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Uh speaker plural, which would be Aqua Asif and OLLI Burton talking about planning a surgical fy three. So we're just gonna wait and see if they're here and then invite them onto the stage shortly. Think a there, I could see a perfect I'll just find out the stage. Oh, lovely. Beat to it. There we go. While you're together. Lovely. I thought I had to send two links. Excellent, great. So yes, next up, we have Aqua Acef and OLLI Burton who will be telling us all about how to prepare for your surgical fy three. How are you guys doing this morning? Good. Is, is uh Mike working. Yeah. Can you, Mike is great. The floor is yours whenever you guys are ready? Perfect. Um I do introductions first. So uh hi everyone. Thank you for being here this morning and thank you um to the team for having us. My name is uh Ollie. I'm currently in my F four now having done surgical Fy three, which I'm gonna talk to you about today. Yeah, and I am a, I'm part of the um asset Council and I'm doing my F three as well. Yeah, and we're, we're covering, I guess aspirations in two specialties today. So, uh I'm in the process of trying to get into neurosurgical training. Yeah, and I'm in the process of hopefully um securing a urology um themed surgical training pathway, whether that is via the quest route or if that's by traditional um training route as well. Ok. So what is an fy three to start with? Um is something that a lot of people talk about. But I think we, we very seldom formally define it. What it specifically refers to is this phenomenon where people take, they choose to take a pause in their NHS training to pursue some other form of activity. So you'll remember from when you apply to medical school, maybe that you, uh, as you apply medical school, you do your five or six years, uh as an undergraduate, you then go to foundation and training, um which is two years uh after your, uh, after you finish your medical school where you'll rotate in medicine, surgery and maybe some community or primary care specialties. And then the typical pathway that we think of is that you would go and do uh core training. In this case, we'd be talking about core surgical training, uh up until ST three and then you would join higher training in your specialty that might be plastics or orthopedics or whatever you want to do. Now, the fy three, I'm sure you can work out, takes place between foundation training and core training, uh a so called foundation Year three. It's not a real formal definition. Yeah, but it just tells you where it is and where people are taking this breakpoint and we'll talk about this. This is kind of the theme of the talk, but it's beneficial for building more specialty experience in something that you're interested in. So, if I was interested in neurosurgery, I might want to do some more time, especially since neurosurgery is pretty rare uh as a foundation job. Um some things are, are common like orthopedics or urology. And again, you might want more time, you might want to work on something specific like research, teaching or simulation. Uh or you simply want some time off and that's ok too. So towards the end of the talk, we'll each talk about our fy three experiences and why we chose what we did. But I think the really important thing to lock down is what you actually want. Um because there's so many things out there that you could do and all of them are exciting and interesting in different ways. But I think it's really important because of that variety that you know what you want out of it. So like I said, that might be gaining some clinical experience, managing stuff on the ward. You might want to be in theater, getting your basic surgical skills from the specialty down, you could develop specific procedural skills. So um in urology you might do, I don't know, s pedic catheters or something a bit more advanced than I would have done working in urology on the wards, building your networks in the relevant specialties that you're interested in. Because that's often half the battle. Uh really importantly for today, improving your portfolio for those specialty applications because you've now got a year um or six months, certainly to think about it and preparation for an interview as well. And the best place to get that is on the unit surrounded by people that have done it and have been through it. Ok. Sure. Um So there's a wide variety of different jobs that you can actually apply for. Um We try to keep it surgically themed. Um Even though this list is absolutely not exhaustive, but on the theme of surgery, obviously, there are trust grade jobs in very specific surgical specialties or they might be mixed, for example. Um It might just be Genser, but then you'd be um assigned to maybe HP for a couple of months and then go into other gi and then go into colorectal. It depends and it's very, very specific based on the trust itself. Um You can also lo for the entire year to gain variety and also um just if you want that freedom and flexibility if you want. Um Ollie and I will talk about our different um fellowship jobs um as we go on, but you can have a dedicated fellowship year in either global surgery, for example, or an entire year dedicated to research. I'm a clinical teaching fellow and all these F three involved uh clinical research fellow, um which we'll talk about later or you could even be an RM O in a private surgical unit, for example, like Cleveland um Cleveland Clinic. Yeah. Yeah, there's, there's one you see now and again, there's, there's a Cardiothoracic unit in London. I can't remember where but they take Rs which is kind of crazy, but you know, clearly it works. Um So one of the most important things we know for, for doctors in general obviously is is skill development and your surgical fy three is a great place to do that. So I've already hinted at this, but practical stuff you might be interested in. Um obviously getting your suturing down is is really important for most surgeons, but it might be more important in places like plastics. For example, when nailing that basic technique is gonna set you up for the rest of your career. Um or indeed carrying out basic procedures. Uh then thinking about your clinical decision making, certainly, if you're spending a lot of time on the wards or on call, this is gonna be your bread and butter, seeing the unwell pre op and POSTOP patients, being able to confidently manage the perioperative surgical patient in your specialty because that, that's what every senior wants, right? They want someone the sho that they can leave on the ward and is confident that they can hold the fall while they're in a theater or in clinic or do something else. Um And I've included simulation here as, as an example of a specific skill that you could develop. Um But you, you can only really, I think get a good feel for simulation by being in one place for longer. So you can identify the challenges and what the trainees either need practice with or maybe what junior doctors or resident doctors aren't good at doing in your department. How do I make a simulator so that people can practice? And that's a really valuable skill too. Uh So the next thing uh as, as I said before is building a portfolio and the really unique element of your fy three year that you'll experience is that it's, it's longer, it's between six months and a year. Usually that you'll be offered posts. So what the obvious place to start with that is audits and quality improvement projects. It's really hard. Um You would agree, I guess to, to make a meaningful change in four months. Certainly not close. Exactly. Yeah. Yeah. So you might be able to do a single cycle of something and gather some data, but that might take you three months to define your question and then do your data collection once you've got governance and stuff signed off. Um because you're gonna be here a bit longer. I think you should be aiming to close at least one audit or quality improvement project. You'll be exposed to a lot. So it's a great chance to think ahead and apply for those presentations and conferences. And um there's a an asset conference coming up in March next year as it sounds like. So be thinking now, what can you apply? Uh what can you submit to that conference? Um research and publications again, think broadly because it's, it's not just the case that this is research because a year is still not super long to, to get a good piece of research done, but think think more laterally. So case reports, qi projects, audits, all of these things are suitable for presentation and publication. So just think more broadly as a unit, write a letter to to a specialty journal, um get your heads together and then getting involved in teaching as well. Because if you're the h that's may be less busy than the foundation trainees who have their own competencies to, to get signed off, you're free from that as, as a a fellow or an fy three. So apply that extra cognitive effort, take charge of the teaching um and tick those boxes as well. And then uh before we move on to the final part of the talk, um this is where we talked about networking and mentorship. And I think particularly in the very competitive specialties, this this is essential, this is not optional. So see this as part of your development. Now on the left here, I've included um Mr Marcus who many of you might recognize and Mr Preso from Queen's Square neurosurgery, who were my academic and clinical mentors for the year and have set me up really well for the application again and I'll hand over to him. Yeah. And then um over here we've got uh mm who is my um one of my clinical supervisors during my um C TF here um during my clinical day in urology, she will tell me that I need to fix my suturing and will tell me off on my bad knots. That's the type of stuff that you need to hear. Um And then my academic supervisor uh ve was also done. He's been my longitudinal mentorship and I think that this f fy three year will allow me to continue to develop under his um leadership. And I guess with the year that you have, you can make the most out of your time, it is essentially a good year where you can get relevant courses out of the way. For example, BSS, if you haven't done it, um obviously with crisp and ATL S, you can get them funded as part of your CST. So maybe not the best place for you to do them, but if you can go for it for sure. Um But then a lot of these C TF jobs or other like um research fellow jobs will come with funding for APG Cert. Usually it's aligned with a university that is closely associated with. Um but there is usually always, always some pot of money for you to carry that out. And that is also a good time for you to do the assignments needed for your PT Cert. Um I know that they have removed it from C SS T but always think about specialty applications or, you know, for the future. Um If you have a key interest in clinical education, it's still worthwhile doing. Um And if you've not done MRC S, this is a very good year to get if you've not done part A or part B out of the way because you've got that dedicated time that you may not actually have in your training when you're battling on calls and stuff. Cool. So we've got a couple of minutes left. Um I'm gonna talk about, I spend about a minute talking about what I did for my surgical fy three. So I did a year as a uh a clinical research fellow in neurosurgery at Queen's Square. So that's the National Hospital for Neurology and Neurosurgery that was 20% funded by some money that came from the Wellcome Trust to give me a day a week protected academic time in uh A I robotics digital surgery and uh for me simulation. So that's what I was employed to do academically and what this gave me this year. So it's obviously a year dedicated experience clinically in the specialty, including general on calls. So I worked as part of a complex spinal team. So that's what I'm most familiar with. But you also cover the hydrocephalus, the pituitary, um the neuro oncology, everything that you need to cover as a good neurosurgical ho developing those basic surgical skills doing EDS, lumbar drains bur holes, the bread and butter, basic surgical stuff. Um had my research out as well, obviously. So that's led to some publications and presentations. And then I took on a formal teaching role as well as the teaching lead sho because I was really interested in teaching and not that many people wanted to do it. So I was able to take off that longitudinal position of leadership, teaching responsibility and lead loads of sessions. And then for me, uh I am 80% teaching and 20% clinical. So this means that um functionally I am super new brief on my clinical day and because I'm in a trust that is very, very busy. Um There's always something for me to do, which is very, very exciting. And um at my stage whilst I uh you know, I love robotic surgery and I want to be a robotic surgeon in the future. For me, I really want to get my core procedures done well. So that means my flexes, my circumcisions, my scrotal procedures. I want all of those to be like, you know, top, top, top and I didn't get much exposure as Fy two because a lot of my time, um whilst I did have a urology rotation, it was mostly spent during on call. Um So, for example, I'm not still comfortable with a stent, which is not good for someone who wants to be a urologist. And that's what I hope this year will allow me to get really comfortable with. And then um the rest of my time I spent doing teaching and that is dedicated time to actually think about not half, you know, um being really lazy when it comes to my teaching or last minute, I can actually have that dedicated time for my medical students, which is amazing. And I think one thing that me and Molly haven't spoken about, which is very important is the locality I've chosen this because I get to stay close to my family. And after being burnt out of the F one and F two, I need to be close to my family. That is my main, that was my main priority this year. If anything above all else. Yeah. And then the final slide because we're, we're drawing to a close just some things to think about. Um I believe John already spoke about the time limits for your specialty. So really think hard about those neurosurgery is 12 months. So if you're gonna spend a year doing it, that's it. That's your neurosurgical time. Think about your work life balance and how busy you actually want to be. After the foundation, you might want to do six months, you might wanna do a year. Think about what you want, how many days a week you wanna work? Job security is tough at the moment. Um, fy three jobs are becoming very competitive in line with specialty training in many cases. So all, I mean to say is put effort into the application and go hunting for the job that you want, it won't come to you because someone else will take it. Um, and, and that's drawn out in the final, er, point, these jobs are competitive. So just, just as you bring your a game to specialty training locations, you need to work very hard on your competitiveness for these jobs as well and that's it. Yeah, thank you guys. Well, thank you so much for taking the time to, to talk today. I really do appreciate it and I can definitely see from what you guys have said that there's so much you can get out of, um, an Fy three or an Fy four, but you just have to be proactive and there's a lot of kind of, uh, life, um, choices and life decisions that come into life planning that comes into all of it. Do you have any questions? Um, so we have one from, uh, where did you search for the Fy three posts? I've seen posts on the NHS vacancy website. But are there any other sources? Yeah. Yeah. Officially NHS Jobs. Yeah, we use NHS JOBS for all of them. Yeah. Um, however, II think, speak to if, if you want an fy three in a particular place, speak to your department as well. It's often, I think a case of asking for a job to be made for you if they really like you and they want to keep you. Um, I think you should, don't wait for them to post a job. You should be saying I would like the job. Yeah. Yeah. And then snoop out on linkedin as well. Usually there are some like, research jobs where they offer like a phd or an MD opportunity which would only be on linkedin, um, rather than just on NHS job. It's like not on Rel, which is the tough part. So you have to look at NHS jobs, track jobs. Um, B MJ careers. Like there are so many out there. Um, but actively, if you already know what you want to do, seek out your supervisor that you want and then ask them if there's a pot of money. It's a, it's a strange discussion because it seems like trusts have different money that are separate from the de so that is something that you'd have to investigate with them. So it sounds like, yes, there, there may be some jobs out there but maybe we have to make our own jobs all about the negotiating. Yeah, great. Do we have any other final questions from anyone? Question for Aqua, what considerations are you thinking about when deciding about doing CST versus the nontraditional crash route for course training years? Sure. So I think um it goes without saying, I think with CST, I know it's the National Training Program route. Um But with Crest, it is the fact that I can, I get more flexibility. Um And perhaps I can in a way choose my own job and in the location that I want um rather than CST being national, I don't have much control over the locality unless I have, you know, a special circumstance in that case, that's different. Um But that's why I'm thinking that route um to get those sign off as much as I, as much as I can because then it comes to more who my supervisors are. Um and my clinical competencies which I think I know I have to do like, you know, IP and everything all of that alongside. But it's the fact that I can choose where I want to do that. Um If that answers your question. Thank you. We've got a couple more questions. Got Jin uh for these fy three jobs. What would make your application stand out or is it just similar to the CST portfolio? I think it's a little bit different. It's not to say that they are more or less competitive, but I think the the proposal is fundamentally different because often with an fy three job, what you are selling is I am a clinically good safe so that you can invest in over a longer time. And I think all that means is that the the application process might look at slightly different things. Obviously, if you're applying for a research post, then by, by necessity, that has more of an emphasis on research than maybe CST might. Um So I would expect to put in to talk more about your research experience and output and the things that you've presented and published. Um And there, there are some fellowships that are very well known in some specialties that, that will be very, very competitive. Um especially if they come with these funded qualifications or they're in a, they're in an academic center. Um They can be, you know, 100 to 1 easily for context s job was one and 200 the job that I currently applied for it was two and 900. So just think about the like, it's insane. Um So, so yeah, that was all I said. Just take it seriously and don't, don't um put half the effort in because it's not a training number. It, it's, it's still a brutal market. Fantastic. We've got one more question if, if you guys don't know the answer to it, don't worry because part of me is also, I think I do, I can, I can have a stab at it. Go for it. So we've got, yeah, go for it if it's 12 months. Um K 12 times by 0.2 which is, which comes out to be 2.4. Yeah. For, for academic posts at, at least for neurosurgery. I don't know how CST lets you put it in but you can declare it this way. And so if I did naught 0.2 W-2 E equivalent, I have only done, uh you know, 8 80% of a year. Yeah. Um So it wouldn't count as the full year of neurosurgical experience. Great. Thank you very much. Thank you so much for your time guys. Um For those of you who have been lucky enough to sign up for planning your fy three session, Aqua and Olly will be leading that from 1230 until 130. If we have any open slots available, we'll be sure to post that into the chat. Um And we'll invite you accordingly. Thank you very much guys.