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Yeah, so, hello everyone. Welcome. Um, my name is er, Kub. I'm an I NT one in Kent and part of the specialty careers team at mind the bla uh, so today we have got uh, Doctor Joan Coma with us. Uh, she's a GP registrar. So she's going to talk to us about, uh, applying to GP training and um AAA day in her life as a, as a GP registrar. Um, so, yeah, um, um just if you have any questions, just pop them in the chat and we can go through them um, towards the end. So over to you, Joan. Yeah. Thank you. Good evening everyone. Um, let me just put up my, so again, I'm Joanne Kia. I'm a second year trainee here in uh Royal Cornwall Hospital. Uh, before I start, I just like to ask, do we have enough already for me to ask this question? Just wondering. Yeah, we, uh, we can, yeah, we can, we can post as a poll. You, I just like to have an idea, at least a ballpark. How many of you are considering general practice as a career? We'll see if there's enough to respond. Yeah. Just give it about a minute or so. So maybe I one, mm. So we've got about, uh, 20 responses and, uh, 65% say that they are definitely considering GP as a courier and 35% are still deciding maybe. Ok. Oh, wow. There's more responses coming in. Looks like there's a majority of you wanting to really go for GP. And I'm hoping you will still be considering going to GP after. Is that, is that a good, a good amount of number that we've gotten already? Yeah, I think so. Yeah. Yeah. No, that's good. All right. So it's good to know that a majority of you are considering to get into general practice. So our objectives for today would be to understand the process of the GP training pathway, examine the opportunities and challenges within the field, explore the key roles and responsibilities of the general practitioner and discuss future career prospect in general practice. So question why become a GP? So being a general practitioner, you do get a diverse clinical experience. Um again, because you, you know, you get any, any, anything under the sun when someone comes into the clinic, um depending on how much you you take in, you can achieve a work-life balance and flexibility. Um But again, again, this is depending on how many, on how much you want to, how much workload you want to take. Uh There is continuity of care which is quite, which is quite good in the, in the GGP setting. There is um community based work, there are leadership opportunities. There's a lot of this, um there's also career developments. Um You'd be surprised. And last, but not least it's a shorter training pathway. However, this should not be the main reason why you want to become a GP. Uh just because it's shorter, doesn't mean it's for everyone unless you have other priorities. And that is one of the main reasons why you want to go to GP. So one of the qualifications necessary is either you have an M BBS or equivalent medical qualification such as a Doctor of medicine. And in order to be eligible for application, you have to have a full GMC registration and hold the current license to practice from the General Medical Council at intended start date and you need to have an evidence of foundation competencies within the 3.5 years of training start date demonstrated either through uh um being currently employed in the foundation program or you have already been awarded a certificate of completion of the foundation program from a UK affiliated foundation program within 3.5 years of the training start date. Or you're actually also currently training, you're currently employed in a GMC approved specialty training program uh with uh either a national training number or Dary reference number. So there are some doctors who are doing, you know, maybe doing an I MT or another specialty and all of a sudden they realize that they would like to go for, they wanna be a GP. Um Another way of demonstrating competencies would be uh you should have had 12 months medical experience after full GMC registration or equivalent post licensing experience along with a certificate of readiness to enter specialty training form. This is mostly applicable to international medical graduates. Um but I will further expound on that. So uh another, I also do want to sort of run through a bit of the ens essential and you know, other criterias that are necessary to get into GP. One that I want to highlight is that once you have a current valid driving license or at least be able to commit to find other alternatives of transport when you're attending an emergency or a house visit because this is part of the requirements of the training program. Uh Some feel that you may not need to be licensed, but if you don't have you again, you need to find other ways of transport to go to house visits or to go whichever rotation you're in cause it's not just gonna be in the GP. Um So I just, this is the person specification. So uh sorry, let me go back. You can find this uh other the other information through this website that I put here. But at the same time, I will also show you a very quick peek of how the what the criterias are. So I already mentioned the, the eligibility, which means either showing employment in either of these, um, either as foundation program or the twelvemonth experience and the rest fitness practice, language skills. This can all be found in that website that I posted and I just wanted to show to you all how it looks like. Thank you. Um, if you have any questions, we'll, we'll, uh, I'll, I'll attend to it in the, in the last part of the presentation. So regarding the certificate of readiness to enter specialty training or otherwise press form, it's required for doctors who have not completed a UK foundation program, but they wish to enter specialty training in the UK. Um This form, you know, it, it shows evidence of competencies in acute care, teamwork, communication, clinical decision making and a form can only be signed by a consultant or equivalent with whom you have worked with for a minimum of three months. Uh Yes, we can post the link later on. We'll do that. Oh, there. Thank you. Thank you Costa. Um And I will show how the form looks like just a quick peek. It's very long. So it's at least uh it gives you guys an idea for at least the international doctors watching how it looks like how it needs to be filled up. Um And the reason I'm showing this is because it's necessary with the application or else you won't be able to apply sorry if I'm going too fast. So these are the consultants or doctors that would have to sign and prove that you provided evidence of the skills necessary. So you fill the crest form for the international doctors um and for the other doctors here in the UK, when you want to apply, we go through the or el so I had to ask a friend to actually if I could get a copy of her form, reason is mine has already been deleted, but at least she kept hers. So as you can see, there are different spaces in the application you have applied. So when you apply, obviously, this is when you fill in the details of you know what your current employment is, et cetera. II, it's very, it's it's a long application form. And then once you've submitted that you need to also make sure that you have your quest form. It's again for the international Doctors, you have your quest form already signed and prepared. As you can see, there's a quest document tab that needs to be submitted in order for the application to go through. So when I applied for GP training at my time, it was a bit more lenient. I applied in December. Um However, the deadline for the Crestor to be submitted was February. Now because of competition, they now require that you have the form already prepared when you apply for GP training. So make sure that's already ready So you've submitted everything you now get long listed. Um After being long listed, you will then get, you know, ma they will make sure that you have everything. If everything is ok, then you get shortlisted. Once you are shortlisted, that is when they will now request those to take the M SRA exam, which I will explain further after if so once you have been invited to, to take the MSR exam, that will now go through the interview phase. So in GP, the only interview that takes place is the examination I believe before COVID, this wasn't the case, it was an exam and there was also an interview, but now it's pure exam. Um and if you pass the exam, just because you pass the exam doesn't mean that you would, you know, you need to have a certain rank. So if you pass the exam and have a good rank, you pass the interview and you eventually at some point will get the offer. So that's the face of, that's how it goes. I know it's a bit vague, but for anyone who does uh for anyone who does the oral form, he will eventually get to see how it, you know, you get uh you get familiar with it. So the Multispecialty recruitment assessment exam, otherwise M SRA it's a computer based assessment. It um it test you in essential competencies. It's also used for other specialities besides general practice, such as radiology, psychiatry uh OBGYN etcetera. It has two parts to it. One part is the clinical problem solving and the other is the professional dilemma section which many of you would probably know as the situational judgment test. S JT. And the good thing about it, it is free. Uh However, it is only given twice a year from the back of my mind. It is given in January and September and I will answer. I'll get to that. And yeah, so now what be, what is it like being a GP? So general practitioners are the backbone of the U K's healthcare system. We are the ones that try to, you know, uh we're, we're the gatekeepers from getting people going into the hospital. We provide for comprehensive medical care, diagnose illnesses and manage patient treatment. And in order to become a GP one requires a combination of academic study, training and experience. Um uh OK, so this is how the training program look looks like. It's a, it's again, it's three years there, it involves clinical post in a range of specia of specialties. And when you go, when you rotate around different specialties, it usually lasts 4 to 6 months. And these are usually relevant specialties to general practice such as rheumatology, pediatrics, psychiatry, rheumatology, et cetera. Uh The breakdown of training is it's 18 to 24 months spent in general practice, post the remaining months. Again, like I said earlier, it's in hospital or integrated training post if it's a bit confusing, II will get to it later. Um The final year of GP PRAC of GP training is dedicated to general practice. So the training program involves developing your skills in diagnostic abilities, patient care and management. You will always or often be guided by experienced GPS throughout training. Usually your educational supervisor, clinical supervisor and also your training program directors or PPD S and portfolio is the main highlight. Actually, I just wanna highlight that this the portfolio. It, it's document, it documents the learning and progress towards completing the GP curriculum and capabilities for general practice. So for those who are in foundation program, I'm sure you have your um oh God, I forgot what it's called. Um Anyway, I know you also have your portfolios to keep up with the same thing with GP but it or it's a bit more detailed. Um We would require 36 reflections and then this, oh, there we go. Horace. Yes. Thank you. We have you have s case based discussions, Micex and all those things um and other requirements in the curriculum of, of the MRC of the R CGP that is involved in this in the portfolio. So in order to become a member of the Royal College of General Practitioners, you need to successfully complete three components, which includes the workplace based assessments, which are, which you will prove through your portfolio, the written examination, which we call the applied knowledge test and lastly, the practical exam, which is called the simulated consultation assessment. So it's in other words, it's an OSK. So if you're able to successfully complete all three of the, of, of, you know, three of three of these components at the end of the three-year training, you get certificate of, certificate of completion of training, just but not everyone finishes it in three years. There are those who take the um who become, who take the L DFD pad you go um less than full time. So I just wanna give a sample of. This is my training timeline. Obviously, it's not yet 2026 but this is my plan. This is when I hope to finish my GP training. So from August 2023 to August 2024 my first year in training was all hospital rotations. Um I did rheumatology, that's a hospital but it was clinic based, but it was, it was all about rheumatology conditions. I saw patients in the clinic. Um And then my second rotation was in community elder care. That was um it was a ward, it was a, it was a community hospital that served, it's, it was like the AM U of the community. Um And then my last rotation for my first year was Psychiatry for, for my second year, which started this year. August, I'm in my integrated post integrated means it's a mixture of uh either ho it's a mixture of hospital and clinic So I'm doing two days of the week in hospice care. Uh and two days in GP, one day is reserved for teaching and personal development or CPD S or other CPD S that you would like to do. By next year, February 2025 to the end of August to August 2025 I will be in pure general practice. So during my second year within this, from August 2024 to August 2025 my aim besides obviously completing my portfolio for this year is to also get the A KT done to pass the A KT. By the second year, you can only take this exam when you're in second year because you should have at least had already a feeling of what GPI of G PGP training is. It's my first year, I didn't have any GP rotations. Um And then by third year, August 2025 to August 2026 I will be in pure general practice. And during that period, I should also be looking into getting finishing my simulated consultation assessment or S EA. Um So these two exams are necessary in order to complete the training. So they in the life of a GP the morning session, I usually, so as a trainee, I arrive, I usually start at, I go at eight o'clock, even though my first, my patients start in, my first patient will come in at 830. And the reason is so that I can go through the list of the patients that I will be seeing if I need to read a little bit more and study more about them. That gives me that 30 minute, gives me time to at least prepare when I start my clinic as a trainee. At the moment. I am given thirty-minute consultations, but for others who are more experienced, they are given 10 to fifteen-minute consultations which involves history, taking physical examination, diagnosis and treatment plan at 10 a.m. For most practices, I heard we have tea break, tea break is really important. Um Others may not go for tea break all the time, but they do try main reason. It's really important that you do set aside time for your again m mental wellbeing. And at the same time, you get to see other people because being a GP is a very isolated work, you're always in the clinic. So being able to mingle with other GPS is actually a good thing and you will also learn from them because this is a time when we're sharing stories or asking for advice. Mm Having a good laugh is also very important. Um Then 1030 another round of consultation until noon, 1230 pm. So 12:30 p.m. for some g uh for so for some, not everyone, not everyone needs to do a home, some will do home visits. So they put it in around lunch time and when you go for home visit. This is a time when you, you need, you might actually need to bring a, a medicine bag is what I call it has all your your things in it for being able to do physical examinations. Um And when you also do home visit, it's not just doing physical exams. You may have to review medication, assess the patient's home environment, um and manage ongoing care for those who are unable to make it to the practice. Um Then you aim to at least have your break, your lunch break by 12 by 1:30 p.m. So during lunch break, some also do their administration. Uh it's one way to fit in the work that needs to be done. I also actually do my administrative stuff during lunch. So during this time period, you complete patient notes, respond to emails, sign pres sign repeat prescription, handle urgent matters that have arisen during the day by two o'clock. Um consultations will, will start, I think this is a little, you know, 130 to 2 that might be too short for some. It may actually be a one hour break, but it's just showing the possible schedules that are out there. So two o'clock start the consultations the same thing in the morning, 1510, 15 or 30 minutes for me f and then by four o'clock, you have M BT, it doesn't always happen in the afternoon. Sometimes it starts in the morning. They have it in the morning. Um And MDT usually would involve district nurses or any anyone else involved in the practice that needs to be in. That is also part of the team and it depends what goes on in the MDT S if they have to talk about certain patients. So by late afternoon and evening time, we finish usually by eight by 5 p.m. and 5 to 6, we do an other, we do more administered duties again. They um it's more administration going through discharge letters, uh looking through bloods, doing referrals, etcetera. So what are other responsibilities and roles of GPS? So we have out of hours. So we GPS sometimes do on calls for emergencies during weekends or evenings. GPS are also, you know, we can do tea, we teach and we train. There's a lot of so in every practice, there's always going to be a trainer who's teaching registrars and there is also clinical audits and practice management. There will al in there's always gonna be Qias and Q I PS involved. So what's the T, what are the things? So, yeah, Gene II feel like GP is a very, it's a highly rewarding profession, but it does come with several challenges. As you see the schedule that I've shown you, it's quite jam packed. How can you see patients and at the same time, be able to do administration. So one of the challenges is the workload, there is high workload and high pressure GPS often have, do you often go beyond our schedule? Um And because of the high workload, we can eventually have burnout and stress. Uh Which is why again, it's, you, it's important you contemplate or decide on how many assess you want to take on as a GP. So sessions is what we refer to how many um it's divided, you have the morning. So two sessions mean you're doing morning and, and afternoon part of the day. So others do four others work for 43 days. If you wanna burn out, you wait for five days. But uh I know a lot of people do 3 to 4 days only of GPS. They don't take, they don't do the whole week. Um It's hard to fi uh worklife balance can be achieved. But for some like partners, GP partners, I think they're the ones who probably find it more challenging to find a work-life balance. Um There is also, it, there's also a lot of politics. There's a lot of loopholes that you need to go through when you wanna do things for your patients. And I think that's just one of the challenges for most doctors, but it's the same thing for GP. But you know, there are also other things that we can do. So life after training. So either you stay in general practice, there are three types, you can be a GP partner. So GP, partners are responsible for running the practice and they are not and are expected not only to do clinical sessions, but they are also expected to take part in the administrative and business side of the practice and they do make more money. But then that will depend on the finances of the practice and how it's di distributed. Salaried GPS are employed by the practice and they receive a salary for, um, they, they, they, they receive a salary for a contact number of hours worked. This is what I was talking about sessions and how many days that you want to work within a week. And then you have local GPS who cover, it's the same thing in the hospital. Local GP SS are there to cover sicknesses um or cover those who are going on leave or to just the backlogs of the practice as well. And then besides being a GP, you can go for a special interest that involves the dermatology, palliative care, sports medicine, others go to academic medicine, which is mainly research. So I work with GPS who actually do two days in the in the GP practice and then the other two days they are doing research during the university doing their part. Um Others do clinical, become clinical leader, medical directors, they go, others go for public health, digital health, others use general practice as another pathway to get into other training. So for example, there is occupational medicine, one of the requirements of becoming an uh to going into occupational medicine is general practice. Um aviation medicine, if any of you have heard of it and there's also rehab medicine. So it again, it still opens you to windows of other opportunities. And then again, you can also go international, you could go to Canada, Australia and New Zealand. Those are the most the famous ones to go to. So uh any questions I'm hoping that wasn't too fast. I think there are questions that are already here. Yeah. So, so there are two questions uh We've got uh um so the first one is do we know when we can start the application on oral? Um I usually keep tabs of it like a month before August. So there's again, there's two, there's two application or recruitment happens twice a year. So for the, how, how do I, how would I explain this? I was there were there not 33 applications? One is the normal December 1, 1 is the February and uh September uh or the, the September 1 is the one with the, the August 1 like. So August, you apply, you take the exam in September. The main, the main recruitment happens in December. So around October, November, I think around that time the applications open and that's when you can fill in your oral form and the, and the application will close by the mid part of December. And then after that, they will start in um accepting people for the MS when to take the M SRA towards the end. And then January is when they do the exam. And then for the next intake, which is in the middle of the year, which is less, less, actually less number of slots, maybe 400 versus the one in January which is 4500. So for the second one that happens around Septem, the exam, September. So around July, the applications open. So that's when you can start filling up the oral form. All right. OK. In July, uh the, so the next question that we have got is from Alice, I've heard that the first set of the M SRA is the only one that counts. Now, if you have passed. Is this true at the moment? Yes, I have been hearing this. Those I have friends who have not been able to take the M SRA for the in. What is it? So they had an, they already had the intake in September for the February start of the year. Um I think people might become more confused now. So those who are taking the exam in January are starting August and those who are taking the exam on September starts in February, I hope that clarifies things. So the ones that are taking that took the exam, this September for the February 2025 intake. I've had friends who've not been able to sit the M SRA because mainly they've already had an, they've taken the exam and they're giving priority to those who haven't, um, because of the competition, that's just how competitive it's gotten. Um, I don't know if this will be the same by next year. I think there's that question mark that's still lingering and I won't be able to really answer if that will be the same for next year. It could possibly be a clean slate because that's when. Um, uh, but, oh my God, who who? Sorry. Um It's this year. Uh All right, erase erase by this year, August around December, they will start having another intake for the August 2026 batch. So T 25. That's ok. 2020 25 ba I'm sorry, 2020 25 batch. So I'm not so sure if they're going to have a clean slate, but it's possible because there's going to be more slots available for the August 2025 batch. There's going to be about 4500. It's possible that people can retake the exam for a better score. Um Yeah, so I just wanted to jump in because I've heard the, I've heard similar things. Um and uh good that Alice brought this up. Um So I think possibly again, everybody is um assuming that this is the case. So if you have given the exam once in the recruitment year, so um main recruitment year being you apply in October, November and take the M sra, I think in January the next year. So um that's the main recruitment year. And then if you have applied once in that recruitment year, you have to use the same score. But people are saying that if you go to the, again, the next main round, the next year, then you can again take the exam, but it's not clear yet. So yeah, that, that's definitely happening. It's, yeah, it's, it's still very vague. Um And only now this has happened because I'll be honest, I took the MSR about three times. I mean, I wanted to keep on trying and because the the the chances really with the one with the, it's it is challenging to study and balance work at the same time. Um when I was studying for M SRI was working in South End as a clinical fellow in endocrine an infection. So it was challenging, but it's not impossible. But obviously, now I would really suggest if you want to really get into a slot study the best that you can because now it's really competitive and new rules are coming out. Yes. So also just, just one point that I wanted to add. Um previously, people used to take M sra multiple times because it was free and it used to be like a practice. So you just go attend the exam and then do it again. But I think that's not an option. Uh They have realized that people do that. So you have to do it once and do it right. And, uh, at least for GP, if that is the case, it is true though. Like this, when I was taking the exam people would just tell me, keep on taking it. It's good practice, you know, and, and it's, it's for free and the more, actually the more you do it, the more you get better at it. But that's not becoming, now it's not becoming an option now available for, for many. Yeah. Um And then someone, can you explain more what it means or is that good? You think that we've covered that part well enough? Do we have anything else? So I think so. Yeah, explain the next question is, could you explain more what it means to be a GP partner? Uh So again, GP partner means you take on more responsibilities as compared to those salaried GPS mainly because you do the, you do the business side of the GP practice, you do the fine, you either take part of the finances. Um, you do the administrative part. It's hard to say really because I've only seen them what they do but they do, they do to take more responsibilities even. So whatever the salary gps are doing, they also have to overlook and see if they're doing everything. All right. Um It just means it's just like owning part of a company, but not in this case, it just means that you're just taking in more things to do. But it's, it's like, well, I think that's how it is. It's like you're owning part of the company because you're seeing how it's running and if it's running all right, if it's doing things meeting the requirements that the NHS and the, whatever p, uh, policies that you have to follow, is it, is it profitable? II think that that's the thing is, is you're doing profitable, are you being paid for what you're doing? So you need to make sure that you've got money coming in and not just only going out. So, so you get paid extra if you're a GP partner now or you make more money, you do, you do get paid extra. So I do have a range here. It could, it could be up, up to 101,500 lbs versus being a salary. Yeah, being a salary GP would be 56 to 85,000 lbs. So there, there is a big difference. How does one become a GP partner? Oh, I'll be honest. I'm not really so sure about that. I um, oh yeah, I uh, I, I'll, I'll go to the next one then. Um, and do you know, I, I'm not really looking at becoming, well, the reason I'm not looking to it because it's not in any of my interest at the moment. It looks like it's a lot of work. I'm not discouraging anyone from becoming a partner one day and the next one is, um, do you know which English speaking countries, recognize UK GP training? Oh, yeah. Again, like I aus Australia, New Zealand and Canada. So with Australia, with Canada, you still have to take an exam depending on the provinces that you're going to go to. Um, Australia. And New Zealand also does reco um, recognize UK GP training. I just not so sure the, on how the process is, I think in New Zealand, you may have to have one year where you're being supervised. And I'm not so sure if it's the same in Australia, but it is, it is transferable. So I know a lot of GPS have gone. Well, I don't know, I've heard a lot of GPS have gone there. OK. Um The next one is, has there not been a reason about the exam being? I think we covered that. Um The next one is for special interest. Can it be other specialties too? Like rheumatology? I've seen dermatology but was wondering about others. Rheumatology. Yes. Um My clinical supervisor in rheumatology was actually a GP. Um And then he just focused on, I think he just did further training and then he also became a consultant in rheumatology. So, yeah, do you do specialist, like for your rheumatology clinics as a, as a specialized uh GP with special interest? I think he did further more training because it's not just special and he just, he went, he just focused on rheumatology. He didn't do any more GP. Um, but if you want to do, be, the thing is when you have special interest, it doesn't mean that this is the only thing that you'll be doing. So for other GPS with special interest, they may do two days, three days as GP and then one day we'll be doing what their special interest is. Ok. Fine. Does it make sense? Yeah. And the next one is why did you personally choose to be a GP? Um I guess priorities in life. Um I wanted to be able to find a job that I know I can find work-life balance um that I can see a variety of people and that could give me other opportunities to do other things. And for example, if I want to go for other specialties, um GP is really a good foundation because, you know, you learn so much from A to Z from, from babies to adults to elders, to elders. So I think it's just a very good um It just gives you very good foundation and yeah. All right. I think it's a physical profession. It's really up to you and how you're going to just manage your career. You did mention uh things like public health, uh aviation medicine. And yes, actually, I will be truthful. I am very much interested in aviation medicine and, and GP is one of the routes to it. So I know aviation doctors who are GPS, they will do one day, two days in the general practice and the other days they are doing aviation medicine. So that's the best part. I know someone or, I don't know him personally. So I attended a digital, digital health conference. Um, one of the speakers works for Microsoft. He does one day of general practice and four days, he's with Microsoft. So that's the, that's the good thing about GP. General practice. You can do so many even just besides by being a GP interesting. Yeah, lots of uh different opportunities there. Um The next one is I believe there's a cut off score. If you score below that, then you will be allowed to take retake the M SRA. Uh This was the, this was the case before but now. Oh yeah, yeah. If there is a cut of score, if you, if obviously you've failed. In other words, you get a band, one band two and two, sorry. Um So there are different levels of scoring. If obviously you've not met the cut off score, then yes, you should. You're allowed to retake the M SRA. That's, yeah, that's correct. All right. OK. Um How do you score highly on the M sra? Oh Dedication II, can I can rephrase it? What, what resources did you use? I think that that's something for me. It was past medicine. Uh OK. Past medicine for me was really helpful, especially the knowledge tutor others did take uh um online courses but I'm not going to be, you know, how would you say this? I'm not, I mean, there are options but I'm not going to be recommending them to you as something that I would say must be having. So, do you have em, Medica Aurora? I think those are the ones that are very common. Um, but just to clarify, these are the online courses that these are online courses. That's another option that you can do if you want to score highly M sra. Um again because it's an S JT and plus clinical clinical is I think something that you can do very well by just doing questions and questions. But S JT the clinical, the the SJ key part um or the dilemma for and I call, I still call it S JT. I think that's also go that's practice. Um And if you have already had experience in the hospital that that is a plus. Mm you can apply it to it. Are you taking the Mr right Costa? Um Yeah, I actually did apply for the MSR as well. II did apply to GP training and I also applied to I MT and then I uh chose I MTI mean it's, yeah, I did, I did use past medicine as well. Yeah. OK. So yeah, no, it, it really varies for me. It was past medicine. Yeah, thing we got. So then the next one is um is it true that getting a job as GP is harder now, especially due to growth of PA S I II don't know if it's because of PA SPS will not be able to do what GPS are doing. I just realized, I think it's just depending on where you're applying for a GP, uh where you will be applying as a GP. When you're a GP, there are some areas that are already very saturated. I think the challenge is depending where you, where you're applying. So if you go to London, it is going to be a bit more challenging to find a job versus maybe Scotland or here in Cornwall or in Wales, maybe. Um But yeah, no, the reality, I it's not just being in the, it's not only just GP, it's just everywhere here in the UK, it's becoming more challenging to get a job, I believe. Sure. Um You mentioned about probably moving into another specialty. How does that work? If one wants to move to internal medicine, I does not, II don't know what that um, me, can you, can you please clarify and we can, we can come back to that. Um, any resources to learn um, for the M sra other than the question banks? Oh, again, uh, em, medical Aurora. I think those are the main two ones that I really know. I don't know of any other, I think. Um, I think from, um, from the colleagues that I talked to one of the things that I can recommend is there's this um there are, first of all, there are MSR papers I think that are available somewhere on the website. Um So there are like 444 or two papers and um there is an Oxford S JT book um which you, which you use for your foundation. I've, I've tried the Oxford ST, I don't think it mirrors very much of the exam, the M SRA because the SAT and M sri realize is more mirrored with GP. So you mean the MS has more GP based? And the, there are, there are some situations that takes place in the GP and that isn't really something that you would find often in the Oxford um handbook. I've read it, I've gone through it. It's ok, but I think it's more applicable to the foundation doctors. But yeah. Oh, good point. Yeah. Um How long would you say one should prepare for the M sra? I would, I would say six months is a good 13 months is ok. But still cutting it, if you're having to balance work and studies, six months should be. This is the practicality. Three months can be possible, but that means you just need to really ramp it up more. Um So I think basically start now if you haven't started already, I'm just saying this now because I'm seeing how very competitive it's getting. So the more you prepare, the more, the better So it's just saying, obviously you will not prepare for it one month before that just will kill. So, um, I'm not sure if you just, you know, if in case that that is your situation at the moment, it doesn't mean that it's impossible. It's still possible because you learn, if you're working, you should be learning at the same time and be able to apply what you've learned in the M RSA exam or MSR. Yeah. Um The other thing we have one more uh can the, can the GP has special, can GP have special interest in Cam S child and, and all, and mental health? I believe so. Can I ask someone who I think is online that might be able to answer that question with mental health wise? I mean, I think so. II wouldn't I, because I know GPS who are having special interest in mental health. So I don't see any reason why they can't do it with child and a adult, it mental health, but I won't be able to give you a 100% answer. Yes. I think more of um I personally think if you, if you do psychiatry, then you also do, um you can also do community psychiatry. Um and Cam S um um I'm sorry, I'm not sure about that one. I never heard of anyone who has, who is a GP and then done um CS but could be, could be possible, could be possible but it's quite a very highly specialized part already of the mental health. Far side. Um, I've only met people who have mental health as a special interest but not adolescent, unfortunately able to give the, uh, 100% 100%. Yes, maybe, possibly perfect. I think, I think that that was the last question. I'll give it about 30 seconds reference. Yeah. So I just, um, I posted the, I've posted the link for the feedback. So if you, if you could please provide the feedback, that is how you get your certificate and it also helps us to um develop and organize future content for you. So again, um Yeah, thank you. Thank you, Joanne for um uh talking to us today about applying to GP. And um thank you everyone for, for attending. Just give, give, give it a minute or so. If anybody has any questions, otherwise they call it today. It was, it was an interesting talk and, and a and a good conversation about various opportunities after, after doing GP learned quite a lot. Yeah. Thank you for having me as well. All right, while we, while we wait for a minute. Uh I was just, I was just wondering, uh it's, it's, it, it seemed like a very, very busy day when you showed your, your schedule from 8 to 6. So do you, is your, are you paid from 8 to 6:06 p.m. or um do you voluntarily go back to be. No, as I, you're obviously paid for the time that you're supposed to be in. But obviously others are spending, there are those who are spending a bit more over time because they need to, they have the amount of work that you have to finish, but others do try their best to finish it on the dot Sure. Thank you. Mm. Can you, can you exception report in GP training or Uh that's something that we do in I NTA sometimes I think it's more easier to do that in the hospital, right? Ok. Being in the GP setting. Um mhm. I've not really seen anyone really um do exception. Uh No one's told me about it. I've done, I've done exception to reporting when I'm in the ward, but I, I've not really have to stay too well. No, I stayed a bit late but not, not that, but the thing is my colleagues are also there until six o'clock. So, hm, just really me. Um but you know what? Maybe I should give that a try and ask if that's possible. Yeah. Yeah, it's just a thought. I mean, ii recently stayed late. So I was wondering um so I've just posted the link to the, to the feedback form again if the, the previous one does not, does not work. But yeah, otherwise thank you, everyone again. Um Thanks for taking the time today and um stay tuned. We'll have more specialty webinars. If you're interested. So the next one is going to be on eighth of October. It's going to be on 90. So if you are interested, we will see you there. All right. All right. Ok, bye. Thank you very much. All right.