a bit more clinical knowledge for their pre existing, um, you know, ability to do an abdominal examination. Um, and obviously that's going to end on your learners. Starting point. You also. So you need to set your clear left, um, and set them out at the start of the session so that you can revisit them at the end and make sure that you've achieved what they wanted to achieve. You also need to, um, make sure that your learners feel safe and supported and not, you know, completely targeted and victimized. We'll touch on that in a second. Um, you need to keep the time as well. You know, nobody wants to have, um, you know, students checking their watches only halfway through the session. Um, just because of poor planning. So you need to make sure that you keep the time. Um, this probably fits in more with sort of lecture based or, um, classroom based learning activities. But even if you've got some students on the ward that June beds are teaching with, you don't want them watching the clock because you've kind of just droned on and on and on and not thought about their schedules as well. Um, one people you thinking, um, you need to revisit your objectives, as I've already said, and make sure that there then met fully. Um, you know, you want this educational encounter to be just that educational and useful for that student going forward. So you also want the maybe give them some feedback. You can give them some pointers. Uh, on maybe their examination technique or, um, their communication skills with a patient while taking a history. Um, and you also want to do that for yourself? So, you know, we think could be a reflective practice. There should be a reflective element to it. And think about what you did Well, how well that session went and what you can do better next time. Because when we're not going to improve, we have to do that as doctors thinking about our clinical abilities and skills. We should also do it with our teaching and learning. Um, just going back to the point about making your learners feel they Hopefully you've all come across Maslow's hierarchy before. And so that's this pyramid. Um, that just shows how humans need basic needs that before they can do all this sort of non essential things, like thriving in an educational setting. You know, that's not essential for survival. But it's important for, um, for us for learning. Um, we've probably all had experience as well. We felt very on edge during a teaching session, so I'm sure we can all think of as an example of that. And maybe you were in a really large group or in a lecture theater, and you got picked on to answer a question, Um, in a physiology lecture at nine AM You're a bit sleep, Um, or maybe you had to perform an examination or a skill in front of your peers and bedside teaching. And and if you're if you're confidence, is, uh is low to start off with in that topic, or even if you just don't really want to be the center of attention. Um, the anxiety and fear of that experience can really overtake any sort of significant learning or self evaluation. So it's really important if you're the teacher, um, and you're in control of that of that situation or that experience. Um, you really need to bear this in mind so making your learners feel comfortable and secure and safe from ridicule, whether that's from their peers or from you. Even, um is really, really important in allowing them to put themselves out there and try out new skills without the fear of making mistakes. Because in a in a learning environment, that's where you want them to make mistakes and get feedback and improve on themselves. You don't want it to be later, later down the line just because they never did it in a in a teaching environment and as a teacher, you've got that power. Where does learning appear? So learning can take place in a variety of settings and it can be in the traditional classroom setting in the form of lectures or small group sessions like PBL. Um, it can happen on placement. Um, a lot of clinical learning will happen on placement that can be on a on a ward round to, you know, greater or lesser extent, um, it can be in clinic. Or it could even be in the break room. You know, we often model behaviors that we see in senior colleagues whether that's, you know, senior medical students when you're a first or second year or registrars and consultants, when when you're a foundation doctor. Um and we we can kind of refer to that as the hidden curriculum. So learning that the things that we learn from observing others, um, for instance, like interdisciplinary interaction and how things actually work in the work base, you know, if we see a consultant, um, what's the formal word for it? You know, being rude about, uh, a nursing colleague or a physiotherapy colleague and working in their clinic. You know, we as a junior, we see that, and we can internalize that and internalize that conflict. Um, so it can. It can be a good thing, but it can also be a very, very bad thing, A very negative thing, because obviously those interdisciplinary complex the things we want to move away from, um, teaching and learning can also happen among your friends or your peers, Um, in the form of study sessions which can either be formal or informal. Um, really, The crux of it is that not every encounter is a formal, structured learning event, but it can be really valuable among the less. Um, and this is where you guys come in. So this opportunity to learn and teach every turn when you're in medical school, you know, as you get into the world of work and, you know, foundation training, your time might be limited, but the opportunities are still there. You just need to find a willing audience and and carve out some time for it. And as you become more senior, these opportunities, um, definitely become more plentiful and easier to take advantage of. It's obviously just a bit difficult to balance it when you're when you're working. Um, especially when you're a medical student, take it. Take advantage of opportunities that you come across to teach. Um, so we'll stick with the same question. Where does learning occur? And we'll we'll think about this in a bit more of an abstract sense. So we're coming back to teaching and learning theory. Now, um, I just want you to imagine that you're on placement on a busy ward and you've been assigned to supervise a junior student. Um, what you're gonna do with them. So thinking back to what we discussed earlier about establishing what they know what they need to know. Um, because we're using are constructive theory to build knowledge and understanding. I'm going to show you a diagram now. So your aim is to get your student in through the stretched own with yellow yellow circle here. Okay, so this green circle is essentially where they where they live, where they're happy. Um, that is the skills that they can do unsupervised comfortably, um, without really having to think about it. Okay, so Let's go back to our example of, uh, an abdominal exam or, you know, hernia assessment or something. So you got a few of them who can do an abdominal exam. You know, they can go through the motions are quite happy with that. That's them in their comfort zone area. When you start to ask them about a stoma on a on a real life patient, um, you are aiming to get them into this stretch zone. However, you don't want to push them into the red circle. The panic zone. The panicked mind just can't absorb. So, you know, thinking about being picked on an electro theater or if this student is, is trying to do the skill and assesses hernia or stoma. Sorry, Um, in front of eight of their peers, um, they're going to be so on edge that they're not gonna necessarily have anything sensible to say. Um, because they're they're just gonna have to, um, you know, think so hard about what they're going to do next, and and trying not to look silly in front of their peers. On the other hand, if you just stay in this green comfort zone, um, there's no educational benefit, and no one's really gaining anything. So you're spending all that time teaching students and, you know, trying to impart knowledge. But, um, they're not going to get anything from it. So you as a teacher, might be really tempted to teach something that you feel comfortable with. But if that doesn't align with your learners agenda, then it wasn't a meaningful encounter. So to pitch your teaching correctly, um, and, well, you need to establish what the student already knows and what they want to learn. And in that way, you can learn or teach anywhere, um, showing you a different a different picture. You got to the point that would be helpful. So, um, these colors probably aren't the best, either, in case anyone's colorblind, but you've got your comfort circle in the middle. Um, you've then got your yellow stretch zone, um, around that and you've got your red panic zone on the outside. Um, and these two diagrams are 22 different sort of, um, people to different representations. So, looking on this side, you've got someone with a fixed mindset. So, um, essentially someone that's scared of failure and actually, you know, when you think about this, a lot of us in medicine are like this. Um, you know, we've been praised for educational achievements from very young ages. And a lot of our, um, self esteem and self worth, especially in a in a professional context, is derived from that, Um so as soon as you make a mistake, you know, when you get to med school, you're suddenly you're not the cleverest first in the room. Um, you make a mistake or you don't do something as well as someone else that can really threaten your, um your own perception of your capability. Um, and that's where you have this very thin stretch zone. Um, you know the area where you're you're able to kind of put yourself out there and and risk something new. You've got a very large panic zone. Look, considering this side of the of the slide, this represents someone with a growth mindset. So, uh, some of the growth mindset is, um, more open to learning. And they're not limited by the fear of failure because you've got all this wider. There's a wider arena where they're comfortable to try something new and risk getting it wrong. Um, because, you know, viewing failure as undesirable outcome is such a huge barrier to learning. Because, really, you you want students to make mistakes while they're supervised so that an experienced teacher or someone senior to them who has more experience at that skill or or that, um, that capability can help them to adapt and refine their approach and increase their chance of success in number one, an exam setting, but also just in the real world, dealing with real patient's. Um, you know, if I I take it to a personal, um, example. Um, I used to avoid bedside teaching like the plague as a student because I was just so scared of doing something wrong in front of an F one who volunteered to do these bedside teaching sessions. But all I really did was just deprive myself of a really good opportunity to learn, because I was scared of what I perceived as as failure. Um, in front of my pears and in front of seniors. Um, and this, you know, this kind of this representation is based on a few different models. Um, like cross keys, stretch model. I think it's called um, but if you're interested in in reading about mindsets, this north are called Carol Dweck. Um, and I've got some references at the end of the talk. Her work is really, really interesting. And it's really revolutionary to read. Actually, um, if you're interested in sort of the psychology of learning and risk, um, it's a really interesting one to to have a flick through. Don't read it back to back, but have a flick through Finally, um, thinking about who your audience are. So what I've said before is, you know when when you you you find an opportunity to deliver a teaching session, you need to understand a bit about your audience. So, as I said before, um, you need to find out a bit about them before you just launch into teaching something. Um, otherwise, it's just gonna be dead boring and not very helpful for anyone. Um, number one you want to think about. Are they? Are they pairs of yours or not? So are they juniors or are they on the same level? Because that's gonna make a difference to what you want to talk about. Um, if you're teaching peers, maybe you want to share a personal perspective on an interesting case that you've seen, um, and maybe stimulate some case discussion because their skills are likely to be on a par with yours. And you're not necessarily going to to teach them anything anything new from a curriculum that you guys have shared for for for years. Um, if they're junior to you, then it is a bit easier. But you still have to ensure that you're aligned with their curriculum and not just jumping way ahead because number one, you're gonna push them probably into the panic zone that we've just talked about. And they're not gonna be able to construct anything meaningful out of that experience because you've you've kind of skipped a few steps of the ladder. Um, it's like building a brick wall and just skipping a few bricks. You know, you're not building anything stable and you're not giving them the tools to construct that threat of significance through what they've already learned and what you're trying to teach them. Now, remember that you want to know what they know and what they want to know. You don't just want to, um you don't want a basic teaching session on what you want to say. It needs to feel about what they want to learn. Um, and remember that alongside other health professionals, we also teach our patient's. So especially if you're thinking about an outpatient or a G P setting. You know, maybe you're discharging a patient with a VP shunt, and you need to educate them or you know their parents. If it's a child on signs to look out for, like red flags, that would warrant urgent medical attention. Um, you have to explain the rationale behind those things rather than just launch into a list of things for them to look for. Um, so we need to be able to establish the right level to teach nonmedical people, too, which is a completely different skill in itself. Um, but, you know, we don't just educate, um, appears or, um or junior or allied health professionals. We also teach patient's. When will I have the opportunity to develop my teaching skills? The answer to that really is as early as you want, and so you can start teaching as soon as you can find someone to listen to you. Um, obviously, if you're a first year medical student, Um, that will probably take the form of teaching peers. Um, but as soon as you get to secondly, a medical school, you have a whole cohort of people that, um not necessarily no less than you, but have learned less than you have spent less time in medical education than you. That there's an opportunity right there and that will continue as you increase in seniority and increase inability. Um, teaching peers is a really good way to revise. That's what I used to do in med school. Because if you can explain a concept in a way that someone else understands it, that's a really promising sign. Um, you know, in reflection of your own understanding of the topic, Um, there are often revision sessions that are organized by senior medical students across all years of med school, and they're really easy to get involved with. If they're not a thing where you are, just make them a thing. You know, this is this is huge amount of benefit that you can gain from that, and you can always get feedback when you get involved with these sessions. Um, again, if that's something that you need to set up yourself. Just go for it. You just need, you know, an hour, um, on a Wednesday afternoon or, you know, whenever you have free slots, um, and you need to hand out paper forms and get feedback. And you can put that in your portfolio, Um, feedbacks really, really important, obviously, for your own development, but also to evidence that you've been teaching If you want these teaching sessions to count, um, on CV or on your CV or specialty applications, um, that's our teaching again is often locally organized, and it probably already exists. But if not, for instance, if you're an f one and just get a few of your colleagues together arranged to to meet for an hour, Um, as in meet some junior colleagues and go through some cases or examine some patient's. And your juniors will be really grateful to get some feedback on. You know, the history examination skills, and you can gain confidence in taking on a teaching role. Um, in something that you probably really comfortable with, um, already as an F one or an F two. Um, when you're giving out feedback forms, um, as well just bear in mind that sometimes paper feedback forms might be a bit awkward, you know, especially if you're teaching to students. Um, and you give them a paper form, and you stand there waiting for them to fill it out. And sometimes you're not going to get quite honest feedback. Um, so you can also consider using Google forms or something similar. Um, and really teaching doesn't even have to be with a medical school. Um, you can teach outside medical school in the community. Um, there can be something completely unrelated to medicine. Or, you know, you can get involved with, like, Saint John's ambulances. Um, Saint John's ambulance. Sorry, um, teaching basic life support and things, um, in the community. Um, and, you know, remember that knowledge is power. The more understanding you can help your patient develop about their health and well being the better off. Um, they are essentially in managing their own their own chronic health conditions. So, um, teaching is really important in G p and outpatient settings as well. Um, in terms of building a career in medical education, there isn't a formal pathway at all. OK, um, there are, however, lots and lots of avenues to, um, you know, building up your, um, your own ability, um, and your own skills in medical education, whether you do that formally or informally, um, one thing that a lot of you might be interested in is the academic foundation program, which they've actually have actually changed the name. Something something else. Now, um, essentially, these are foundation programs that last the same the same length as the standard foundation program. Um, it's two years, Um, and you usually replace one of your foundation jobs with a essentially with a four month post in usually research or maybe medical education. Um, you will get the same sort of the same amount of clinical exposure. Um, but we'll talk about that in a in a little while where I should talk about that on the next slide, I remembered, um, you can do postgraduate qualifications. So I did a postgraduate certificate in medical and health education and that let me kind of look at the teaching and learning theory and evidence based and think more about assessments and how useful the kind of assessments that we we do in in undergraduate and postgraduate settings are um, you know, you might come across, uh, opportunities where that can be paid for for you and maybe an F three job. You're probably a bit busy in F one enough to to do those postgraduate qualifications. Unless you're, um, Superman or Superwoman or something. And they're often quite expensive as well. And really, what I would encourage you to do is just to get involved with any available teaching opportunities, as I've talked about on the last slides, Um, in terms of working within universities. So, um, you can there are clinical lecturer positions available, And you you need a C c t, um, or a PhD to, um to work in those those posts. And obviously, if if you're all, um, you know, no more senior than enough to, um And then that's a little bit of a way away for you. Um, but if you are really interested in working in medical education in a university, for example, that's what you need to work towards. So, um, for me, I have tourism gp training. Um, and one of the reasons for that is I will get to my my certificate of completion of training my C c t fairly early and that will will open up sort of formal educational post for me. Um, and you often, you know, if you work in a university in a clinical lecturer position, you'll often combine that with a bit of research. Um, in medical education, um, so academic foundation program. That's what I started talking about five minutes ago. Um, I've got slide on it, actually, and they're really competitive posts. So, um, standard foundation program tracks don't require you to interview. Um, you just have to do. Obviously, you have to do your medical school exams, you'll get ranked based on them, and you'll also have to do the S J T the situational judgment test. Um, unless they dramatically change something this year, that's how it's it's worked for a while. Um, and you don't have to interview for for your normal foundation jobs for the Academic Foundation program. You do have to interview, and they're very competitive. Lots of people want it. Obviously, um, because it's it's a really good educational opportunity opens the doors to research and things, which in standard foundation program jobs, you might not have a lot of time for, um So you have to have something that stands out on your CV and to apply for these, um, and teaching is just one aspect. So teaching is not to be all and end all, obviously. And you know, you can get involved in research, quality improvement. Um, there's lots and lots of things that you can use to make your CV stand out. Um, but obviously, we're focusing on teaching in this talk and within the academic foundation program, you might have opportunities for subsidized teaching courses. Um, I'm not sure if you can get, like, postgraduate certificates and things subsidized, but, um, you know, you you might have access to some some teaching courses. Um, if you are within a standard foundation program job, you can also use your study leave, and you're study budget to go on teaching courses. So there's a course called Teach the, uh, teach the teacher. I think, um, Oxford Medical run that, um really good course. It's two days. Um, you can get your study leave. It's a few 100 quids, so you can also use the study budget that is allocated to each and every one of you, um, to to do that course, Um, I would highly recommend it, Um, as a bit of stepping stone if you're interested in education. Um, if you if you wanted to apply for the academic foundation program and you didn't get it, um, it's not the end of the world at all. I didn't do an academic foundation program. Hence, I don't know very much about it. Um, but, you know, you have the same variety of jobs. You probably would do five clinical jobs rather than six. Um, so you're gonna have either the same or less even less clinical exposure. And you are still going to have opportunities to develop teaching and and leadership evidence. Without this, it just might take a little bit more, um, effort and a little bit more work. Um, you know, I would just recommend, like with everything. Just find some people that have done this, um, and and see what advice they can give you and see whether they have enjoyed it as well. Um, it might not be for everyone. Um, but finally thinking about F three posts. So foundation year three as it's turned, um, is extremely popular. Um, most doctors take a year out of training after f two. I think over changed it a little bit. Maybe. And so these are old numbers, but you can see that two thirds of doctors took an F three year in 2018. Um, and people do loads and loads of different things. And there are three years, you know, you can go traveling and just not work for a year if you if you're fortunate enough to be able to afford that. And I wasn't, um you can locum so you can just pick up ad hoc shifts at hospitals, um, and maybe explore a few different specialties, especially if you're undecided as to what you want to do. Long term, Um, you can do a medical education post, and that's what I'll talk about now. Um, So I I did a anatomy demonstrated job in my, um a three year, uh, so it was a job that was 100% teaching. There was no clinical, um, aspect to it at all. Um, there were lots of lots of medical education posts available. Um, and they have different amounts of clinical commitment, So I would say Think about how much you want to do. Um, you know, in retrospect, doing a job with no clinical, um, commitments at all, you know, was a is a bit of a jump, especially coming back to clinical practice. Um, but this plant there was plenty of opportunity to to do local trips and things. I just didn't do it. And what? There's loads of jobs that do, you know, sort of 50 have a 50 50% clinical commitments, 50% teaching or 8 to 20 or you know, some something along those lines, there's lots and lots of different teaching jobs. They're becoming increasingly popular. Um, and there are really good ways, obviously, to demonstrate your teaching skills. Um, but also leadership especial t interest. So you'll have teaching jobs that are, you know, maybe teaching and e d. Or teaching and obscene Gainey or teaching and general medicine. Um, if you're interested in a particular specialty, um, especially if it's a competitive one. Um, it would be a really good idea to do a teaching job within that, because you're you're getting to develop your interest in that specialty and gain more clinical capabilities. But you're also getting to explore something a bit different something you might not have had a lot of opportunity to and have a look into in F one and F two. Um, as I've mentioned before, you might get opportunities for postgraduate study. A lot of these are three post fund postgraduate certificates. So that's definitely something to ask about if you're interviewing for these jobs, Um, and you can find them on NHS jobs so that there is an NHS jobs website and you can also approach universities. Um, you know, if there's a particular place you want to work or a particular speciality, you want to work and just contact them. Um, put the feelers out. You know, even if if things aren't advertised, it may be that jobs are becoming available in a few months. Um, just reach out and investigate, um, and look into the areas that interest you. So we've come to the end of the talk. Um, just to finish off just to kind of conclude what I've what I've talked about. Um, teaching is a skill. It's something that you need to learn. You know, it might come naturally to you. Just like, um, you might be really, really good at physiology. or, um, you know, just be dead clever and not have to revise for exams and, you know, be one of those people. But there's always room for improvement, and there's always, you know, areas where you need to refine your abilities and your own understanding. And teaching is a skill that you definitely need to learn and need to be comfortable doing. Um, as a doctor, the best learning experience is is when the learner walks way thinking that was good, that was useful. Um, you need to be able to adapt what you know and help someone else understand it to, you know, it's not. It's not a one way street where you get to talk of somebody and then you walk away thinking, Yeah, I've really enhanced their understanding, but you actually haven't. Um, the really important thing about teaching is checking in with people and making sure that you're on the same page. Essentially, that's obviously something that I couldn't do with this recorded lecture. But hope you've I hope you've all you know, taken something away from it. Hopefully, um, just take advantage of opportunities that always will be opportunities to teach. Um, formally, you know if you if you can, you know, do a bit of teaching for medical students' one lunchtime or, um, informally. It can just be taking some, you know, junior medical students under your wing and, um, you know, spending a bit of time talking to them about what they want to learn and things, um So just take advantage of opportunities. And, you know, if you take advantage of lots of opportunities and reflect on how those teaching encounters go, you can then try out different ways of of doing things. And until you figure out how how you like to teach and and how you like to approach, um, you know, learning encounters and and things like that. And remember that while you're learning to teach, you're also a learner as well. So that's it's really important to reflect on things. I know. We all hate the word reflection. Um, you know, if you're an F one or F two, you're doing your portfolio. You know, just hearing the word reflection probably makes you dry heave. But, um, it's important. Doesn't have to be like sitting down and writing a reflective essay. You just have to think about what was good, what was bad. And what am I going to try and and do next time? It can be as simple as I ran over time, and they were a bit stressed because they have to get to a teaching session. So I'm going to, um, structure my session rather than just winging it. You know, it can be as simple as that, but reflection is so important to get better at anything. So coming back to our learning objective, um, we have thought about, um you know what good teaching looks like. Um, we've thought a lot about why it's important for us to learn how to teach. And we've thought about ways in which medical students and foundation doctors can develop their own teaching skills, Um, through their through their early careers. Well, that's the end of my talk. Thank you very much for listening. Um, if you have any problems or, uh, you know, questions or queries or concerns, Um, please don't know why you'd have concerns, but anyway, um, please just drop me an email. Um, my emails on the screen Merriam dot Ali seven at NHs dot Net. Um, yeah, and that's me. I'm just going to finish off with my references. Um and so this is how will that work? If you're interested in that, there's a couple of others there, and that is the end of my session. So thank you very much for listening.