Core surgical training: 12 tips for securing a postBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6132 (Published 13 October 2014) Cite this as: BMJ 2014;349:g6132
- Wen Ling Choong, core surgical trainee year 11,
- Mohammed Abdul Waduud, academic foundation year 2 doctor2,
- Aileen J McKinley, consultant general and colorectal surgeon1,
- Satheesh Yalamarthi, consultant general and colorectal surgeon3
- 1Aberdeen Royal Infirmary, NHS Grampian—General Surgery, Aberdeen, UK
- 2Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde—General Surgery, Glasgow, UK
- 3Victoria Hospital, NHS Fife—General Surgery, Kirkcaldy, UK
Applying for core surgical training in the United Kingdom can be competitive and stressful. Wen Ling Choong and colleagues give tips for securing a post
Recruitment to core surgical training in the National Health Service is centralised and managed by the Core Surgery National Recruitment Office (CSNRO). In 2014, 615 core surgical training posts were available and 1370 applications were submitted to CSNRO, giving a competition ratio of 2.2:1. The process of applying for a core surgical training job in the United Kingdom can therefore be competitive and stressful.
Here are 12 tips that could strengthen your application. If you follow these tips and perform well in the interviews, you will be well on your way to success. If you are not successful at your first attempt, you should continue to build your curriculum vitae (CV) and apply again. It is important to reflect on the areas you need to improve in to make yourself a stronger applicant.
It is essential to read the information provided on the Kent, Sussex and Surrey Deanery website (www.surgeryrecruitment.nhs.uk/). The earlier you start the more likely you are to be prepared for a successful application. Since there is so little time in foundation year 2, you should aim to read the person specifications and start tailoring your CV in foundation year 1. It may be helpful to speak to colleagues who have made recent core surgical training applications. Make a note of key dates so that you can complete your application on time. Applications to all specialties are made through the Oriel online medical recruitment system (www.oriel.nhs.uk/Web/). Outcomes are also communicated through the Oriel system when available. You should spend time researching the different local education and training boards to provide you with the best training experience and workplace in your surgical field of interest.
Start saving money
Applying to any specialty can be costly. Start saving from the start of foundation year 1, as taking exams, doing courses, and attending conferences can be expensive. Some of the expenses incurred include the intercollegiate membership exam of the Royal College of Surgeons (£1415), the Basic Surgical Skills course (£550), the Advanced Trauma Life Support course (roughly £700, depending on the venue), and the Care of the Critically Ill Surgical Patient course (£790). Your employer will provide only limited funds for essential courses, such as the Advanced Life Support course. Some units may provide funding for you to attend a conference to present work you have done, so don’t be afraid to ask.
Pursue extra degrees
Intercalated degrees are now common among applicants for competitive specialties. An extra degree gives an applicant extra credit in a job application, and work from degrees such as BSc, MD, and PhD can lead to presentations or publications. Consider doing a part time MSc degree, some of which can be done online via distance learning.
Passing the surgical entrance exams at a junior level will help strengthen your application for a core surgical training job. The intercollegiate membership exam for the Royal College of Surgeons has two parts: MRCS part A and part B. Core surgical trainees must successfully complete both parts before being appointed to a specialty training year 3 post. MRCS part A is a paper based exam that requires candidates to show broad and in-depth surgical knowledge as outlined in the syllabus. MRCS part B, on the other hand, is an objective structured clinical exam and tests a candidate’s ability to integrate surgical knowledge into daily clinical practice. Both exams can be taken in any of the four royal colleges of surgeons (London, Edinburgh, Glasgow, and Dublin). You are eligible to take the exams any time after you have graduated, but it is useful to have had some clinical experience in surgery before taking part B.
Attend relevant courses
The royal colleges of surgeons run a wide range of surgical courses. The Foundation of Clinical Surgery course gives medical students and junior foundation doctors an insight into basic history taking and clinical exams essential to practising surgery. The Future Surgeons: Key Skills course, run by the Royal College of Surgeons of Edinburgh, allows a more practical approach in learning basic surgical techniques. This course is delivered using a series of tutor led demonstrations with the opportunity to practise on animal tissue. The Basic Surgical Skills course is tailored for junior doctors who are interested in pursuing a surgical career. It has been designed to teach participants the key basic technical skills expected of a safe surgeon. Other surgical related courses include Advanced Trauma Life Support, Surgical Training Education Programme (STEP) Core, STEP Foundation, Care of the Critically Ill Surgical Patient, and Systematic Training in Acute Illness Recognition and Treatment for surgery (START surgery). These surgical courses are worthwhile but expensive, so choose wisely.
Participate in academic activities
Be opportunistic and always keep an eye out for audit or research projects and teaching opportunities. Consultants and senior trainees will almost always be eager to take on enthusiastic junior doctors or medical students to assist them in their current projects. Most projects that are well planned and can realistically be carried out within a set time will provide the opportunity to write an abstract for an oral or poster presentation at a conference or, more favourably, in a publication. If you do an audit, completing the audit cycle is important. In terms of teaching opportunities, speak to colleagues concerned with undergraduate medical school teaching. If you are keen and willing to help outside work, there are often undergraduate objective structured clinical exam practical sessions that require an extra pair of helping hands.
Apply for prizes
Look out for regular updates from various medical societies. For example, the Royal Society of Medicine has a number of prizes available for medical students and trainees.1 Presenting at conferences also has the added benefit of potentially winning a prize.
Be aware of leadership and management
The General Medical Council provides comprehensive guidance on how doctors show leadership at different career stages.2 Some examples of leadership at a more junior level include leading an audit project or quality improvement project at the workplace and being able to work in a team and to delegate tasks to colleagues. Other more defined leadership roles include being a committee member of various associations, such as the BMA.
Evidence of commitment to a surgical specialty includes current clinical experience, such as general surgical jobs in foundation training. Applicants who do not have surgical experience from foundation training are encouraged to arrange a surgical taster week. Evidence of commitment also includes operative experience, which can be recorded in the form of a surgical e-logbook, and workplace assessments, such as case based discussion, mini-clinical evaluation exercises, and direct observation of procedural skills. View these as tools, rather than as extra workload, to help show your surgical repertoire to the interviewers.
Have reference letters ready
Choose your referees wisely and do not leave this to the last minute. Consultants are busy and may be on leave when your deadline approaches, so give them plenty of time to complete the reference letter. It is polite to contact your referee in advance asking them for their support and enclosing your current CV. The reference form can be found on the Core Surgery National Recruitment Office website.3
Write a clear and concise CV
Applicants are expected to provide an up to date CV during the core surgical training job interview. This will be reviewed by the interviewers during the portfolio station. BMJ Careers has advice on medical CV writing.4 It is a good habit to start writing your CV as early as possible in your medical career and constantly update it throughout your medical training.
Perform well in interviews
The structure of the interviews in 2014 consisted of three 10 minute stations with a three minute break between each station. The three stations are the clinical scenario station, the management station, and the portfolio station.5 Medical interview preparation books or interview courses can help prepare applicants well for the interviews. Practice can improve performance and reduce hesitation. It is a good idea for prospective applicants to practise, and practise again, with colleagues or, even better, with one of their consultants before the real interviews.
Competing interests: We have read and understood BMJ’s policy on declaration of interests and declare that we have no competing interests.