A Realistic Guide to Applying to the UK Foundation Programme

Read time: 6 minutes

In this post, Maddie Wigmore-Sykes, a final-year medical student, breaks down the stages of the UK Foundation Programme (UKFP) application process.

Applying for my first job as a doctor filled me with equal parts excitement and dread. Navigating the UKFP website, working out where all the tabs were on Oriel and keeping up with the many deadlines can get a bit overwhelming. Never fear though, as here is our realistic (and slightly lengthy) guide to the UK Foundation Programme. Keep reading for further details on how to get each section done – dates provided are for 2022 starters!

For those of you who, like me, didn’t have a clue how any of this works, here’s a brief overview of the application process:

    • All foundation programme jobs in the UK are applied to via an online platform called Oriel
    • Your university nominates you at the start of your final year as eligible to apply for the programme and Oriel will contact you to create an account and fill in your relevant details for your foundation programme application
    • You can also choose to apply for an academic foundation programme (AFP) or a foundation priority programme (FPP) at this point (further blog posts on these incoming…)
    • In order to somehow stratify thousands of applicants, the UKFP uses the Situational Judgement Test (SJT), an ethics exam designed to “test the attributes needed to work as a foundation doctor”. Your SJT score gets combined with points you’ve accumulated from your decile and any additional academic qualifications for a grand score out of 100 (the good news is that you get 34 points for the medical degree – phew!)
    • As part of the application, you must rank where in the country you want to go for your first job
    • Oriel then matches you to an area based on your preferred locations, highest scorers first, and once you know where you’re going, you can rank the individual jobs – easy, right?

National Application Window (8th – 22nd September 2021)

It’s really important you don’t miss the deadline for national applications. This is where you will fill in all your details onto your Oriel account, including any additional qualifications or publications that may get you some extra points for 2022 entry (apologies to our 2023 starters who will be affected by UKFPO’s new guidance). Make sure to find your degree certificate early – you need to prove you have that iBSc!

The team at Oriel will then verify your additional educational achievements and provide you with an educational performance measure (EPM) score out of 50. For further information on how this works, check out the UKFP FAQs here.

SJT Booking Window (4th – 7th October 2021)

Another date to add to your diary is the deadline for SJT booking. You do this via the Pearson Vue website and can choose to sit the exam at a local Pearson Vue centre or at home with an online invigilator. You will be able to sit the SJT between 7th – 19th December 2021 and 18th – 23rd January 2022. 

Preparing for the SJT is difficult, it’s designed to be hard to revise for. There are official practice papers here, which give you an idea of the style and content the exam covers, which is mainly the contents of the GMC’s Good Medical Practice. Private SJT courses are advertised in the run-up to the exam, but these are by no means necessary to get a good score. Your SJT score gets scaled across the rest of the country into a mark out of 50 so is worth the same as your EPM score.

A further blog post on preparing for the SJT is in the works – watch this space!

Location Preferencing (deadline TBA – last year’s deadline 18th February 2021)

As part of the application process, you will have to pick your location preferences for where you want to work. For this, the UK is split into 20 different foundation schools, some as large as Wales and Scotland, while London and the surrounding area is split into three different schools. Deciding where you might like to start your career is really exciting; you might want to stay in the place you studied, move closer to home or try somewhere completely new.

Unfortunately some foundation schools are more competitive than others, so it’s worth ranking all the options just in case. The schools do release cut-off scores from previous years, but they tend to fluctuate so take them with a pinch of salt.

You have a lot of time to think about this, so don’t panic.

National Allocation (10th March 2022)

This is the day where you will find out where you’ll be working and Oriel will inevitably crash just as you’re about to log in. You’ll also get your SJT score so you’ll have more of an idea of how you’re ranked. It isn’t always good news for everyone, but there are excellent hospitals in all areas of the country and a lot of really good jobs!

The application process now changes slightly depending on which foundation school you have been allocated to. In the smaller areas with only a few hundred jobs to rank, you go directly into the programme preferencing stage, where you rank as many jobs as you want based on location and specialty. This requires either a complicated spreadsheet or a lot of flashcards. Bigger schools, such as South Thames and North West England, have a group matching stage first where you pick individual regions or trusts first. Once you’ve been matched to the smaller group, you can then rank the jobs as above from a much more manageable pool. 

For one-stage preferencing, the deadline is 31st March 2022. For two-stage preferencing, the group preferencing deadline is 16th March 2022 and the programme preferencing deadline is 31st March 2022.

Match to Programme Results (7th April 2022)

You’ll find out where you’ll be working and what specialties you’ll be doing and it will all suddenly feel very real! Most programmes have a really good mix of surgical, medical and community placements so whatever you end up with, you’ll get some great experience.

Good luck with your applications and let us know if you have any questions in the comments!

The Best Apps That Will Save You on the Wards

Read time: 3 minutes

In this article, Anush, a final-year medical student, discusses some of the best apps you can use while you’re on the wards.

MDCalc

MDCalc Medical Calculator Review | Educational App Store

“Can you do an AMTS on this patient?”
“Can you check Wells’ score the patient in bed X?”

MDCalc let’s you pull out any of the millions of scoring systems used in hospitals up on your phone. Gone are the days of looking confused as you struggle to remember all the components of a score in front of a patient.

The Official BNF AppGet ready for the improved BNF app | BNF Publications

Do you ever forget the doses of certain medications? Do you ever blank on the important side effects or interactions?

If you answered yes to either of these questions, the official BNF app will definitely help you out!

Much more easier to navigate than the ye olde physical BNF book, you can easily search for the drug you’re looking for. You can even list several drugs if you’re worried that some are interacting!

MicroGuide

Antibiotic stewardship is a hugely important part of medical practice. With the rise in resistant organisms such as MRSA, ensuring we give appropriate antibiotics based on the source of the infection and local sensitivities is key.

This is why antibiotic guidance varies so much between trusts! Luckily for us, we can easily check the local guidance using MicroGuide – download the app, go to “Get Guides” and find the trust you’re placed to get started!

Induction

Ever asked if you could ring microbiology to chase some cultures? Or wish you knew how to bleep the F1 you’re meant to be shadowing but just can’t find.

Induction is one of the most useful tools – it effectively acts as a directory for all of the registered bleeps and phones for the hospital, so you can quickly contact whoever you need. In addition to these, it allows you to ring hospital phones from your own mobile. Very convenient!

 

A Realistic Guide to Teaching as a Medical Student

Read Time: 6 minutes

Vikram Thirupathirajan (Y5, Education Officer for UCL Surgical Society) provides his views on the benefits of teaching at medical school and how to get involved in teaching as a medical student.

As a doctor, you will be a teacher- regardless of what specialty you go into. No matter what stage of your career you are at, part of your role will be to conduct some form of teaching to those in an earlier stage of the career to you. So it does not come as a surprise when teaching forms one of the highest-scoring criteria for a medical portfolio. 

In addition to helping with your portfolio, teaching, particularly as a medical student, has several other benefits attached to it.

Teaching is the highest form of learning

This is a unique benefit for teaching as a medical student, as medical school is a key time when you will be learning some core concepts that will stick with you for life. There is scientific evidence to suggest that teaching someone else about a particular topic is arguably the best way of retaining information, which makes sense if you think about it- in order to be able to teach someone something, you will have learnt that something to a high standard yourself. Especially in a course where what you are taught will be needed for life, being involved with teaching will help you consolidate that knowledge for yourself as you teach it to others.

Starting early sets you up for life

In a profession where teaching is incredibly prevalent, being able to master the skills early is very useful. What better place to start, than at medical school itself? This is the place where what you teach, and the skills required will be most transferable to when you teach as a doctor. 

You become an organised medical student

Teaching at medical school is on the whole, voluntary, and requires extra time to do it. Naturally, setting aside time for teaching, particularly if you are organising the teaching yourself, will help you learn how to prioritise and how to schedule. This will in turn make you organise your own studying and you’ll notice yourself becoming more productive and efficient.

Getting into teaching as a medical student

Have I convinced you enough to get into teaching? UCLMS offers a wealth of opportunities for medical students to undertake teaching at medical school.

Join a student society

This is one of the easiest ways to get involved in teaching. This is a very good starting point to get a flavour of what teaching as a medical student is like. You can then build on this afterwards to take up roles in education subcommittees in the society and/or onto the main committee as the education lead for the society. Taking up such roles will enable you to organise and introduce widely recognised teaching across the medical school. AGMs are currently upcoming this month so if a committee role interests you, do consider applying. Applications to be a tutor for events vary in terms of when they go live, so do keep an eye out for updates, or contact the society’s education lead.

Most sports clubs, in addition to UCL Medical and Surgical Societies conduct teaching for younger year students. For preclinical year students, Medical Society tends to teach physiology-related topics, while Surgical Society teaches anatomy topics. Sports clubs will conduct more informal teaching on all topics. For clinical years, most societies will conduct teaching on all things clinical medicine and surgery.

Set up your own teaching

Alternatively, you can independently start up your own teaching series on your own or together with a few other medical students (I would recommend the latter). Whilst getting a wide reach with this may take longer to achieve (but it definitely will happen given the age of social media), you have more freedom and flexibility in when you start, what you teach and can truly make it your own thing.

Setting up your own teaching or being on a committee role for education also gives you the opportunity to try and introduce something new- embrace this! Whilst teaching the same topics in the same way is good to reinforce memory, it can limit you to what you teach. Therefore, look for gaps; if a particular topic isn’t taught very well, focus on that. Alternatively, try a different approach to teaching something. For example, some students in the past have taught by the traditional method of going through each topic one at a time, whilst others have approached it as a case-scenario. Trying different ways offers a new perspective to learning content, which is very useful given that medicine is such an evolving field. Furthermore, introducing innovative teachings can form a basis for research or audits.

Teaching with the medical school faculty

The medical school themselves also have opportunities available for teaching. Notably is the Anatomy Lab Near Peer Tutor (the Blue-coats). Agreed, the anatomy lab is on hold at the moment due to the current climate, but it is something that definitely will return. This opportunity is available for third year medical students and involves being student tutors to help teach and answer any questions that students in years one and two have about their anatomy dissection and related topics during their Anatomy Lab sessions. Information about this releases in the last week before the start of the new academic year- the medical school will email you themselves. 

On a university-wide scale is the Transition Mentor Scheme. This involves mentoring students in their first year, part of which involves teaching. Student societies are increasingly adopting mentoring systems; mentoring is a brilliant way if you would like to be involved in widely recognised teaching but would like the freedom in choosing and organising what you would like to teach. Applications for this also open in term 3.

Though less traditional forms of teaching, the medical school’s education faculty also have numerous projects on offer. Examples of such projects include being question authors for formative exams, being involved in student Q&A and teaching for formative exams you helped write etc. Why, this very blog itself is a project from the medical school’s education faculty. Again, this will be widely recognised by the medical school, who will commend your work as necessary with certificates. Arguably more importantly, you will build contacts with the medical school faculty, get further opportunities and much better insights into the workings of your MB BS course. If you are interested in being involved in a project, let either myself, Anush, Jess or Maddie know and we can direct you appropriately.

Creating the future doctors 

This is the reason why the idea of teaching exists to begin with- to pass on your knowledge to future generations. Medicine is a subject where being accurate and competent is important, and so younger-year students gaining insight into what you learnt and how is crucial. In fact, students will most relate to you, the older year medical students, because what you have experienced will be very similar to what they experience, and so you will be able to relate to students’ challenges best.

Therefore, by getting involved in teaching, you play a part in cultivating the next cohort of competent medical students and future doctors, both a huge accomplishment and honour.

Top 10 Tips: Getting into Research as a Medical Student

Read time: 8 minutes

Introducing our new series: Top 10 Tipsa simple guide to help you achieve your goals!

In this blog post, Jessica Xie (final year UCL medical student) shares advice on getting into research as a medical student.

Disclaimers: 

    • Research is not a mandatory for career progression, nor is it required to demonstrate your interest in medicine. 
    • You can dip into and out of research throughout your medical career. Do not feel that you must continue to take on new projects once you have started; saying “no, thank you” to project opportunities will allow you to focus your energy and time on things in life that you are more passionate about for a more rewarding experience.
    • Do not take on more work than you are capable of managing. Studying medicine is already a full-time job! It’s physically and mentally draining. Any research that you get involved with is an extracurricular interest.

I decided to write this post because, as a pre-clinical medical student, I thought that research only involved wet lab work (i.e pipetting substances into test tubes). However, upon undertaking an intercalated Bachelor of Science (iBSc) in Primary Health Care, I discovered that there are so many different types of research! And academic medicine became a whole lot more exciting…

Here are my Top 10 Tips on what to do if you’re a little unsure about what research is and how to get into it:

TIP 1: DO YOUR RESEARCH (before getting into research)

There are three questions that I think you should ask yourself:

    1. What are my research interests?

Examples include a clinical specialty, medical education, public health, global health, technology… the list is endless. Not sure? That’s okay too! The great thing about research is that it allows deeper exploration of an area of Medicine (or an entirely different field) to allow you to see if it interests you.

2.  What type of research project do I want to do?

Research evaluates practice or compares alternative practices to contribute to, lend further support to or fill in a gap in the existing literature.

There are many different types of research – something that I didn’t fully grasp until my iBSc year. There is primary research, which involves data collection, and secondary research, which involves using existing data to conduct further research or draw comparisons between the data (e.g. a meta-analysis of randomised control trials). Studies are either observational (non-interventional) (e.g. case-control, cross-sectional) or interventional (e.g. randomised control trial).

An audit is a way of finding out if current practice is best practice and follows guidelines. It identifies areas of clinical practice could be improved.

A quality improvement project (QIP) involves planning and implementing an improvement strategy, assessing if it improves outcomes or patient care and seeing how things could be further improved. QIPs follow the Plan, Do, Study, Act cycle.

Another important thing to consider is: how much time do I have? Developing the skills required to lead a project from writing the study protocol to submitting a manuscript for publication can take months or even years. Whereas, contributing to a pre-planned or existing project by collecting or analysing data is less time-consuming. I’ll explain how you can find such projects below.

3.  What do I want to gain from this experience?

Do you want to gain a specific skill? Mentorship? An overview of academic publishing? Or perhaps to build a research network?

After conducting a qualitative interview study for my iBSc project, I applied for an internship because I wanted to gain quantitative research skills. I ended up leading a cross-sectional questionnaire study that combined my two research interests: medical education and nutrition. I sought mentorship from an experienced statistician, who taught me how to use SPSS statistics to analyse and present the data.

Aside from specific research skills, don’t forget that you will develop valuable transferable skills along the way, including time-management, organisation, communication and academic writing! 

TIP 2: BE PROACTIVE

Clinicians and lecturers are often very happy for medical students to contribute to their research projects. After a particularly interesting lecture/ tutorial, ward round or clinic, ask the tutor or doctors if they have any projects that you could help them with! 

TIP 3: NETWORKING = MAKING YOUR OWN LUCK

Sometimes the key to getting to places is not what you know, but who you know. We can learn a lot from talking to peers and senior colleagues. Attending hospital grand rounds and conferences are a great way to meet people who share common interests with you but different experiences. I once attended a conference in Manchester where I didn’t know anybody. I befriended a GP, who then gave me tips on how to improve my poster presentation. He shared with me his experience of the National institute of Health Research (NIHR) Integrated Academic Training Pathway and motivated me to continue contributing to medical education alongside my studies.

TIP 4: UTILISE SOCIAL MEDIA

Research opportunities, talks and workshops are advertised on social media in abundance. Here are some examples:

Facebook

Search “medical student research” or “medsoc research” into Facebook and lots of groups and pages will pop up, including UCL MedSoc Research and Academic Medicine (there is a  Research Mentoring Scheme Mentee Scheme), NSAMR – National Student Association of Medical Research and International Opportunities for Medical Students.

Twitter

Search #MedTwitter and #AcademicTwitter to keep up to date with ground-breaking research. The memes are pretty good too.

LinkedIn

Opportunities are harder to come by on LinkedIn, since fewer medical professionals use this platform. However, you can look at peoples’ resumes as a source of inspiration. This is useful to understand the experiences that they have had in order to get to where they are today. You could always reach out to people and companies/ organisations for more information and advice.

TIP 5: JOIN A PRE-PLANNED RESEARCH PROJECT

Researchers advertise research opportunities on websites and via societies and organisations such as https://www.remarxs.com and http://acamedics.org/Default.aspx

TIP 6: JOIN A RESEARCH COLLABORATIVE

Research collaboratives are multiprofessional groups that work towards a common research goal. These projects can result in publications and conference presentations. However, more importantly, this is a chance to establish excellent working relationships with like-minded individuals.

Watch out for opportunities posted on Student Training and Research Collaborative.

Interested in academic surgery? Consider joining StarSurg, BURST Urology, Project Cutting Edge or Academic Surgical Collaborative.

Got a thing for global health? Consider joining Polygeia

TIP 7: THE iBSc YEAR: A STEPPING STONE INTO RESEARCH

At UCL you will complete an iBSc in third year. This is often students’ first taste of being involved in research and practicing academic writing – it was for me. The first-ever project that I was involved in was coding data for a systematic review. One of the Clinical Teaching Fellows ended the tutorial by asking if any students would be interested in helping with a research project. I didn’t really know much about research at that point and was curious to learn, so I offered to help. Although no outputs were generated from that project, I gained an understanding of how to conduct a systematic review, why the work that I was contributing to was important, and I learnt a thing or two about neonatal conditions. 

TIP 8: VENTURE INTO ACADEMIC PUBLISHING

One of the best ways to get a flavour of research is to become involved in academic publishing. There are several ways in which you could do this:

Become a peer reviewer. This role involves reading manuscripts (papers) that have been submitted to journals and providing feedback and constructive criticism. Most journals will provide you with training or a guide to follow when you write your review. This will help you develop skills in critical appraisal and how to write an academic paper or poster. Here are a few journals which you can apply to:

Join a journal editorial board/ committee. This is a great opportunity to gain insight into how a medical journal is run and learn how to get published. The roles available depend on the journal, from Editor-in-Chief to finance and operations and marketing. I am currently undertaking a Social Media Fellowship at BJGP Open, and I came across the opportunity on Twitter! Here are a few examples of positions to apply for:

TIP 9: GAIN EXPERIENCE IN QUALITY IMPROVEMENT

UCL Be the Change is a student-led initiative that allows students to lead and contribute to bespoke QIPs. You will develop these skills further when you conduct QIPs as part of your year 6 GP placement and as a foundation year doctor.

TIP 10: CONSIDER BECOMING A STUDENT REPRESENTATIVE

You’ll gain insight into undergraduate medical education as your role will involve gathering students’ feedback on teaching, identifying areas of curriculum that could be improved and working with the faculty and other student representatives to come up with solutions. 

It may not seem like there are any research opportunities up for grabs, but that’s where lateral thinking comes into play: the discussions that you have with your peers and staff could be a source of inspiration for a potential medical education research project. For example, I identified that, although we have lectures in nutrition science and public health nutrition, there was limited clinically-relevant nutrition teaching on the curriculum. I then conducted a learning needs assessment and contributed to developing the novel Nutrition in General Practice Day course in year 5.

Thanks for reaching the end of this post! I hope my Top 10 Tips are useful. Remember, research experience isn’t essential to become a great doctor, but rather an opportunity to explore a topic of interest further.

Jess

 

 

 

A Realistic Guide to Surgical Rotations

Read time: 3 minutes

In this post, Ritika Gera, a fifth-year medical student, gives some tips and tricks for making the most of your surgical rotation.

Starting a surgical rotation can feel challenging and scary! It’s normal to feel overwhelmed in an unknown situation, and theatres are like walking into an entirely different universe with new rules to navigate. However, theatres can also be a great learning experience and feel really enjoyable. To help you make the best of your time in surgery, here are some top tips:

Tip 1: Know a little about a lot (not a lot about a little)

No-one expects you to be an expert in any specific operation, so don’t spend hours and hours pre-reading. A general rule of thumb is to know 2-3 sentences of information about any procedure which you can use to show your understanding. It’s also useful to look up indications for and complications of the procedure to illustrate a holistic understanding.

Tip 2: Don’t panic about anatomy!

Try to have a basic understanding of relevant anatomy; much like your pre-clinical anatomy labs, things will make a lot more sense when you have some background knowledge. However, please remember you don’t need to know anatomy at the same expansive level expected in pre-clinical study!

You should revise anatomy which is clinically relevant and links to particular pathology/presentations. For example, you should know the path of the axillary nerve because it’s more likely to be damaged in a fracture of the surgical neck of the humerus. Being able to correlate this information with your knowledge about the function of the posterior cord of the brachial plexus is extremely valuable in clinical practice.

Tip 3: Early is on time, on time is late

Ideally, try to arrive at your theatres slightly earlier than timetabled, so you can accompany the surgical team on their preoperative rounds and clerk a patient. Once a procedure starts it can be difficult to enter theatres so always aim to arrive 5-10 minutes ahead of schedule!

Tip 4: You miss 100% of the shots you don’t take

Ask to scrub in and assist and don’t expect the surgeon to offer. It’s important to clearly state what you need from the session; even if you can’t do much to assist, scrubbing in is a key clinical competence which is important to practice.

Tip 5: Always ask for help when you need it

It’s vital to always ask for help as and when you need it; when it comes to scrubbing in and assisting, no-one expects you to get it right on the first try! Remember the team you’re with once had a ‘first day’ of their own, and if you ask for help, they will understand and do their best to assist you.

Theatres can be a fantastic learning experience for medical students. It’s an opportunity to see things you’ve spent years studying come to life in front of you. You learn valuable skills along the way, such as how operative emergencies are dealt with safely and effectively, and you are exposed to the realities of being a surgeon. Use the opportunity to ask questions, not just about medicine, but about what surgeons’ lives are like; this is vital for figuring out if surgery is something you want to pursue. As with any rotation, to make the most of it, it’s important to be proactive, keen to learn, and enthusiastic to help.

 

The Best Apps and Websites for Pre-Clinical Medicine

Read Time: 5 minutes

In this article, Anush will discuss some of the best apps and online resources in order to maximise your learning in pre-clinical medicine.

Smartphones and tablets are an intrinsic part of our lives (for better or for worse). Distractions aside, here as some apps we’ve found really useful when studying and preparing for exams.

Anatomy Apps

TeachMeAnatomy – Free (iOS/Android/Web)

Struggling with anatomy and need more visual summaries of what is going on within the oh-so-complex human body? TeachMeAnatomy is a Wiki of all the anatomy you’ll need to know during medical school. Concise and colourful, it has lots of very useful labelled diagrams, without vast amounts of text. An especially useful feature is being able to test yourself on the material you’ve just learnt through quizzes.

Link: teachmeanatomy.com

Acland’s Anatomy Atlas – Free (Web)

The famous Robert Acland takes you through the anatomy of the body using real dissections in this blast from the past. Filmed in the late 90s, UCL gives us institutional access to an online version of this, arranged by organ system.

Link: https://aclandanatomy.com/

Biodigital Human – Free (Web/iOS/Android)

Imagine taking your dissection table on the go with you, wherever you are and whenever you want. This is the Biodigital Human, a free tool you can use on your computer or mobile device. You can focus in on part of the body with pre-made models, or start off with a complete human body and dissect it layer-by-layer.

Link: https://www.biodigital.com/ 

Note Taking and Revision Tools

Notion – Free (Web/iOS/Android)

An all-in-one workspace allowing you to organise your notes in a Wiki-esque format, Notion promises to be more than just a word processor. You can collaborate on notes, add tasks, sort them in complex databases and embed dynamic content, like useful videos and audio clips. All you ever need to stay on top of uni work! Best of all, login with your ac.uk email address and enjoy unlimited storage and premium features for free.

Link: notion.so 

Google Drive – Free (Web/iOS/Android)

The original collaborative word processor allows you to write together with shared notes and presentations. It worked well back in 2015 when I started university and it works just as well now. If it ain’t broke, don’t fix it!

Link: drive.google.com 

Anki – Free (Web/PC/Mac/Android) or £23 (iOS)

Spaced repetition is a fantastic way to help make those facts stick – reviewing content regularly ensures it is fresh in your memory. 

 

Anki is a flashcard app that makes spaced repetition easy – it contains algorithms that calculate exactly how often you need to review information for optimal memory commitment, based on how confidently you previously recalled the information. All you need to do is make the flashcards (or import a revision deck).

Link: https://apps.ankiweb.net/

Microsoft Onenote – Free (Web/iOS/Android)

A fantastic tool that allows you to put all your notes in one place, whether they be digitally handwritten or typed, OneNote lets you import documents and other media, allowing you to annotate them however you wish.

Link: https://www.onenote.com/

A Realistic Guide to the NHS ePortfolio

Read time: 4 minutes

In this post, Maddie Wigmore-Sykes, a final-year medical student, demystifies the NHS ePortfolio and explains the best ways to get yourself MiniCEXs and CbDs. 

Starting your clinical years of medical school is a time of excitement and new experiences, including your new companion: the NHS ePortfolio! Designed to help you gather feedback and reflect on your performance, the ePortfolio is something to get your head around and get used to – we’ll be filling out CbDs and MiniCEXs for a long time.

The bread and butter of the ePortfolio is the supervised learning event (SLE), a form you can send to doctors (FY2 and above!) who have witnessed you performing examinations or taking histories. They can then provide you with areas you did well on, and some areas to work on. At UCL, we’re expected to do four or five of these per term. SLEs are broken down further into CbDs and MiniCEXs, but what do they actually mean?

What is a CbD and how do I get one?

CbD stands for case-based discussion. The best way to get a CbD is to find a patient, take a history from them and then write up your findings. Try to think up a management plan based on the patient’s case and do some reading around their condition for bonus points. You can then present the patient to a doctor in the team who might ask you some questions about the case, such as what your differentials are and what you would do next if you were managing their care. 

Module tutors are well-placed to present CbDs to. If you set up a meeting with them every few weeks, you can present a new patient to them each time and get a few CbDs straight off the bat. You can also just ask a friendly doctor who you’ve met a few times if it would be okay to present a patient to them – they’ll almost always say yes!

Here’s an example of what to write in your CbD ticket to send to a doctor (not a real patient):

CbD Example Ticket

So how do I do a MiniCEX?

I’m not sure if anyone really knows what a MiniCEX stands for or what makes it mini, but please let me know if you do! Effectively they’re all about examinations and you’ll need a doctor to watch you perform one on a patient from start to finish. They might then ask you to present your findings, which is really good practise for OSCEs and future life. 

Bedside teaching is a perfect opportunity for getting a MiniCEX, so it’s worth brushing up on some examination skills beforehand and then being brave and volunteering to have a go! Twilight tutors are also keen to get patients with good clinical signs for you to examine as well. 

Here’s an example of what to write in your MiniCEX ticket to send to a doctor (not a real patient):

MiniCEX Example Ticket

Actually getting your SLEs signed off

To complete an SLE, you have to log onto your ePortfolio and send the doctor assessing you a ticket. You can do this by going onto Forms and then Ticket Requests. You’ll need to know the doctor’s email address to send them a ticket, so make sure you have that written down! Remember, the doctor has to be an FY2 or above to fill in your ticket. I’d also recommend uploading a photo of you to your ePortfolio profile – some doctors will get a lot of tickets and you want them to remember who you are.

Inevitably, some of your well-crafted tickets will not get filled in, so it’s worth doing a few more SLEs than you need to, just to make sure they all get done. The ePortfolio has an option to send reminders, so if it’s been a few weeks, don’t be afraid to send one. It might take a while for doctors to complete your ticket, so try to be organised and get your tickets sent out before the end of the module to prevent a mad dash to complete your ePortfolio! 

 

In summary

  1. If you’re feeling nervous, do some SLEs with your module tutor. You can prepare in advance of the sessions and you’ll feel more comfortable with someone you know.
  2. Volunteer in bedside teaching to do the history or examination, it’s a great opportunity to have a doctor watch you perform these skills.
  3. When you’re in clinics or in the Emergency Department, you might be the first person a patient sees so you can elicit a history and examine someone without already knowing their diagnosis. This might be a bit trickier, but is definitely the most valuable way to do an SLE.

A Realistic Guide to Surviving Out-of-Hours Shifts

Read time: 7 minutes

In this blog post, Jessica Xie (final year UCL medical student) explains the ins-and-outs of out-of-hours shifts and how to be smart with your time.

As a clinical medical student, you are expected to be in clinical practice from 9am – 5pm Monday to Friday (except for Wednesday afternoons. Hooray for RUMS Sports!). This makes any time spent on placement outside of these hours (i.e nights and weekends), an out-of-hours shift. Night shifts are typically 8pm – 8am. Weekends are typically 8am – 8pm.

At UCL Medical School, the number of mandatory out-of-hours shifts depends on your year of study (e.g. in your final year, you are required to complete two night shifts and one weekend shift across the whole academic year).

You’re probably thinking, doing night and weekend shifts in hospital sounds awful… why would anyone want to? There are, in fact, many advantages of undertaking out-of-hours shifts, both for your learning and for gaining first-hand experience of what life as a Foundation Doctor/ Internal Medical Trainee/ Specialty Trainee will be like. Also, some students enjoy these experiences so much that they voluntarily attend more shifts than required.

Why Out-of-Hour Shifts Aren’t As Bad As You Think

Opportunities, opportunities, opportunities

You’ll spend most of your time on out-of-hours shifts shadowing whoever is holding the bleep (junior doctors, SHO, registrar or consultant). These are excellent learning opportunities… you can attend to emergencies as they arise and, depending on the specialty, this include going into theatre to assist. For example, I assisted in a Caesarean section at 2am. I was also allowed to suture. This was a great learning experience and something that I may never get to experience again.

Out-of-hours shifts tend to be excellent opportunities to get procedures signed off and for Supervised Learning Events (SLEs) – watch out for a post by Maddie on how to ACE these assessments!

The ‘Junior Doctor’ Experience

With a smaller team working on nights and weekends, you’ll have more opportunities to ‘think like a doctor, act like a doctor’, with particular emphasis on the latter!

These are exciting opportunities to really develop your clinical judgement and skills. You may realise that you are more competent than you think you are, which will always give you a nice confidence boost!

However, you must of course only do things within the limits of your competency and follow all the usual rules, like gaining full consent from patients and ensuring that a chaperone is present for intimate examinations.

A Step-by-Step Guide

    1. Preparation

Pack a meal, snacks to pop into your pockets and plenty of fluids.

Similar to my advice for prepping for ward rounds, write down what you want to achieve by the end of the shift.

What to bring with you:

      • Stethoscope
      • Black pen
      • Notebook or tablet/ iPad
      • Handover sheet from handover meeting
      • Mobile phone – put on silent and I recommend you to download a few of these apps:
        • BNF
        • Microguide
        • UpToDate
        • MDCalc

If you know which doctors will be doing the shift, you may want to let them know in advance that you will be joining them.

2. Attend handover

Who’s who?

Introduce yourself to the team. Ask to shadow a doctor(s) and explain to them what you would like to achieve by the end of the shift (e.g. SLE, practice a specific examination).

Exchange contact details (usually a mobile number) with your supervising doctor and make a note of the name of which doctors are holding bleeps, their bleep number and ensure that you know how to bleep. Some doctors create a Whatsapp group for the shift.

Know the schedule

Some shifts have specific times for various members of the team to take breaks… and ensure that you take one, too! It is really important that you take care of your wellbeing. Ensure that you stay hydrated. If there’s an opportunity and place for you to rest or nap, I strongly recommend that you do!

There may be a mid-shift meeting at around 2am. You should attend this. It allows the whole team to get their bearings, identify which tasks still need to be completed and delegate the work appropriately. This is a great opportunity for you to jump in and offer to help out and/or ask to shadow a different member of the team.

3. Make the most of the shift

Same as for a ward round, you should aim to help the team as best as you can.

I recommend that you ‘follow’ a patient through from when they present to the hospital, to their admission as an in-patient or discharge:

      • When in A&E or AMU, clerk patients as they are admitted
      • Present to the doctor
      • Ask the nurses if you could take the patient’s observations
      • Perform bedside investigations, like urinalysis and an ECG
      • Perform clinical procedures, like venepuncture
      • Order investigations on the computer
      • SBAR handover to the team who will admit the patient onto their ward or write a discharge summary
      • And at each step, ensure to check that your supervising doctor is happy for you to proceed

Be proactive

Seek learning opportunities, ask patients and healthcare staff questions about anything that you’re unsure about and attend to emergencies as they arise.

4. After the shift

Congratulations! You’ve completed your first out-of-hours shift!

Take a moment to reflect on your experience: What did you learn? What did you do that made you proud of yourself? What are you hoping to achieve next?

Finally, if you have completed any procedures or examinations that require a sign off, make sure you contact the relevant person(s) for their email address(es).

Being Realistic

I’ve explained above why out-of-hours shifts are not to be feared, but let’s be realistic: out-of-hour shifts can be tough; twelve-hour-long shifts can be pretty draining. After completing a night shift or two, take the next morning or day off to reset your body clock. So don’t schedule a night shift the day before compulsory teaching! If you know that you will miss teaching, politely notify your tutor or the doctor in advance.

Also, despite your best efforts to maximise outputs, you may not achieve the goals that you intended to, especially if the shift is quieter than you expected. If this does happen, don’t be too disheartened or surprised if your supervising team suggests that you head off home a couple of hours early; you’ve gained a new experience and that’s what’s important.

Top Tips

To summarise, here are my top tips to surviving out-of-hours shifts:

  1. Plan ahead to ensure that you are physically and mentally prepared for the shift.
  2. Look after yourself – when you’re clerking in a patient at one moment, then assisting in theatre in the next, it’s easy to forget to take breaks! Remember: you need to look after yourself before you can look after your patients.

Thanks for making it to the end of this post! I hope I’ve managed to convince you that out-of-hours shifts can be excellent learning opportunities if you come prepared and know what you want to achieve. If you have any questions or comments, feel free to reach out to any of us.

Good luck,

Jess

Managing Medical School (even when it’s really hard)

Read time: 4 minutes

In this post, Maddie Wigmore-Sykes, a final-year medical student, gives her take on how to get started at medical school and what to do if it all starts going a bit wrong. Expect some motivational content along the way.

Finding your groove

OK sign X-ray

When I first arrived at medical school, excited and more than a little scared, I had no idea what to expect, nor what was expected of me. I remember sitting in a lecture theatre, completely unable to follow what was being said, surrounded by 300 other people who seemed to know exactly what they were doing. They probably weren’t any more enlightened than me and, even though there will always be that person who claims they’ve done the whole course by Christmas, most of us were just pretending we knew what to do.

It is clichéd, but true, that medicine is a marathon not a sprint. You do not need to turn up on your first day with an understanding of how to learn from lectures or knowing what an OCaPE (Objective Clinical and Practical Examination) is. Spend the first few weeks, or months, getting your bearings and experimenting with different learning styles to find one that works for you. Here are a few suggestions on how to take notes in lectures:

      • Print and annotate on the slides
      • Review the lecture slides before the lecture, make a template for your notes  and add to them during the session – this requires some forward-planning
      • Type as you go (if you can keep up with the fast-talking lecturers!)
      • Rather than writing notes on the information given to you in the lecture, write questions to test yourself, along with short answers, or note down which page of the lecture slide shows the answer
      • Call me old-fashioned, but I found that handwriting notes helped me to stay focused during lectures

After lectures, try consolidating your learning with some fun (ish?) activities. Test yourself with flashcards or set up a revision group with your friends where you can quiz each other – make it a regular thing so you’re committed to going through your notes. 

There will be endless resources recommended to you by both fellow students and lecturers. It’s impossible to use them all, so it’s worth trying a few before you buy, and just because your friend has already completed *insert random question bank here*, doesn’t mean you have to as well. Stick to your learning outcomes for each lecture and find materials that complement those and you’ll be all set. For more information on some of our recommended resources, as well as how to improve your learning in our new online Covid-19 world, check out Vikram’s post: A Four Step Guide to Working from Home.

Losing your groove and getting it back again

Six years is a long time to be on your A-game and a lot of us will have a wobble or two at some point. I never quite found my footing in first year and ended up failing and having to resit the exams; as a previously high achiever at school, this felt confidence-shattering at the time – how could I possibly become a doctor if I couldn’t even get through year one? Clearly I was wrong, as I’m now set to graduate in 2021, but it took me a long time to get over it. 

With the competition inherent to medical schools and our own personal drives to succeed, it’s no wonder we feel this constant pressure to prove ourselves. We’re ranked from our very first formative and subsequently measure ourselves on how well we’re doing compared to a cohort of very academic people, losing sight of the fact that simply being a part of this cohort is an amazing achievement in itself. It’s natural to want to do as well as we can, but if you do ever feel disappointed in your performance, pick yourself up and remember that a ranking in a year group does not define who you are or how good a doctor you can be. 

It’s okay to feel overwhelmed sometimes, medical school is difficult! If you find yourself wobbling or just need a bit of support, look after yourself and remember that help is always available. Transition mentors and other older year students can be great sources of advice and we’re always happy to offer guidance where we can. Personal tutors and the medical school student support team can also not only help with practical solutions if you’re struggling with motivation and organisation, but also assist you with any health and welfare concerns. 

TLDR: Medical school is difficult, but if you stay calm, get help when you need it and remember you’re more than your latest exam result, you will be okay.