Join Dr Aditya Gangal & Dr Anush Shashidhara in their webinar on applying to IMT!
Webinar Recording
Summary
This on-demand session, relevant to medical professionals, will cover the basics of Internal Medicine Training (I MT) and provide the audience an overview of the application process, timelines, and scoring matrix. It will offer an in-depth explanation of interviews and stations, going through good versus bad work examples on how to answer questions. The session will provide a comprehensive list of the available specialties, such as General Medicine, Cardiology, Endocrinology and Diabetes, Neurology, and Genitourinary Medicine. Furthermore, it will explain the timeframe for each year of training and the responsibilities of a medical registrar. Sign up now if you would like to learn more about Internal Medicine training!
Description
Learning objectives
Learning Objectives:
- Recognise what Internal Medicine Training (IMT) involves and why it is a common choice for medical specialists.
- Understand the structure of an IMT training and the associated timelines for when applicants should apply, expect interview and offers to be released.
- Identify the two different types of medical specialties which IMT can provide and the differences between them.
- Appreciate the prospect of specialising in a non-medical specialism via Internal Medicine Training, and understand what specialisms are available.
- Explain the role of a Medical Registrar and understand the expectations of leading the emergency/arrest teams.
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Computer generated transcript
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The following transcript was generated automatically from the content and has not been checked or corrected manually.
How many people do you have? We have got, I see. I'm gonna, people. That's f cool. Hi, guys. Uh I'm anus. I'm the medical lead at mind the believe. And this is a and I'm at a, at a couple of is and I just wanted to give you a twist of sort of the basics of time to hear and, and a brief overview. Um We will probably make a start in a couple of minutes. So if you want to just grab a cup of tea or something, we will start in like two minutes and will field any questions at the end. So if you put them in the chart, we'll, we'll scroll through at the end and we can answer anything we can to the best of our ability. Most of this stuff is available on the I MT recruitment website, but it's all in this presentation with, I guess a bit of personal anecdotal experience from both of us um for your convenience in one place. And yeah, as I said earlier, we'll try and answer any questions we can as we, when we get to the end. Cool. Let's see how many people we have um, we're up to 19. I think I saw 40 registered. We can give it another minute a minute or two just to give it a minute. I might turn my camera off just for the sake of my internet. Not dying. Sorry. Everyone's gonna get like some inception nonsense in a minute. Um Is that ok? Yeah, no worries. Um Can, can someone message in the chat to say that they can access the chat just so we know that you can't? Perfect, good, good, good, good, perfect. Thank you guys, right. We'll start in just a moment, right? We'll make a start. So yeah, as I said, I'm a new, this is a, we're both I MT ones in London. We've both been part of mind the mind the bleed for a few years. Now, today we're just gonna give you an overview about how to apply for I MT some of the things to consider and how the process itself works. So as I said, what we'll cover, why do internal medicine? Hopefully you guys already know the answer to that because that's why you're here. Uh the timelines this year in terms of dates when you need to apply, when you should expect uh interviews to be released, when you should expect offers to be released, the the dates of all of these, there's a table somewhere in the slides and we will also go through the scoring matrix coming soon over the course of the next couple of months. Uh Not today, we'll talk a bit more about interviews stations and the structures of these stations. And we'll go through some good versus bad work examples on how to answer the questions that you'll be asked to interview. So to start off with why choose internal medicine. Here are some of the reasons I think a lot of us who, who have gone into I MT or are you or might have already applied to I MT will be giving you for choosing it. So I guess it's the job that makes you feel most like the medical detective. So clinical problem solving work in a team. In order to make a diagnosis, you need a good attention to detail when examining and investigating patients and you get a nice mix of acute and chronic issues. Again, that depends on what subspecialty you choose down the line. But most of them have a good mix of acute and chronic issues. People, internal medicine is really good if you like managing acutely unwell patients. So you're part of the emergency team and at some point, you'll probably lead the emergency team and you make some very, very important decisions about people's lives. If you like word based procedures, ie not in the theater environment, there's uh lots of specialties with opportunities to do that. And I guess most importantly is a, is a means to an end for your desired higher specialty. If you're hoping to become a medical consultant and on the counter, why not internal medicine training lots of antisocial hours on the road to me and I are both on it at the moment and we do a lot of nights and a lot of long days as I'm sure he can confirm and the training for a lot of these medical specialties is like often quite long 7 to 8 years to consultancy. Which when you're comparing to things like GP or radiology is it is significantly longer. And at times, it can feel like service provision over training, especially if you're working in a unit that is not necessarily very well staffed or has a very high patient turnover. But there are some pros and cons for you to think about when, if you, if, if you're still on the fence about applying to I MT, there's lots of resources online and I'm sure everyone's familiar with the junior doctors, read it and lots of people will talk about the pros and cons. So make sure you make a well informed decision. And in terms of higher specialties that are available through I MT, there are just some lists for your own convenience. So specialties are generally split into group one or group two specialties, group one specialties require you to complete all three years of I MT and they expect you to act as the medical registrar during training. So these are the ones that you're usually dual CT and the specialty as well as general internal medicine at the end of the day. And group two specialties only require you to do the first two years of the I MT. So you don't need to do the third year. We'll go through what each of the years is in a, in a moment. But these are generally the single CCT specialties or the ones where you ct with some of the ni other specialties, I'll go through the, the, so the lists are here. So group one specialties are any all of the big general medicine specialties, acute medicine, cardiology, endocrinology and diabetes. Notably, there's a few things I'd like to point out. So neurology has just come back into a group one specialty over the last two years, it used to be group two and genitourinary medicine used to be a group two specialty that's now group one as well. Uh So there's the list for your reference and then group two is a lot of the niche specialties. These ones, you don't act as the general medical registrar. The interesting thing of note is infectious diseases or tropical diseases. If you, if you do these with general medicine, you'll have to do I MP3 and uh you'll do act with that. Otherwise you can choose to do them with microbiology or virology. And if you choose to do that, you don't need to um CCT with general medicine and you therefore, you don't need to act as a general medical registrar. So there's two different routes for that. Um And then there's a few other opportunities via I MT. There, there are some of the nonmedical specialties. So just doing pure micro virology or occupational medicine will accept trainees who have completed two years of I MT. And you can generally apply for intensive care medicine, single CCT after the first two years of I MT as well. Um We're not really gonna talk about a CCS internal medicine today because largely because I, neither of us really have experience in applying to that. Um, as we're both I MT trainees, but we might be able to put on some A CCS events in the future if over the course of this year. Great. So, um I'm just gonna briefly talk to you guys about the, the structure of I MT broadly and, and this is quite nicely set it up in terms of explaining that it's divided into sort of I MT for the first two years. And then depending on which path you take there may or may not be a surgery involved as well. So, firstly, just talking about the first couple of years, um I presume most of you in the audience are sho level or very keen f ones. Um And so you'll be familiar with a lot of the work that you'll do in your I MT one or 92 years. So you're still working as a medical sho just gaining more experience and you're gonna rotate through between four and six jobs in various specialties. So most rotations that you'll have in, in theory will be six months long, which is different, obviously to what it's like in foundation on paper. But in practice, um that can vary quite a lot. So for example, and I both um are currently working ICU jobs, but we're switching next week uh to different jobs and having done a three month rotation in ICU. So far, I know that in other hospitals as well, oftentimes it will be four months doing the speci the specific specialty and then two months covering the acute take and so on. So there's quite a lot of variability in terms of how that actually works. And your main focus during this time is obviously just accruing more experience going through the specialties that you may or may not be interested and then also um completing your M RCP. So the M RCP including all three parts. Uh So in case you're not familiar, there's two written papers, uh part one and part two and then there's the paces exam which is a practical exam. Um And so um those would all need to be completed by the end of your I MT two in preparation for being the med reg in year three. So, II mean, yeah, so IM D3 is going to be your first year as a med reg. So uh this will mean that often times, especially out of hours, you'll be the senior most decision maker on site. Uh and, and you'll be a general registrar at this point. So again, 26 month rotations in this year and you'll be two specialties, often times it will be acute med had with something else. Um And, and you'll have on course as a medical registrar on call. So you'll be doing things like covering the medical take and so on and, and managing and organizing that. And during your first couple of years, you'll hopefully have a crude enough experience, skills and kind of knowledge to be able to run that. And that's supplemented by having completed the M RCP. Uh Also just, just to note with that uh because this is something that threw me a bit when I was going through the applications is that when you're preferencing, um your I NT three year won't necessarily be there as um you'll generally just continue in one of the two hospitals or three hospitals that you've been in previously during the earlier years in the I NT just for continuity sake. Just so you're familiar with the hospital that, that you'll be running at, at night time. Yeah, and I was just gonna add whe when you're active. So in your it three, you are also expected to lead the emergency slash arrest teams for wards in the hospital as is the role of the medical registrar. So um, that's a big step up from being a medical sho, yeah. Sorry. Go on. Yeah. And that was, and often people who pass M RCP in second year in their last, in their second year of I MT, sometimes they'll act up as a medical reg, with supervision of this registrar in order to gain some experience before they are the on call registrar. Yeah, that's, that's, that's quite common and actually quite important. I know a lot of hospitals who do these, uh, reg ready courses where either, um, you know, with supervised practice or in a simulated setting, you'll be kind of acting as, as a medical registrar just to make sure that when you do start to, to actually be the med reg that you're, you're not going into it like, and you have some sort of experience in it. And the only other thing to mention is if you get a specialty that has its own on call rota in your I MT three, for example, Gastro, you won't be on call for the, you're usually not on call for the specialty. You'll be on call for general medicine because you don't generally have the skills at that point to be on call for the specialty. Yeah. But yeah, it really depends where you work. Cool, great. And then, um, just, just the link here, we'll, we'll circulate the slides via med all later on. Uh, but just, um, it's, it's quite handy to go over the person's specification. Um It will highlight things like eligibility criteria, desired and essential criteria and so on. So in case there's any specific gaps in your portfolio or anything like that, that you want to address, this is a good way to do it just to add to that as well. If you guys just search on Google just for I MT um points portfolio, which I initial just gonna go through in a second. That would also be a useful framework to guide your application. Yeah, there's a really good website if you just search, I think it's, it's a I MT recruitment. I think it has everything in one handy website. Great. And now we're just gonna quickly go through time lines. I think this is a pertinent time to do it as um applications opened yesterday. Uh Sorry, day before yesterday. Sorry, I was just coming off nights ago since I'm a bit confused as to what day it is, but I believe it's Friday. Um So um applications did open yesterday um and they'll be closing in about a month. Uh So we have a bit of time um which I think is, is good to consider all the options, consider how you're gonna strategize your application and so on. So once the applications close, um you'll then hopefully be shortlisted and then you'll receive your invitations to interview by sort of mid to late December a week after that, you'll then have an opportunity to book your or sorry, within the week after, after the in the invitations, you'll have the opportunities to book your uh your invite. And then the actual interviews are held over quite a wide period starting from the second of January all the way through to the 16th of February. And these are uh online interviews, which again, we're gonna go through in, in more detail later. But just, just to note that following the interviews, um the rankings are then released normally about 2 to 3 weeks after that. Um And then having hopefully secured a, a competitive spot, you will then have the opportunity to preference your programs, which is quite similar in, in a lot of ways as to how you would have done it for your foundation program. This is also all done through Oreo, um which, which I'm sure you're all familiar with and enjoy very much. Um So yeah, just uh just uh just to know it's, it's quite similar in terms of how you, how you set that all up thereafter. Um Offers will then come out by the 19th of March. Uh And then after that, there's a series of further offers. So if you're not happy with what you initially have, you can hold the offer and, and wait for upgrades depending on what other people might or might not choose to accept. And then by, by the sort of ninth of April is when everyone has their final preferences and will know where, where they're working for the next three years. You also, then, then get some feedback for your interview, which, which is actually quite handy. Uh And then you'll be starting on the first Wednesday of August, um A as with anything and that's gonna be the seventh of August 2024. So I think we've highlighted some bits of this. So, yeah, as I mentioned, uh it goes through a um and there's a few important sections to highlight. Er so firstly, there's a self assessment uh section again, looking at that point scoring matrix which I know is gonna go through shortly will highlight exactly kind of how, how that goes. Um And you're expected to assign yourself a score, it's important to be realistic with these scores. I know it's nice to be aspirational and to kind of think that you might have got more points than, than you actually do uh because it is quite competitive but it's important to be realistic. Um Just, it's just like a you avoid disappointment and b hopefully it wouldn't turn into a Probi issue for anyone, but it's important to just be kind of honest and, and, and candid about how you're scoring when you're declaring these points as part of that, you need to declare supporting information for your self assessments. So these, this can be in the, in the shape of letters from, you know, societies or, or medical education and so on wherever you're working at the moment, just highlighting what you've done for quality improvements. I it, it takes place. Um I mean, you will need some sort of letter from a consultant or, or someone in, in a similar senior role just to highlight your specific involvement. And these are just the ways in which you can clearly show what you've done. I think it was what. So when you, when you submit the application in November, you need to write a bit about what you've done and then later down along later down the line, they might ask you for the letters and stuff that you might need to upload. Yeah. Yeah, it's, it, it, it's a randomized kind of quality insurance process. Um But just, just do make sure that you have all of that stuff to hand when you're applying. And also just on that anything that you're declaring that you have points for on your application, it's something that you should have already completed by that stage. It, you're not allowed to sort of um add things that you will have done by the time interviews come around and so on. So it's only stuff you've fully completed. Yeah. So think about it as anything that you've completed by the time you click submit on your application is the point at which that's the cut off for having things done. Yeah. And then uh it's less important, I think in the I MT application than it is in some other applications. But there are a few what we call white space questions where you can write. Uh um It's, it's 250 word questions highlighting things like for example, why you've applied for the specialty. So it's, it's in some ways quite similar to what you might have done back in. You were applying to medical school in the sense of a personal statement. And then similarly, um the other question is what have you done to prepare for internal medicine training in particular? Uh So that would be kind of some of the supplemental stuff you're doing to boost your portfolio. And I think uh in that section, it also sometimes asks about courses and things that you might have gone to. So if you've done a LS or you've gone to any courses that you think are relevant to internal medicine, that's like a good place to mention those as well. And also um if you've, let's say, been very keen on and already done your MCP part one or something like that, that's also worth getting in there. Mm To be fair, I think I go as far as saying, if you've sat it and you're waiting results or you've applied to a, you can probably mention that as well because it does show some commitment. Definitely. So I'll talk a bit about the scoring matrix visible on the website. I've just put it into one place. So it's convenient and we can chat about things. Uh main areas to school in are education, teaching quality improvement and then leadership slash management. It's a bit much to be honest, but it is what it is. So to start off with education, two main scoring areas, post graduate degrees. So if you've got a phd, you score four off the bat, you've done a master's degree. Um you get three points and anything else you, you get 1.4. Um You can't claim for membership exams including M RCP. So I if you happen to have completed it already, that doesn't actually score you any points though. And the other side is additional achievements. So if you've got an a high achievement award for your primary medical qualification, IE finals of med school that is only awarded to the top 18% of the year, then you, you score full points. I know a lot of med schools do this thing where you get a merit. If you come in the top 20% if you finish in the top 20% and get a merit, it might be worth emailing your medical school and asking for some clarity about where in that top 20 you were because if you can get something that says top 18% it gets you some extra points. I know loads of people. I went to UNI when did that? Because we, we had that system. Um If you've got an international or national prize related to medicine that scores you two points. And then any other kind of prize at med school that wasn't awarded to more than the top 20% scores, you one point research, you can get points for both presentations and publications. So if you've been involved in an oral presentation that you or someone else has delivered at a national or international conference, you get seven points. If it's opposed to you get five points. And if it's regional, you get five points. If it's an oral, oral presentation, if it's a regional presentation that was just opposed to it's only two points and an oral presentation that was just local. So in your trust, you still get two points for that. So don't forget about these, like you might not necessarily have some of these higher point things. But if you presented something at a local meeting in your department that would still put and you can get a certificate to prove it, you can actually get some points for those things. And I think this is like an area that a lot of people under declare for um publications. Yeah. So if you're, it, it, it all depends on whether you're, it's a PUBMED uh cited journal or not. If you're the first author or the joint first author or the corresponding author on a paper, you get eight points if it's PUBMED uh cited, if you're a coauthor, that's six points. Uh And if you're the first author or joint first author, if more than one pubmed articles, then you can also score five points. But not that the first two things are for original research. And the third one is for things like letters, reviews, case reports, things that aren't like original research but are still improving our evidence base for some uh some conditions are responding to original research. Teaching splits into two things. Um And so this is the one where people are, are always a bit worried about. What can I claim for? What can I not claim for? I think the guidance is quite clear. So in terms of teaching experience, you score full points. If you've helped organize a teaching program alongside teaching onset teaching program for at least three months or longer, you don't actually need certificates or anything. What you need is formal feedback. So is that through DCT forms, is that through feedback forms or teaching observation forms? You just need formal feedback over a course of three months and you need to show that you've been involved in the organization side of it. A certificate might help you to show that you've helped organize, but you like it's technically not necessary uh three points as if you've just done the teaching uh involved in the organization. And then if you've been doing some ad as well, training and teaching. So I know a lot of people do things like PG certs and things in your foundation years, often by the time you're applying, if you're like an F two, you won't finish the PG cert. So you actually can't claim for it. But anyone that's had some training and teaching methods. So usually they're happy with anything up to around two days worth of training. So that could be like a teacher, the teacher course or some foundation schools do like some training and teaching over the course of the two years as part of their foundation training, that will score your point as well. If you've got a master's level qualification, you get three points, but very few people have that. Um Q I is one that is uh hopefully a lot of have. So if you, it's only two cycles for I MT not three cycles, like some other um specialty applications. So if you're involved in both of the two cycles, you get full points automatically. If you're involved in one of the cycles, you'll get three points. If you're involved in a single cycle, you'll get one point that hopefully you, you will have been involved in the Q I project and leadership and management. Again, this is one that I think a lot of people struggle to expect if you've had any kind of local leadership and um position and can demonstrate making any impact that's worth two points. Even if that is like being a student represented uh representative when you were at university or a junior doctor. Representative when you were in foundation training, all of these things will count for two points and a few people will have held national or regional leadership positions and that will score you four points. So have a look through that in your own time. Figure out what score you you think you're gonna get and you'll be able to score yourself appropriately. As as you said, try not to try to be honest, try not to over score yourself as like it's very tempting to be a bit lenient but just score yourself for what you can actually evidence in case they do ask you for it. Would you add anything? Yeah. No, I think, I think definitely just to emphasize that last point. Um I mean, hopefully it it'll never come, come to light, but it's just important to just avoid over scoring yourself and leading to issues uh down the line. I think the the only other thing just just if it's alright just to add in there is I was just um looking through kind of um points from previous ea groups and I think so there's a big changes to how they were scoring um people in 2023. So, so sorry for, for the last application cycle, the one that we went through and that they removed certain previous things, but the the average score I believe was around 17.5 points. Um So that's kind of the, the mean score um as to, you know, what, what most people would have. So just, just to give you guys some sort of idea as to as to where you may, may sit, but I don't think there's any formal data. There's nothing that I can find about what the interview cut offs generally are. Yeah, the, the highest score I knew of last year that didn't get an interview was. But obviously this is a very anecdotal sample size of people that I worked with was probably, I think 13 or 14, but like that's not reliable and it will change year to year. So please don't use that as a marker of anything. Cool. So that's the, so the scoring matrix. Yeah, often there is a cut off that is just based on a more normal distribution. We I don't think it's ever released what the cutoffs are. Um And there's no way of saying what the cut off is for your year group. So just be honest with yourself, fill out the forms, hopefully you'll get an interview and, and once you've got an interview, that's all that really matters. So getting, getting an interview is, is the key here. So the the score doesn't really matter once you're past that point. Yeah, really just, just emphasizing that last point. I think it's, it's important to know that it's almost like it's, it's two different bits of the application and nothing like your, your scoring doesn't really matter at all when it comes to your interview. The only time that it matters is to get to that first stage thereafter. It's purely about how you're actually doing in the interview itself. Yeah. So there's like no difference between you getting like 17 and 30. There was no difference after that point. And then, yeah, I just wanted to briefly touch on twos themselves. Now, we will hopefully be doing a sort of more comprehensive thing later on in the year as, as it approaches to time. But I think it's still sort of useful maybe just, just to sort of highlight a few different bits. So, yeah, firstly, uh just indicating the timing. So it's held between the second of January and the er 16th of February this year or 2024. Um And again, th this can be a bit confusing on the website but you can book independents from any region. So the interviews are online and I think they have been since around 2020. And um the, and so each Deanery will normally have a number of interviews available. This is not in any way related to where you do or don't wanna work. It's purely just um for them, I think to organize on their side as to where people are. So, don't worry if let's say you wanted to fly to London, but you're being interviewed by one of the Scottish sceneries uh overall, that's, that's not gonna change. And the interviews are still kind of held on a, on a national pool. And as for the format of the interview, it takes place over the course of three sessions. Um So the first one is probably the one that you can do the most kind of paperwork to prepare for. And if I remember correctly, you can also kind of jot down a few bits on a piece of paper beforehand just to help you structure this if that's useful for you. So uh it includes two aspects. So firstly, there'll be a, there'll be two minutes at the start of this station where um as as an initial said, it's kind of like an elevator pitch on your achievements to date that are relevant. And so I think it's important here to not kind of go into, into, you know, too many um things. It's it's about highlighting a a few key things um and kind of, you know, linking it back to I MT going through things like the person's specification and seeing how what you have on on your portfolio links well to making you a suitable I MT candidate. And then thereafter, there there are a few minutes where they can then ask you a few questions. So if there's anything in particular that you think you're strong on in terms of your experiences or your portfolio that you want to highlight more, uh you can kind of bring it up during this initial bit and then hopefully they'll, they'll then sort of prompt you for some further questions on that. The second um scenario is, is in a clinical scenario. Um This can be sort of anything from something that you might encounter on the acute take to something within a specialty. It doesn't, it doesn't require a lot of highly specialist knowledge. Um It kind of requires just kind of f two level of knowledge uh with experience um in, in sort of, you know, managing a lot of common situations that come up as an sho um Yeah, just, just emphasize that I think for this, it's important to have a grasp as to how to manage kind of some of the more common emergencies in lots of specialties. But still also to know that you're, you're still expected just to kind of manage this scenario at the level of, of an sho you're not expected to, you know, have definitive management plans in place and so on. You need to know things like when to escalate a situation to the medical registrar or when to call a specific specialty. And in, in fact, I think that often comes across very well in these interviews, looking through some of the feedback in terms of knowing what your own limitations are. II think they, they don't like when you're trying to sort of do more than what you're realistically expected to do at, at this stage. And then at, at the end of the clinical scenario, you're gonna have a one minute period to use uh SBAR style structure uh to hand over this patient as though you were going off shift. And that this again gives the interviews an opportunity to um kind of see and, and kind of concisely get all the information that you've picked out from this scenario. And again, to know that you're a safe and competent clinician, the SBAR thing is very, very, very important to prepare, like to be good at because it's worth a shed load of points in the grand scheme of the interview, despite it only being a minute long. So we'll go over this when we do our, um, talk on it in a few in a couple of months that it's really important that you are used to doing sbar handovers. Absolutely. So, yeah, I mean, even, even if you guys wanna start kind of start practicing this now, uh, with friends or when you're at work, uh, just to get comfortable with it, I don't think that's a bad idea. And then your third station, uh, is a general station kind of attaining to anything within the domains of ethics, professionalism and chemical government. So as, as it would have been for you guys, when you're applying to medical school, I think it's important to be familiar with some of the key things like GMC is good medical practice. There might sometimes be some ethical dilemmas which are, I guess are, are loosely similar to the sort of thing you might see on an S JT type examination. Um And again, I think this is when it's, it's an opportunity to really highlight that, you know, how to work within the NHS, kind of, you know, doing, doing things on the floor rather than just in theory and knowing how to kind of um tacitly manage situations. Um again, also just emphasizing to know when you need to escalate things appropriately and not just trying to sort of solve entire situations on your own, especially when it comes to like, you know, the there's a lot of uh practice materials out there which highlight your classic ethical situation where you found someone from work who's acting appropriately, let's say they're inebriated and they come to work. And so knowing what you can do and what you can't do in these situations, I think is really important. And then kind of the last thing to touch on is how rankings and listings work. So after the interview, you'll hopefully be deemed appoint. So you haven't done anything extremely questionable, um which applies to 99.99% of people and you'll be given a national ranking and you are invited to rank your job preferences. This happens on oral, as we said earlier, I think the big difference. So a a few of you might have gone through foundation training in the UK. So the big difference between ranking for I MT. And ranking for foundation training is you're not ranking regions first, you have access to every single job in every single region and you just rank your, the jobs that you want and each job will tell you exactly what the rotations are hopefully and w which hospitals they're in. So you can plan it out quite well. There are some trusts that don't put their jobs on particularly well or they're like will confirm. Uh And then I think there's a couple that allow some flexibility. So it really depends on the jobs that you rank, but there's no regional and then local ranking, it's just you just rank all of the jobs off the bat. Um The one other thing again, I'll mention, but I don't know too much about it is you can also rank a CCS internal medicine jobs when you're doing this and you'll be able to see those on oral as the four year programs rather than the three year programs. So if you want to do that rank those, if you don't want to do that, avoid ranking four year programs, and you should hear back about offers on the 19th of March, you can opt in for upgrades as said earlier. So this is where if someone with a higher rank than you declines their offer, you might be offered this instead. So if you're not super happy with your job, um you can opt in for upgrade and you might get something higher up your own ranking list. Um You, you guys will know what the kind of things you want in terms of the jobs you're, you're going to apply for and where in the country you want to be. We're not going to go over things like that. The only recommendation I make is if you know anyone that's working in that region or in the hospital that you're thinking of ranking quite highly, um, it might be worth asking them a few questions about how protected they are, how the training and teaching is. Um, it's not always possible but if you can, it's always useful to get a bit more insight. I don't know if a got any more advice. Yeah. Yeah. No, definitely. I think um, as much as uh you can kind of read up on, on what's available at our hospital, but I think there's nothing about getting the information first and from, uh, from people who have actually work there. I think there's also a website, I think it's called junior doctors dot org dot UK. Something where people have kind of annoys anonymously, er, given reviews about kind of what the training is like and so on which obviously take it with a pinch of salt because it is anonymous and we don't know how reliable it is, but there's often some useful information there particularly as to kind of how, um how specific specialties are run. You know, I mentioned earlier about um how in, you know, sometimes in certain specialties, you, you'll have four months in one aspect and then say two months covering the acute take and so on. So that's information that sometimes is available on that website. So it's, it's worth finding this stuff out just because it helps you make an informed decision because it's, it's a big decision to decide where and how you're gonna be working for three years. And I believe that that is all we really wanted to talk about today. So scan that code and in a mo I think we'll start going through any questions you might have so pop them in the chat as well. But that's a rough overview about the application process and the things to look out for. And we will advertise more information about any upcoming webinars on things like interviews and more. I mt related content in the next couple of months. As I'm sure you're like, if you guys will be looking out for that, right? Have you got any questions in the chat? Nothing. Just, yeah, it was just a question earlier about um if you've done presentations as a student, if that still counts. But uh yeah, I mean, yeah, it it it does definitely count while you have evidence. Yeah. Uh There's a question saying any specific portfolio that we need to follow from now. Um I'm gonna say that to me as in, in terms of making your application. Um And so the answer to that is no, um it's more just knowing what the requirements are. So when you say portfolio here, it's, it's slightly different to kind of the portfolios that you use when you're in, let's say the foundation program, what we mean is just kind of a, a record of all of your achievements that are relevant for your application. And so I if you go on to the person specification or the I MT recruitment website, it will quite clearly highlight what, what information you need to have and how you need to demonstrate the information. Uh So that's kind of what I would advise uh to follow basically. Um where did we get up to? Sorry. Um We got Stephanie just asked a couple of questions if you want IP competency based. If you want 60 80% less than full time, would you need to extend training even if you've met competencies? So it's a bit iffy. So if technically, you do need to complete all three years, if you're thinking about doing a group, one specialty, the only and you have to do two years if you're gonna do a group two specialty, but there is a way to expedite your internal medicine training. So if you, if if you can get everyone to sign off that you're working basically at a really high level and you've got all your competencies done, you can actually do the three year program in, I think 28 months instead of 36 months. But honestly, I think it's really, really hard because people need to basically write down and you need evidence that people ie consultants think you're working above the level that you need to be working at. So if it's something you want to try, so I don't know how that would translate over to less than full time. But I assume if you're less than full time and you can get that signed off that you're working above the level, then you could probably not extend training. But I think you would probably need to contact someone from the school that you're applying to in order to find out exactly how that will work. I'm afraid, I think it's, it's also quite as, as bad, II think it's quite sort of region specific cos I know, you know, so um just to highlight as well guys that as part of I MT you need to have done some time in intensive care, uh some time in care of the elderly and then also time on, on the acute take. And, you know, so these are things that do take a bit of time. But I know that sometimes, you know, people can negotiate with their deaneries just exactly how they wanna structure the training program. I think that would be a specific discussion to be held with either the general I MT team or more specifically, you know, deaneries when you get a place. Um, in your opinion, is it feasible to do? I want to see if you want enough. I do. Yeah, you can do both parts. One and two if you're bored. Yeah. On, depending on, on how much you want to enjoy or not injure your F I two year. I mean, if you've got really busy jobs, don't, if you have a chill set of f two jobs then you can. Yeah. Yeah. And I mean, I think, yeah. So, I mean, if you can, it's probably a good idea. Um, I mean, so I'm obviously in I MT one now. I just did my MSG part one last week. It was, it was fine just to prepare for, but, you know, it gives you slightly less time to go through than having to prepare for part two and faces and so on. I, there is one downside to doing it in F two, which is, so there is a study leave that you can specifically take for doing M RCP part one and two and I MT one and two. And you can't take that if you've already done the exams. So you are basically losing on, on a, losing out on a bit of time off. That's true. I don't, I don't know if you're gonna factor that into your decision, but II think you should know because I don't know. Um, how can I demonstrate my commitment to specialty, including M RCP part one. What other options do I have? Um So it's just things like, like general interest things. If you've been to any conferences, if you've been involved in any projects that haven't necessarily been published or presented things like that, you, you can use as evidence and then if you've done courses like a S or ultrasound, you can talk about how you've done those because you're interested in blah, blah, blah and you think it will hold you in good stead. So it's things like that, things that won't score you points under the scoring matrix, but you think will make you a better I MT one is what I would describe it as Yeah, yeah. Although also if let's say you wanted to go in, you know, let's say if you scored max points on some research you've done or, you know, through an amazing Q I that you've done and that, that is on your point scoring matrix. But you want to highlight it again as an example of commitment. It's certainly worth kind of talking that up. But yeah, definitely. Yeah. No, no, sorry go I II was just gonna say, yeah, certainly use it to highlight anything that doesn't come up as a, as part of the key point scoring matrix. It's a good opportunity for that. And we've got a question from shari recommendations, good resources for the MM RCP exam. Um I mean, there's, it, it, it, it's very subjective. Um I mean, II don't know what you used. I generally use pass meed just because it was what I was comfortable with from medical school. I just, I just used pass med and pass test and did loads and loads of questions and then made like a list of things I got wrong and then would go up and read about this. I assume that's similar to what you did. Exactly. That. Exactly. Yeah. Yeah, that, that's how you do. Part one and part two, I think recommendations are just to use resources that you're familiar with. Um, don't, don't start trying lots of new things because I think it can just get a bit confusing if you're using two or three question banks. Um, unless that's something you're already doing and you're comfortable with it. Don't try to expand new horizons too broadly like that. Yeah. Are you keep doing what you've been doing so far? It will probably keep working. I can, I highlight if I have done any course for ultrasound and have a certificate for that. Yeah, you can absolutely put that in your commitment to specialty. That's like a great example of something you can put in commitment to specialty. They will never ask you for the certificate for it. Probably, but it's good that you have one. Yes. Um, for commitment to specialty, if I have tailored my portfolio for gastro specifically today, am I a disadvantage for I mt for not including other medical specialties. I don't think you are not at all. I think if you're preparing to do gastro, then you will all of the stuff skills required um are relevant general medical skills. So I don't think that's the case unless I do notice a difference. No, no, definitely. And I think, I mean, the way you could even spin it to your advantage in, in saying to you is that gastro patients are often some of the sickest patients in the hospital. If you, if you have skills or you know, portfolio aspects that have, have been tailored to that in particular, it actually comes across quite well, I think, or it can come across very well depending on how you talk about it. Mm. And so we're gonna ask, is it essential to rotate different medicine? It's, it, it's not, I think the only requirement is that by the time you start I mt you should have worked in the NHS in any capacity for 12 months. I don't think it needs to be that you have already done 12 months in the NHS when you're applying. I think it's more just that by the time you've, you know, that you'd be starting in August 2024. Hopefully, uh then you will have, um, will have had that time, but that's really the only requirement it's quite different to surgery. I think in that way, in that there's less restrictions as to who can and can't apply um I only did four months of medicine in I in F one and two. And I think a lot of people only do one medical job. So you definitely don't need more than that. Yeah. What kind of evidence will be sufficient for presentations, teaching posters, et cetera presented locally. If you've got a consultant, if they can, if you can write like a one line sentence or letter being like, I can confirm that this person has presented this blah, blah, blah on this day to these people that will be more than enough. And most consultants are happy to sign that off, especially if you do all the hard work and write the letter for them. Um Don't just ask them for a letter. Um Is it enough if I use Hors portfolio for your competencies? So if you're talking about F one and F two competencies, then yes, that's sufficient. Um Because that's what you need to prove before you can apply to t that you're competent from an F one and F two level. So as any kind of logbook of your competencies is actually sufficient. But yeah, if you're using h that's just convenient because you can get loads of people to sign you off on things. Yeah. Although I think for the purposes of I MT applications, it's not necessarily, you know, um and, and this, I guess links into what Phasal has just asked as well. Er Horus itself isn't actually needed at all for the purposes of um, of uh I MT applications. So let's say you're an I MG, you've come into the UK work as an sho you might not have used Horus at all, depending on, on, on where you are. You don't need it at all. Um, it can be used as a guide as, as an initial said, there are some of the things that you might expect to be competent in, but for demonstrating the things that you need to get the points on your portfolio, I don't think it matters at all. It's more about, you know, let's say having letters for presentations or certificates and so on. Those are the things that, that you actually need in order to demonstrate your competencies or your suitability, your basic competencies like the requirements that will be on the personal spec Yeah, you can look up the foundation year one and two requirements. So as long as you have some evidence in terms of logbooks or whatever from wherever you've come to show that you can do like basic skills like venipuncture, cannulation, things like that. You'll be fine that and yeah, have a look on the personal spec website about things you need to do to be eligible. Any other questions. And also guys, we'd be really grateful for any feedback, including anything you think you might want to see from us in terms of other I MT stuff going forward, anything you think could have been done differently. It's, it's all really useful for us. Uh just to see how we can optimize this. Yeah, we have a plan in terms of what we're gonna deliver over the next couple of months. It's just if there's your feedback is useful because there might be something there that we haven't thought of. And also just in case ei either you guys yourselves want to watch this back or you know, anyone who could make it today will be uploading this, but it's on medal on the event page. And also we'll be popping it on, on youtube later on on our channel. No worries at all. Right. Thanks everyone. Um Feel free to email us as well. Um II have to mind the team in case you have any other specific learning questions. That's completely fine. Ok. All right. Thanks everyone.