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Ok. Yep, we're alive. Wonderful. Ok. Hi and welcome everyone and a happy new year to everyone that celebrates. We're excited to kick off our first powells webinar um for 2025. Um POWs is a globally recognized um society and we help students along their way during medical education and we're happy to um host our first um guest speaker, Doctor Heyer Monzo and he's a graduate from King's College London. He graduated in 2018 and he's currently ast four ophthalmology resident at Saint Thomas Hospital. He's um done his elective at the renowned Wilma Eye Institute at John Hopkins and he also runs um a course of school candidates pursuing a speciality in ophthalmology. And we're very happy um that Doctor Munza has um supported us in our journey and, and presenting this webinar today and sharing his expertise. Um I'll let vu my colleague take over to navigate the slides and um Doctor Monza to present. Thank you so much, everyone once again for joining. Cool. Um Thank you very much for the introduction and thank you everyone for attending. I'm going to just talk a bit about ophthalmology, um you know, as a specialty how to apply what to look out for and a little bit about my journey as well. So, yeah, I'm ready to go to the next slide. Can you hear me? Yeah, there was a connection problem. Yeah. Uh So um yeah, we can go to the next slide. I'm sorry, can you uh see the presentation? I can see the presentation but it's just on the um introduction slide. Oh yeah, there we go. Um OK, perfect. So why ophthalmology? I personally decided I wanted to do it in around my fourth year of medical school. And a lot of there were a lot of reasons I kind of decided that I wanted to do something surgical, but I didn't want the busy lifestyle that comes with general surgical specialties. Um work-life balance was a really important thing for me. Um Then given the direction of the N HSI wanted something that would give me a lot of opportunity to work outside of the NHS as well. Um So through posts elimination, that kind of came down to a few things, mainly ophthalmology or dermatology. And I thought ophthalmology as a training pathway was really, it was um really attractive. So it's a very rewarding career for one, you know, you're, you're essentially working to save people's sight and it's one of the most important senses. And as a result of that, you see very instant success in your work, very instant results. So you have a patient who comes in with a cataract, they can't see and cataracts the number one cause of curable blindness in the world. So after a 10 minute operation, they can see again and just seeing the patient really happy. And you know, it's, um it's very, very good if you want quick results and you want to feel like you're actually making a difference to someone's life. Um It's an exciting and very dynamic career. So it's rapidly changing with tech and with A I, um it's something that will continue to change. There's so many technologies that we use in ophthalmology and there's so many opportunities for people now that are even leaving clinical, the clinical side of it and they're going purely into, into tech. And we have so much imaging that we use in ophthalmology. And um you know, even 10 years ago, a lot of the imaging that we use today wasn't even around. So, um it's very dynamic and I think that makes it quite exciting as well. Um And that, that means that there's a lot of opportunities in ophthalmology as well. You know, if you're quite entrepreneurial, um it's a good career to go for. Um I mentioned worklife balance. And I think for me that's the number one reason why I really enjoy my job. Um We don't do weekends, we don't do nights. Um We don't really do any unsocial hours when you're on call. Most places you do them from home. So, um you're just giving advice over the phone, there's not many ophthalmic emergencies. So, yes, you do have to go in sometimes, but generally speaking, it's um it's a really nice specialty. Um And also as a consultant, the work-life balance is, is really good in training. It's great. And even as a consultant, it's really good in some specialties, you know, it's busy as a trainee. Um But then once you're a consultant, it's nice and relaxed. But I feel like in ophthalmology, it's fairly relaxed all the way through. It's run through training without constant hurdles. So run through training is basically um so when you do F one and F two, that's um that's your foundation training program. After that, you apply to specialty training. So some specialty programs like medicine, um you have to do internal medicine training. I MT one, then I MT two, then you reapply for ST four positions in gastroenterology or cardiology or whatever it is you want to do with the medicine, same for surgery, you have to do core surgical training. One, then CST two, then you reapply again through the whole process to whatever surgical specialty you want to do. Um whether it's, you know, general surgery or urology or whatever, um run through programs. There's, there's a few of them out there, radiology, ophthalmology, um OBS and G and E PS basically means that after F two, you apply to that specialty and you then get a training job, a training contract which lasts for 567 years. However long that training program is and you're then set in that geographical location in that group of hospitals. That's where you'll be for the entirety of your training. And most people get offered a consulting job wherever they train usually is what happens. So you're pretty much set for life in that wherever you get your training for. So it's good for that kind of certainty. You know, you don't have to move around a lot and it's good if, if you've got a family um is a good mix of clinical work and surgery, which is something that, that really attracted me towards it as well. So, um there's a lot of clinical knowledge required and there's a lot of general medical conditions that affect the eyes and something that I feel, you know, you feel like you're making a difference because it's something that's really niche. We're not taughtt a lot about ophthalmology in medical school and even in F one and F two and when you're on call, as the ophthalmology registrar, often you're the only person in the hospital who knows about something. Um So when people call you and you help them, you feel like you're making a real difference. Um And so that clinical acumen I think is great alongside that you're also performing surgery. So it's a very surgical specialty. Um It's very visual. So, um right from day one you're getting taught, um, microsurgery. And I think that's a great skill as well. Um, it's remarkable because when you start in SD one, you've never done any microsurgery. And by the end of your first year you've done at least 10 cataracts start to finish completely independently. So, um, it's amazing how much we can learn. And, um, again how rewarding it is, it's a clean specialty. If you don't like blood, it's a good specialty to go for. It's very much like dentistry. Um, you know, you operate sitting down, it's very relaxed. It's a nice relaxed theater environment. It's not toxic at all. There's very little emergencies. It's an outpatient setting. So, you know, um, um, like, you know, um, it's very relaxed and, um, as a doctor, sometimes I feel like something we don't talk about enough is, I mean, it's a, it's a busy, it's a busy job and sometimes it means that we let ourselves go a bit. Um, but in an outpatient setting, you know, you can, you can dress nice to work and, you know, you can look after yourself. You have time to, um, have a life outside of work. Uh, you finish at five o'clock every day to 9 to 5, basically. So I think that's, that's a great thing about an outpatient specialty. Lots of opportunity for charity work. So to do cataracts, like I said, number one cause of curable blindness worldwide. Um, enormous demand for cataract surgeons worldwide, um, minimal equipment required, very cheap, set up, required. Um, so, I mean, you can go anywhere in the world, you can affiliate yourself with any charity, go anywhere in the world and do high volume cataract surgery, which is, um, which is great. You can take a year out of training to do it. And that counts as part of your, you know, your surgical numbers and the Royal College will support you. Um So, yeah, and finally it's financially very rewarding. Um, we don't do things for money, but um it's good to know that you have that to fall back on. You know, you can work completely privately if you want to. And um it's got really good returns privately as well. So, um yeah, you can go to the next slide, please. So, ophthalmology in the NHS. Um So like I said, it's a run through specialty training program. It's a seven year program as of 2024 as of August 2024. It's now a 5.5 year program. Um So the way it used to work before was you do seven years ST one all the way up to ST seven after that, you have to do a fellowship in whatever you wanna subspecialise in. I'll go through the different subspecialties a bit later. But now what they're doing is it's 5.5 years the program and then the final 12 to 18 months is going to be the fellowship and then you apply for consulting jobs. So essentially, it's shortened by a couple of years, which is pretty good. Um They've condensed the program and the fellowship into seven years now. Um National recruitment. So that's how people apply. It's a national recruitment after completion of your foundation training. So you apply for ophthalmology or any specialty um around the October November time of your F two year. Um You then get, you know, your interviews and everything happens around January, February and then you get your offers in April and then you start the following August. A lot of people take an F three year, which is what I did and I'll talk a little bit about that later. Um And um yeah, um approximately 80 to 90 posts per year. Um which doesn't sound like a lot, but if you plan well in advance and you know, you want to do it from the get go, then there's no reason why you can't get one of those posts. Um like just regular people get the jobs and you're no different to any of them. So all you have to do is just play your cards, right? And plan plan. Well, um so it's specialist training from day one. There's no service provision, which is a big problem with training in a lot of NHS specialties. Um So what an I MT one doctor does or what A C CST one or even CST two doctor does on a day to day basis is essentially no different to what an F one does. You're writing discharge letters, you're, you know, you're ordering bloods and all these kind of jobs which, you know, really, you're not progressing in your career. Um, I guess someone has to do them. But I think if you look at the American model or in some European countries, the doctor does what the doctor is supposed to do and um you have other people doing these other jobs. So I think the good thing about a lot of run specialties and particularly ophthalmology is you have specialty, you know, it's, it's specialty training from right from the beginning. So you're learning how to do cataract surgery from your first month as a, as a trainee. Um And every single session that you have in your timetable is something that's relevant to your career and you're not just filling gaps. And, um, you know, just, there's, there's no service provision really, which is great. You feel like you're looked after, you feel really valued as a trainee. Um It's a highly rewarding and diverse career. Like I said, you know, there's so much you can do with it. There's so much scope you can, there's so much business side of it as well. You know, people open private clinics, people set up charities. Um People get involved in tech, they come up with surgical devices, they collaborate with, you know, med tech companies, it's highly rewarding, not only from a financial point of view, but also from a human point of view. You know, when you see the results Day, one, POSTOP in clinic and you see someone so happy they can see you've changed their life. It's a great feeling. Um, it's one of the most competitive, but like I said, don't let this deter you. Um, you just have to plan your application, it, it, you know, very well and you'll be absolutely fine. Um Go to the next slide, please. So this was the 2024 specialty training competition ratio. It's for different specialties. Um Just to give an idea. So yeah, everything went up last year, everything like um every single specialty and one of the reasons for that is um a lot of people used to take f three years before, but there's, there's not that much locum work available anymore because that's been allocated to different, you know, for a lot of different reasons, there's not enough locum work around. So for that reason, a lot of people have been forced to apply to specialty training straight away after F two just so that they're still in a job. Um and they're still working. Um I think the best advice I can give is if you're in medical school and you want to do ophthalmology or you're thinking about ophthalmology, even if you're thinking about lots of different things. Um It's worth building your portfolio and start starting to work towards it because then when you come to your f two year, you already have quite a lot of stuff in there for you to apply. Um And yeah, um if you wanna do one of the other specialties on this list as well, just, you know, have a think about building your portfolio. Um the websites of some of these specialties have exactly what you need for your portfolios and I'll go through some of the ophthalmology ones um on the next slide or in a couple of slides. Yeah. So this is the training pathway. Um It says academic training pathway at the top, but it's, it's kind of like both. I'll explain um what it's showing. So, yeah. Yeah, medical school. Um then you have your foundation program fy one fy two, there's also the academic foundation program. Now they call it the S FP specialized foundation program or something I think. But that's basically an academic program, which is what I did, which is basically in your f two year, it's 50% clinical, 50% academic. So my academic part was medical education. Um The reason I applied for the academic foundation program is because in the ophthalmology application, you get three points for completing a degree in um a higher education, um a medical education, you know, higher education certificate um in um um any, any sort of post grad degree in med ed. So I basically that was the reason I did it. Um, I think that's a good, I mean, it, it's a good reason to go for it because o often your DNA will fund the PG cert or they'll fund the, um, the medical education degree. If you do it yourself, you can, but you'll have to fork out about 2 to 3000 lbs. Um, which I still think is a worthwhile investment long term because, um, it will really go a long way when you're applying for consultant jobs. But if there's a way to do it for completely free, um applying for the S FP or as it used to be, the A FP is a good way to go around it. Um and not just for ophthalmology for anything. Um So yeah, after that, you apply for ophthalmology specialty training and then you go from ST one and you progress all the way to ST seven. Some people apply for an ACF. So if you want to go into research or academia full time, then a FP. Yes, that's the first stepping stone. And then you apply for an ACF post, which is basically three years of your whole specialty program is allocated towards research in which it's 50% clinical, 50% research. This doesn't add any extra time onto your training. The training pathway is competency based. So you have an E portfolio and you have to get signed off for X amount of things as long as you're able to do that, you'll still, you know, finish the training pathway on time. Your, your consultancy date, your CCT date is not gonna change. Um, and yeah, um, I mean, the advantage of doing an ACF is you get funding for a phd often or if you wanna go down that route, you can become a lecturer. Um, personally, I don't have much of an interest in it. I might have to do one to get a consulting job. Um You tend to have to do one for a lot of specialties in London, but we'll see, I don't have a natural interest in it. Um So I'm just in the conventional route. Um but the A CFI think there's one or two posts in the country um for both specialties. So it's, if you're really, really passionate about it, you basically do it. Um And yeah, then at the end of it, you become a consultant. So you apply for a consultant job. And yeah, and that's it. During your seven years of training, you're expected to do your F RC OP exam, which is a post grad fellowship exam. And that basically certifies you as a fellow of the Royal College of Ophthalmologists. And it just means that you, your knowledge base is um up to consultant level. So there's certain time there's a timeline which you have to pass the different components. So the part one which is just basic sciences, you can do that at any point from F one onwards. So a lot of people nowadays they're doing it in F one or an F two. So then when they come to apply to ophthalmology, they've got some points for the application already um in the bag and um I'll go through the points allocation a bit later, but you get, I think three points for um passing the exam, it's a very tough exam. Part one is the hardest out of all of them, but it's still possible if you plan it correctly. Um, you have to pass that by the end of ST three. Um and you have six attempts, then you have your refraction certificate, which is basically the same exam. One of the same exams that opticians do, um for prescribing glasses, that's a practical exam, you have to also pass that by the end of ST three. Um then you have your, um, part two written and oral exam and you have to pass those two by the end of the whole training program. Um Yeah, so it's, um, it is a lot of work but you're given time to do this. It's very well supported. There's a lot of study groups running during your training and you have two half days per week during your training to help you advice for exams. So they accommodate everything around it. It's basically, um it's taxpayers money that's going into training you and it's the college and the N HSS. Job to make sure that they're training you well. And at the end of the day, they're churning up consultant level, you know, um doctors who are really good. So everything on the training program is geared towards making that happen um ready for the next slide. So my journey, I um I did a biomedical science degree first um before I did medicine. So I did that at Saint George's during that time. Um I actually applied for medicine first time, but I didn't get in and I was unsure whether I wanted to do medicine, whether I wanted to do dentistry. So um anyway, I did a biomed biomed degree. Um I then decided to go for medicine. Um I did that at King's. I graduated in 2018. Um while I was at Kings, it's a dental school as well. I saw a lot of dental students and I realized that's actually a pretty good job as well. So I thought what in medicine is the most similar to that? So I thought ophthalmology. Yeah, it ticks a lot of boxes. Um So I decided around fourth year that yeah, I wanna do ophthalmology. Um I then did my elective which was um my King's had a partnership scheme at some universities and I think a lot of med schools have this kind of, they have partnerships with different places around the world where you can get your elective, you can get it funded. So um you apply and then if you're successful you can get a funded elective, which is basically a very tailored elective where, um, it's four weeks, you have a set time. Um, and it really, you can gain a lot for your, um, application. So I did that for four weeks and the other four weeks I went traveling in Malaysia. So it was a good, it was a good balanced elective. I got some traveling and I also got something um you know, something relevant out of it. Um I then did my F one and F two, I did the academic foundation program in Southend in Essex. Um And in my F two year, I did the PG cert in medical and healthcare education that was funded. Um And it was the a the degree award was given by Ruskin University in Chelmsford, which was the local um university and medical school affiliated to my hospital. Um Then I applied to ophthalmology in my F two year. I was unsuccessful because I didn't have enough points in the publication section um in my portfolio. So in my last three year, I thought, OK, how can I improve that? So I did a research fellow job at the Western Eye Hospital um Imperial um which basically I worked with one of the professors who was writing papers quite regularly. I worked with her and a phd student and she had a lot of stuff that was in the pipeline. It was ready to publish. Um, I helped in, you know, proofreading a few things and adding a few paragraphs here and there. And then I also did some first author. I wrote some things for her as well myself. So it was a busy six months but I managed to get quite a few publications out of it. And the other days of the, I did that two days a week, the rest of the week I just locum in A&E or in general medicine. Um And yeah, it met my objective. I was very um honest with her from the start. I said, um I need papers basically and she was very helpful and she said, yeah, of course. Um, you can join us. So I think, yeah, if you're in a similar situation, just approach people and you might get ignored by some people, but you'll also get taken on board by some people. And I think um you'll definitely find opportunities to publish. It's difficult in medical school, but you'll find, once you start working, there's a lot more opportunities and you just have to ask people and be persistent and you'll find a way. Um And then 2021 II got my ophthalmology training number in London, er, which is my first choice as well. So, um I have no regrets so far. I'm really enjoying it. Um, next line, please. Um, ophthalmic subspecialties. So it's such a niche specialty. Um The eye is such a small organ but it's so complex and there's so many different subspecialties within the eye. And I think that's quite fascinating. Um, you really become a very, very highly specialized, um, doctor. So, you know, you're just specializing on a tiny, tiny piece of anatomy. Um, which I guess for some people they actually, they actually wonder, you know, is, you know, I've studied all this medicine. What's the point of being so hyper specialized? Um And I thought that as well initially, but then I guess how many UTI S do I wanna see? How many pneumonias do I wanna see? Um II think um we need more experts in medicine. And I guess if I was unwell or if a family member was unwell, I'd go to someone who's a real expert in one small niche thing. So I think it gives you an opportunity as a specialty to do that. Um So you have oculoplastics which, you know, you can specialize in orbit, you can specialize in lids and lacrimal can do cornea and refractive. So that's um you know, a lot of corneal w um corneal um conditions and then refractive is basically laser eye surgery. Um You can have glaucoma, you know, there's vitrea retinal, which is basically retinal surgery and there's medical retina. Um there's uveitis, there's pediatric ophthalmology and strabismus which is squint and then there's emergency and community ophthalmology and there's neurophthalmology as well. So, yeah, when you get to your final year of training, you choose what you want to subspecialise in and then you do a fellowship. Some of them are 12 months, some of them are 18 months. The 18 months, one ones are the ones that are more um surgically heavy. So that would be oculoplastics, cornea glaucoma vitreoretinal. Um Those would be 18 months and the rest of them are 12 months. Um after that, you may wish to do further fellowship. So a lot of people go abroad to places in Europe, Australia, the US. Um just to gain some more experience, make yourself more employable. Um maybe do a phd but that's up to you. Um But yeah, a lot, lot of different things to choose from. Um next slide, please. So um core skills for success. So before training, I would say plan early to avoid getting caught at the bottle neck, be driven and motivated and aim high. Um And believe in yourself. I think having, having a lot of self belief goes a long way. So um if you look at the competition ratios and you think, you know, that's hard. Yes, it's hard. But just think that that could be me, you know, I'm no different from anyone else who gets in. So um I think a lot of it on the day of the interview is down to the mental side and mentality, I think it's very important. And I think if you've, if you're not confident in yourself and you don't believe in yourself, then I think you've already lost. Um, I think a lot of it, the interview is, it, it's just two conversations, each of them 10 minutes and your performance is so much down to how you feel on the day rather than how much knowledge you have. Even if you have, I think 50% of the knowledge if you speak confidently and you speak well, um, you're more, um employable at the end of the day, when, when you have your interview, you interviewed by other consultants and they're looking for someone who they'd like to have as a colleague. So even if you don't have the perfect knowledge, um just being a likable and confident person goes a long way. Um I think I have a slide that goes through um you know how to plan your portfolio. So I'll wait until that slide to go through those things. But yeah, during training, um you, I mean, you do so much to get into training, but then once you're in training, um it's kind of like getting into med school, you do so much to get in. Once you're in, you still have to keep working in order to come out at the other, at the other side. So, continued involvement in research and innovation. Um So during, during your training in your portfolio, you have to show evidence that you've been involved in audits and qis and research and publication. So I think, um, um, just keep it on top of those things from the get go. Um, keep on top of your training by that. I mean, um, surgical numbers that you need. It's not so much of a problem in ophthalmology as it is in some other fields because your timetable gives you your own operating list and that's usually dedicated for you. You'll get your numbers, but even then, sometimes, particularly in London, it's a bit difficult because you've got fellows coming from all over the world, you've got generally more complex pathology, you've got uh more complex cases. So as a result, as a trainee, particularly a junior trainee, there's not much left for you to do on the list. Um If that's the case be proactive and you speak to your program director and they're so accommodating, you'll find that they'll just find an extra list for you or they'll change a timetable in some way. And um I think that's what makes it a really good specialty as well because there's not many of us, they really get to know you well on an individual basis. So any needs that you have, they'll look after you. Um networking is important again because of, you know, um you know, um opportunities outside of clinical work as well. We have a lot of pharmaceutical companies we work with because Pharma is a massive part of ophthalmology, you know, eye drops. Um and surgical, you know, devices are really really crucial to what we do. So um you can, you know, working with pharma networking with Pharma is is very important. Um and future planning. So yeah, um just like medical school, your training will just fly by and before you know it you'll be applying for fellowships and then one day consulting jobs. So just plan ahead and think what do I need to do and try and do what you, what you can um next slide, please. So this is the breakdown of the application. So you apply on um oral, which is the same platform you use to apply for your foundation training, you do that around October time. And that's just a generic application where you put your previous, your, your list of previous posts and your um your personal details and you just nominate two referees, then you send that off and you can apply to as many things as you want by the way. So I apply to psychiatry as well, even though I have no interest in it, I thought if I don't get into ophthalmology, at least it's something that I can do. Um So I'm not unemployed and then I can just reapply to opal on the side again, you know, the following year. So you can apply to lots of things. I know people who apply to 56 things. One of the reasons why the ophthalmology competition ratio seem so high that you have about about 13, 1400 applicants for um 80 to 90 posts because a lot of people apply because it's an attractive specialty or just for the sake of it. Um They don't really have much of a, you know, portfolio for it. Actually, the a if you look, if you look at that, those 1300 people, the number of people who actually are serious about it is probably about half of that. So if you're serious about it, you're on only really competing with about, you know, 6, 700 people. So um it's not as bad as it looks on paper. Um Yeah, so you do the, you're invited to set the M SRA exam. So the M SRA exam is, it stands for Multispecialty recruitment assessment. Um So this initially was an assessment that was only, um it was only carried out by general practice. Um So it's a GP exam and it's, it's a little bit like med school finals. I'd say it's a little bit easier than finals. Um And um yeah, it's, you sit in the Pearson View Center, which is the same place that you sit your driving theory test. Um There's sorry about my cough, there's a clinical component and then there's ast S ta situational judgment test. So that basically gives you scenarios you might encounter in the workplace such as an upset colleague or someone who's been bullied or an angry patient. And it gives you different options and you have to rank from 1 to 4. What would be the most appropriate response, the least appropriate response. So, um yeah, um you do a clinical part of the exam and the sat part and then you get a score. So all the run through specialties use this exam now and it's basically just a hurdle to get to the interview. Um So it filters people out. You have to get a certain cut off for ophthalmology that cut off's pretty high. I think you have to score at least 70 75% um to get invited to interview. But then I, like I said, it's not the hardest exam in the world. There's question banks, the passed question bank is really good. So is um M CQ bank which you can um um sign up to online. So yeah, you do this exam in your January of the year that you apply. So you then have your evidence folder, which is the portfolio. This is all uploaded online ever since COVID. Um It's worth 50 percent of the total waiting. Um And um you, once you do your MSR exam, you'll be sent a link to upload your evidence onto the portfolio and it's really neatly laid out online. So you have your um you know, it's all in the subs subsections of the portfolio. Um you know, education Commitment Publications, it's all there. So you just upload PDF files as evidence for everything it asks for and you'll see what I'm talking about in a minute, the ophthalmology portfolio is so um you know, it tells you exactly what you need to do. So there's nothing that's unclear. Um Then that portfolio, the deadline to upload stuff is usually around mid feb or something like that and then it locks off after that. Um and it said through for assessment. Um and then you have your interview which is worth um sorry, it says 20% but that should be uh 30%. So the interview is worth 30 percent. So you have two stations, one is a communications station which is often um an angry patient or breaking bad news to someone. And then station two is clinical knowledge. Now, clinical knowledge is that aimed at F one or F two level and it's nothing really ophthalmic. It's usually some general medical stuff with ophthalmic manifestations. So in my interview, my scenario was um you have a patient who's just been diagnosed with Bell's palsy, please explain the diagnosis to them and counsel them on steroids because Bell's palsy also affects the eye. You know, you have to speak about that. But then the question on the steroids, that was basically the, that was the backbone of gestation. So they had a lot of questions about prednisoLONE. And so you just have to know, you know, monitor blood sugar and you know, uh bone protection and you know, tell them all the different side effects of steroids and just go through it and that's the clinical life that they're assessing you on basically um ready for the next slide. So yeah, this is an example. You can find this on the seven deanery website. So seven deanery is basically the Bristol Deanery. They're in charge. So one deanery in the country they're in, they're in charge of national recruitment and it happens to be seven because that's, that's like the head, the headquarters for the um Royal College. So they're in charge of um national recruitment on the seven deanery forms, your website, you can click on evidence folder and then you can scroll through. I mean, there's, there's a lot of I'll just screenshot one segment of it, but um there's different sub sub um subsections to the portfolio and it shows you how many points you get for each one. So on the screenshot, you can see um ophthalmology, specialty links and commitment to date as a career. So that's the most high yield section of the portfolio. It's 12 points up for grabs here. So how this shows you. So refraction certificate, two points F RC for part 13 points um or one point for attempting and then you, you can just go through that list and see different things. So what I did was I went through this uh when I was in medical school, it's more or less been the same for years. They change a few things every year, but largely it's the same and then you just work through this bit by bit and do as much as you can. And then before you know it, you'll have a lot of points. Um So the portfolio is out of 50 it's marked by two consultants. Um And then their score is averaged. So to get a job you're looking at about, you need about more than 30 out of 50 to stand a chance. If you want a job in London, you want about more than 40 out of 50. So that's a good marker to go by. Um So just work on it slowly and medical school is a good time to start. Um The earlier, you know what you wanna do, the easier your life will be later on. Um And by the way, this section, the commitment to, you know, the specialty links, this is the only section in the portfolio that has to be ophthalmology specific, the other sections. It doesn't matter if it's not to do with ophthalmology. For example, if you've done an audit in something completely different or you've done a paper on cardiology or you've presented a poster on stroke, you can still use that and it will count as points. Um OK, next line please. Yeah, so this is kind of what I was explaining earlier. This is the timeline for last year, a couple of years ago. So um the vacancies are published for all the different specialties. End of October, you then create an account and you apply on this online portal. Um You're automatically invited to sit the M sra I'd say the exam needs about two months of prep. Um uh I just did about 100 to 200 questions every day after work. Um and just do high volume questions and then um you do the exam in January, then you do your portfolio, you upload everything. Um You then get your feedback for the portfolio. Um your invitation to interview interviews are usually middle of March. Um after you do the interview, you can start ranking your jobs. So because ophthalmologist, there's not many jobs rather than ranking the deaneries, you can actually rank by hospital. So you can rank, you don't necessarily have to rank all the London Hospitals, you know, or all the Birmingham Hospitals, you can do a mix. So um if you wanna put a hospital in Manchester as your second choice and then a hospital in London as your third choice and you can kind of mix and match all over the country whatever you want to do. Um So yeah, um you, you rank your, your jobs and then they send the offers out usually the end of March. Um you can then accept your offer, you can accept with upgrades, which basically means that if you didn't get your first choice, you can accept it. But then if someone drops out or a vacancy comes available in one of your higher ranked jobs, then you'll get that or you can reject it. Um, it's highly frowned upon to accept an offer and then reject it. Um, and you'll be blacklisted and they'll remember if you apply again. So I wouldn't recommend that. Um, so only ranked places that you're certain you're gonna go to. Um, yeah, next slide. So what's life like as an ophthalmology trainee or an ophthalmology resident? So, this is my timetable at the moment. So, um I'll go through the on calls first. So weekends are usually one and 12 because we don't have zero days in ophthalmology, you could never work Saturday and Sunday. Otherwise you'll work too many days in a row and your road will become non compliant. So you just work Saturday or Sunday. Um, I usually on a weekend I go in around 11 a.m. 10 AM 11 am I see any patients that may have been referred from the previous day. It's not many usually. And then I stick around till about 34. and then I go home and then I'm on call continuously until 9 a.m. the next day. That's now as an ST four when you're more junior, er, depending on the hospital, some places it's from home, but some places I was at King's for, I was at KC H King's College Hospital for ST one and se two. I had to be on site for 12 hours when I was er, on a weekend. So I was, um, yeah, maybe a bit more busy. But, um, again it's compared to other specialties, you're not actually doing a lot when you're actually at work. So you have time to revise for exams or do whatever it is you wanna do, you can take your ipad, you can watch a film or something, um, in your free time while you're not having to work. Um, most places have nonresident on call so you don't have to be in the hospital. Um, and weekdays are usually one in two weeks. So, uh they're usually not too bad. So for a weekday on call where I currently work, I finish whatever clinic I'm doing at 5 p.m. I go down to eye casualty and see if there's any patients left over from the day. Usually they've cleared it up, but if not, then I just help clear it up and then after that I usually go home and then I'm just available for advice over the phone until 9 a.m. the next morning. So at the moment, yeah, I have my, I have two, you have two admin sessions from ST three onwards from ST one and ST two. You have one admin session a week which is a half day, um which is allocated to you to do. It's called an RST A session which stands for, um, I think research, study, training and audit. So you can do anything to be honest. You can do whatever you want in that time. No one's gonna chase you up on it. Um, um, you can sleep, you can go to the gym, you can do whatever, but, um, it does help using that time to, you know, towards stuff that you eventually have to show evidence for. Um, so you can just plan your, your training accordingly. Um, so yeah, they're pretty handy. So, um, yeah, Monday, I have admin session in the morning. Then I have eye casualty in the afternoon. Tuesday. I have a Peds clinic. Then another admin session I usually finish that day around 11 a.m. 12 pm. Then I go home Wednesday. I have theater in the morning. Um There's one of my two theater lists and that's a peds list. Um Sometimes you have some oculoplastics, peds cases on that. Then you have teaching in the afternoon, which is really good because it's consultant led you gain a lot of knowledge from teaching. Um Sometimes it's virtual. So if they can't book a room, you just go home, log on to teams and you do it that way. Thursday. I have a Peds clinic again in the morning and a medical retina clinic in the afternoon, Friday. I have laser in the morning, which is retinal laser IU use lots of different lasers in ophthalmology. So um it's pretty cool. It's like playing a video game. You just switch your brain off and you just look through the microscope and you aim for, you know, whatever it is you're lasering and you just zap away. So it's nice. You get a very varied timetable and you have theater in the afternoon, um which is an adult cataract list. So, um I'm currently on a Peds rotation. So that's why it's peds heavy, but I have an interest in retina. So I asked for a medical retina clinic which they were able to accommodate for me, which I do Thursday afternoon. I'm changing timetables in February. So I'll have something that looks a bit different, but I'll still get my two admin sessions and my two theater sessions and I actually want some more cataracts. So I've requested that and I've been given two cataract lists. So that just shows how accommodating they are. And um another reason why I really enjoy it. Um Next slide, please. Oh, yeah, I'll just add Moorfields um Hospital City road branch. That's the only place where you have to do nights on site. That's because it's a fully functional hospital, even though it's just a night hospital, you do night shifts and, but they give you a room with a bed and you know, bathroom and everything on on site overnight. So, um you still get quite a few hours of sleep there. Um So it's not too bad. Ok, practical advice for international grads. So I think don't be put off by the competition ratio that I said. Um everyone's on the same playing field when they apply. And um it just comes down to who does better in the interview and who's got a better portfolio. So anyone can start building that from any stage. So the earlier you decide the better um things you can do in medical school are elective. So you only get points if it's an undergraduate elective. So whatever you do in medical school is very important. So start planning early if you're in third year or fourth year research again, I mean, it is difficult in medical school. I found um difficult for people to take you on, but you can give it a go doing an intercalated degree like an intercalated BSE um can help or a masters if you have an opportunity to do it integrated in your course. Um If not, it doesn't matter, that's something you can do during F one and F to um post it. So posters is a really smart way to get points. So um in medical school, I would make posters on any little audit I did or the most random stuff like I made a random poster on just a review of um robotic surgery and ophthalmology. And you'll be surprised how many conferences accept these posters. So II submitted so many to the conferences and I thought this is rubbish, you know, they're not going to accept that, but they accepted it and then you can go present that and a lot of medical schools will give you funding for this. So um you can go, you know, present your poster and that goes in your portfolio. Um There's six points up for grabs in the poster section in the presentation section. So there's three points for an international presentation, um two points for national, one point for regional. So even if you do two international as first offer, you're maxed out the points um and courses. Yeah, Um organizing courses um is important also attending courses. So um if you organize an undergraduate ophthalmology course um at your uni through your ophthalmology society or something like that, you can use also attending courses. If you attend a conference, even if you don't present anything there, you'll get a certificate of attendance and you can use that in your portfolio. So these things help and yeah, don't worry if it takes you more than one go. I got it on my second attempt. Um A lot of people get it on their third, even fourth attempt. So if it's what you wanna do, don't be disheartened. Keep trying and good advice. I'd say detach yourself to an ophthalmology department somewhere. Um That way you build a rapport, they know that you're committed. So they're more likely to give you things to do such as research and for the rest of your career, you'll then have a group of people who, who know you who trust you. And if you ever need anything career wise. Um It's great to just have those contacts. Um I think that's it. So um we can do AQ and A if anyone's got any questions. Hi guys. Can you hear me? Yep. Um So firstly, thank you so much. Um Hey, for the informative um session that you've given. Um We really appreciate you sharing your time and expertise with us today. Um Thank you everyone for joining in and if anyone does have questions, feel free to add them on to the chat and then um hey, I can go through them in order. Um And after the question and answers are done, um I think VU will send a feedback form. So if you can kindly fill that in, that would be appreciated. Thank you. Hey, Darl. If you have a look at the chart, there's a few questions coming through, please. Oh, yeah, I can see that. So the first question is um are there any websites youtube channels that you could recommend for medical students that helped you in understanding challenging topics for ophthalmology? It's a good question. Um So challenging topics for ophthalmology, I think um there's some good Instagram pages out there. So um if you type in ophthalmology, you'll come up with a, you'll get quite a few pages. Um and they kind of give very good synopsis um using different illustrations. And I think um I'm not sure, I mean youtube channels, there are a few, but I there must be a few. I'm not familiar with any websites. I wiki is pretty good. So I wiki you can use. Um And it just gives a good um summary of um every eye condition you can imagine. Um Another question is, have you encountered any challenges during your residency? Uh What was the most difficult and easiest part? That's another good question. So, challenges I'd say in the first year, it's a really steep learning curve. Um because it's something that you've never learnt before, it's a completely new organ system and it's so niche and you really feel like, you know, nothing. Um you feel really stupid and I think it's normal. Um But at the time, you know, you feel helpless sometimes cos you feel like, you know, what am I doing? I've, I've graduated about three or four years ago. I should know this, but you just got to be patient and you've just got to do a lot of reading alongside your work and people at work, they're really patient, particularly with the ST ones. They know that um you're fresh to this and you're new to this, so they'll make it easy for you. But I think that was a challenge. I think also um it's natural to worry about your surgical numbers because you have to get certain numbers each year. And I think um you, we have a log book which we have to keep, you have to log all of your surgical work in there. So, um I think that's something that you find yourself constantly thinking about. Um But you just have to remember not to worry too much. And at the end of the day everyone gets there. So you've just got a plan, plan. Well, um the easiest part of the residency, I think, um I think I'd say the people just settling in, everyone's really friendly. I've never met an unhappy ophthalmologist. All the consultants are super nice. So I think that was definitely the best. Um Got a question if I do a clinical attachment at an ophthalmology department at one of the hospitals in my home country or in Bulgaria where I study, would it still be relevant for my UK application form? Yeah, it will. So um have a look at the guidance you have um you get a 0.1 point for doing a taste a week which can be anywhere. You also get a point for doing an elective. If that's during medical school, that counts as an elective. You get a point for that. Um You also get a point for attending 10 clinic and or 30 sessions in your own time. So you can do that anywhere again. And it will count. Um Someone's asking have you done any research during your medical school or during training? How difficult is it to balance your training with research work? Um So doing medical school. Um not really, I did a BSE before So, um, yeah, I did that beforehand. During medical school, I didn't really get involved them too much towards the end. I did a few posted presentations and I helped to write one paper after my elective during training, I've done a lot more. Um, and actually it's not too bad, not too hard to balance it because you have your admin sessions, you can do a lot of work during that time. And, um, even after work, remember it's a 9 to 5 job most of the day. So, um you have plenty of time to balance whatever it is you want to do alongside your work, your clinical work. Um Another question is there anything we can do as medical students who develop relevant clinical skills for ophthalmology? So interestingly, there aren't any prerequisites for um you know, dexterity or hand eye coordination or anything required because they train you up from scratch. However, what you can do is um studies have found that people who play video games generally are better surgeons, particularly microsurgery where you're looking for a microscope and your hands are moving, you know, so you're not actually looking at your hands, you're looking for a microscope. And then um so, you know, that's one way I guess um learning to use your, your weaker hand because you want you, you, you're using both hands and actually both feet as well. You know, you're using all four limbs because you're using both your hands to operate and then you've got your foot pedals down below. So, I guess, um, um, any sort of dex dexterity. So sometimes I brush my teeth with my left hand, I guess. Um, you can do things like that. Um, but no, not really, it's not really important to, I guess, develop those skills because it'll teach you from scratch. I think that's it for now. Any other questions? Sorry guys about the cough? I have a question. Doc uh Do you, do you have to work weekends also? Do you have to work weekends? Um I do work weekends, one in one weekend in 12 weeks. So and it's just Saturday or Sunday and they were both days. Um, so it's, it's pretty good work life balance and the weekends are pretty chill. You don't have to do a lot on them. You just go in for a couple of hours and then you're at home after that, you just have to be um within an hour of the hospital any more questions? Excellent. Is there anyone else that wants to type the question in or ask anything? No, no vy was this recorded or um are you happy for us to share the slides? Yeah. Sure. Yeah. Ok. Um If anyone doesn't um I can drop my email address as well in case anyone's got any questions further down the line, I'm more than happy to help. Yeah, that would be great if you don't like. I can um if you send it on the chart, that would be good. Otherwise I'm happy to share it as well. I'll send it on the chart. Yeah. Thank you. OK. Mhm. Ok. Uh Thank you once again everyone. Um oh, we've got someone saying no more questions, but that was very informative. Um Thank you again for your time and everyone else for joining and hopefully we look forward um to you joining um our other webinar that we've got set up and uh have a good rest of your evening, take care and hopefully see you all soon. Thank you, bye-bye.