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Hello, everyone and welcome to our event tonight. Um It's our fourth teaching event in the series. Um I'm gonna hand over to Kerry in a second just to introduce tonight. But before I do so, I just want to ask you all to fill in the feedback form at the end. Um and particularly just give us any ideas you might have for any future events. Um So I'm just gonna hand over to Kerry now. Yeah. Um Thanks again everyone for coming in. So yeah, we are speaker tonight is she is co training and her first like C one is in fractures in the Royal at the minute and is moving on to pediatric fractures after. And so yeah, she obviously did her family last year so good and fresh. Have lots of information for. Yeah, make sure to fill in her feedback and be very nice. Hi, everyone. Uh I'm Kerry, as Kerry said, I am currently in uh TN O in the royal er as I ct one. So tonight I was asked to give a wee talk. So I did this uh interview. So sort of, I think it was around the start of March last year. So, um, today I'm just going to give you a wee talk, um, sort of about what to expect, um, with initial emails and stuff that you get with Nimda and then just talk about the interview itself and the stations that are, you're sort of expected to sort of know and then happy to answer any questions or anything at the end. So, as I said, we're going to talk about um sort of the sort of the actual interview itself. Um and what to expect we're going to talk about the sort of three main stations um or domains that come up in the interview, which is your portfolio station, Clinical Station Management Station, and then sort of going to talk you through some of the stations that I had in my interview last year. Um and the feedback that I received from the panelists, the consultants and then going to open the floor up to questions. So obviously, for CT you can apply in Northern Ireland and you can apply in the rest of the UK. Um Tonight's talk is just going to focus on um Northern Ireland. I only applied to Northern Ireland. Um So it's going to be the same principles. I think the actual application is perhaps a wee bit different, but the actual interview is going to focus still, you know, either if you do an interview in Northern Ireland or the rest of the UK, you're still going to be expected to talk about your portfolio. You're still going to have a clinical station and you're still going to have a management station. I think perhaps, you know, the national sort of interviews, they maybe have a presentation included in their interview. But um from last year, that wasn't the case for us. And I would imagine your interviews this year are going to sort of follow the same set. So I think you'll have sort of three main topics, which is the portfolio, the clinical and the management station. This is um a table just of the sort of competition um ratios for the different specialties and stuff. Um This isn't obviously them all, but you can see for um this is from the 2023. So this is from my year applying for course surgery training. There was 51 places available, 564 people applied. Um, 100 and 42 were interviewed 100 and 33 appoint um and 46 accepted. Um So you have an 11 to 1 ratio. Probably the main thing from this slide issue. You want to probably be thankful that you're not dermatology or radiology. Um Core surgery training is obviously competitive to get into, but there's actually a fair amount of jobs um available in Northern Ireland. Um And something I also just wanted to emphasize about this, I think it was in the 2022 year that 108 person that was interviewed was offered the sort of last core trainee job in Northern Ireland. So you may, whenever you get your interview, you'll be to be given a rank out of 100 and 33. So depending on what your rank is, obviously, if you're within the 46 you're automatically going to be offered a job. But you have to remember a lot of people are obviously applying from Scotland, England and Wales. And if they obviously get a job there, then they're going to sort of forfeit their place here, which means that's another place opened up for someone here. So, you know, initially when you get your ranking and it's maybe 50 60 70 or whatever, you know, still hold on to a little bit of hope that you actually are in with still a chance of, of getting a job here. I know people in my year were quite a bit far down the list and still manage to get a job interview after, you know, the short list or sort of after everyone, all the other uh sort of after all of the other applications, sort of came out for the rest of England and Scotland and Wales. So once they all got their jobs, a lot of people, a lot of spaces basically became available here and they were offered the job. So, um if you initially don't get an offer, you know, don't lose all hope there's still a good chance that you'll get a place. So this is the initial email that you'll get, you'll get an email inviting you to the core training interview. Um You'll get it on your oral account, but you should also get it on your personal email account. So it's really important over the next couple of weeks like this, this email came out on the 15th of February last year. So it's really important around this time that you're looking at your oral account every day, you're checking your emails, checking your junk emails to make sure that you're not missing any important emails. Once you've accepted your interview, you'll have to book like an interview slot or a time, you'll get an email. And this is honestly as much information as I was given about the interview last year. So it's a 30 minute interview consisting of a combination of CV clinical and management stations, the set up of it. So it last, it's online I II. As far as I'm aware, I don't think you have been given much information about the interview process this year, but I'm pretty sure it's still online for yourselves. I think it was. Um So perhaps I can't quite remember. It's 20 to 30 minutes. I would say my interview was 20 minutes maximum. Um There's two panelists, so there's two consultants, there's usually a person writing notes and then I had like a lay person who was sort of just making sure that they were being fair just like wee points for the actual set up of the day. So when you join the interview, um you're admitted into a waiting room until the panel is ready. Um When you join the interview and you are admitted to the waiting room, it says that you have, you know, in the sort of pre emails that you get, it says that you'll have 10 minutes before you're accepted into the room. So I thought, ok, I'll go in, I'll have 10 minutes to sort of try and settle my nerves. Um, of course, as soon as I press, like, enter, I was, it was straight into the start of my interview. So this is sort of a very minor detail in today's talk, but just sort of to prepare you because I think whenever I first went into my interview, I felt quite flustered and stuff because I was expecting to have 10 minutes to sit and sort of do and say nothing and to sort of try and calm down. Um, so just before you, like, even like, log into your, as soon to sort of start your interview, make sure you actually take that time to try and sort of collect yourself like 1015 minutes before. Um, and not expected it in the 10 minutes. You're in the waiting room because you might be admitted straight away once you are in the interview. Um, you'll initially sort of, I think I remember someone just holding a camera to their face and was like, right, what was your ID? So you show them, I showed them my passport, you have to show them around your room. So you let your whatever device you're using and show them around the room. So again, make sure your room or whatever, wherever you are is nice and tidy. Um So that's that and then this is just a few of the responsibilities for applicants that was sent through in an email as well. So, you know, make sure that you have your photo ID, if you don't have a driving license or a passport or whatever, now, you know, make sure you, you dig it out and try and find it, don't be leaving it till the morning of your interview, make sure that you have a, a decent um wifi connection and make sure that you're in a quiet place. Um I remember I put a sign outside my door saying like, do not disturb because they're obviously in these sort of situations, they're very sort of strict with, you know, people walking in or if they hear noise in the background. So make sure that, you know, make sure if you're living with whoever, make sure that they know not to disturb you during this time. Um Make sure that there's no one else in your room, make sure that there's no other devices or anything. I was paranoid, even if my phone was off that it would still somehow manage to get a text through. So I had all my other devices sitting in another room just in case I didn't wanna sort of give them an excuse to um you know, penalize you for something that's sometimes out of your control. Um So then just so that's just a wee sort of um talk about the actual interview. So the sort of main domains then as I've mentioned, our portfolio, Clinical and Management and Ethics Station. So the main things that they sort of want to um see in your interview, um what's your clinical skills like? What's your surgical knowledge like and your ability to sort of diagnose, investigate and manage surgical patients and that will sort of come in the clinical section when they're asking you um about maybe like a trauma call or an acutely unwell patient. And the main thing in this is that always be safe, patient safety is obviously the number one thing and always escalate, they're looking at your academic skills which will mainly be covered in your portfolio. They're looking at your personal skills, what's your communication skills like your leadership and all of that? And then they're looking for your commitment in your specialty. So have you attended courses, conferences? It used to be, I think more of a thing. Have you done your MRC S because you used to get points for that back in the day when you were doing your application. But I don't think for my, well, for the Northern Ireland last year, you didn't get any points or anything for the portfolio station. Uh You got an interview based on the exam that you all did in January and then you got a job solely based on your interview score, I think England and stuff. Um Part of their overall ranking, I think a certain percentage of that comes from your portfolio. But from last year, that wasn't the case for Northern Ireland. So that's why it's really important in your interview if you can as much as possible, particularly in the portfolio in the CV section to talk as much um about your portfolio as possible. So this is all the sections that are on the portfolio fee section in on your oral account. So the main thing here is to make sure, you know, all of these inside out, um you can sort of be asked questions on any of these and any of the sort of questions they ask in the CV portfolio station, you can actually whatever if you prepare your answer in the right way, you can actually um touch on each of these. So have a sort of quick um like a couple of sentences that you can say about each one of these headlines, like for example, your teaching experience, you know, make sure that you can, you know, give a um sort of an efficient sentence about OK, what have you done to teach? Like, what have you gained from it? Like, feedback, reflection, publications, audits. Like what like did you initiate the audit? What did you do? What did you change? What was the outcome to your sort of commitment to specialty by, you know, going to different courses and conferences and stuff? Um And then any sort of other presentations or achievements or whatever you've achieved. So the main thing is go back through your sort of oral account and go back through this portfolio section because I'll have this sitting in front of them on the day. And my, one of my first questions was basically about my portfolio and I think it was my commitment to the specialty, but actually, you know, instead of just answering about courses and conferences, I was able to sort of bring in all the stuff that I had said in my um portfolio section. So sort of main point from this slide is make sure you know, your portfolio really, really well, this is a really good mnemonic that I came across last year whenever I was prepping for the interview. Um and I used it in um and the answer I give for the, the question I had so goes by camp. So the clinical academic management and personal. So in whatever question you get asked in this section, whether it be, how have you been a good leader or whatever weird question they'll ask you. Um you can sort of link in all of these domains. So um you can for the clinical section, you can talk about your work as a uh foundation doctor or whatever stage you're at on the wards, you can talk about your time in theater, your experience on the log book. Have you assisted in? How many cases have you actually been able to perform? Some cases? You can talk about your work based assessments, you can talk about feedback. They always love feedback from an academic point of view. You can talk about your, these are just examples that I've thrown in you. So be able to make your own up or whatever. But from an academic point of view, you can talk about the teaching you've done. Have you been involved in any journal clubs? What ait and present have you done from a management um point of view? Um What committees are you on? How have you shown the leadership um your sort of management dealing with a busy on call and then from a personal point of view, again, feedback, feedback, feedback, reflection. I love reflection and then make sure you have something else apart from medicine um to talk about as well. So I my question was relating to commitment and specialty. So by literally, you know, you could say about as a foundation doctor being on like a busy ward. Um you know, I've really enjoyed the challenge of Ward rounds and theaters and being on calls. Um I've shown my clinical experience through however many cases you have on your log book. Um I've also been able to do a lot of work based assessments with consultants or whatever. And then for academic, you can say you were a clinical foundation supervisor for medical students. I did weekly teaching and presentations. I was also involved in audits which looked at whatever you looked at from a management point of view. I have. Um I'm currently on a committee um which has shown this. Um I've showed leadership every day being on call and making decisions about sick, acutely unwell patients taking the initiative to escalate to seniors and to call other specialties from a personal point of view. Um on reflecting on this year, I've realized that these are my strengths. I think surgery is a good career for me. Um outside of work, I do whatever. So, um I would really try and learn this um pneumonic and have your own sort of answer to that. As I say, I think whatever kind of question that they can ask you in this station, if you talk about clinical academic management and personal, you're covering your whole portfolio and you'll get points for sort of each thing. I think if you get asked a question on leadership and just talk about leadership, um you're not actually giving them an opportunity to give you more points by talking about, you know, the rest of your skills that you have. So, again, with any sort of, if you also prepare general questions that and that are specific to your C EV um and, you know, practice with friends and stuff and in answering these questions, this was my very first question I think because when I went in, I sort of got accepted straight away. I was a wee bit waffle, so I probably waffled quite a lot of this station, but I had that main uh acronym in my head. So um I was able to um come up with an answer. Um So the stuff highlighted in red is, is what I've copied and pasted directly from the consultant feedback that I got at the end of my interview. So some of it looks a wee bit waffle and stuff, that's what the consultants have said. But I just wanted to sort of emphasize sometimes you're always like, what do consultants actually want or what are they looking for? So this is exactly what they sort of said after each of my stations. So as I said, my question I think was about a commitment to the specialty. Um So they said strong portfolio in me, to me is able to transfer experience to patient care. So going back to this slide, you know, you can, you can link each of these things to sort of patient care um and your experience. Um And I would really, if you don't want to use this sort of um model, I would try and find your own model, that sort of brings all of those together so that you can cover your whole portfolio and sort of the one question. Um And again, provide examples of leadership teamwork and communication. But as I say, if I even ask a question about communication, you can say, you know, from a clinical perspective, I communicate every day with patients on the ward. I also liaise with like theater staff and stuff when in theater. So you don't really sometimes, but you know, you, you know what it's like um from an academic point of view, um Communication is really important as particularly when teaching medical students in, particularly when being involved in audits. Um and ethics always say about ethics when you're talking about audits. Um and then in management, um every day when I'm on call, communication is really important when you know, discussing diagnosis with patients, when having to escalate and speak to other specialties and ordering scans. And then from a personal point of view, it's really important to receive feedback from the consultants and reflect on it. So I hope you are, I know I'm sort of going on about this point, but I hope you can see that any sort of question you get in this station, you can link back to this model and you should be fine. Um So if you have any questions or anything uh on that section, um you can feel free to put it into the chat or um we can go over it at the end. So the next one is clinical. So I got asked two questions in the clinical section. And so the main type of things that you'll get asked in this section are trauma calls, um acutely unwell award patients or POSTOP patients. So a trauma call, they take the form out of um atl S type scenario and you're, you're a member of the trauma team. Um and I just sort of um sort of, I would when you're doing any sort of trauma call or a TLS you always want to start with, I would commence the primary survey following the principles of A TLS with simultaneous assessment and resuscitation of the patient in an ABCD manner. If you don't want to use that just have a slick line that you can say that um you're basically following a ad in an A TL sort of fashion, um acutely unwell ward patients. So they want to make sure that you're competent and safe in managing acutely unwell patients on the ward. And the key thing here is to know when to escalate and then POSTOP complications. So no sort of common POSTOP complications such as your compartment syndrome, you an osmotic leak or like Turp syndrome or, you know, that was just a few that came to my head. But sort of, you know, the um the sort of general POSTOP complications were sort of the main, um, specialties and have, and as I say, as long as you're safe and those, if you don't know exactly what to do, as long as you're safe and no, you know, patient is at risk and you escalate, you know, you're going to pass the station, but, you know, the people who are going to get top marks are the ones who know a wee bit more detail with exactly what to do with compartment syndrome or you know what to do with if you have a leak or something. So again, um the read is very waff, but it's just what the um panelists had given me and my feedback. So my first um station was a trauma call. So it was a young gentleman who was involved in an RTC, had presented with sort of chest injuries. I think he was hypotensive and tachycardic. Um So the main things with any um of these trauma calls is go know your ad inside out. I know that was sort of when these were medical students and finals. That was a thing. But for the sort of trauma causing the ATL protocols, it's a wee bit more advanced than that. So things to sort of highlight in the trauma call in an ATL S scenario. Um You know, apart from saying you're going to approach this in an ABCD E fashion using a TL S protocols, always do airway and see spine immobilization as your first thing. Um So on the ATLS course, they sort of teach you to walk into like a trauma station with your hands out, ready to hold the C spine and someone to sort of check the airway. Um So airway and C spine are obviously the things you're going to do first and always say three point immobilization. These are just we key things for the ATL S. You're going through A, then you're going through B you're saying, you know, you're going to check the respirator rate, do a gas. Um You're going to get a portable chest X ray, you're going to look for any chest wall abnormalities, any flail segments, any sort of bruising asymmetry and chest rising, whatever. Um And then the main thing with this is if you find a problem with B, then stick with B fix it before you move on. Don't go through a whole A to e whenever they've had it. I think in my patient had a massive like hemonia or something. Um So you need to fix that, intervene and then re reassess and then move on. So again, from you can see in the feedback, they give me um important thing as well with trauma call. If like in the royal, I'm in, as I say to in the Royal at the minute, when you get a trauma call, the trauma call goes out a wee bit in advance before the patients here, not always, but in an ideal world, it usually does happen. So whenever you go down to a trauma call, there's obviously a team lead and everyone's given their roles like airway anesthetics are always the airway. Usually the general surgery team or B which I never understand. And then Ortho or c um, and then whoever else is around does the rest. But um, it's important that you establish before the patient comes in who's doing what in the airway. So that's just like a wee side point. If you've never really been involved in trauma calls, that's actually what is meant to happen. So make sure in your interview that, you know, you say, you know, prior to a trauma call, you would um establish the roles of each team member and you would approach the patient with an A TLS protocol using IE or something. So, again, like as mentioned and c spine immobilization, again, something that's I don't think has done that well from being a trauma cause. But in the ATL S, even if your oxygen is 100% you basically, they go straight away and put like a 15 L non rebreather mask on. So, you know, obviously you don't know what the oxygen stats are, um until you sort of get to be, even though you sort of do in real life because they're hooked onto a monitor before they arrive in Ed. But, you know, when you're talking about stabilizing the c spine in the airway, just say you would apply high flow oxygen. Um as well. Again, my patient had like a query flail segment needed a chest X ray and an ABG. Another thing to note in trauma call is always do a log role, um palpate the spine and do apr if appropriate. Um especially if you're worried about any sort of um like neurology or central cord syndrome or something like that. Um And then as I say, my patient, it was that they had chest wall injury, so had to do like a um a needle decompression um and a chest drain and we random things, but I was asked the sort of um the boundaries and stuff and the region for a chest drain. So as I say, usually the decompression in old books will say mi clavicular line, second intercostal space, but actually the new 10th edition of the A LS Trauma is um fifth intercostal space, um just anterior to the mid axillary line. So if you haven't done the ATL S, you might actually not know that. But that's something I think that they asked on purpose in my interview to sort of catch people out because I think maybe a lot of people hadn't done the ATL S and I had just done it before the interviews and stuff. So I was able to say that. So that's just a wee side point, but just something to note Uh And then again, I think my patient then was dropping their G CS. So it was like he had to reassess if you were worried about a reducing G CS, then anesthetics involvement. Um So know this station inside out because he will most likely get a trauma call. My other friends had different types of trauma calls like falls or buildings and stuff like that, but it's all the same principle. The main thing is to always reassess if you've done an intervention. Um if you're worried about airway or anything in any way, get anesthetics. Um And always say you would have a senior there no matter if it's something simple, just say you'll have a senior and you'll um they can, that's you showing them that you're safe and they can't argue with that. Um My next station was that the patient had presented to ad with back pain and urinary retention. So I started with doing an AD E assessment and they were basically like, yeah, ad E is fine, move on sort of thing. So sometimes that throws you off and you're like, oh fol, what do I do now? Sort of thing. So the main thing that they wanted here was a focused history. So you're not actually taking, I think from memory, I wasn't actually taking a history from the patient. I was saying what I would ask. So obviously, the main thing here you're worried about is like prostate cancer with like Bony Mets or something. Um So you sort of focused that on previous history of past medical history, weight loss, night sweats, fever, any urinary symptoms regarding prostate or whatever. Um, so you can see there that I had asked all of that and then regarding M DTI think that I had to, I say to the patient, what I thought was wrong. So you introduce yourself, also be familiar with breaking bad news. I had to assess what the patient knows so far we needed to get further investigations like CT S MRI S, whatever. Um, and then you're able to speak to your patients about the initial concern. So I wasn't blasing saying everything's ok, you'll be fine. I said, like we're worried here that there's maybe something sinister going on. Like I think I just came out and said cancer or something because you want to be honest, but you don't want to, you know, you want to make sure that the patient knows what's happening. There's nothing worse than, you know, ordering all these scans for patients and they have no idea, sort of what's going on. So, um, I was sort of just honest in that situation and as I say, it was an obvious sort of back pain prostate type, um, cancer sort of station. Um, and the important things here are, are making sure that you order the appropriate scans, having an MDT approach, you know, when you're going to speak to the patient, bringing someone with you. Um just the sort of general principles of breaking bad news and then um seeking obviously urology advice because it was, it's their sort of station. So I was there sort of um patients. So that was sort of that station and that was the feedback. So some you'll have your trauma call type scenario where you want to go through AD E but sometimes you'll have these other stations where they'll be like, yep, ad E is fine to concentrate on the actual um issue. So key points. So as I say, you know, your ABCD inside out practice presenting it and ensure that you're using the appropriate adjuncts and always reassess after an intervention, always escalate to seniors in any scenario. Um I would always say it just shows that you're safe airway concerned, just get anesthetics um immediately don't wait. No, the landmarks for the chest, the chest drain and the, the decompression. Um any trauma called immobilize the sea spinal three point immobilization, which is your collar block and tape and airway support and don't forget to add oxygen. And then as I say, you know, your common surgical emergencies as well. So that's the clinical station. So again, if anyone has any questions or anything, feel free to ask, um these slides also will be made available. I'm happy for them to be sent out. Um whoever is asking. So management, so dealing with it. So again, general questions that you'll get are you're dealing with a colleague, dealing with a patient or dealing with consent and ethics and stuff. So probably the main thing to say here is the ideal situation that you would say if you dealing with a colleague is never what happens in real life. Um But you know, just say what they want to hear. So and dealing with a colleague, these are just as I say, examples again, it's maybe a colleague being late to work, which we've all had experience with. It's load of gaps which we all know, obviously it's not getting enough the time or there's conflict with within your department when dealing with the patient that may be an angry upset patient, that may be dealing with a complaint, um communication skills, breaking bad news like I did with the sort of prostate cancer. Um again, dealing with the patient. So with regards from a surgical point of view, the who checklist your A SA grade and the NC EP OD, which is your National Clinical Excellence or, or inquiry of the perioperative death, whatever that stands for. But it's basically whether your surgery is an emergency, urgent or elective and then dealing with consent. It is a really important topic. One of my questions was on consent that I had in my exam. You need to be familiar with the different types of consent and the sort of legal issues that come up around that as well. So again, one of my stations was rota issues. I think the scenario was ra gap. Someone's all sick, you're not getting enough theater. Um, the wards need covered and the bleed isn't covered, but you're meant to be in theater or something along those lines, which is sort of a day to day in the life of a surgical sh. But, um, so again, something that I'm going to talk about is another wee sort of um model to sort of um come up with a good sort of answer for these type of questions. But in, in this question, you always want to seek out information. Um if you want to sort of find out what's going on, you want to escalate, um and you want to sort of come up with an initiative or come up with a plan. So again, in this situation, I had talked about wanting to understand, well, why is the RG is the person who's off? Ok. Do they need help? Um Talked about sort of seeking more information and being sort of empathetic towards the situation, patient safety. So obviously the main issue, even though I meant to be in theater, the main issue was the fact that wards weren't covered and no one was holding the bleed. So as much as you don't want to, you're going to have to go on the ward and hold the bleed because it's the safe thing to do. Um, you want to sort of escalate. So you would initially discuss, you know, with your voter coordinators if they're not able to talk about it, then your clinical or educational supervisor, um, and then sort of taking the initiative. So what can you do to improve these things? So, you know, you could try and get someone if they're willing to cover or go to the ward and make sure all the patients are safe and whatever. And then we have to go down to theater if there's time at the end of the day or something. Um Again, the main thing with this is so, so I is already escalation. Um Sorry, excuse me. Uh The second Panelist had said about alternative solutions and ensuring the patient is safe. Um And that you would take the bleep um and ensuring that you're empathetic towards the reasons for the gap, not that we ever are, but you have to sort of say that. Um So, um as I say, that was one of the patients, uh The next patient was a patient on the operating table. Um And they changed their mind about the consent, you had already consented them. So this is a really important reason why you need to know the different types of consent. Um And so I take up my throat um and to understand the capacity and time dependent um aspect of that, the patient, I was on the table. So I'm actually just going to take a quick break and get a drink because I'll be able to finish this talk otherwise. Sorry. Yes, you owe me, Carrie. Sorry about that. Um That was me not being prepared having um What about my side? So um main thing about consent is you weigh it up, communicate it. Can they say it back to you and can they understand? Um So this patient was on the operating table. Um And they changed their mind and I think that they were ready to like anesthetize them. So we sort of had to talk about that again. I said about they consent, the main things, we consent to different types of forms and then understanding capacity um and advanced directives and stuff like that. So the main thing um for this station is to follow this model. So spy so seek information, patient safety and should have escalated and support. So in any of these situations, sorry, I'm going to have to mute again. Sorry. Um So the main thing is you want to seek information. So in any of these questions, ask? Ok, well, why is there a road a gap? So why did the patient change their mind? Obviously with um a patient changing their mind about consent? Are they confused? This patient's obviously getting surgery? So like your acronym thing for a patient being delirious or something, you know, peeing infection, that sort of thing. Um Patient safety. So we always want to to ensure there's patient safety. So for the rota thing I said. Ok. Well, why is there? Um, I wrote a gap is someone unwell, has someone gone off on sick leave for stress? My main concern here with there being water gaps is the fact that there's a patient safety issue, meaning w jobs are on calls are at risk of not being covered. I would take the initiative and first of all, talk to the coordinator and understand if there's anything that can be done, if there's no or whatever in the interim, I would make sure that the wards are covered and there's someone on call. I would escalate this to my clinical supervisor, an educational supervisor and I would provide support to whoever's sick or something. So again, again, with the consent one. Ok. Well, why has this patient changed their mind? Are they acutely unwell? Are they delirious? Um The main thing is patient safety. So again, this patient, I think had a, I think they had a femoral hernia that was a risk of obstruction. So it was obviously like important that they got the surgery. I would take the initiative. And first of all, um escalate to my reg and my consultant and I would get them to come down to theater. So quite a lot of the time in theater, you're the sort of one there at the start and then the consultant in reg will sort of come on in. So particularly in like Ortho, you're the one initially sort of setting up the images and stuff and with the r and getting the patient prepped and then the consultant will come in later. So it's important this patient was obviously lying on the bed. They were acutely unwell there or I think they had an obstructed femoral hernia or something. So you can't really be like, yeah, it's OK. Go back up to the ward there. But you know, you're taking in issue. The main thing is patient safety. I'm concerned about the patient in this case is they have a femoral hernia, which is at risk of being obstructed. That means they're at risk of becoming acutely unwell. Um I would take the initiative and escalate to my seniors. I would check to see if um what consent form they sign and if they have an advanced directive, I would escalate um and offer support. So as I say, in any of your management ethic stations, if you sort of follow this model, um then you can cover all the main points which is mainly patient safety and escalating. Um And you can see here that um I got they had talked about me looking for solutions. So looking for alternative solutions ensuring patient safety. Um and then sort of for taking an initiative would look to optimize opportunities in the future. So I think I said about, I don't actually know what I said, but I think I said something along trying to get extra data time speaking to my clinical supervisor. And then as I say, empathy for reasons for the gap. So um support, you know, supporting your colleagues and stuff. Um obviously, you're always frustrated when there's gaps, but um you need to be supporting too. So and again, the consent one was understanding the capacity. So have this model in your mind when you're going through these stations and you'll hit all the key points and you'll get, you'll do well, these are just a few wee random slides that I've thrown together for the um management stations. So consent form. So your form one is adults with capacity in Northern Ireland. That's your pink consent form. Form two is your parental agreement um to investigation or treatment that's for Children. That's your yellow one. form three is um sort of patient parental consent for procedures where consciousness of the patient is not impaired. Um I don't actually know what color that is and then form four is, you're unable to consent and that's lack of capacity. That's your green form. So as I say, make sure, you know, the main things for obtaining consent, make sure you know a bit about advanced directives. Um and make sure, you know, if a patient signs a consent form and they sort of change their mind and stuff what that can mean. Um So usually when they come in and they sign a consent form, if a patient sort of signs a consent form but their capacity changes sometimes that can um sort of blow the waters a wee bit. Um So just make sure you look up and you're familiar with that. So I also want consent forms, make sure you're familiar with actually consenting someone. If you've never consented someone before, you don't know, see the forms like you can look them up on Google or you can see them in the hospital, just make sure you know, the sections of it. So the sections, the main thing is like what operation they're having then it's like then it's like, why are you doing this operation or what's the intended benefit? What's the intended risks or the outcome? And then it's your, you know, the complications. So make sure you're familiar with actually consenting someone because you may be asked to consent someone for like, you know, please consent someone for an appendectomy or something. So make sure you actually um confident in the actual consent form and the sort of the headlines that you would need to cover. Um and that's for that. Um So this is the classification I was telling you about which is about um the sort of the how they sort of grade the emergent, the urgency of surgeries and stuff. So you have your immediate, that's like your rupture AAA or your um laparotomy or something like that. And that's to be done within sort of minutes of the decision to operate from your time to theater. So, for example, we had a um or your life or limb at the weekend, we had a trauma call where, um, there was basically a limb and a non viable limb after someone got ran over. So we, as soon as they came to Ed, after the recess call, after they had sort of gone through the pa scan, we wheeled them straight to theater and they had an amputation of their legs. So that's your, that's your sort of type of thing that goes immediately like your limb or life threatening injuries, your AAA that sort of thing. Urgent cases are within our. So that's maybe your debridement, um laparotomy for um a perforation or something or um angio or something like that. So again, and they can um they're usually meant to be done within hours of once you've made the decision expedited is the likes of your um sort of nerve injuries or your excision of a tumor or something or like coronary angio or something like that. Again, that's to be within days and then elective is like elective AAA or your lap co um or something like that. So just be familiar with that guideline um because you may be asked about it and it's just important to know what stuff is actually immediate and urgent and what stuff can actually wait a wee while again with stratification. So this is your A SA classification, be familiar with this as well, um, every day and the issues, you have to say the A sa great as part of the who checklist. So, um, just be familiar um with that and obviously the higher, um the more sort of complications and stuff and then this is your who checklist, be familiar with this as well. You may be asked to go through the who checklist as sort of part of a management station. So be familiar with before induction. Um you know, is the site marked? Um have they confirmed their identity? That sort of the, the this will go through that then for skin incision, um you talk about like as antibiotic therapy, um being given, you talk about everyone has to introduce themselves, then you get asked about um sort of specific things about anticipated blood loss and stuff. The anesthetic will get asked about concerns and nursing team. And then as essential imaging display in orthopedics, we always have to have the images up on the screen and they get checked during this process as well. And then before the patient leaves the theater, the nurse will be like, what procedure have you um done. Is there any complications they'll ask the anesthetics, have you got any concerns or anything um before they leave the operating theater? So just be familiar with that checklist, um if you haven't had much theater experience or whatever, it's, it's, they do it every day and um it's, it's um important for patient safety. So these are just some of the sort of resources that you can use. Um, I, you thought core surgery prep was quite good. I can't remember how much it was but it had like scenarios and you could work through them and it sort of gave you a scenario, then you sort of answered it in your head and then you were able to sort of give you follow on questions. Um, these are just sort of other, um, I never actually had the interview book. I just really used sort of online sources. Um, the main thing I would say is, um, practice with your friends. Um, a couple of weeks prior to the interview sort of every other night or so, a group of two or three of us would have practiced online, given each other scenarios and stuff and given feedback as well is really important because obviously they're going through the same thing and surprising how much you pick up for them stuff that you didn't think would maybe come up. Um, you know, then you're like, oh, flip, I need to go and look at that sort of thing. Um, so I would really get a group together and start practicing as much as possible because as much as you're going over it in your head and stuff, actually being able to articulate your answer, um, and saying it in a sort of quick and methodical way to sort of get you the maximum points without running out of time is, is really, really important. So that's it. So, um as I say, I hope that was helpful. Um I'm happy to answer any questions. Um This is just a quick feedback. It'll take you less than a minute to um fill out if you, if you wouldn't mind filling that out for me. And as I say, I'm happy to answer any questions if you need. Thank you very much. Carry. That was great. Um So I just choked through it. Don't worry, that was very insightful. Um So I just have a few questions that have come through during the talk. Um So the first one is um so is it just the one room um with the same two panelists for the whole time or for each station? Do you move to like a different room? Yeah. So it's just the one room. So as I say, I had two consultants who were sitting at a table and then there was two sort of ladies sitting at the side. Uh One of them I think is like an adjudicator or whatever you call them. And then another one was like a lay person that was just making sure everything was ok. But there was two main consultants and you stay in the same room. Um And as I say, it's um it's 20 to 30 minutes. I would say my interview is maximum 20 minutes. It goes by a lot faster than you think and don't be put off by them. They really don't give you a lot at all and they don't really say a lot. They're not really reassuring that, like, yeah, she did. Well, there, um, they ask you the questions, they don't say anything after and then at the end they just about say thank you and then you leave sort of thing. So, um, you know, don't be put off if they, if they're blunt or anything to you, it's um that's how it was for me anyway. OK. Um Another question was, so how long after the interview did you get the job offer? Oh gosh. Um when did the job? I think it was maybe like a month or two after not long. Um because then you get um you get your ranking and then once they would have all the rankings done, then you basically select your jobs and stuff. So it wouldn't have been any more than two months. I can't remember exactly. But it's, it's not as long as you think. OK. Um Another question if you don't mind carry. Yeah. So um so for the clinical stations, do the examiners give you the clinical details? Like the heart rate, the respiratory rate, um what you can see. So like as you go along. Yeah, so they give you, so I think like in my scenario for the RTC and stuff, it was the patient, it was an R TCI think they gave me the, I think they gave me the general abs and then I sort of still think whenever I went through them because you're so used to going through the obs and stuff. I asked for them again and seeing if there was any change. But they give you the main, sort of like for my patient, they were like, they have obvious chest wall injury or something. I think there was something obvious that they gave me that I knew it was sort of something to do with the chest. So on going through breathing, I was like, I want to make sure that there's no like tension pneumothorax. So I'm going to check that the trachea is central. I'm going to make sure there's air entry, there's no obvious flail segment um or anything like that. So you, for the, for B and C, you want to make sure that you're ruling out all of the sort of major um traumas that are sort of associated with those in the trauma call. So they sort of make it obvious whether I think they want you to sort of concentrate your sort of focus on stuff and they give you the sort of clinical details, but you still have to sort of ask for them and say what you would be looking for. So don't just say you don't just say what spirit exam you're going to do and say, and don't say anything what you're looking for, say that I want to make sure they don't have attention. Pneumo thorax. I want to make sure they don't have a hemo pneumo thorax or a fla segment or anything like that. And likewise for e you know, make sure you want to make sure that they don't have like um like a perforated abdomen or something or a splenic rupture, you know, if they have abdominal pain, make sure that you're sort of saying things that you're wanting to rule out or whatever. Perfect. Um So another question, when did the feedback come through was that at the same time as your job offer? Um No, I think it was a bit later. Um So it was, let me actually see if I can find that. Um It was at the same time as the job offer, it was a bit of time later. Um But they give you basically the feedback, literally all the sort of stuff I had highlighted and read. There was the feedback I got. So, um they, and they sort of give you this sort of station and panelists one and two will say, um their thing, feedback, hold on. I might be able to find it and you can ask me another question. I'll see if it comes up on my emails here. Um Yeah, so I say there's a question in the chat. So it says the results of the, of the M sra are out by the ninth of January. Is that the same date as the interviews will be released? That meant to be the ninth of February. Is it, do you mean? Sorry, sorry, the ninth. Yeah, I just read the ninth. Yes, the ninth of February. Um, so, yeah. Well, I mean, I got my interview for, on the 15th of February, so I'll imagine they'll want obviously to look at it probably won't be the exact same day. Um Because um they'll obviously have to see like the rankings and stuff, but it'll be probably like a week or so. After the M the M sra results are out, mine was out on the 15th of February and I probably got my M SA ra results a similar time around that. So they'll obviously take a while to sort of look at everyone's points and rank everyone and who's invited to an interview and stuff, but it'll be, it'll be a week or so. After that, I would say I can't find that interview or I can't find, sorry that email about the feedback, but it was definitely after the job, I think it was after I got like the job. Yeah, that's great, Kerri, thank you. Um Just a reminder as well. Um If you filled out Kerry's feedback form, but if you could also fill out um our feedback form, which is just in the chat section, um And Kerry will send you our feedback as well. Um I don't know if there's any more questions. Um, do you have anything else, Dad Kerri? No, just good luck. As I say, I know it's hard because I always sort of get nervous around the interviews and stuff. But it will be the main thing I would do, can say is sort of stay calm and I know like, I've been in talks before and people say that and you're like, yeah, good one. But honestly, because as I said, I was definitely thrown off initially when I was sort of brought straight into the interview. And for my first question, I could feel my nerves are a wee bit unsettled and I maybe didn't answer it as well as I had maybe prepared. So, you know, just take that 1015 minutes before the start of your interview and, and just be prepared. And the main thing is just prepare like over this next month, you know, prepare and the main advice I would say is get in the grip with a couple of, with a couple of friends and practice doing the interview questions and stuff. As I say, if you have those main models in your head camp for the clinical and or camp for the portfolio and your spies for the management and you know, your a to e inside out, then you can't go far wrong in any station. Always just say patients here and you'll be fine. No, thank you very much. I really appreciate you. Giving up your time. Um And I find that very helpful myself. Um But yeah, no, thank you. No worries. Thank you very much. Um And just a reminder as well if people fill out the feedback forms as well, but I think we'll wrap it up there for now.