Getting into surgical training is an exciting prospect but also competitive – even more so if you are limited on where you can move geographically. It’s fair to say you’ll have to make sacrifices in some form, and giving yourself time to plan and prepare your CV and application is very important. But this shouldn’t discourage you.
When I was coming through the system, the picture looked bleak. There were very few surgical training posts available, competition ratios for jobs were high and many trainees a couple of years older than me had to choose other specialties or move to other countries. I was warned many times that it was almost impossible to get into specialties like ENT. If I wasn’t in the top 6 in my medical school I thought, how could I have any chance of ranking in the top 6 in the country?
You soon realise though, that the things that determine your academic ranking at medical school are very different to the qualities that mark you out as a top surgical trainee. Above all, never lose sight of being a kind to your colleagues and other hospital staff, being compassionate to patients, going the extra mile for others and maintaining a service-focussed attitude. It’s these sorts of trainees that tend to naturally fall into the best projects and opportunities to enhance their CVs. It’s these trainees that tend to receive the best advice to help them get through exams and interviews.
Although surgery will always be an apprenticeship, selection processes have changed a lot in the last 10-15 years. Whereas you previously may have been interviewed by local selectors who knew your character and how hard you work, nowadays selection is much more a more national, structured and anonymous process. You therefore need to prepare for it well to do yourself justice. You can’t rely on your good reputation and glowing references any more. Here are some pearls of wisdom to help you prepare well for core surgical training and registrar national selection interviews:
1. ‘Keep your finger on the pulse’. The goalposts are always changing. The selection criteria for this year might be different to last year. But I find that the most committed trainees can often anticipate this by keeping up to date with the latest professional body publications and feedback from the previous year’s selection process. For ENT, the AOT google group is good for this info.
2. Ask ask ask for advice. You’re not going to be able to prepare for this by reading books. Most trainees and consultants will only be happy to pass on advice to someone that’s keen and motivated, so don’t be reluctant to find more than one mentor.
3. Team up with your peers. Work on papers together, do interview practice together, pass on advice to each other. There are enough jobs that your best friends should never be seen as your competition.
4. Turn up to events. Join your speciality’s national association, join the national trainee association and go to as many conferences and courses as you can. Not only will you learn things that are relevant to your chosen specialty but you’ll also start to meet older trainees and consultants that will pass on gems of advice. At first this can be quite daunting, going to events where you know no one and no one seems to take any notice of you, but this will very quickly change the more events you attend, and you’ll find that people start to look out for you and give you encouragement.
5. Download the latest portfolio scoring criteria. Download the portfolio scoring system 2 years in advance. That way you can plan ahead and start ticking off all the things that are going to score you points at the interview – audits, publications, posters and presentations, exams, courses and teaching.
6.These are not interviews! You need to think of these sorts of interviews far more like exams (though rest assured your consultant interview is very much a very personal interview!). Most specialties now run a form of national selection. You’ll be interviewed by people that probably don’t know you. You’ll be asked standardised questions, often with discrete factual scoring systems. In the past people have been guilty of thinking that they’ll be able to come across well in the interview. But unfortunately, personality plays little part in these sorts of interviews, and you just need to prepare the material like you would an exam.
7. Advice for Communication skills interview stations. Do what you would do in normal clinical practice, as long as what you do in clinical practice is good! You should practice various scenarios with colleagues and friends, asking for feedback on your verbal & non-verbal skills, fluency and empathy. There is also revision to be done for this station – such as reading patient information leaflets, reminding yourself of the risks of common operations, knowing the main points of any key specialty guidelines and how to break bad news and deal with complaints.
8. Advice for Clinical skills interview stations. Obviously, there is no better preparation than good practice and being a keen trainee. The senior trainees you know will be able to give you an idea of common things that tend to come up in these sorts of stations. If you end up having a mind blank in the interview when being asked to tie a knot, don’t worry – this happened to me at an interview once and I’m still here today.
9. Advice for Clinical scenario interview stations – The art here is not just knowing your stuff, but being able to deliver it thoroughly, logically, succinctly and fluently. Therefore, you need to practice. Going on the standard courses for your specialty helps with this.
10. Advice for Management interview stations – Again this is station you need to have read a lot and also understand interview technique in order to frame your thoughts. Whenever you’re posed with a problem that you need to solve I’ve always encouraged trainees to form the answer in terms of ‘immediate and wider issues. Immediate issues often pertaining to patient safety and solving the problems that day, with wider issues a reminder to not forget discussion about how you learn from that problem and change processes to improve things for the future. Things you can read include GMC publications, your specialty association and Royal College publications, Guidelines on risk management, complaints processes and clinical governance procedures. This station is where medical interview guide books come in handy. It’s also worth being clued up on training issues from sources such as the JCST website and your specialty’s CCT checklist.
Hopefully by sharing this advice the most committed trainees will be able to give themselves the best chance of success. A career in surgery is a lifelong vocation where you will be privileged to make a huge impact on many people’s lives – both patients but also colleagues and staff. Make sure you always keep that your main focus. You’ll find more ENT related posts on my Instagram account @earsurgeonjoe.