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Hi. So, hi, everyone. Uh Sorry about the uh minor delay, but let's just crack on. Uh So my name is Reas and I'm a classic themed CT one currently based in the Northeast. So, welcome to our first um session on ma the scalpel, a webinar series uh conducted by the National Surgical Teaching Society. And for this particular session which is on CST portfolio breakdown, we are collaborating with the Sunland Surgical Society as well. So, thank you to them, right? So hopefully we should be able to uh finish within the hour. Uh But at any point if you have anyone has any questions, just drop a message in the chat and we'll sort of take it from there, right? So, the main aim uh for what we are trying to accomplish today is sort of just breaking down this year. The call surgical training self assessment, which uh was recently released at 2024. Um Self assessment has been released, I think on the 26th of October. So we're quite fresh. Uh uh what I'll talk about was is about how I evidence my own sort of work from the multiple domains I will go through and I also wanna sort of, uh, talk about sort of priming your portfolio, not just for call surgical training, but for specialty training as well. And again, you know, how to maximize your points with as little effort as possible. Um, so that's what we'll be focusing on, uh, for today. So, um, I'll be sort of absolutely honest. Uh, when I graduated from medical school, uh, this was back in 2020 when COVID hit, I had a rough inclination towards surgery, but I hadn't sort of, you know, jumped in wholeheartedly. And at that point, when I looked at my self assessment score, I realized I only had about 4%. Again, you, you have about 18 months since graduating uh from med school for your first application cycle, which is uh towards the early uh towards the start of your F two. And when I first applied back in 2021 my portfolio score was about 51%. So just to sort of make you aware in 2021 the, the interview system was still based on your portfolio as M sra uh hadn't come into play at that point. So I still managed uh to get an interview, but I didn't get a uh a post. And then again, you know, at that point, I did a uh clinical teaching fellowship at Sunderland uh medical School and I sort of worked on my portfolio. And by then by the second application cycle, I scored about 90% of the portfolio. Uh But when MSA was introduced, it was that which dictated whether or not you got an interview. So, so long story short, I finally managed to get a CSD post and not these. Um So as you can see, a lot of people sort of told me right at the start or if you've not really sort of built your portfolio since, you know, the first day of med school, your chances are slim. I don't think so. I think it really, what really matters is knowing exactly what you want and then there are ways to sort of eventually uh boost your portfolio. Um And it's all about, you know, deciding whether or not you want this. So next slide, there we go. So this is the um most recent uh timeline that, that they introduced a couple of days ago. So if uh some of you might be aware that on our, the advertisement is out. Uh So the closing date for CSD application is on the 23rd of November. I think one thing to be really mindful about is the M sra sort of invitations which uh comes out live on the 19th, mainly because I think the two week period of the MSR window between the four to the 16th, again, some people might be on nights, some of you might be on call. So it's really important for you to be able to, you know, decide when you wanna set for the MSR. Um And again, that makes a huge difference because the M SRA eventually uh dictates whether or not you get an interview. So there's a lot hanging on just that one exam. Um And then once you uh the, the, the heartbreaking thing about the uh recruitment timeline is the fact that the MSR scores come out on the eight. you receive your interviews uh on uh interview, invite on the eight and then your interview dates are sort of, you know, a coup couple of weeks after. So a lot of people sort of even after sitting for the M sra not knowing whether or not you got an interview you start preparing, um which I think is still the best option because you wanna give yourself as much time as possible. But, you know, there can be uh certain instances where you don't make it, but that's OK. You always have the next year. So this is something to keep in mind. One thing I definitely wanna sort of bring to your attention is the fact that this timeline can change. So last year during I was sort of during my application because of the junior doctor strikes and so on, they had to change the uh interview dates, they had to change a couple of, you know, the the the release dates. So there's a lot of stress that was going around and uh you know, as, as someone who went through that, I can, I sort of still imagine the, the frustration that sort of comes along with that. But I think the main focus is not losing focus. Um Also just sort of, you know, keep, keep sort of working on your interviews, keep working on your, on sort of, you know, MSR and so on because in the end the dates or the timelines is not something you can dictate what you can dictate is, you know, how you do for the interviews in MSR. So this is the current breakdown of the um CSD application. So the MSI consists of just 10%. Um you know, just as in a quotation marks the portfolio, which is what we're gonna be focusing on a majority for today, uh consists of 30% and interviews mark 60%. Now, although the interview and the portfolio, you know, um accumulate for 90% I still feel the MSR is the most important thing because in the end, even if your portfolio is, you know, 100% as in 30 out of 30 if you don't do well for the M SRA you won't get an interview. So the portfolio bit, you know, completely uh is negated because of the fact that, you know, you've not managed to get an interview. So I think although the MSR only consists of 10% that's gonna be, you know, to get to getting an interview and that's when everything else sort of um, matters. So try to keep that in mind. Uh A lot of people last year didn't take MSI too seriously. Uh because, you know, they were either focusing on MRC S or because of the fact that it was recently introduced, no one really sort of, you know, put as much effort. But again, a lot of people re realize that, you know, if you don't get the interview, the portfolio doesn't make a difference. So I'm sorry to get you an interview slot. Most important thing, the interview gets you a job, the 60% holds, you know, the most water. So obviously you wanna do as well in the interview. But the portfolio, which is what we're gonna talk about today gets you the job that you really want. So for example, I wasn't too um keen on general surgery. Uh although general surgery is the most common sort of theme that you find in CST, I was looking towards either trauma and orthopedics or plastics. Uh and I managed to get a plastic, the job mainly because my portfolio was strong. So that's something to keep in mind. So this is how the um most recent 2024 surgical training self assessment score looks. Um And you can find this either on the a advert or you can just sort of search 2024 call surg training. You've got a couple of um websites online that have already broken down the scarring systems and you can use that as a guide again, it's very hard for me to sort of, uh gauge exactly. Um, the, the, um, what do you call the, the number of people who are applying this year or people who are applying over the next couple of years? Um, but either way it's really important for you to sort of, you know, have this in mind and use this as a template over the next, you know, couple of months trying to boost uh your portfolio scores based on this. So the CST can be broken down into four main domains. So that's your commitment to surgery, uh Q I projects and clinical audits, um presentations, publications. And the last one is teaching experience. So what I'll do is I'll break down each domain and also show you an example of exactly what I did and how IE evidenced it because that's also something that a lot of people sort of find quite stressful. So the first main commitment to surgery, um you can sort of subdivide it into three sections. One you're looking at your operative experience. So this is, you know, the number of times you've gone to theater, you've assisted. Um and you know, you scrubbed in. So what they're looking at is for involvement in more than 40 cases. Uh The second one is attendance at surgical conferences and the third one is uh surgical days a week. So now this is new, uh, previously, when I applied, they wanted, uh, you to undertake an elective in your, in a surgical speciality and you got full points. But I think because of COVID, they've decided to change this up a little. So now they're focusing more on sort of surgical, takes a week. Right. So, for those who are applying this year, so you have about, uh, three weeks or just more than three weeks now, before the uh, application window closes and you have until, uh, early sort of the first week of December for you to accumulate all your, uh, evidence, getting 40 cases in, in theater. I'll be honest, is easy depending on which specialty you, for, for example, uh if I, if I, you know, I'm interested in general surgery and if I go for colorectal procedures, um where, you know, each procedure takes about 2 to 3 hours, that's not the most, you know, useful. Um, the, the best way to make use of your time. Let's put it that way. Whereas in plastic surgery, you know, you can get through 8 to 10 cases in eight hours within a sort of, you know, your eight-hour cycle. So for those of you who are interested in sort of, you know, you still need a couple more numbers. I highly advise trying to go, you know, speak to a couple of plastic surgery registrars as it chose consultants. Uh, let alone make it very clear that you know, you need the numbers. Yeah. Are you applying this year? Can you join them for data? And more, more often than not, they're more than happy to help. And that's a, um, you know, that's one of the best ways. Um, whereas if you've got your 40 if you've got more than 40 cases already, now, you know, that's good. Put that aside, focus on something else, um, of the portfolio. Uh, someone recently asked, um, exactly, you know, what you need to do in theater to get those numbers. So if so, um, I'm sure most of you are aware, you've got the E log book, uh which is essentially the logbook that most, uh if not all of us use uh in the UK. And when you sort of sign up using your GMC or your email address, if you're a medical student and so on, the most important thing when you are sort of, uh, putting in the information is the uh appro the sort of, um, what do you call your, your, uh, what's that word? Your, the, what you've done in theater? So, for example, uh I, if you can see at the bottom, right, assisting counts as part of your numbers, everything counts except observed. And the only two difference is if I go into the theater, I don't scrub in, I just look from the side that's considered as observed and that does not count to your, um, surgical numbers. However, if I've scrubbed in, I've not done anything at all other than scrubbing and standing beside the surgeon that considered assisted because you have scrubbed in and you are there to help. And that is, you know, that counts just towards your number. So, so make sure that you're aware and every single uh number that you've logged on counts for assisted or higher at this stage, most likely assisted would be uh when you go for. So use this as a platform for you to sort of, you know, list down and you know, have all the numbers uh good to go. So the second point, uh the second sort of subdomain and commitment surgery is um the uh conferences which we'll come back to later on. The third one is your surgical experience ie attendance for twice a week. Now again, if you've got some time, if you're applying, you know, over the next year or two, more than enough time for you to sort of, you know, uh plan, it takes a week in a specific department that you're interested in, for example, in your surgery or transplant unit, something, you know, quite exciting. However, if you are applying this year and you are looking at trying to find the fastest way where you need to get five days surgical taste week. I highly advise you just if you're currently in a medical uh ward or you know, any other placement, just speak to the surgical unit within your trust within your hospital saying, look, I need to get five days twice a week. Can we sort of, you know, um, get this done as soon as possible and because you're doing it within your hospital, all the bureaucracy of paperwork and so on, but 90% is, you know, not necessary. So you can try to plan it out quite quickly if you are proactive. So it's not sort of, you know, all hope is lost, you still can do it. It's just that you need to make a couple of calls, speak to a couple of people and, you know, try to get a consultant who's happy enough to, you know, get you to sign off for the day week and once you get that done, uh, I've attached a letter uh, on the bottom, right. So when I applied last year, all they needed was sort of, you know, evidence of a surgical placement or elective, um, in a surgical unit. And that's exactly what I did. So I wrote a sort of very clear letter for my consultant here to sign off and I showed them evidence of my elective and my surgical placement and so on. Right. Uh I might be sort of, you know, really speeding through this by any point. If anyone has any questions, just drop it on the chat and then we can sort of pause and sort of go through them. All right. So, like I said, surgical conference, you need to attend three S surgical conferences uh for you to get the full points. Again, this is very, very simple. Uh But I'll come back to this later on as to, you know, how you can make use of this uh point, this clinical atta sorry. Uh So someone's asked this clinical attachment count as an elective. Um That's a really good question. Um II would say yes, but again, one thing to know is in the, a sort of vacancy advert, um You will have the um uh the handbook which essentially breaks down all the sort of, you know, um questions and answers as to what exactly counts for regional presentation, local presentation, uh what an elective means and so on. So it might be worth sort of looking at that which is on oral or online uh just to clarify, but I would assume clinical attachment would count as an elective. But as you can see here, the electives only count for two points. Um Whereas if you're doing something a bit more sort of like something simpler like a surgical case week, um it'll be sort of three points. So try to sort of, you know, uh maximize the points and uh just to uh note y the points don't add up. So if you score the maximum point in one domain, that's as much as you can. All right. So, um yeah, surgical conferences, we can come back to this uh in a wee while the next domain that uh that the um portfolio has is qy and clinical audits. So when I applied, uh again, that was the, the, the sort of green boxes that I've attached uh talk about, you know, sort of highlight the ones I managed to get. So I um got a quick question from a couple of people, right. I'll finish the clinical audit bit and then we can come back to the questions if that's OK. So oops, so clinical audit, so the maximum points you can get is if you're involved as the lead in all of on all aspects of a surgery, the clinical audit or Q I project. And as you can see here, the notes include, you know, it has to be two cycles and it has to be surgically themed. So if you do this, you secure eight points. But to, to top this off, if you manage to present this at a national and international conference, you get another five points. So any audits that you've done that, you know, uh is considered part of this. If you presented it, you get further points. So I'll just break it down um with this example. So in this, I presented an audit, I think at a national conference. But the, the main thing I wanna highlight here is the fact that this is an open, this is an open cycle audit in the sense where I've done my first audit, I've introduced a change, but I'm yet to, we all did that. So because of the fact that I've not, you know, showed that my change has shown an improvement, this wouldn't be counted as a full cycle. This is only one cycle. So if I were to do this, I would only get sort of two points because I was involved in the clinical audit and I only sort of managed to do one cycle. Whereas if I bring you to the second example. So this is the one which I submitted where I identified an issue, I introduced a change by sort of, you know, speaking to someone and making them responsible for um BP monitoring in um neck or femur fracture patients. And it showed that it sh it, that my change did evoke an improvement by it doesn't have to be, you know, like 50% it can be even like five or 2% which is exactly what happened here. It went from 67 to 70%. This is a closed audit which immediately uh you know, II managed to get the full points. And also because of the fact that I was the first author II sort of designed planned it and I managed to present this at a national conference. So I managed to get all 13 points. A lot of people sort of tend to get confused between uh what an audit is what AQ I is. Uh sometimes I get confused as well but to, to the best of my abilities, uh, to my best of my knowledge, I would say that AQ I project is where you're trying to show an improvement or you're trying to show, you know, evoke a change by using something. Whereas an audit can just be looking at, you know, how well the department is washing their hands or how well, uh, the theater is using the wo checklist. Uh If you do one cycle, it's an audit. Whereas if you, you know, evoke uh some form of change and show an improvement mainly that becomes a quality improvement project. All right. So just to quickly go through some of the questions, uh someone asked, they attached examples of a signed lock book this year. It looks like like two times one with more detail. One. Do you need both form? So that is a good question. I think when I did have a quick at the uh handbook, they made it very clearly that you can, you only need to submit one logbook. So it's a consolidation um for um consolidation report which you can get from the log book website itself. Uh So if you go on that just consolidation report and you just need that one sheet signed by a consultant and they would accept that. I hope that how that sort of answers your question. Uh Danielle said, uh I am g now working in UK, I've get involved in quite a few cases in my home paralog EOC book. I've also had the same case in UK Total. Good the cases from back home. So, yeah, absolutely. Um All you need is for a consultant to sign you off. So as I said, suggested for as well, all of this should be on your log book and all should be uh you should print off the consolidated report. So you might have like 5060 sort of cases there and you need a consultant to sign you off saying yes, you know, I agree that the pa this uh student or this uh doctor has, has been part of 60 cases and that's it. That, that's all you need essentially if you're working as a surgeon, I sure do. You need to take it twice a week, I think, based on the, the, the new guidelines, although you are working in a surgical department, you need to do a, twice a week to get the full points. So that's what sort of differentiates. Um And, you know, uh it doesn't make that much sense, but I guess it's because of the whole COVID pandemic which led to this sort of change cause previously it was electives and surgical placements. Whereas now it's uh twice a week. Uh this presentation need to be surgical. Yes. Um As you can sort of see here, I think that they've uh sort of made it very clear that it has to be a surgically themed audit for you to get full points. Um However, if, if it's not surgically themed, you can still get sort of six points. Uh and that's the only difference, but it still has to be two cycles instead of one, right? Uh Is that time limit of how long ago presentation you have done? Middle Me? No, absolutely no time limit. Um Anything since you started medical school counts. So again, again, med school, you know, kudos to, you try to slowly build up um especially if you're applying, you know, over the next couple of years cause things can change the um self assessment almost on a sort of yearly basis. So try to try your best to, you know, uh do as much as you can uh in based d different domains so that you are to a certain extent. Um you know, um you, yeah, to a certain extent you're able to still get the points even if they change things drastically, right? OK. So coming back to the audits, um so as you can see, this is a full um closed cycle, presented it at a uh national conference and the evidence that they require is just a certificate. So, II sort of showed here that I attended uh the event and I presented the, you know, long standing BP and that's it, that's all they sort of uh really need um as a evidence for your, for your self assessment. And now the reason why I sort of left commitment to surgical conferences later on because I feel the best way, uh is to always go for conferences where you're gonna present. Because as a medical student again, you know, most conferences are quite cheap. It's subsidized, which is good. But as soon as you come into sort of foundation training, everything gets, uh, it gets really expensive. I'm not gonna lie. So there are a couple of conferences that I've gone for which, you know, go up to about 200 to 300 lbs. And if you're going for conferences where you're not gonna present, that's a real, real waste of your, of your money and time. Cause if you start doing a couple of audits and believe me, any audit that you do, if you can find a place to present it, you know, either local regional natural uh conferences and whenever you, it is accepted, that's when I would suggest, you know, you attend the conference. That way you can sort of, you know, uh one stone, two birds. So a few more questions can surgical case a week be in the same department that you worked as uh a different as fy, but in a different branch of your trust. Yeah, I think that should be fine. I think as long as it is very clear that it's a surgical case a week, I think that's all you need because in the end they don't know which department that you've worked in, they won't know, sort of where you worked in all you need is a confirmation from the consultant that you're under, that you've undertaken a surgical case a week uh in, you know, in w whichever department how would you advise? We maximize the training, qualification points if we don't have AP set. So we will come down, uh we'll come to that uh later on. Uh But that's a really good question. Um I think that's something that all of us think of as well, but we, we will get to that does online conferences come? Absolutely. Um So now most conferences are also doing EPOS. So over the last two conference that I've uh submitted, both of them just had epos. So, you know, you don't even need to be present. All you need to do is just be online on the day where, you know, uh the you, you will need to answer a couple of questions if anyone does have. So, and you know, you get your certificate. Uh And yeah, you almost minimize the amount that you spend on accommodation and travel as well. Virtual con. Yeah. So same thing, virtual conferences would count as well as long as you, you know, you've got some form of evidence that you did attend it. Um uh You did attend the conference, right? OK. So now moving on to presenting in publications. So this is um a segment which I found quite difficult, uh, to be honest. Um, right after sort of med school because as I su suggested after med school, uh I didn't have much on my CV. So it was very difficult for me to uh convince, you know, either surgeons or registrars that, you know, I can take on a full, uh full blown research project. So I started off slow. I started off with a couple of audits. I managed to present a couple of audits, like what I showed uh to local conferences and then I sort of slowly built up. And by the time I was doing my clinical fellowship, I managed to uh present one of my um projects at a national conference. And that's the way I managed to get eight points. One thing I've realized, again, you know, sort of just uh based on personal anecdotes um audits that I've uh submitted to conferences. Most often they tend to be uh poster presentations. Whereas when I started doing research projects like um systemic review and meta analysis and so on, that's when I started to get a few more oral presentation of. And also, again, try to be smart about where you are submitting your papers. So for example, if you know, right, you know, you've got a really good paper that you want uh it to be sort of um published in a really good journal, then absolutely, you know, try to find uh conferences like August or bas or, you know, the, the major ones where your work would be recognized. Whereas on the other hand, if you're trying to do a project where it's just solely for the points, and let's be honest, you know, we are here because we want to try to maximize our, uh our chances of getting to call surgical training. Even, you know, even if the audit is uh not groundbreaking, try to present it or, you know, submit it in places where you think you might have a good shot at trying to get an or oral presentation as opposed to, you know, always going for a post presentation in the large conferences if that makes sense. Um That's something I sort of realize as well, like the ones which I've worked with different consultants that I wanted to be recognized. I tend to go for bigger ones. Whereas uh smaller audits that would not be accepted in bigger conferences, I tend to go for the regional uh or local ones. So that's one way to sort of try to differentiate. Um So men has asked to our presentation first line at a under graduate national conference by R CS its points. Yes, absolutely. Uh No. So it doesn't have to be anything bigger scale as long as it's very clear that, you know, you've got a, uh you've got a certificate or some form of uh confirmation from your consultant that, you know, you did win a prize at a uh undergraduate level that's more than enough. So, you know, kudos to you. So I think it, it really depends on, you know, your opportunities as well. So the opportunities that I had was presenting at um or sort of poster and oral presentations at conferences, uh I know some people who manage to sort of, you know, get first authorship uh full points. But again, it's all about, you know, how much time you have. For example, if I'm applying, you know, this year and I have another month, less than a month I would definitely look at right. You know, what's the conferences that are coming up where I can submit my work and I can get a couple of points most often, you know, the um abstract um deadline has passed, but it, it's always worth a shot, sort of emailing them saying, look, you know, I've got this paper, would you be interested uh or can I sort of present it at your conference? Uh Is there any slots? Uh I've tried it once it works. So again, you know, no harm in trying. Uh let's put it that way. So it's all about, you know, trying to maximize your points in the time you have. Whereas if you've got another year plus, then, you know, by all means, try to go for the full points, you know, try to present your work, uh you know, you know, in a natural stage or try to publish a first authorship. Um Again, with time with mentorship, these are possible. It just takes a bit more time than, than, you know, doing a simple audit. Uh What would be considered a competitive score for portfolio? I've heard most people score 46 plus points. Is that correct? So that, um I don't think um anyone has ever sort of, you know, um, done a paper where they tell you exactly. You know, what's the average? I hear this 46 quite often. And believe me, when I first heard that I was like, dang, there's no way I'm gonna get a, a post because 46 is quite high. But, and I realize that it most often is especially with, you know, with, with the uh system now where it's out of 52. I think most people are hovering around the thirties, you know, the thirtyish um range. So try not to let that sort of, you know, be a hindrance. Try not to let that bother you. You just focus on your points, how you can improve, you know, one point at a time and that's all you, you know, that's all you can do. So try not to let um you know, other points or other people sort of uh portfolio sort of, you know, scare you do publish abstracts count or no. So, unfortunately, abstracts uh case reports, they don't uh they're not counted. It's all uh you know, it's only stuff that's published on PUBMED, um, which are taken into consideration or, you know, if you've won a prize or if you sort of presented. Um, and, um, you know, at an actual stage or, um, an oral presentation, I think 11 of the good things about this is because there's just so many different, um, you know, options. You've, you have so many different scoring systems, it's worth looking through the handbook to try and identify, you know, exactly what each score or each sort of domain means. That way you can sort of match your, what you've done with, you know, exactly. And try to get a rough idea as to where you stand uh in terms of the presentations and publications, uh this presentation of conference need to be surgically themed. Well, based on this, I don't think so. Um I think if they wanted to be surgically teamed, they would have made it very clear. So I think you're still in the clear, uh again, like I said, definitely have a read through the handbook. But to the best of my knowledge, I don't think they've asked for surgery themed uh presentations or publications. It's all about, you know, whether or not you've had any first authorship, then, you know, you get full points. Whereas for the Q I projects, that's where they sort of emphasize it for the need of it being sly themed audits. So that's the only sort of uh key difference, right? So Yeah, this is, again, you know, uh the evidence that I gave, um, you don't need any consultant to sign you off. All you need is a certificate of your uh oral presentation or post the presentation. Uh, as well as what I did was I included my attendance uh attendance certificate as well. I know that was a bit pedantic, but I just didn't want to take any chances. So I sort of just, you know, gave both of them and you're in the clear. So just make sure that you have all of this sort of ready to be submitted for. Um So someone else, one of the conference was general uh not surgically them, but I presented surgical paper. Yeah, absolutely. So, as I suggested, I think um presentation doesn't have to be a surgical conference. Uh It doesn't have to even be a surgical paper. It can be anything that you've presented. Uh Whereas if you're doing a if for the QR project, that's when it has to be a surgically themed one. So that's the only difference does presenting in a national conference abroad count as an as an I MG. Um Sorry, could you just clarify when you say national conference abroad? So, although you've present, if, although you've presented abroad, the conference would have a very clear sort of um I, you know, titled whether or not they are regional national or international conference. Uh So for example, if you went to, let's say, uh Singapore and you presented at their regional conference that wouldn't be considered as a national conference, that would be a regional conference. So that's something to sort of keep in mind as well. So, teaching experience, um this is something that they've recently changed this year. Um So I've just highlighted a couple of things that they've changed. So previously, if you work with local educators, you design or organize a teaching of uh sort of four section teaching program, you get the full points. Whereas they realize that a lot of people started doing that online and, you know, it was a bit unfair. So now they've introduced this face to face teaching, which I'm not gonna lie does make it just a tad more harder uh for you to get this ticked off. Uh So when I did my sort of teaching experience, essentially, I did an online one where I worked with a couple of my colleagues. Uh we designed, I think six webinars and we d delivered it on uh Facebook. Uh So because of the fact that we managed to get a few students from different universities and different trusts immediately it became a sort of regional teaching and we got full points. So I think with this, it's really important for you to, again, you know, assess how much time you have, you know, how much um how, yeah, how much time you have to uh sort of give to get those two points because in the end, the only difference is two points, you know, for, for, for when I tried to organize the online teaching, it didn't really take that much. All it took was just, you know, speaking to a couple of people, speaking to the undergraduate team uh of my trust saying, look, you know, we're gonna organize this. Are you happy to start publishing or start uh publicizing our webinars, which they were obviously were more happy to do and then sort of, you know, trying to disseminate that on every social media platform where we're gonna do something face to face, especially for it to be a regional face to face teaching, you know, that includes a bit more logistics in trying to, you know, get students in trying to have uh have it, you know, scheduled into their timetable and so on. So I definitely see, you know, a bit more of a struggle. But nonetheless, if you have, you know, uh another couple of more years, obviously, this is something that you can easily incorporate um by speaking. So I'll talk about how I did it uh the next slide, but just something for you to be aware. Uh Another main point is the fact that the only difference between local and regional is the trust. So for example, if I do it, if I presented uh teaching uh webinar in one hospital, it's local. Whereas if I do it in multiple sites immediately becomes regional. So and so the difference between local and regional is very, very small. So try to make use of that information and try to, you know, immediately think at a regional level, what can I do as opposed to um you know, thinking at a local level? So for example, you know, uh as you the letter shows, um I spoke to the undergraduate uh education team in County Durham and Darlington. And what I said was, look, you know, we've got a couple of colleagues who are interested in uh contributing to the Newcastle University teaching. Um You know, we do have expertise in, let's say, you know, surgical. Uh I think my friend wanted to do medicine. So, you know, we did a bit of cardiology, gastro, so it was a good mix and we did sort of a couple of sessions online and we had um a fairly good turnout. II would say, I think about 10 students on each session, which is more than you need. Again, like it's not about, you know, getting 100 students. Um All you need is a couple, you know, a couple of students uh for you to get feedback form and for you to present that to, you know, present that back to either your consultant or whoever, you know, you're looking uh to sign you off. So again, like I said, with uh online teaching, it's quite straightforward. Um you can sort of speak to a couple of colleagues uh speak to a couple of medical students. So, what I did was I spoke to the Newcastle Medical students. I spoke to a couple of physician associates saying, look, you know, we've got the session coming up over the next couple of weeks. Um would you be interested and sort of just try to publicize as much as you can? Uh And because of the fact that we did it online, uh and we managed to get a couple of uh different uh students who immediately immediately became regional. I think one thing you can consider, especially if you're trying to do a um regional teaching face to face session is trying to speak to, trying to sort of, you know, attract um students where you've got different medical students in the same trust. So right now I'm currently based in James Cook and in, within our trust, we've got three different medical students at medical schools that are rotating, I think in the supplementary handbook, they made it very clear that if you, you know, if you provided a teaching session where you've got different medical schools coming in, uh that doesn't count because it's still one hospital. So, you know, you could sort of try to disseminate that information between these medical schools and you know, somehow trying to create a face to face teaching again, logistical, it's gonna be logistically challenging, but it's still possible. But the question is, is it were the two extra points between 8 to 10. Whereas if you've got, you know, any other domain where you feel less work is gonna give you more points, then that's, you know, that's your answer. That's why you need to be focusing on. I want to sort of, you know, prescribe where it's all about the points. But unfortunately, that's just how it is. Um it's because of the fact that, you know, the uh combination ratio is so high. Um It's about, you know, 1 to 4 post where the points really do matter. And like I said, as a side, although MSR is gonna get you the interview, you know, having a really strong portfolio is gonna allow you to have, you know, the job that you really want, right? A couple more questions um Before we proceed, uh if we download regional teaching series, um whereby we give both face to face and virtual sessions. Ah um And that's a really good question. Um But I have a feeling if you do sort of state in your uh confirmation letter that you have, you did four sessions, you know, two face to face, two virtual. I have a feeling they'll penalize you uh because they are very, very strict with sort of awarding points and they are more than happy to take away points. Uh You know, they just have to be as strict as possible. So I definitely would try e especially the fact that you know, if you are trying to do face to face, I would say, you know, just make sure that you do all, you know, all your sessions face to face. And if you're not applying this year, you're applying, you know, in the next year or two, I highly recommend not just stopping at four sessions because you know, if you've worked so hard, you've, you know, try managed to do this face to face teaching for uh you know, face to face regional teaching and you do four sessions and a year or two from now, they say, 06 sessions will count as full points, then you'll be, you know, kicking, kicking yourself in back. So try to do more if you have time because in the end, it's always gonna be helpful. Uh what can be used as proof of teaching? So, um good question for that. So what they want is not feedback forms. So what you have to do is once you get, let's say, for example, you do a teaching session, you have a feedback form from the students. What you need to do is show that to your consultant or to the person that's gonna sign you off. And then, you know, you get, let's say the consultant sign, signing off saying this person undertook, you know, da da da regional teaching session, four sessions, blah, blah and the feedback from students was positive. You know, that's we're happy and that's all you need to submit. So you don't need to submit your feedback from for the, from the students in ha it has to be a consultant uh with the GMC number sort of signing you off saying that, you know, they were supervising you. So on, in this case, for example, my ex example, for my example, here it was the director of medical education who who sort of signed me off. So although I had all my um feedback from uh online feedback from, from the students, what they want is literally something like this, a letter confirming. Um sort of what you've done. Does it be, does it have to be a medical student doctor? It can be, yeah, absolutely. It can be any healthcare professional can be nurses. Uh That, that's why I suggest that sort of physician associates as well because the, the first few years of the curriculum is quite similar to medical students. So that's why I sort of targeted those group. Uh It can be anyone uh within the healthcare profession. So try to, yeah, try to keep an open mind um and try not to just soly focus on medical students because, you know, even uh nursing students, uh nurse specialists, anyone um who, you know, who is considered part of the healthcare uh team uh would be, would be good. What is the best way to get a feedback for teaching? It's better to have contract or feedback or both? So again, you know, try to simplify it as much as you can. Uh, I think the, the way I get a feedback were online was just sort of, you know, setting uh feedback forms and immediately sort of, you know, getting them back. And the, the main purpose of the feedback form is not to submit as evidence. It's to show your consultant or the person who's gonna sign you off that, you know, you've done this, teaching, the feedback was positive and so on and so forth. So it, it, the, the feedback doesn't have to be, you know, uh complex. Uh uh When I was doing it online, the best way for me to get a feedback form back was by sort of, you know, providing the certificate. So, you know, you give and take kind of uh approach so that worked uh well to a certain extent. Uh But in the end, the feedback form is mainly uh for a consultant to approve of what you've done. Can you please name some online or virtual plan for calling where we can do post presentations? Um So let me just have a quick thing to see if I can think of anything um anything online coming up. So I, the I think the best way is just to look, you know, the best uh place to look uh on just now is on Twitter. So as soon as the, you know, CSD advert comes out, everyone sort of, you know, um tries to chip in, tries to be as uh as helpful as they can by posting sort of conferences, you know, online conferences, uh things that you can do to, you know, pick up the few extra points before um before you uh you know, uh before the deadline. And it's a really, really strong and, you know, supportive community, uh especially on Twitter. So if you just go on Twitter and search call surgical training, self assessment, you get all these uh links to, you know, how you can best sort of try to, uh get the last couple of points. Do we need to mention topic of teaching? Nope, absolutely not. Uh, all you need to do is, uh, say, talk about teaching, that's it. So it, it can be sort of surgical topic, like I said, you know, because, uh the team I was working with was also interested in medicine. So we did a bit of a mix. I did surgery, they did medicine and it didn't matter. All it has to be is some form of teaching. You can surgical conference, please explore. There you go. So again, you know, trying to, you know, sort of share among yourselves, you know, any conferences that are coming up or any sort of even regional teaching. Uh, you don't have to be, you know, in the same trust, you can be different trust, you know, trying to organize a, an online thing. And yeah, it's not full points, but it's still eight points. And the only difference is two. So it's not the worst thing if we made a teaching session, do we need to find a sign that up? So, so I think the, the most important uh point here is it has to be sort of um it's some form of a series. So like, you know, it's defined as four more sessions. So what I would suggest is try not to have, try not to do sort of four individual sessions, try to encompass that into some form of, you know, series or webinar. That way, it just looks like it's packaged nicely. So, for example, uh you know, in my example, here, you know, we sort of um started off the uh I can't remember the, yeah, the Northern Medic Facebook group. And on that, you know, we did like a 66 session webinar on different topics and it just looks like, you know, it's packaged nicely because I think on here it says if you, if you've done a couple of regular teaching sessions uh for more, you only get two points. So that's another sort of huge difference, right? If I've just done, you know, teaching sessions for medical students like bedside or, you know, one of the uh teaching fellows have asked me to do a teaching session on uh ECG and I do that, that only gives me two points. And the reason is because you have to work with the local educators to design and organize a teaching program which you know, enhances the teaching for healthcare professionals and so on. So that is the main point. So that is why I worked with the uh County Durham Darlington uh undergrad team and sort of try to identify exactly which topic the students felt that they needed a bit more help. And because of the sort of, you know, of the feedback we got from the undergrad team, that's the way we managed to design a session, which supplements their current curriculum. So that's really important point because even if you've done like, let's say 10 teaching sessions, 10 bedside teaching sessions, it only still counts for two because you've not sort of designed uh an organized uh teaching session with the uh undergrad team. So that's where it differs. So try to keep that in mind as well. Um So a few more questions they are calling for if you mention. So they are calling for paper and deadline is 5th November. So I think the, yeah, so the deadline for all your uh evidence is the deadline of the advert, which is the fifth of November. So, uh ok. No, not fifth of November. I think the deadline it should be 26th of November. So it's the end of the um advert itself. So it should be either, you know, whenever the 23rd or 24th of November. Um So you still have the next month or so to, you know, really try and sum it as much as you can try to get as many points as you can. This teaching session like this, what you're doing right now? Does it count as teaching? So this one? No. So as I said, because of the fact that for example, although I get feedback from yourselves, this, um, if I were to do this because I'm part of, you know, the National of Teaching Society, it, it, it becomes a bit gray because it's the fact that, you know, it was part of the committee uh that we managed to organize this fall section webinar. However, if I were to, let's say, you know, do this out of my own accord with a couple of colleagues and we did exactly like this. It's still very hard to convince, you know, the, the um CST team that, you know, I worked with local educators because at this point, it's, it's just me sort of, you know, putting out teaching sessions. The main difference is, you know, you speaking with uh you know, the, the uh undergraduate teams of, let's say Newcastle or Sunderland or Cambridge, Oxford, wherever you are from and identifying, right? You know, what is it that the students feel that they're lacking and how can I supplement that? And that's the biggest difference. So, although you, I'm sort of doing this, this wouldn't be counted, this wouldn't account for the 10 points. This would still account for for the two points. II. Hope that makes sense. Um Some DJ is not directly attached to a med school and do not have localizing in the hospital. How can so just have a look just, just uh because every hospital, every sort of uh district general hospital or tertiary center, although they might not have medical students, they would still have a me a medical education team. So it might not be for uh let's say medical students, but they might have a team for foundation doctors. They might have a team for nurses, physical therapists, they would have a team that sort of, you know, overseeing all the training um healthcare staff. So a and sometimes it's not obvious you just need to sort of, you know, pick up the phone call switchboard. That's what I did. I literally, I had no idea um who the, my, my undergraduate team was in my uh hospital. As soon as I saw the 2021 self assessment I saw, right? I need to do uh this, this session. I literally picked up switchboard. I was like, please connect me to the education team and they're like, sure. And you're like, oh, there you go. There is an team and I, you know, I start the conversation with them. I was like, this is what I'm planning to do, you know, can you help, you know, and like I said, more, more often than not, they are more than happy to help out. So it's, it's about, you know, trying to really be proactive, trying to really, you know, take every chance that you find because, and, and also trying to help out, you know, one another cause again, you know, the points aren't sort of limited, you know, you all can get sort of, you know, maximum points if you're working together as opposed to, you know, doing it individually. So I sort of put up a couple of things here. So, you know, introductory sessions for New F One. So if you were an F three, just now, even if you do like, you know, introductory sessions for F one that counts and, you know, you can sort of, uh, can, you can sort of, you know, speak to your education team and say, look, you know, we feel like the F ones are lacking in this, this, this, that's why we are introducing a session on this, this, this and there you go, you know, you've identified a, um, weakness in the curriculum and that's how you're supplementing it. Uh, regional teaching is again, you know, more than one hospital. So if possible, try to, you know, have that in mind, try not to, I, if you're already sort of going through all the hard work to organize a teaching session, try not to do it at a local level immediately think of how you can sort of, you know, um, make it regional because again, online, um, making it a regional teaching session online is quite straightforward. So you should either be sort of, you know, thinking of this or this. Um, if you have the time, however, if you've got another couple more sort of weeks, if you're applying this year, then, you know, this is your best bet. Again, you can only do with what you have. So I would definitely suggest, you know, doing four teaching sessions, you know, over the next 23 weeks, doing two sessions a week immediately, you get you the two points. So it's about trying to maximize uh your points, right? So the last uh domain. So in the teaching domain, you've got to, you've got teaching experience and you got training in teaching. So, um I think someone asked earlier on about, um you know, doing APD set, there is a question, you know, I get asked quite often. There's a question I asked quite often as well when I was applying because I'm like, right, I won't be able to, you know, do APG Cert in the next year. And question number two is, do I want to do APG cert? Well, in my case, I actually like teaching. So I did do APG Cert, but it was mainly for, not for CSD. It was uh you know, my own um enthusiasm for, for teaching. So that's one of the reasons uh I can you know, uh quite clearly and quite constantly say not many people have APG cert. So, you know, most often most people would have, you know, this around this domain, uh substantial training for lasting at least two days. And I've added a couple of examples. So I did uh for my first application, I did the training and teaching five day course. Again, it's really, really expensive. Um So for, for example, you can see it is like 360 bucks. Um, I think it, it really depends on, you know, whether or not you think it's, um, I, it's worth it. So I did the P GC, you know, because I II felt it was worth it for me. Uh, when I did the fight a teaching, it was purely just to get the points. You know, I like it, it was a very short, simple, sweet, uh, cost, but it was mainly to get the points that I needed. So I think it is, you know, on you to sort of, you know, tally up all your points just now and sort of start to think about. Right. You know, what else can I do without breaking the bank? What I can do if I broke the bank and what you absolutely have no chance of doing it over the next, you know, month or the next year and a half. Uh, and then sort of, you know, trying to work based off that. Right. Um, so a few more questions, um, I'm starting a such job from first. Remember, do you think I can ask for a teaching session? Yes, you can absolutely do. But I think again, you know, bearing in mind that the, you have until end of November to get all your evidence, sort of, you know, a nice and, uh, collated so you can try to push, but you need to really be proactive, you need to really try to speak to, you know, more than a few people to try to get that sorted. But trust me, I did. So for example, this um this teaching session that I did. Um So, you know, as you can see here, it started, you know, um early August, which is, you know, around when I was thinking like for me to get, you know, the full points, I need to get a few teaching sections in. So that's when I did and it was all, you know, within a couple of weeks. So it's possible, uh you just have to, you know, really push for it. So, um I think that is essentially, you know, that is um the self assessment. Um They've, they've really summarized and they've broken, they've removed all the unnecessary stuff like M RCR A and so on last year. So it's quite sort of, you know, specific to the follow domains that we spoke about. Um I think one of the things I definitely would sort of suggest is right now, your focus is going to cost training. Absolutely. That should be the only focus if you're interested in applying. However, still have in mind, you know, the secondary goal which should be, you know, high specialty. So for example, um when I was applying for CST, the first time, my only focus was CST or when I was applying it for the second time I realized, right. So, you know, I've my portfolio is looking somewhat, OK, what can I do that will not just improve my portfolio now, but my sort of, you know, high specialty portfolio. And because I'm interested in plastics, I was looking at the plastics portfolio, right? You know, what can I do, which would essentially, you know, help me both ways and trust me, you know, it, even if you have to work, let's say, you know, like 20% more, the fact that, you know, you've covered both domains in both portfolios is a huge, huge relief because I know some people who are so focused on CST applications that they didn't look at your high speciality. And right now they have to, you know, run the rat race again, try and do the the teaching sessions again in a different way because the portfolio require requirements are different. So try not to let that, you know, try not to um to have that happen to you, try to, you know, have a look at both. Um and sort of, you know, build a project or build, you know, something which would satisfy both needs. Uh, point number two, read the self assessment guidance. So again, on Ariel, you have the, um, sort of advert on there. You've got two, you've got the self assessment handbook and you've got the supplementary handbook, which is really, really long, but I definitely suggest sort of having a read because in there it differentiates the nuances between local versus regional uh the posters, the oral presentations, what counts, what doesn't count? So again, and no one's gonna tell you unless you sort of, you know, go through this, read through it and, you know, definitively sort of um know the difference between what is accepted and what is not. Uh Another reason why I definitely suggest reading is because when you're submitting your evidence, some, some um I think like a couple of domains where they say you only can submit, let's say two or three. And if you've not read and if you've by accident submitted something that, you know, from the start very clearly, they say they're not gonna accept, they won't allow you to resubmit something else. So that is one of the most important thing, make sure that you've read it so that, you know, everything you submit, you know, they should accept, you know, barring any sort of um uh yeah, but are buying any major issues uh consider projects that align with your specialty of interest. Yeah. And, um, like I was saying, if you're interested in trauma and orthopedics try to do a few more projects in TN O if you're interested in plastics, like, uh, vice versa. However, if you're applying this year, if you've got another month or so, try not to be picky, just go for anything that, you know, is gonna get you the points that, you know, is because every point, you know, makes a huge each difference. Again, although the MSR is the one that's gonna dictate by then I get an interview. Every point makes a difference in terms of you getting a job because although, you know, you've got about 630 jobs and so on, but, you know, ev even two or three points is gonna make the difference between, you know, ranking, you know, top 100 top 200 top 300. It does make a huge difference uh because the margins are slow so slim, you know, once you get to that point, so try to keep that in mind, don't take on your uh loyal projects. Um One of the mistakes I made right at the very start before I had any experience right after med school was just taking on every project because I was like, yes, I'll do this. Yes, I'll do that. And, you know, after I finish, I'm like, right, OK. You know, how does this benefit me in any shape or form? Yes. You know, obviously, it helps, you know, building that network, trying to be the person who, you know, people can depend on. It's really important. But at the same time, try to make sure that, you know, it, it helps both ways in terms of, you know, benefitting your portfolio, your require E as a trainee as well. So that's something to keep in mind. I've already mentioned every point counts. Uh So, you know, make sure that you've, and also uh your time counts as well, especially if you're applying this year. So try to see, you know, what you can get over the next, you know, couple of uh weeks as opposed to thinking of PG cert, which obviously, you know, there's no way for you to finish. Uh Some people last year were uh considering Mmr CSI highly advise against MRC S because M SRA is the main thing you need to be focusing on. Um Obviously, you know, over the next uh month, your main focus is portfolio, try to boost it up to the best of your abilities, but you, you should already be starting, you know, a bit of Srm Sra prep. Uh um And you know, trying to ensure that you score the best. So for some of you who might not know, we are also doing the M sra um webinar series this Thursday. So please join us for that as well. We've got one of my colleagues who's also plastics them, who you know, scored ridiculously uh in the Mr and she's got a lot to share with you all. So definitely you sort of attend that and something to keep in mind. Um for some, like, for instance, you know, if, if you're still post, uh if you're just finishing med school or you're still in med school or even if you're f one, you know, 12 to 18 months is more than enough time uh to build a strong portfolio. You know, if every, you know, every week, you know, you review what you need, what you have left remaining. Uh you know, what are the projects that you can undertake other project? You should, you should honestly say no to, if you played smart, you definitely can sort of um get, get a strong portfolio by then. And also it's really helpful to find a mentor. Uh It can be any sort of um sho ct one ct two within the department that you're working with or just, you know, email some uh any registrar consultant that you've, you know, enjoyed working with. Say I'm really looking, you know, I really want to apply for CSD. Do you mind sort of giving me some advice and most often they'll, you know, point you in the right direction. So uh that's something to also sort of uh give it a, give it a shot. Um So that is the end of my presentation. Um It's very hard for me to sort of gauge how, uh, the audience is because of the fact that it's, uh, online. But I hope that was helpful. Uh, we still have a couple more questions that's coming on in the chat. Um, put all your questions now and, you know, I'll try my best to sort of go through them. Um, so, uh, yeah, speaking on feedback, if any comments or questions please. Yeah. Oh, sorry that, that, uh, I get teaching points if I'm not registered yet. Yep. Absolutely. Um So you don't have to be registered at GMC. You don't have like for any medical student can do the teaching sessions. Um So it doesn't, you don't need a GMC number for that. As long as, you know, you've got someone to evidence and someone to confirm that you have done uh the teaching in accordance with, you know, any particular curriculum and so on, you know, that's, that's all that matters. Uh Someone said I'm, I'm starting to build my E LOG. Yes. Very good. Do I need a consult to sign off after each year? So, yeah, that's a really good question for you. So I have uh one of my good friends have also asked me that. So you don't need to get the a consultant to sign you up after every case. Uh They tend to get a bit sort of annoyed by that as well. So what I would suggest is, let's say, for example, you're in your surgical placement, jot down all your, you know, procedures that you've assisted, you know, you've scrubbed in and so on and the end of your placement, you know, speak to the, your clinical lead or the lead for the uh placement itself and get them to sign you off. Obviously, you know, it's, it's, you know, you shouldn't be sort of, you know, adding procedures that you didn't attend. So most of like, you know, uh a almost on all cases, the consultant will be more than happy to sign you off and, you know, they might ask you a couple of questions as to or who are you with what you do just, you know, out of interest, but, you know, try to get it all signed off at the end and again for your um CSC application when you're submitting evidence, it's a, you have, it has to be a consolidation report which is on log book, which is like sort of, you know, a link where it allows you to sort of print out all your procedures in every different specialty under one sheet. Uh So it gives you a good summary. So that's something to keep in mind. They want a man department and ID and letter from journal for this year. The email does not have all the info he wants and journal has not run with a letter and how to tick the letterbox even though it's published. So that's um that's a good question. I didn't realize that they want the uh permit ID and letter from. Why do they want so much? I mean, just me one second, let me have a look, um uh evidence of per so to be honest, II think you might be able to get away by just essentially put uh putting in your permit ID, giving them your DUI number and also get giving, you know, taking a screenshot of that. Um I'm not too sure if they suggest, you know, getting the journal a letter from the journal. Um If you can't get the letter from the journal, I would highly suggest you, you know, speak to your uh educational supervisor, show them all the and say, look, you know, I presented this, I, sorry, I published this, this is my ID da da da da. Can you sign me off? And at least, you know, you, you tend to um you know, at least have some form of evidence that has been reviewed by a consultant with a GMC as opposed to just go going with the PM previous previous years, they just accepted P me. But yeah, um that's at least one way to sort of circumvent the issue CPD two day teaching cost, but it was all virtual if we had a separate phase, teaching session would, yeah, it seems like it cost must be in person. So I think for you to get it for you to get three points. Uh I no II don't think it makes a difference between, oh, this does not include online only classes. Oh my God, I sorry. Team II didn't realize this bit here where it says online only causes cousins must have a face to face component. So this because of this bit here now, I don't think even these ones are accepted. Oh That makes it a bit tough. So I think, yeah, like you know, you might be right where it says, you know, face to face, it has to be very clearly, face to face causes. So this the first one here might be a face to face course, whereas this one here is online. So trying to, you know, when you're looking at courses over the next couple of weeks, try to make sure that, you know, it is, it does say face to face or it is, you know, um not online because yeah, I it's a waste of time and effort if, if they don't give you points for that as well. So, uh thanks for bringing that up to my attention because last year it wasn't, they didn't really specify any difference between face to face and online. Uh It seems like three points ago. Yeah. So does the evidence that you've been signed off this November or uh, yeah, it could be after November but um it can be sort of post um November but just make sure that, you know, all your evidence is up to the end of the deadline. So for example, even your, the procedures that you log, make sure that it's, you know, up to um the deadline which is 26th or 25th of November, try not to include any procedure that you've done after that. Um Just so that, you know, it looks clean and nice. I mean, if the evidence was finished before, um I mean, if the evidence was finished before the end of the application deadline but was signed after that. Yeah, so that, yeah, again, that, that should be fine. Uh as long as it, you know, it's all before the deadline. Uh but teaching should the letter be provided by staff on your postgraduate uh education to emphasize what we look at or it can be so it can be from a uh so it can be from a um clinical supervisor. However, the reason why I suggest you speaking to the education uh team is so that you can identify any sort of uh bits. So for example, uh II show, show it here. So the whole idea is to, you know, design, organize a teaching session um where you've identified any gaps in the program, which you're trying to supplement. So that's the main thing. That's why I suggested trying to speak to the education team and it just looks, you know, uh I would say it, it just gives, it looks better. For example, if it's from the education team as opposed to a consultant, like, for example, I know uh mind who did it, um who did like an A&E sort of a teaching session and the A&E consultant signed them off, which is absolutely fine, but it's very hard for them to then use that to suggest that, oh, I designed a session which, you know, looks at the program and so on. So it becomes a bit more sort of at that point. So if possible, try to get the education team to sign you off. Uh Yeah, so it can be signed off by associate specialist as long as uh you know, they've got a GMC number. Um and you know, you've got all the information on that. Um Thank you. Uh Thank you, Daniel. Well, I'm glad you found that useful, um had six months experience surgery not taking one year as a, what if I didn't get position? Do I need to change job specialty? Um Sorry, I, I'm struggling to understand uh your question about the changing jobs, which I could you clarify that bit. Uh What's the difference between MSR and R CS? Uh M SRA is the exam that you need uh to do to get the interview for CST MRC S is the membership for the Royal College of Surgeons, which you eventually need to do once you get into CT. So for now focus in the MSI because you want to get into CT. Uh and that is, you know, something like a, it's similar to the GP exam which, you know, a lot of specialties now use as a, uh for the interviews. Well, um, can be signed by the head of Academy undergraduate who's an associate who's, but he's not, uh, the specialist REG II think they can. But again, you know, just, just be just obviously try to have a read through the, um, uh supplementary handbook and also make sure that, you know, it is accepted. What you can also do is email the CSC team and clarify that as well if you are concerned. Uh But ideally it would be, you know, uh important that you get someone with the GMC number uh to sign off. So I think it should be fine. Uh Someone, yep, someone gave a link. Uh Do you have, do you get a preference? Yep. So you get to rank all the 600 jobs uh that are available. So you do get to preference and after you sort of uh rank, then you get your uh ranking, your overall ranking, organized teaching need to be done post graduate. How do you get APG Cert, how long? So PG certs are normally one year um courses. So, you know, it can be with you. So Dundee edible and so on and they cost quite a bit. Um So you can definitely sort of, you know, go on and just search PG and medical education and you know, you will get a couple of uh good years uh to sort of, um, try it out with, uh, does organized teaching need to be done post grad. No, it can be done as an undergrad as well. I know, uh, a friend of mine in med school sort of did his, uh, teaching sessions um in med school for, you know, like 1st and 2nd year. So it can be done whilst in med school as well. Uh So it can be signed after November, but make sure all your evidence is before the deadline, if that makes sense. Uh Do you think they will could change the scarring exam? No, II, don't think so. So the they've uh made it very clear this year that the M SRA is for the interviews. Uh So just focus on the mm sra for the time being. Um And, you know, that's for the interviews, uh sometime next year or sometime in Jan, the PG said will this? Uh Yeah, it won't count. Unfortunately, if it's not done by uh November, that's uh it is uh quite a painful pill to swallow, but that's unfortunately one of the sort of uh rules or one of the things that they've clarified in the past. So I think that's us done with all the questions. Um I hope the session was useful again. Uh I'll just drop my email down on the chat if you've got any more questions. Um I hope this was useful. And again, good luck to everyone who is applying this year and to those of you who are applying for the next year to, you know, have, have this in mind also have the self assessment, you know, somewhere in your periphery where you can always come back to and good luck and definitely sort of uh join us again on Thursday for our M SRA talk. Uh and you know, hopefully it's as useful as well. So take care. Have a good evening. Um, you know, see you all again.