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Ok, we're alive now. So if you can hear me and see MS Johnson, can you just give her a thumbs up? Mhm. Ok. We'll start from 10 past 10. So three minutes or something. Yeah. So that's working now. It's not working. Well, that's very good. Thank you for letting us know. Thank you. Hi. Hello. Well, I think that we've got another viewer with us. Um, we will wait for another 23 minutes and then we will start that if you have any questions that you want mister to address, you can write it in the chart and we'll come back to this, these questions between Yeah. Ok. So we shall start in about a minute and a half. We have a good couple of more people with us now. Can everyone see us and hear us? All right, if you give a thumbs up on the chat box, I think that's the only way to know if you guys can hear us and see us as well. All right, shall we start? So we have? Ok. What do you say that? Yeah. OK. Good thumbs up. So fine. All right, let's start. Yeah. Ok. Yeah. Uh All right, good morning slash afternoon slash evening, depending on which part of the world you are. Uh, my name is Amia. Um I work as an, a specialty registry and vascular surgery in Brighton and I am from Bangladesh. I did my graduation from Bangladesh 2017, finished my F one, came to this country as an F two and then progressed up to the ladder. And I'm gonna start my higher speciality training in vascular surgery and Edin Hospital Cambridge from this October. Now, the reason of me saying all this is a co many of you might be thinking, oh, this boy is flexing. However, that's not the reason. I'm sort of just trying to prove my relevance to sit here and have a chat with you guys. All right. So, so we're gonna talk about a couple of things and then in between, we will ask for some questions and if you have any queries, then I'll answer accordingly. And our beautiful host Fa Fabia is keeping an eye on the chat book. So she will let you know. And I can also see if at any point you can't hear me or see me, just write in the chat box and we can sort that out. Hopefully, I don't have much slides. It's more about a talk rather than a lecture. So I would really appreciate if you try to understand the system and, and if you have any queries, obviously, let me know, obviously we're gonna talk about the ST three portfolio and interview series mostly for vascular surgery. However, most of the surgical specialities and other specialities like a ne has also has got quite generic application pattern. So any any speciality expert should have a bit of help or guidance from this session. So, yeah, I mean, do you want to be a highly glorified plumber? We we vascular surgeons, we call ourselves highly glorified plumber, nothing else really. So this session is probably gonna be for you. So today we're gonna talk about how to get into the ST three training program in the UK, which is a national uh training program. You can compare it to a residency and back in us or in other countries as well. So we're gonna talk about those portfolio. We're gonna talk about the interviews as well. And at the end, I'll just give you a brief idea about what do you expect as a vascular registration with some common scenarios as well? OK. I hope you can see the slides moving. Uh If not, please let us know. So this is basically a very general way to understand how the training system works in NHS or in the UK. So you finish your medical school, then you do one year of F one which is equivalent to internship in many other countries. Then there is one more year which is called a foundation Year two. It's not an, it's basically post internship but it will a bit less than a medical officer. If you think about that way in Pakistan or India, we have good medical officers. It's somewhere in between. So as an F two, you, you sort of rotate in different specialities and find what you want to do. That's why this country has got a foundation program of two years. So once you finish your F two, if you wanna do surgery, then um, there are ways to get into surgical training, but most common way to get into surgical training is through a core surgical training. So you do a core surgical training after an application process and interview and you get a number, then you go to uh two different hospitals for two years and you do four rota four surgical rotations in in different surgical specialities. Sometimes you can add or you know, you can alter one rotation to an it rotation that can also help um in your application courses as well. So you do finish your two years of post surgical training. And by the, by the end of your CST or two, you should fi if you have to finish your membership of the uh Royal College exam, which is the Mr CS, both parts. So once you, that's an essential criteria, once you finish your MRC SS, then you are sort of eligible to apply to become a registrar. Now to become a registrar. I mean, you can become a non training registrar and then you can become a trainee registrar later on as well. So, uh, that's two ways to go for it. But if you apply for ST three, that, that's when you, that, that's your E three there. So that's when you, uh, actual surgical speciality training starts. It's mostly six years of training. And then by the end of your, um, seventh year, which is your year seven, you have to start sitting for your er S exam. So then you take an year and a half to pass both of the pa parts of your ear exam. So once you finish your year eight, that's basically essentially your whole uh training period. And you have successfully completed the fellowship exam, which is the, and uh for orthopedics is a far CTNO for general surgery, it's a far general surgery for vascular, it's a far, it's vascular and then you get CCP, which is the certificate of completion of training or in a simpler term, you become a consultant, then, er, e either you go for another fellowship to, you know, have some super specialization in something in any part of the world or you get a consulting job and start your consultant life. So that's basically a simpler way to understand how the training system works. Now, we're gonna talk about ST three mostly and it's the, the, the purpose of this webinar or this session is mostly to understand how the ST three recruitment system works and how you can maximize your points over there. OK. So the steps of recruitment uh there is a system uh is a portfolio called el where you have to put your application and the application generally opens in sort of mid, mid to late October and application, the, the whole recruitment process. It, it's a long process, it takes on around six months or so. So you look at the application premi preliminary application opens around um mid to late October and then they, they give you a couple of weeks to put all your, all your evidences and, and do a proper application. So that's the application via Oriel. Then you get long listed based on some essential criterias, which we're gonna talk about next. Then the main part is getting shortlisted that's based on your self assessment score. And that's where most of us, most of the international medical graduates struggle. Once you're shortlisted, then you will be called for an interview. We'll talk about the interview as well. Once you have, you have done your interview, then you will put your preferences, which is if you, if you're going for vascular surgery. So vascular surgery has got run about 30 jobs throughout the country. Then you'll have to rank those do jobs based on your preference or your geographical preference. Or you know, if you have any particular interest in going to a region or a hospital. So you basically rank those jobs or those diaries accordingly. Hello? Can you still hear me? I can hear you. Yes, you can hear me. Yeah. Yeah, I think everybody should. Yeah. OK. All right. So then you put basically rank all those jobs uh in, in the, in the oral system, you rank those job based on your preference and then based on your portfolio score and your interview score, cumulative score will give, they will give you a rank and then they will offer you a job based on your preference. So once you get the, get a job, once you get a number, then there are multiple ways to deal with it. Either you can reject it, either you can straightforward, accept it or you can hold an upgrade, wait for an upgrade. OK? We're gonna talk about that. So let's go to the first bit, which is the long listing criteria. The long-lasting criteria is not extensive and it's pretty self-explanatory. You have to pass your M DS or equivalent obviously. And then you have to pass your Mr CS, as I said earlier by the time of the post start date. And you should have a complete employment history from the day you have been awarded your primary medical uh qualification that also includes your internships, your um jobs that you have done in your home country or in any other country. And then the other thing you need is the evidence of achievement of, of your core surgical training, which is essentially CT one and CT two years. Uh you can get, if you're doing a diary, core surgical training, then you get a RCP, that's the annual review of your competencies. And you need to submit those reports to the application. If you're not doing a formal diary, CST, then then also you need to get signed uh a crest form which is the certificate of readiness of entering into higher speciality training that needs to be uh validated by a consultant signed and then you need to submit that as well. These are the basically essential criteria. If you fulfill these essential criteria, then your application status would change from applied to long listed. OK. Then comes the shortlisting part which is the most arduous part of the whole application process. So this is a self assessment scoring system which has been in place since the COVID time before the COVID, there was no self assessment scoring. As far as I remember you go with your big fat portfolio physical one and then you you negotiate or bargain with the interviewers, which your portfolio points and then they give you points there. But nowadays from COVID, the self assessment scoring system is there. So it's basically a 10 questions that appear on the application form along with a couple of possible responses and then that gives you certain points and then you have to have an accumulated uh decent point to get, get to an interview. Obviously, you have to provide substantial evidence for your response. Ok. So there are 10 questions we're going to talk about those 10 questions. And after we have talked about those 10 questions, we will ask for your, your queries, your questions. If you don't understand anything, please do ask. But if you are planning to apply for a speciality, training in any surgical speciality or say vascular surgery, if you're gonna be a plumber, then you, you should really understand this bit. So question one, it says, I mean by the end of July 2023 because I've, I've, I've taken out my application form, but it's the end of July whichever year or completion of core training. How many months will you have spent in total in any job in medicine that includes clinical and a nonclinical jobs post foundation program. This is basically the end score and this is where we struggle the most. OK? So the end score is obviously you can see 00 to 39 months. It's one then 2345. OK? Um The more points you have, the more end scoring you have the more difficult it's going to get for you to get into a program because a couple of questions that are gonna come later will be divided by your M score. Now, the caveat what I have found so far and I have had so many questions about it is like, what's the post foundation program? Because UK has got two years foundation program. So their clock starts after F two. However, for us who comes from different country, most of the countries have got one year of internship. So you, our clock starts from the day we finished our internship. However, if you land on a job in N NHS as your first job as an F two, then you can possibly bypass that and you can possibly make your clock start from the day you finish your F two. So just keep in, keep in mind about this end score, you will understand why this end score is very important. And you have to, you have to keep an eye on it. Uh You'll understand it soon. And obviously they say you need to provide all these evidences like the page of your contact of employment, which is a pretty self-explanatory. Really. The question two is the question two is and three, these are basically your experience segment. OK. So by the completion of core training or by the end of the July of whichever year you're applying for, how many months will you have spent in total in vascular surgery and, or general surgery? That's for vascular surgery. If you're going for TNL, that's going to be for TNF. So they don't want a highly experienced person to be an ST three, they want someone whom they can train. That's why you can see that if you have, if you have experience in vascular and general surgery and any post foundation job in any country for, for a range of 30 to 59 months, you get four points, 21 to 30 months. However, you get eight points. So you should, you should aim for the maximum point which is eight. That means you need to be very careful that it doesn't really pass the 30 month period. Ok. And where we make mistakes is we count from the day, we are replica until the day we are applying. But you have to count by the end of July of whichever year you're going to apply for. For example, I applied, I'm gonna start my one, my training in 2023 October. So I applied in 2022 which is last year October. So last year October, so I had to calculate all of my points, all of my experiences until July this year. OK. So this is very important. So you get eight points for 21 to 30 months. But if you pass your 30 months, then you start losing massive amount of points kind of similar. But it's the other thing is your uh other speciality experiences. If you have done a rotation, then you should have done at least two of these mentioned specialities, at least four months uh be if you're doing post surgical training, obviously, you're doing a six month rotation. So that shouldn't be a problem. And uh the reason I was saying is uh they sometimes do itu because uh doing a rotation in itu also gives you a point. So that's one. So again, all these other than the N score, which is the question one in all other questions, you should really aim for the maximum point. OK. Next is question four, which is your operating experiences. Now, vascular surgery and general surgery has been together for ou up until 2019. The application where together you get a number and then you decide you want to do general or vascular. But from 2019, um the curriculum has been separated. So there is separate application for both the specialities but still in vascular application, appendicectomy points count. And in general application similar to the exploration also counts because it's mostly they want to see how good you are in terms of your tissue handling and your basic surgical skills. So the most basic surgical skill in vascular surgery is femoral artery exploration. Obviously, you can see, as I say, they don't want a highly experienced very experienced surgeon to get in the three. That's why if you see for your appendicectomy, the maximum you can get is four by doing maximum of 99 appendix. But if you hit 100 then you lose all the points. Same for femoral artery exploration, you can do up to 50 that gives you maximum point. But as soon as you hit 51 you lose all fo all three points. So again, you have to be very careful of how much you're working and how many years you're working. Obviously, the reason for this is if you have done say 100 and 10 appendi, then very likely you have worked in that speciality for more than 60 months. So that's a reasonable adjustment at all. It all coincides with each other. Really? OK. Then this bit, it's question five A and five B is basically, is your publication tab. So if you have a first author paper that gives you two points and if you have a coauthor paper, then that gives you one point. It does not really matter if the that's an, I mean, the sorry, published abstract or case report or letters that won't count, it has to be a pub indexed journal. VA OK. So, so you have to submit the PM ID number. So that means once your paper, obviously many of you probably have uh have experience in publication. So you already know that once you publish something, once something gets published in a public index journal, your, they will generate you PM ID number. So you need to put that in there. So question five A and five B, we'll, we'll have to come back to this question because M score plays a big role in question five A and five B as well. So for now for first author papers, you got two per paper and for co author paper, you get one per paper, OK? Six is basically presentations so it can be national or international. They do not count post presentations and local presentations won't work as well. Ok. Now one presentation gives you one point. However, there, there is a caveat here and many of us I made the same mistake. I thought that I have to present that to get the point for presentation. However, that's not necessary. It's basically any of your work where you are a listed author that needs to be presented. You do not have to be the presenter. If you are the presenter, then that's fantastic. But if you're not the presenter, you can still get points for presentations. If your work has been presented by someone else in a national or an international conference, then the question seven is audit. So you get one point per audit. However, um uh I you most of you know that a audit has got two cycles, you have to do a first cycle audit. Then you, you should have a recommendation that how you can change things. Then you give it a bit of time and then you close the loop. So that's called a closed cycle or a full cycle audit. So if you're doing a full cycle audit that gives you two points. So each cycle counts as one audit, sorry, one point, each cycle counts as one point. But you have to have evidence for every single cycle you have been involved with and to finish it off, obviously, every cycle needs to be presented in a local meeting or a national or international meeting in whichever way. So if you're presenting that in a local meeting, that is not gonna count for your presentation points, but that's necessary also for your audit points. OK? And also in these two questions, question six and seven N score plays a big role. So we're gonna talk about that. So that's your publication, that's your audits and presentation. Then question eight is if you have a higher degree or an equivalent um thesis or dissertation, which is either an MS C of some sort of any must of some sort or MD M phd, obviously, an MD M phd will give you two points and the must will give you one point. Now, this sounds a bit ridiculous to me because if you're doing a phd or an MD that takes at least 2 to 3 years. And then if you, if you're not working for 2 to 3 years, your end score is still going to show up and then your chances of getting, getting a Lumbar will be much, much lower. So I don't really understand why phd and MD is included in the application process, but they might have a reason. So question nine is leadership or management. Since your primary medical qualification, the good thing about this is it can be within medicine or outside of medicine. So it's basically if you have a leadership or management role. That can be say, say if you say you are the general secretary or president of the culture club or a sports club of your own medical school, that counts as a local or trust level. OK, but say you are part of a national debating society, you are a general secretary, you held a role over there that comes as a national ob obviously, if you have a national or regional level role, it can be outside medicine that gives you two points, but you have to supply evidence to support your response, which is a certificate that can say that to whom it may concern. Uh Mr or M has worked as a say secretary or whatever role in a national setting or a regional setting with us for this amount of period of time. So ideally more than six months, question 10, the last question is I if you have any form of qualification in teaching, obviously, if you have a PGCT, which takes around a year to do you get maximum point. Most of us have done a substantial in interactive and practical teaching qualification which is teach the teacher or train a trainer, Oxford Medical and ISC Medical. They do offer these courses. It's like a two day course or I think um Oxford Medical One is like an online virtual one. You get a certificate and then you get one point there. OK. So that's your question then. Now coming back the self assessment weighing formula. That's where the N score comes to play. And that essentially, to me was the most difficult part to understand and work around it basically. So question five A uh I hope you remember the question five and five B where your publications. So if you do a first of the publication, which is five A that gives you two points per paper, which if you're doing a coauthor that gives you one point per paper, sorry. And then six is presentation and seven is audit. Now the number of presentations, number of audits and number of publications will be divided by your N score. OK? So if your ear score is one then well and fantastic. And obviously in a paper in a publication, you can only maximum score is eight in presentation. It's two and it's audit, it's four. So if we think that your E score is one, then you essentially need say four first author paper to get eight points or eight second or, or coauthor paper or a mix and match to get maximum of eight. If your N score is one, then you need only two presentation to get the maximum point because the maximum point is two and audit, the maximum score is four. That means you only need two full cycle audits or four first cycle audit. So that's pretty straightforward to get in a year or two. But the problem comes when your end score starts going up. If your end score is two, then you need 16 paper say coauthor or eight first of paper to get maximum score of eight. Yeah, because you need 16 that will be divided by two. Same for presentation. If you under score is two, you need four presentation to maximize the score. And then you need eight audits to maximize your score in the audit section. So easier way to understand or remember is whatever your end score is, you have to work that times harder. So if your end score is three, then you need to work three times harder than the person whose end score is one. If your end score is four that four times and then end score is five that five times harder. And this is the by far the most difficult part to get through. And this is the most difficult part for international medical judges like myself because we do pass our MD BS, then do our foundation. Then it takes a hell lot of time to get GFC registration through whatever route or the membership route. Then you find the job, then you come, then you get settled, then you start understanding the system by the time you have understood the system and someone has spoken to you about the application, your score is probably three. So then you need to figure out, ok, I have to work three times harder than my colleague goes and the score is one but there are ways you can, you can sort of tweak things. For example, as I was saying, when I landed in this country in a job, my job was averted as a F two job. So that was signed off as an F two job. And luckily I was lucky enough that they counted that job as an F two. So my clock, I came, I started in NHS in 2019, but my clock for N score started in 2020. So the first year was counted as an F two. So that gave me N a score of one for this year's application. And that helped me a lot. OK. So that's essentially these are the 10 questions and these are the self assessment vo formula. Um I'll leave these slides on and ma mainly the end score slide on. And we would, if you have any questions now about this part, then please ask now and then we will move to the interview. So for me, how if you can come in and see if there is any question from the audience, we can answer. Yes. So um nobody has asked questions, but I've provided two things here. One is in the, in the quest form. This is, this is not uh similar to what you have to apply when you apply for core surgical training. This is dedicated for surgery itself. Yeah. Uh So there is a crest form and this is another one. This is for surgical specialty training. Yeah, and the other crest form is for MS R essentially, OK? And the other link is uh regarding your person specification. If you go through that link, you'll see the self assessment scoring, the the the things that Mister Hassan just said the scoring system, everything is there so you can have a read through and probably just print the documents out and have them in front of you and when anything is done, you can just take that box. So um these are the two things that might be helpful. We do have a question from say the who asked for CST? There is a barrier of 18 months. So my question is that 18 months counted till time of application or till I get offer and join the number done? Sorry, I have to myself. So that's a very good question. Say that. So the 18 months is, is counted not till the time of your application. It's basically till the, until the July of the year you're gonna start your CST. So the CST mostly starts from August time. OK? So if you say for example, you wanna apply for next year's CST, the application will open around end of October. So your that means your CST if you're successful will start from August 2024. So you, you'll have to count your 18 months until July 2024. I hope that makes sense. Any other questions so far? If you have any doubts regarding your scores or any particular section. Yeah, in the meantime, you can expe you can sort of um share your experience of dealing with the end score and the portfolio. Why you felt the need of it. Yes. So I very, I've heard about N score previously but I was not aware of how things were counted, how the months were counted till I spoke to you, which was I think 21 week back and I felt that it would be really, really difficult for me to get into training. But then I had a chat again with you and we had a similar discussion regarding because I'm interested in trauma and orthopedics. So we sat down and discussed and I think it's achievable but we have to work a couple of times harder and be more strategic regarding the portfolio bit. Ok. So another question by Doctor Chowdry is there is for us who are already overqualified if we get our Crest form and enter into ST three or ST four, will we get AC CT at the end or will it be a Caesar alternative pathway kind of a certificate? Oh, thank you for your question, Doctor jury. Uh That's a very good, very good one actually. Well, so at the moment there, so there are two ways. Yes, one is CCT and one is a Caesar which is the certificate of eligibility to a specialist registration. However, in the UK since 2021. There, there is no difference between the CCT and the seizure. Once you finish your seizure, if you go by the alternative pathway, you still get your CCT the certificate itself. It, it's still called sorry CCT. There are some differences now in the UK, you can still get a consultant job, same pa same salaries, everything is fine. But I think it's a in the Middle East or in the Gulf countries, they do prefer CCTS like proper training CCTS rather than seizure. Uh Coming back to your question, if you enter into ST three, you get your CRE form signed and you enter, enter, enter into ST three and finish the ST three until ST eight and you pass the course. Yes, you get AC CT but if you don't, you have to get into, I, I don't know what you mean by entering into S TT. So you have to get into the national training program. If you're not doing a national training program, if you're, if you're doing sort of um designing your own training program um by GI getting a rcps like ST three, ST four that will lead you to seize. But if you are in a national training program, then yes, you will get AC CT. It's only Middle East like the Gulf countries. They do prefer CCT. So once you have CCT, you can straight go to Gulf countries and work as a consultant. But if you have Caesar, then you have to work two years. I think as far as I remember as a consultant in the UK, before you can get a job in golf countries. So you can still get a job. But for other countries like Australia and New Zealand and Canada CC and C is pretty much the same. Yeah. OK. Yeah, thank you. I had a question regarding the transform. There is a portion regarding uh me proving that I've got basic surgical skills. So uh so do I have to provide documents because I've done mine from Bangladesh and that's not acceptable. No, that's, that's not what they're asking for that. Then they're asking for your BS S certificate. You any of your consultant has to take that box saying you have got basic surgical skills itself. It's not the course. It's like you can do sutures, you can put the incision, you can put the grain stitch like that basically. And you, you, you know how to handle like basic handling of tissue. OK. So that's not the course. OK. OK. Great. Um Andriano has a question here. Yeah, he says that he has passed in 2016, F one was completed in 17. What will be my N score in 24? July? Would they count another year for F two? They won't count your year spent after your F one back in your home country for as an F two. So you're essentially if you have the work since 2017. If you have worked in um, in your home country, then that won't count as an F two. So your clock will start from 2017. So say, uh for the maths purposes if, say if you have finished your F one in July 2017 and you wanna apply for next year. So July 2024 that's 17, 18, 1920 21 22. 23. 24. I'm pretty bad at maths. That's eight years. So 18 to 12. Yeah, you can do the math. So that means your N score will be let me see the score. So and that's 96 months, isn't it? Yes. OK. Thank you Fabia for doing the calculation. So your N score will be five because 88 months or more your N score is five. I hope that's clear to you as well. Um Oh I wanna add something. Yeah, I wanna have something uh regarding Regs question that came into my mind. Don't get me wrong. It's it's theoretically still possible for you to get a number uh with the N score of five, you just need to work five times harder. There is a good thing about it which is if you're coming to this country after a variable period of experience in different specialities back in the country for whatever reason and then you come and find your N score as five, you have basically nothing more to lose. So you can take more time to build up your portfolio five times stronger than a person whose portfolio is uh who, who has got N score of one and then you can still apply for it because after 88 months, your N score will always be five. So even if it's 100 and 30 months, your N score is still five, so you can utilize that time because you've already lost five points. So you can work five times harder or you can take five times more, more uh time than a person with N A score of one, get the necessary numbers. The only thing you'll have to bear in mind is you should not really uh exceed these maximum point in your experience section. So you should probably need to switch your jobs here and there like switch specialities that doesn't make you overqualified for ST three and still work for the publications, audits and presentations because those are the sectors or sections where any score comes into play. I hope that's clear, isn't it? It is. I mean, ii I was having a discussion yesterday with one of my registrars and he was saying the, the registrar who was before his rotation, his end score was five and he got into training and you just have to be more strategic and work really, really hard. It's not impossible. Exactly. Yeah, exactly. I mean, it's not, it's not impossible. It's theoretically very much possible if you were, if you, if you know what you're doing basically and, and you just have to work harder. It's not only hard, you have to work small as well. So you have to sort of the best way do. II, I, I've known the pe I've known the person who used to be my registrar and he has been a great help in shaping my career so far, which I've seen in his house. He's an ST six vascular surgery. Now, I've seen these, you know, these uh application form, the shortlisting self assessment criteria when he was applying, he basically printed them and put it in the wall and he used to go through them every single day. So that OK, I'm not losing points. All right, I'm gonna er, hit the 30 minutes time. So I need to find another speciality to go and work for. So if you work strategically and smartly, it's still doable. Great. If we don't have any other questions, we can move, move off to the Yes. Yes. All right. And all right. So the next bit is the interview. So the interview pattern is basically, it's all virtual at the moment. MS teams. So they give you a clinical scenario, they give you a management scenario to read both. You have to read uh these two scenarios in five minutes. Uh One scenario will be a clinical evaluation and one will be a management scenario and then you can take points, you can note down anything you want, but you have to finish that in five minutes. So that's a pressure. Then you get, then that's, that's basically the break room and then you get into one of the interview rooms, there will be four interviewers, then they will start asking questions. So they will discuss 10 minutes around 10 minutes. They will discuss the clinical scenario mostly how are you going to manage this scenario? How are you going to to deal with that patient? And also it stays, I mean, I know it says clinical scenario and questions, but it al almost always has got a management component. What they're looking for is are you a safe doctor? They're not looking for fantastic, you know, decorated surgeons. They're looking for safe clinicians. They're looking for someone who can manage the S OS who can handle an emergency and escalate when necessary and he can sort of arrange things. So for an example, in our speciality, the most deadly emergencies are rupture AAA. So being an sh I was an sh and vascular surgery, if I get a call about uh from a ne about the rupture, I would straight call my registrar. But as a registrar, I cannot straight call my consultant. So I'll have to see the scan, figure out what to do if he's operable or non operable. Decide on that, get all necessary people. Then let your consultant know that. Ok, boss, we've got a rupture. Uh we can do an er, theater is ready. We should be in, in the next 15 minutes. So you make your way in. So, so they, uh they, it's, it says clinical though, it says clinical scenario, but it's not only clinical they want to see, are you safe? And how are you managing your time? And how are you managing the patient? And do you have the basic idea of the speciality you're applying for? Then they say, OK, we're gonna talk about the management scenario and question. They will ask you if you wanna see the management scenario once again, you can, but you have to keep in mind that the minute or 30 seconds to a minute you spend to see the station again or the scenario, the scenario again is, is, is, is part of that 10 minutes. So you should have, you should allow full 10 minutes for them to question you so that you can answer, you can justify your answer, you can change your answer and another discussion so that you get maximum points. So the management scenario has got clinical component and management component. So mostly they will say, ok, you've got a patient who is sick in A&E you've got a patient who needs to go to theater now and then you've got a patient who is very sick in the ward, having an emergency, medical, medical emergency call. How are you gonna delegate the uh tricky situation? So that does include how are you going to use your manpower? The management scenario generally says, OK, you've got an F one or you've got an F two or you've got an AC P like advanced clinical practitioner? So you need to know, OK, how much can you expect from an F one or an intern? How much can you expect from an F two? And how much can you expect from an AC P at the same time? How much can you expect from AC T two if you have AC T two as an as your sho uh it's, it, it makes your life as a red much smoother because CT two is basically a senior sho slash junior registrar, isn't it? So you can leave him or her to. So one or two things for you. So you need to, you need to have a firm idea about your resources, about your available resources and what, what manpower have you got and what level out there. So, so that's your, basically that shows your management skill. So working in NHS, I know more. Most of you are probably working in NHS, but working in NHS is not only clinical, it has got sort of multidimensional work, including your management skills, including your leadership skills as well. So from the management scenario, they see that how good is your management skills and how good is your leadership as well? Then the next bit, I mean, the whole whole um interview is like 45 minutes. The next 10 minutes is your portfolio questions. You do not need to present your portfolio anymore and they don't have your self assessment score as well and they don't have your portfolio. So this is the time to sell yourself. You are the product that this is the time to sell yourself. Whatever your self assessment score is, it's done. They don't have it, they can't see your portfolio. So they will ask you a couple of general questions. Why vascular surgery? Have you taken an informed decision? How many uh researches or the experiences do you have? Can you talk about one of them? Yeah. And what makes you feel like that you can become a surgeon? All these questions are very generic, however, you need to answer it in a way that shows them, OK, these are not, well, these are not only rehearsed answer that should make sense once they say, ok, why vascular surgery the way you should answer is so that they understand, ok, this boy or this girl's personality goes with vascular surgery. So you have to, you have obviously it will be well rehearsed. You will write up a script, but this script has to has to involve your personality and try to find a bridge between the personality you have and the speciality you want to apply for uh uh if you know what I mean. But because you say you cannot really say, oh, from a third year I always interested in surgery and I like surgery personally. Then I got into vascular surgery rotation. I love vascular surgery. I think I can be a vascular surgeon. I have the personality of a vascular surgeon. I like the speciality that won't work. There has to be a nicely structured answer that should involve clinical component. Why you know clinical component management component and your personal aspect, academic aspect as well. You have to prove that or they have to be reassured that, ok, this boy or girl has taken an informed decision, he or she knows about the speciality, he or she knows about the problems of this speciality. And what are the opportunities of the speciality? In short? You should have a good understanding of the speciality you're applying to and that should collaborate with your personal aspect as well. OK. So they don't ask and any question about uh have you done any course or the other question they ask is because you have put your application in October and then you doing your interview in March April time. So they said, what have you done in this three months if you have anything significant? Like say uh probably I had one uh one more publication and then I stepped up as a, as a started working as a registrar in the hospital. So that gives you some, they make a note of it and they just put a command that this boy or girl has done some significant things or some good things in, in uh in this period of time after that, he has put his application in the next bit would be the last 10 minutes is basically a communication scenario and questions. So they would be they have to uh uh have to assess your communication skill as well. So they will show you a scenario. OK. That can be AAA patient whose, whose operation has been complicated or a patient part, he was being a bit difficult to manage like all these scenarios. And then he's mostly surgery related. And then you need to speak to one of the actors or one of the interview will act as an actor, probably son of a patient or a wife of a patient, something like that. And then you have to convince them like you always do in your daily work life. So this interview is like a wholesome interview because in the clinical scenario, obviously, they're looking for a safe clinician and a bare with bare minimum of knowledge and skill. OK? So that's one second management scenario. They're looking for your management skill and your delegation skill and your leadership skill portfolio questions is they want to know more about your personality and to be perfectly honest, I mean, in my port questions and they asked me, what are my hobbies? What do I do other than other than doing medicine? So I play guitar and I've been playing guitar for quite a good amount of time. So I told them that and they really appreciated that fact. And then I do like traveling, someone likes playing football and they really appreciate those things and they want to know who they are appointing. They cannot only a point, a portfolio. They need to know who the person is, how you are. What's your personality? I mean, every person is different but they need to know what are you a, you know, easy going man? Are you gonna be able to blend in the team? Do you have much more hobbies and things? So it's the old this country I think they really appreciate. If you have, if you have something that, that is your interest outside of your work, they don't really appreciate people who only work goes home, come back work. So if you have something cultivate it, so the communication and then obviously in the communication scenario, they are, they assess your communication skill. And again, I've, I've had multiple questions about actions about uh pronunciation and this and that none of these really matters. I mean, I don't have a perfect pronunciation. My English is pretty bad. However, you just need to be, your handwriting needs to be legible as well as your speaking needs to be understandable. So as, as long as the, what you're saying is making sense and what you're saying is coming out of your mouth, what you're thinking is that, that's, that's more than enough and they don't really look for any accents and all these things. So there are a couple of rumors that you have to have a good accent and things like that. Uh That's not how it is. So that's essentially the interview pattern. I mean, the purpose of this webinar is not going deep into the questions and scenarios, we can probably do one of that later on. But this is basically the pattern that this is what you should expect in your interview. OK. Before we move on to the uh uh sort of the last segment of this session, if you have any question about the interview, you can ask if be allows us to, of course, the the chat box is open for everybody and please ask them if you have any other questions for me. Then regarding interview regarding the interview date, then we can move on to the last segment. I mean, the last segment is just sort of advertising my own speciality. A bit of flexing. I should do that. Really. Any questions about the interview patters is that clear? We are running like it should have been an R but you've, you've crossed it. But um I think it was a helpful session for me. It helped others as well. What I'll do is I'll send a feedback in the chat where you can give us a feedback because this will be a series. It's, it's, it's the first episode of a series. It's the first surgical specialty that we're working on and we will work on other specialty surgical specialties as well. So, if you can give us a feedback of how else, what else we can do in this series, it would be great. And you'll get a certificate after you've done your feedback. Mhm. Well, that's very good. All right. I think there's no question. So I can probably sort of get into the last segment very quickly. Yeah. Yes. Yeah. Ok. So WW what are you expecting as a day as a vascular registry? You, uh you've got basically six year olds to play. You do ward round, you do on call, you do C po which is the emergency list. You do elective list, which is the training list. You do clinic with the consultants. I mean, it's a supervised clinic and then you do the multidisciplinary team meetings, you lead the MDT S and M and MS as well. So these are the six rules in short as you can expect with the Vasco register. No, only the vas go any other registrar. Really? Ok. Now, some common scenario is just some pictures and, and scans. I quickly go through because they're running out of time. So the most common things we see as a vascular surgeon or in our on call is an acute limb ischemia. This is one of the acute limb ischemia, then critical limb threatening ischemia. And that was like this sort of two months back then it turned into this. Then I had to do this and the rupture AAA is a lifesaving, uh, life-threatening emergency. You can see the arrow. That's the rupture. That's the whole hematoma around. That's your aorta, which is first aortic dissection is another thing we deal with with cardiothoracic as well. There's a type A and type B symptoms and we need to manage that as well. Uh We in, in invariably see these cases as a, as a vascular registrar, you're on call and arteriovenous fistulas. These are the fistulas you do for dialysis. And then both of these are complicated by aneurysmal dilatations. You need to manage that part as well. So these are the couple of um regular cases we see as registrars, obviously there are complex other cases, but the common cases are this. So you need to be, uh, once you prepare for your interview, you need to know about these cases as well. So you will be, you will be knowing about these cases because you'll be asked these questions as well. All right. Hey, everyone can come down. I got this happy plumbing. That's the end of the session. It's been a nice hour, hour and 15 minutes. If you have any question, please ask, uh, do the feedback and you can always sort of, uh, contact me through social media, email, whatsapp, whatever. Good. Thank you for your time over the weekend and have a great weekend. If you have any question, we'll keep the, keep, keep it open for another 23 minutes if that's all right. Yes, I think, I think we've touched most of the topic. Thank you for joining in and I will announce the dates for the next sessions in the coming weeks and months. But in the meantime, I will also have surgical sessions where we will discuss different topics, uh, not just portfolios and interviews, which are also important, the surgical topics, um, important ones which you can also join. And thank you, Mister as it was really, really kind of you because I know you were doing your own calls and you were very, very tired and it was very busy and I'm very grateful. I'm very grateful that you join. Thank you guys. I, well, I have provided the feedback form in the chat if you could just give the feedback and get your certificate and thank you for joining and you're keeping this, um, you're recording this and you'll leave, leave it recorded, isn't it? Yes, this will be recorded and will be available if you want to come back. Uh And um, if you have any question these Yeah, exactly. You can just go through it again. Ok, then. Thank you. Yeah. Ok. So shall we end the session? Yes. Yes. Ok. Thank you. Yeah. All right. Thank you so much. Thank you, everyone. Bye bye bye.