Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Hi, everyone. Uh, welcome to, er, this online, er, webinar, er, as part of our E GS weekend. We have, er, Miss Deborah Markham and Miss, er, Nick Watson, er, talking about National selection for ST Three General Surgery. Um, so please any questions, fire them in the chat and we will do our best to answer them. Um, but I will hand over to you. Thanks very much Michael. Um, so thank you for inviting me to talk about ST three National selection. Um, because obviously there are some changes to it and obviously everyone's going to be quite anxious about getting it right. Um, so I'm hoping that today's webinar will be useful from that point of view. Um, some of the slides will be very familiar to you if you've watched the previous webinar that was recorded at the core, um, training hub. Um, but we're very happy to take your questions as we go along. Um, and, uh, Nick Watson, who I'll introduce in a moment will be fielding them in the chat, but I've also put some frequently asked questions at the end of the presentation. So hopefully some of the questions you're asking will be covered by those. So what I'm going to be talking about today is obviously the structure of national selection and the context of the national selection and general surgery. So that you can understand why some of those changes have occurred. Um in inevitably, that's going to mean we have to show you some analysis of the process that we had adopted since COVID and, and tell you something about how we decided on the changes. And then I'm briefly going to go through the similarities in selection compared to last year, the differences in selection. Um and also give you some tips um on preparing for selection before I answer your questions. But what I'm not gonna be talking about today. So please don't ask the questions is individual questions about what score your particular evidence would be given. It's very difficult to see it without seeing the evidence itself. Um We can't really score it or give you anything accurate. So this is going to be more about generalities and principles. So who am I? Um I'm the lead for national selection for ST three in general surgery. And I've been a consultant surgeon at Warwick Hospital for just over 18 years. I used to be the core TPD for the West Midlands, uh South and I am on the specialist advisory committee which is the committee nationally, which is responsible for general surgery training. Um So, er, until this summer, I was also the liaison member for the East Midlands. Uh, and I'm an examiner for the Fr CS in general surgery and endocrine. And I think that I will reference why some of those um, experiences have I think helped us to refine and improve this particular process. I'm ably supported here by, er, Nick Watson, who's gonna be watching the chat. He's currently the deputy lead for national selection, um, and next year will be the lead and he's a consultant colorectal surgeon and she she forest hospitals and has been for 10 years. He's the current TPD in East Midlands who I used to work with as their liaison member and is also on the SAC in general surgery where he is the member for the east of England. So it means that between us, we have a lot of experience of overseeing how CPS for registrars work across the board. He's very involved in education and is a member of the S GBI Education and training Committee. So I think it's important that you understand the context of national selection. National selection is a mandated process which has a very clear um design which is undertaken by the SAC and the Royal Colleges. But we have to integrate that design into a process which is then administered by the medical and dental recruitment and selection board, um which is part of a stroke NHS England, which we just merged recently. Um And so therefore, in order to um design a recruitment process we have to, to design something that can be administered. So there's a bit of give and take between the two of us. So remember that what we are trying to do in this process is select for training ST three to ST eight. So we need to try to assess people for their aptitude and readiness for ST three training. If you're successful at this process, this is likely to be the last step before your consultant interview in your career. So it's really important we get this right. What we used to do pre COVID was we used to interview all applicants in a multiple mini interview format face to face in a five station interview at which we looked at your paper portfolio in real time and every applicant was interviewed and ranked and obviously the top applicants were given jobs. Unfortunately COVID hit around sort of February March 2020 just at the point where the process was just trying to take place. So we ended up with an emergency transition to a virtual process. And self assessment was what we reached for in that emergency, not because it was brilliantly well designed or well validated, but it was because it was the only process we could think of to actually have a process at all. We were unable to interview anyone in that first round. Everything was on the self assessment uh scoring with some um attempts at verification of those portfolios, but it was very rough and ready because it was an emergency. Unfortunately, we also found that this coincided with an enormous surge in applicant numbers. Um perhaps because when it was virtual, people didn't have any borders that they needed to worry about. And so we've suddenly become unable to interview everyone even virtually. And so a shortlisting step had to be added to the process from 2021 onwards. And so again, we reached for the self assessment um questionnaire and then we uh ask people to upload their evidence. And the problem was that we were constantly moving data between different systems. And that meant that that led to a significant chance of errors where there was a complex manipulation of data with multiple systems. And we were using this uploaded evidence as a proxy for the very good process we'd previously had. So concerns were raised throughout the period of COVID by steering group members, the SAC trainers and interestingly trainees very markedly who felt that this process wasn't really fit for purpose. Um And as a result, an independent external review was commissioned by MDR S from a group called the Workplace Psychology Group. And they agreed that there were some immediate areas that needed to be improved. And so as a steering group, including our trainee rep Martin King, um who will be known to you probably um and the SAC, the J CST asset more widely and the Royal College of Presidents, we came up with some principles and some changes that needed to occur. In order to meet these immediate areas for improvement, we felt that underlying that any changes we made, we needed to really um hold on to the importance of fairness. And so uh we wanted to ensure that when we designed a new process, it was fair and didn't advantage one group or disadvantage one group more than any other. We felt that it was very important that we kept the person's specification for the job role unchanged, partly because actually the person's medication was very good. And so therefore, it didn't need changing. And we wanted much more of an emphasis on quality, not quantity. What we realized was that the problem with a self assessment questionnaire was that it rewarded people who completely over scored themselves. Ultimately, the self assessment score never did form part of your selection. The self assessment questionnaire simply brought you the opportunity to upload your evidence and have it verified. And what we were finding was that increasingly people who grossly overs scored themselves then got the opportunity to upload their evidence. And when their evidence was scrutinized, having been uploaded, they were downgraded massively because they'd overs score themselves in the first place. And our real fear in terms of fairness was at that point, there were a group of people who were significantly more honest in their self scoring and modest and those people were disadvantaged by their very honesty and modesty and that meant that it was a really unsafe process and we didn't feel we could carry on with it. Obviously MDR S and he scrutinized our proposals for deliverability and our original proposals were not considered to be deliverable. But these were the proposals that we have arrived at. And we think that alongside our trainee rep, these are the best proposals that we can come up with in the current world of selection. So in terms of the overview of the current selection process for 2024 the evidence for each question is now going to be significantly structured in templates. And that was arrived at because we felt that we needed much more information from Chinese about what they had learned and what they had contributed to the portfolio that they were submitting to us. There are questions in each template which further structure the answers and every template needs to be countersigned by your educational supervisor or equivalent in order to provide first of all, a further level of scrutiny, somebody to base to um bounce some ideas off but also a further level of scrutiny for quality assurance. And for some of the questions, there will be additional evidence that you need to to provide an upload, which is clearly described. I've just put a short bit of the the overall table for timeline which is present within the applicant handbook here. And what you will see is that obviously the applications opened on the 16th of November and they do not close until Thursday the seventh. And those of you who have opened the application form will realize that there's actually very little to fill out in the application form itself. But what it does tell you is what are you going to need to upload and that evidence upload will finish on the ninth of January. So effectively, you have until the ninth of January to produce your evidence and upload it. And anything that you can show that occurs up until the ninth of January can be uploaded as evidence. Anything after the ninth of January however, is not admissible and then the interviews will take place. Those top ranked people will be in invited to interview uh between the 19th and the 21st of March. So in terms of those similarities to previous selection, the person's specification, as I've already mentioned remains completely unchanged, the wide window for application three weeks remains the same. The wide window for evidence upload, four weeks remains the same. In fact, I think we've slightly increased. It. Shortlisting for interview is by portfolio school and shortlisted candidates are going to be called to virtual interviews. And as before the port portfolio score is added to the interview score to give you your overall rank score. But there are some significant differences. And one of them is that the time since qualification has been removed, there is no longer an N number and that is um that has been decided for a variety of reasons. One of which is around that complex manipulation of data that I mentioned that was considered to be one of the major risks in the previous process. Another risk is that people who have spent a little while deciding that general surgery was their career path were very disadvantaged potentially previously and we didn't feel that was appropriate. There is no self assessment score at no point. Will we ask you to self assess yourself? That's because it never is going to make part of your scoring process. However, this time, every single portfolio which is uploaded is going to be scored by a pair of consultants and those consultants are all going to be face to face in a large room where they can be briefed and where we can deal with any divergences, any uncertainties amongst us, so that we can make sure that there's as much standardization as possible in the way that portfolios are scored. Furthermore, scoring is now going to be on quality, not quantity. So instead of having a, a single score for every possible audit from the absolutely um almost meaningless to the very, very, very complex, you will get more points if you've done a really good quality er clinically er valuable audit where you've done all the legwork. And so it should be, in addition to that, as I've already mentioned, the evidence upload is structured by these templates And part of the reason for that is that last time we found that a lot of candidates who we felt probably did deserve some points had not followed the instructions for evidence upload, such that we were unable to give them the points that we thought they probably did deserve, but they had not demonstrated that they definitely deserved. And the reason for that is actually giving people the benefit of the doubt is a very unfair process. It's very unequally um applied and very difficult to apply across the board. So therefore, we have made it very clear what you need to upload. And if you don't upload it, you won't get the points for it. I've already mentioned about the counter signing and that's something new. And the other thing is that people will have noticed that there's no education and leadership questions in the application form. We're not going to ask you to upload evidence about education and leadership and those were considered to be the most unsafe questions in the previous process. We weren't happy with the degree of quality assurance and standardization, we could apply to those things. And so therefore, instead of trying to do that by means of paper portfolio or templates, we've moved it into the portfolio interview stage. It's not that we're not going to give you points for education and leadership, we're going to give you points in the interview rather than in the paper portfolio. So this is what I would recommend you do, please please sit down and read all of the information in the applicant handbook. It will take you a 1.5 hours minimum and that is because every word in the applicant handbook has been very carefully weighed by myself and the steering group so that it actually is as clear as possible. Please please read the information we've given you and you might need to make some notes as you go. And I want to remind you this is your last interview if you're successful before your consultant interview. So give it some time, read the templates really carefully and that will help you to start thinking about what examples you want to use. What examples exemplify your best audit and start collecting the evidence ready for that upload window, which hasn't yet opened. Stop. Um Speaking to your consultants about it, please read the person's specification. Um I put the link there. The person's specification is the thing that underpins the process of section. We can't give you credit for things that aren't on the person's specification, the essential and desirable qualifications or qualities that we're looking for in an ST three are outlined in person specification. And that means those are the criteria we're going to grade you against. So when you're trying to think about what evidence you want to collect, think about what it is. We're trying to, to see whether you assess that attitude for training that we're looking for in choosing our trainees for selection comes from the person's specification. So when you're preparing for selection, read those questions and the instructions carefully and start gathering the evidence and filling in the templates. Remember that you don't need to upload them yet. So you can draft and redraft, you can put the drafts past people and use the person's specification to decide which evidence to use. And the information we've given you in the handbook and in the application form and in the templates will help you to decide what are the key features which we will be looking for. When we're giving you a score. It's not an accident that we're asking you to make the choice. We're asking you to make the choice because A, you know, your portfolio best and B because actually that ability to make judgments is partly what we're trying to select. We want you to have insight about yourself. And we want you to be able to analyze the information that's in the person's specification in the handbook. In order to make those difficult choices, alert your educational supervisor or equivalent early to the need for them to countersign your templates. We have tried to put the information out there. Don't be terribly surprised if, when you go to the educational supervisor, they go what they want you to do what um because actually we can't get the information completely out to absolutely everyone. We've tried our best but there will be some people out there to whom it is a surprise. But we hope that the information that is there that you can show them will make it easy for them to understand what it's all about. And use your mentors, your educational supervisors and actually honestly friends and family, particularly people involved in hr and selection and other works, walks of life. One of the things which is, is uh really common is that when you have put a lot of effort into something you've written, some text happens to me all the time. You think? Well, that's absolutely clear. It says exactly what I think it says and then you show it to somebody else and they go mm what do you mean by this? So make sure that you use all of the people at your disposal to scrutinize your application and improve it. You don't need to upload it until the end of the evidence upload window. So I know that I've concentrated a lot about the portfolio because that's the thing that's changed the way that the portfolio is graded and scored has changed a lot. But I know that people also want to know about how they should be preparing for the interview, which is absolutely right. So here are a few ideas about how you prepare for the process of the interview. Remember that it's going to be a virtual interview, we're going to be looking to um give you an opportunity to communicate with us. Um And we are going to be marking you on communication more this time than we have done in previous years because we wanted to add a specific communication station, but we were unable to. So we've enhanced the points which are going to be awarded for communication in all three of the interview stations. So that means you need to be comfortable, you need to be at ease, You need to make sure that your camera and your set up are comfortable for you to use. At the beginning of the interview, you will need to turn your camera around and demonstrate that you are alone in the room. Uh And that there are no other screens that you are able to use, that you can look things up on. For example, it's very important that you shouldn't be able to cheat and I'm sure none of you would. But unfortunately, uh in some of the other surgical specialty interviews last year, some people did cheat and were accused of fraud. Um And that went up to the GMC. Um You need to choose a good place to sit with a suitable background. Um Remember that if you're going to be sitting in a, in a room with a real background, you probably shouldn't have your washing hanging up behind you. Um And you need to make sure that your partner isn't sort of nipping out of the shower um whilst you're on camera. Um, if you're going to use a background um for a digital background, please make sure that some of the things you you're wearing are not sending, um, the, the, the camera a bit bonkers and reacting against your, your chosen background. Um And please don't choose the Lego Star Wars um, background. Um, it might seem amusing at the time but it, it, it won't go down well, choose something which is smart and comfortable to wear, particularly at least above the waist. That's the only bit of you we're going to see because you'll feel better and, and we feel better. Um and in particular, you know, things like uncomfortable ties or worrying about whether your neckline is too low is not something you want to start have suddenly start thinking about during the interview. Just as last year, the interview is structured into three domains, the clinical, the management and the portfolio scenarios, each of 10 minutes. As I've already mentioned, there will be more emphasis in the marking of the of the communication elements in all three of those interviews. And within the portfolio station, there will be more evident, more emphasis on talking about your education and leadership experience for the clinical and management uh interviews. There is a scenario that you need to read and mark and inwardly digest and you will have five minutes for each of those before your 10 minute interview. So five minutes of reading, thinking time before each of your clinical and management stations. Remember that your stations could be in any order um because we're rolling you through in cycles. So if you're trying to prepare for the content of the interview rather than the process, go back to that person's specification. When you're trying to structure your knowledge of your portfolio, make sure you've got something in every category that make sure you think about what those best examples are to show that you possess those knowledge, skills and attitudes um that we are going to be looking for in that person's specification to ensure you have the aptitude for ST three training, particularly for the clinical scenarios. Just practice presenting clinical cases, asking your consultants to ask you questions, practice amongst yourselves in small groups, um practice with registrars who've been through the interview. Um It's not cheating to ask them. Um That's absolutely fine. They'll be able to give you some examples of, of what they were asked about management about clinical cases. You want to just get that facility to thinking to think through and then communicate about the er clinical and management scenarios er that you actually encounter in the NHS on a daily basis. But you need to sort of crystallize some of that thinking. I just want to remind you again about the context of selection. Here, we are selecting for training ST three to ST eight. And so that means that I'll just take the example of appendicectomy if you have done fewer than five appendicectomy. Frankly, you probably shouldn't be applying for ST three in general surgery. You need to go away. You need to get more uh experience and you need to reapply, you're not ready for training at ST three. Because if you become an ST three, you're gonna be at the sharp end. Similarly, if you've done 80 appendicectomy, you shouldn't be applying for ST three. And that's why there is almost a bell shaped curve in terms of the scoring that we give people for appendicectomy numbers. There is a point at which you probably shouldn't be applying for ST three. You should consider another route to the specialist register. So we're trying to find those people who have the aptitude and are ready for ST three training when you are answering the questions that we ask you about, for example, the clinical scenarios, we need you to think like a registrar, think about the best ST three, you know, and try to think about what it is about that person and the way they answer things and the way that they approach clinical scenarios that makes you want to be them and then try to work out how you are going to demonstrate that to us in the interviews in March. I'm going to ask you to continue to give us some questions, but I am going to go on to some slides um which cover some of the frequently asked questions before I stop sharing and hand over to Nick. So question one is the one which is about general surgery, months in general surgery, please, please don't try and count jobs when you've covered both the specialty and general surgery on call. In. Question one and question two, that happens quite a lot. Um And it doesn't benefit you. Um, when we come to look at your portfolio, the same pair of consultants will see your question one and question two. So if it's a general surgery job, fine, if it's not a general surgery job, don't try and count it in question one. In question two, there is a very clear list of what counts and you must have done at least four months in each of two specialties to get the points. So if you've done four months in one specialty, you'll get two points. If you've done four months in each of two specialties, you'll get four points and there is a maximum score of four points for this question and please don't count the same jobs in question one and question two. This uh question has come up multiple times from Chinese and social media and in previous presentations, you must not have any gaps in your log book. And what that means is not that there can't be a lull in your logbook where you were doing six months of TN O and you didn't do any appendicectomy. That's not at all what we're saying. We're saying that the start date of your log book must be the beginning of your post foundation time in general surgery and the end date must be now. And if you have an a start date and an end date, which covers that whole period, then it will capture all of the appendicectomy you've done in that period. If you have start dates and end dates, which are different from that, then we will make the assumption that in the gap, you've done a whole load of appendicectomy that you don't want to count. And I'm sorry to say that we're basing that on previous experience, not, it's not that unexpected that people will try and game the system. But I'm afraid I'm afraid, you know, that will be picked up. So make sure that your logbook has a start date that begins at the beginning of your post foundation time in general surgery and carries on to the present day. It must be congruent with the time claimed in general surgery publications, the paper must be actually published by the end of the evidence upload window. And the reason for that is you're going to need to upload the paper as evidence. So if it's not published, you can't, you will need to um ensure that we have the information that we've asked for. So level of authorship. But in addition to that, you're going to be um, filling out the template where you tell us about your contribution and tell us some things about the quality of the study and the impact factor of the uh publication. It says application there. I thought I'd changed it. I'm sorry, I haven't, er, impact factor of the publication in terms of presentations. Ideally, we need a meeting program with your name highlighted. Um And we understand that some meetings are virtual and therefore there won't be a physical meeting program. If it's a virtual meeting, you need to give us the best evidence you can that your presentation was accepted and that you presented it. So an email simply saying it was accepted does not meet that uh criteria and points again will be awarded for a candidate contribution being the presenter of the work, the quality of the study and the scope of the meeting we have um explicitly included poster presentations this time because we recognize that we need to reward broader categories um than previously. So presentations is now a broader category. Um Similarly, actually publications now does include uh published abstracts and um case reports which previously were explicitly excluded. So that's um the end of my presentation, I'm going to try and stop sharing my screen. Hopefully I can do that fairly soon. Uh huh uh huh, perhaps not. Well, I think that's fine. We haven't had the there's not been any activity in the chat which is fine. I think this is being recorded and hopefully a lot of people will be viewing it later on, I'm quite happy to take any questions if people wanna put questions in the chat. Now, otherwise, I suppose the, the only other thing that perhaps we've had out of previous iterations of this talk is just with the presentations, publications and audit section. People will notice if they're replying that there's a limit on the number of items we are asking people to submit. Um And that might cause people a bit of anxiety about what is my best presentation. What is my best publication, which are my best audits? Um And it's the ones where you've made a substantial contribution to it and you can describe using the template what the nature of your contribution to it was. So, you know, the idea behind that is that gift authorship rightly shouldn't be considered equal to something that someone has really, you know, devised themselves come up with, motivated other people to join in with them, completed, finished, seen through, even if it's on the face of it, a sort of slightly smaller project. The other questions that we've had are, um, can people count work that they've done before they started training? Um, you know, sometimes people have got publications from medical school. That's absolutely fine. It doesn't matter when you did it. Um, we've asked been asked whether publications and presentations on they have to be on surgical topics, general surgery topics and they absolutely do not because it, you know, it's, it's relating what you've done to the generic person specification elements. Really. Um It doesn't matter if it's a, if it's a microbiology publication, what we're actually interested in is not just have you got a publication but it's what did you contribute towards it? What did you learn from it? How's that going to enable you to develop um as a surgical trainee? Um And yeah, just to reiterate what Deborah said is that we are in the interest of trying to make sure that everyone has the most opportunities to be able to submit something in that section. It, you know, I if all, if you've done a case report or a couple of case reports and that's all you've been able to do, then put them in. They would, they would have been excluded previously to even letters technical tips. You know, if that, if that's, if that's what you've got, that's your best thing, put it in as your best thing. Um Collaborative publications of which there have been many now and will continue to be. Um If your only contribution to a collaborative publication has been one of the 100s of people who've contributed some data to the overall data set, but you haven't been involved in the conception of the study, writing it up the rest of it, then I would advise that you probably look, look at what else you can submit and see whether there's something where you've been more personally involved. Um Because collaborative yeah, that degree of contribution to collaborative studies is probably going to be scored a bit lower than, than a lot of other things. I don't know. Can you think of anything else that's about? It just occurred to me, Nick that were asked last time. Um One was, can I submit the same work in my presentations, publications um even in my audit section. So, you know, if, if it is your best example for each section. Absolutely, absolutely. You can submit the same work because we can imagine a situation where, you know, it might be a fantastic audit you've done, which is really, really valuable and then it's gone on to be presented as a, you know, a national or an international meeting and then you've, you've managed to publish it. It will be invidious for us not to reward you for each of those things. Um But don't just assume that it should be the same thing each time, make sure that for each category you've chosen the best example. Um Nick mentioned er collaborative papers and it was the bane of our existence. Last time was people submitting collaborative publications. And despite the fact that last year, er as this year, it requested that you upload the list of collaborators with your name highlighted. We still have people submitting lists of collaborators running to five pages with no name highlighted or not submitting a list of collaborators at all. If you don't submit the evidence we won't give you the points. Thank you. I think that's been really, really informative and some of those changes are really, really inclusive. Um So I'm sure trainees appreciate the the the those changes. Um As I said, this will be distributed to all the rude dukes and asset members and Mohan Academy members and a GBI. Um So thank you again for taking the time. That's been really, really great. Um Good luck to everyone applying guys. Please do apply. We really want your applications and Michael, thanks so much for the opportunity to speak to the trainees. Um and, and put that information out there. I do hope that they understand that we think this is gonna be a much, much fairer process than it previously was. There were all sorts of unexpected unfairness in the process that we had to adopt in COVID which we felt very uncomfortable about in terms of their, of their impact on trainees. All right. Thank you. Thank you for both for taking the time. Really appreciate it. Have a, have a good evening. I'm just gonna share a closing video quickly. Good. Ok, thank you very much. We'll we'll depart in that case. Thank you. So, yeah.