Competition Medical jobs are competitive; it is important to maximize your chances of getti ng a job. Apply for several specialties; rank as many regions as possible; check competitio n ratios and person specifi cations (b p49, (cid:27)specialtytraining.hee.nhs.uk); consider a back-up choice, eg a less competitive specialty or region. A good CV also helps (b p54). Researching a job Adverts rarely give a true refl ection of a job. Phone up hospitals withi n the region and ask to speak to the person doing the job at the moment. Quiz them on the t ypes of placements available, hours, support, teaching, conditions, and what their intervie w was like. Would they accept the job again? Contacts With human resource departments and structured inter- views, the days of jobs bein g just a consultant phone call away have gone. There is no doubt that some networking still occurs, with mixed results. Senior contacts are useful for tailored career guidance, CV ad vice, and giving realistic views of where your CV can get you. Accepting a job With a move towards unifi ed, online application processes, strict and auto mated rules are essential to ensure a rapid and fair allocation to posts. In order to allow for choice, under certain circumstances it may be possible to accept, or hold, an off er, and later upgrade, or apply to a diff erent post, providing you notify all those con- cerne d. Outside of this formal process, it is unacceptable to turn down a post you have already accepted unless you have an extremely good reason. The GMC take a clear position on your ob ligation to protect patient care by not compromising the recruitment process in this way, t hough notice periods vary by seniority. OHFP.indb 50 OHFP.indb 50 30/05/2014 16:17 30/05/2014 16:17 51 SPECIALTIES IN MEDICINE Specialties in medicine The Certifi cate of Completion of Training (CCT) can be awarded in numerous specialties shown as follows. A selection of subspecialties are also shown with bu llet points: Allergy Anesthesia Immunology Infectious diseases Intensive care medicine Medical microbiology and virology Me dical oncology Medical ophthalmology Medical psychotherapy Neurology Neurosurgery Nuclear m edicine Obstetrics and gynecology Pediatric anesthesia \200 Obstetric anesthesia \200 Pain management Acute medicine Audiological medicine Cardiology Cardiothoracic surgery Chemical pathology C hild and adolescent psychiatry Clinical genetics Clinical neurophysiology Clinical oncology Clinical pharmacology Clinical radiology Materno-fetal medicine \200 Gynecological oncology \200 Urogynaecology Occupational med icine Old age psychiatry Ophthalmology Oral and maxillo-facial surgery Otolaryngology (ENT surgery) Pediatric surgery Pediatrics Interventional radiology Dermatology Emergency medicine (EM) Endocrinology and diabetes Forensic psychiatry Gastroen terology \200 Hepatology Community pediatrics \200 Neonatology \200 Oncology Palliative medicine Pharmaceutical medicine Plastic surgery Psychiatry of learning disability Public health medicine Rehabilit ation medicine Renal medicine Respiratory medicine Rheumatology Sport and exercise medicine Sexual health and reproductive medicine Trauma and orthopedic surgery General adult psychiatry Addictions psychiatry \200 Liaison psychiatry \200 Rehabilitation psychiatry General internal medicine General practice General surgery Breast surgery \200 Colorectal surgery \200 Upper GI surgery \200 Vascular surgery Ge nitourinary medicine Geriatric medicine Stroke \200 Orthogeriatrics Hand surgery \200 Spinal surgery Tropical medicine Urology. Hematology Histopathology Forensic pathology For more details on the career options available to doctors, including all of the above, se e So You Want To Be A Brain Surgeon? (Eccles and Sanders, OUP, 2008). _OHFP.indb 51 _OHFP.indb 51 30/05/2014 16:17 30/05/2014 16:17 52 CHAPTER 1 Being a doctor Your curriculum vitae What is a CV? This is a Latin phrase which means \200\230course of l ife \200\231. In modern days it means a document by which you advertise yourself to a poten tial employer: a summary of you. When will I use a CV? You will need a CV for many of the jobs you will apply for after grad uating. If you join a locum agency, they will use your CV when fi nding you work. You shoul d also upload your current CV to your ePortfolio in advance of every annual review. What is included in a CV? The most important information to include are your contact detail s, a list of your qualifi cations (those already acquired and those you are studying for), any outstanding achievements, a summary of your employment to date, and the details of your referees. Other information can be included, but do not overcrowd your CV. CV philosophy Your CV should not be a static piece of work, it should evolve with you and r efl ect your changing skills and attitudes. It is important to keep your CV up to date, and from time to time reformat it to freshen it up. Use your CV to demonstrate how you have le arned from your experiences rather than just listing them; a potential employer will be muc h more impressed if you indicate you learned about the impor- tance of clear communication whilst working at a holiday resort, than by the actual job itself. Getting help Human resource departments and educational supervisors can give advice on writ ing a CV, and often you can fi nd people \200\231s CVs or templates on the internet by sear ching for \200\230CV \200\231. Try to keep your CV individualized, so do not simply copy s omeone else \200\231s template. Before writing your CV Ascertain what a potential employer is looking for when sending in y our CV; check the essential and desirable criteria and try to echo these. You need to alter the emphasis in your CV to match the position you are applying for, eg highlighting your c ommu- nication skills or leadership experience. Layout Your CV should look impressive; for many jobs hundreds of CVs are received and yours must stand out. It needs to be clearly laid out and easy to follow. The key information an d your most important attributes should stand out prominently. Think about the layout befor e you start writing. Length Two sides of A4 paper are ideal for a basic CV (and an optional front page); add mor e as your career progresses. Remember For most jobs, the candidates applying will have very similar qualifi cations and so the only way you may stand out to be short- listed for interview is via your CV. Make it as interesting as possible, without it looking ludicrous. Personal details Name, address which you use for correspondence, contact telephone numbers (home, work, mobile) and email address are essential. You must state your type of GMC membe rship (full/provi- sional) and number. Stating gender, date of birth, marital status, natio n- ality, and other information is optional. OHFP.indb 52 OHFP.indb 52 30/05/2014 16:17 30/05/2014 16:17 53 YOUR CURRICULUM VITAE Personal statement This is very much an optional section. Some feel it gives you an opportu nity to outline a little about yourself and where you see yourself in 10yr; others feel it is an irritating waste of space. Education List your qualifi cations in date order, starting with the most recent or current and progressing backwards in time. Indicate where each was undertaken, the dates you were there, and grade. Highlight specifi c courses or modules of interest. GCSE and A-level resu lts are less important once you have graduated. Employment and work experience List the placements you have undertaken during the F1 and F2 years starting with the most recent. Include the dates, specialty, your supervising consul tant, and address of the employer; consider adding key skills that you attained. Interests An optional section which gives you a chance to outline what you like to do outsi de of medicine. A well-written paragraph here can show potential employers that you are int eresting as well as intelligent. Publications If you have not yet got your name in print try to get a letter in a medical jo urnal (b p58). If you have got publications put the most recent fi rst; ensure they are ref erenced in a conventional style (see www.pubmed.com for examples). Referees Your referees should know your academic record as well as your ability to interact with others. State their relationship to you (such as personal tutor) and give contact add ress, telephone number, and email address. Ensure they are happy to provide a reference, gi ve them a copy of your CV, and tell them when you are applying for jobs. Headers and footers Having the month and year in either a header or footer shows the reader you keep it up to date. Photographs Some people include a small passport-sized photograph of themselves near the st art of their CV; this is optional but not necessarily recommended. Why should your physical appearance be of relevance for selection for any job outside fashion and media? The \201 nished CV Use the spell-checker and get a tutor or friend to read over it to ide ntify mistakes and make constructive criticism; be prepared to make numerous alterations to get it right. Technical points Use just one clear font throughout. To highlight text of importance use th e underline, bold or italic features. When printing your CV use good quality white paper an d a laser printer if possible. The covering letter Whenever you apply for a job, you must send a covering letter with your CV and application form. This should be short and to the point. Indicate the position you are applying for and briefl y say why the job appeals to you, and highlight why you are sui table for the job. _OHFP.indb 53 _OHFP.indb 53 30/05/2014 16:17 30/05/2014 16:17 54 CHAPTER 1 Being a doctor Post-Foundation Program CV Name: Address: Charles J Flint 14 Abbeyvale Crescent McBurney \200\231s Point McBurney McB1 7RH 0111 442 9 85 0968 270 250 0111 924 9924 bleep 1066 charles.fl int@mcburney.ac.uk 12 June 1991 0121231 (full) Home: Mobile: Work: Email: Date of birth: GMC: Personal statement I am an outgoing doctor with an enthusiastic yet mature outlook. I have strong communication skills and experience of working indepen- dently, both as a team membe r and leader. I am conscientious, trust- worthy, quick to learn, and to employ new skills. My long-term aim is to practice an acute specialty within the hospital environment. Education 2008 \200\2232013 University of McBurney, McBurney \200\231s Point, McB1 8PQ 2013 MBChB: Upper Second Class, 2011 BMedSci (Hons): Employment history 3 Apr 15 \200\223to date F2 to Miss Broom, Emergency Medicine McBurney Royal Infi rmary F2 to Dr Fungi, Microbiology McBurney Royal Infi rmary F2 to Dr Golfer, General Practice Feelgood Health Center, Speake rtown F1 to Mr Grimshaw, General Surgery McBurney City Hospital F1 to Dr Mallory, Gastroent erology McBurney City Hospital F1 to Dr Haler, Respiratory Medicine McBurney City Hospital 5 Dec 14 \200\2232 Apr 15 31 Jul 14 \200\2234 Dec 14 3 Apr 14 \200\22330 Jul 14 5 Dec 13 \200\2232 Apr 14 31 Jul 13 \200\2234 Dec 13 OHFP.indb 54 OHFP.indb 54 30/05/2014 16:17 30/05/2014 16:17 55 POST-FOUNDATION program CV Postgraduate clinical experience During my F1 year I developed my clinical and practical sk ills and became confi dent with the day-to-day organization of emergency and elective admis sions in both medicine and surgery. Since commencing F2 I have built upon these skills and now appreciate the wider role of the doctor in the smooth running of acute admissions and liaison with the community teams prio r to, and after, hospital dis- charge. Formal skills I have include: \200 ALS provider (2013) \200 Basic surgical skills, incl uding suturing and fracture management. Research and audit \200 I am currently involved i n a research project comparing capillary blood gas analysis with arterial blood gasses in a cute asthmatics \200 I undertook an audit of antibiotic prescribing on surgical wards to investigate whether patients were being managed in accordance with trust guidelines. I pres ented the data at a departmental meeting and repeated the audit after 2 months, demonstrati ng increased compliance During my SSM I was involved in research investigating the role of caff eine upon platelet aggregation. Interests I am a keen rock and ice climber and have continued to improve my grade since lea ving university. I have organized several climbing trips to Scotland and one to the Alps. I am interested in medical journalism and have spent a week in the editorial offi ce of the International Journal of Thrombophlebitis. Publications \200 Flint CJ. Letter: Student debt. Medical Students \200\231 Journal 2013; 35(2): 101 Flint CJ and West DJ. Multiple Sclerosis in social class three. Journal of Social Medicine 2013; 12(9): 118 Lee S, Flint CJ and West DJ. Caff eine as an activator of platelet aggregation. International Journal of Thrombophlebitis 2011; 54(3): 99. References \200 Dr Ian Haler, Educational Supervisor, Department of Respiratory Medicine, McBurney \200\231s Medical Center, McBurney \200\231s Point, McBurney, McB1 7TS T el 0111 924 9924 ext 2370. ian.haler@mcburney.ac.uk Mr Ivor Grimshaw, Educational Supervisor, Department of General Surgery, McBurney \200\231s Medical Center, McBurney \200\231s Point, McBurney, McB1 7TS Te l 0111 924 9924 ext 4637. ivor.grimshaw@mcburney.ac.uk _OHFP.indb 55 _OHFP.indb 55 30/05/2014 16:17 30/05/2014 16:17 56 CHAPTER 1 Being a doctor Interviews Interview preparation Employers must allow you time off to attend the interview itself; try to give them as much notice as possible. Look at the recruitment website for in formation about interview format, ques- tions and what to bring; try to talk to previous ap plicants. Interview day Arrive at the interview with plenty of time, allow for all sorts of delays on the roads or train, even if this means you have to read the newspaper for an hour. Relax a nd be yourself with the other candi- dates before you are called in; most of them will have similar qualifi cations and experience as yourself and will be just as nervous. Dress smar tly in a simple suit and tie for men and suit for women (trouser or skirt). You will normal ly receive specifi c instructions as to what documentation to bring, which you should follo w exactly; as a minimum, bring a copy of your CV (b p52) and a summary printout from your e Portfolio (b p8). The interview Relax. The worst that can happen is that you are not off ered the job, which is not the end of the world. The format of interviews varies, but there are usually 2 \200 \2233 interviewers; introduce yourself to all the panel and wait to be off ered a seat. For some posts there will be a series of panels, each with a diff erent brief (eg CV verifi ca tion, clinical scenarios, personal skills), and you will rotate between panels. Take a few moments to think about the questions before answering and ask for a question to be rephrase d if you don \200\231t understand it. Always make good eye contact with all members of the panel and be aware of your own body language. Common questions It is impossible to predict the questions you will be asked, but they are likely to include questions about your port- folio, relevant clinical scenarios, and curren t medical news/issues. Many questions have no correct answer and test your communication sk ills, common sense, and ability to think under pressure: \200 Talk us through your portfo lio; what are you most proud of on it? \200 What is missing from your portfolio? \200 W hat qualities can you off er our training program? \200 Why have you chosen a career in \200 ? \200 What do you understand by \200\230clinical governance \200\231? \200 Tell us about your audit. Why is audit important? \200 If you were the Secretary for Health, w here would your priorities lie? \200 How would you manage \200 (specifi c clinical scen ario)? \200 Where do you see yourself in 5, 10 years time? \200 If you were the CT1 in the hospital alone at night and you were struggling with a clinical problem, what would you do? Tell us about your teaching experiences. What makes a good teacher? Clinical scenarios Inte rviewers should not ask you specifi c medical questions (eg what is the dose of \200 ); th ey can pose scenarios to discuss your management of a situation. These often focus on key i ssues like com- munication, prioritization, calling for senior help when appropriate, multi dis- ciplinary teams, clinical safety. For some specialties, a few formal OSCE-style statio ns may be included \200\223 you should be told about this in advance. Results and feedback If you are unsuccessful, try to obtain some verbal or written feedback about how you could improve your CV or your interview skills. Remember there are always me dical jobs so you will fi nd something. OHFP.indb 56 OHFP.indb 56 30/05/2014 16:17 30/05/2014 16:17 57 MEMBERSHIP EXAMS Membership exams To progress beyond through the ST years you will need to complete the memb ership exams of your chosen specialty and meet the appropriate level of competency. The exa ms are diffi cult (often only 730% of candidates pass per exam) and expensive (though often tax deductible b p41). Most mem- bership exams take place 2 \200\2233 times a year. You ne ed to apply about 2 \200\2234mth before each exam. In the past, Foundation doctors have rec eived advice not to sit membership examinations \200\223 this may well allow focus on othe r areas of development but you may then miss early opportunities to start building this asp ect of your CV. Medicine Regional examination centers throughout UK and overseas; all cente rs use the same exams. The MRCP has three sections: \200 Part 1 Written basic science, 419, \211 12mth after graduation \200 Part 2 Written clinical, 419, <7yr since Part 1 \200 PACES clinical skills, 657, <7yr since Part 1. You need to have already passed Par t 1 to apply for a medical ST3 post, and pass all parts of MRCP in order to commence such a post. Surgery Regional examination centers throughout UK and overseas; all centers use the same exams. The MRCS has two parts, you are per- mitted 6 attempts to pass Part A, and 4 a ttempts to pass part B: \200 Part A MCQ (Basic sciences and Principles of Surgery in Gene ral), 493, eligible from graduation Part B OSCE 894, eligible after part A. To apply for an ST3 position in surgery you need to have completed the entire MRCS. General practice You need to be a GP registrar to take t he MRCGP exams. There are three parts and no time limits though the GP registrar post is a year long; 10% fee reductions apply to associate RCGP members: \200 AKT (written exam) 517 \200 CSA (clinical skills) OSCE stations, 1737 \200 ePortfolio similar to the FP portfolio. Access costs 611, but is free amongst other benefi ts for RCGP members ( 163 registration, plus 369 annual cost). You need to complete the MRCGP to become a GP. Other membership exams in the Foundation years Emergency medicine (MCEM) Three-part exam (t wo written and one clinical) required to apply for ST4. Part A may be sat as early as F1, b ut all parts must be passed within 4 years of fi rst sitting Part A (not passing) Anestheti cs (FRCA) Full primary (MCQ and OSCE) exam only open to anesthetic trainees, though F1 and F2 doctors can attempt MCQ com- ponent. Applications to ST3 are only permitted when all par ts of the primary FRCA are passed Obstetrics and Gynecology (MRCOG) Part 1 (written) eligib le after grad- uation; part 2 (written + OSCE) after further 2yr O+G experience Pathology M RCPath normally completed during ST Pediatrics (MRCPCH) 3 written papers (attempted in any order after grad- uation); clinical exam after 12mth paeds experience and passing all writt en Radiology (FRCR) Can only be attempted after gaining training post Psychiatry (MRCPsych) Can only be attempted after gaining training post. _OHFP.indb 57 _OHFP.indb 57 30/05/2014 16:17 30/05/2014 16:17 58 CHAPTER 1 Being a doctor Continuing your education Educational requirements You will be assessed throughout the FP t o ensure that you are developing as a doctor and learning new skills. This will be done by Foundation assessments (b p8), your ePortfolio (b p8), meetings with your clinical supervis or, informal feedback from ward staff , presentations and attendance at teaching sessions. These assess- ments should not be diffi cult but it is essential that you complete them. Study leave There is no formal provision for study leave for the F1 year; in the F2 year yo u will be off ered the chance to spend taster weeks in specialties of your choice. You may be allowed study leave for specifi c courses but this will be at the discretion of your cli nical supervisor and policies vary widely between Foundation schools. Study expenses F2s may get a study leave budget of 300 \200\223400 per 12mth though again this varies by Foundation school. Check with your postgraduate center. You can only use th e money for recognized courses and revision courses; never for sitting membership examinati ons. Postgraduate courses There are hundreds of these and the costs range from free to > 1000 p er day, most are about 100 \200\223150 per day. During the FP years Advanced Life Support (ALS) is important and may be compulsory. Check the BMJ advert section for potential cours es and try to speak to other people who have done the course. Exam planning Once you have d ecided on a career plan (b p51), you will need to consider taking the appropriate membershi p exami- nation. Membership exams are diffi cult and expensive but essential for career pro gression, so start early. See b p57 or the relevant Royal College website (b p600) for more detail. Getting published Having publications on your CV will give you a huge advantage when applyi ng for jobs. It will be far easier to understand what sort of thing journals are looking fo r if you read a few regularly. There are many ways to get your name in print and you don \200\231t have to write a book (which is not great for the social life). \200 Book review s Get in touch with a journal and express interest in reviewing books for them; you don \200\231t have to be a professor to give an opinion on wh ether a book reads well or is useful Case reports If you see something interesting, rare, or just very classical then try writin g it up. Include images if possible; get a senior co-author and ensure you obtain patient c onsent in line with the journal s policy \200 Fillers Some journals have short stories or funny/moving one-liners submitted by their readers. Write up anything you see which others might be interested in; ensure you obtain patient consent Letters If an article is incorrect, fails to mention a key point or has relevance in another fi eld then write to the journal and mention this; it might be worthwh ile asking a senior colleague to co-author it with you \200 Research papers If you have p articipated in research make sure you get your name on any resulting publications. If your audit project had particularly interes ting results you may be able to publish it. OHFP.indb 58 OHFP.indb 58 30/05/2014 16:17 30/05/2014 16:17 59 AUDIT Audit Audit is simply comparing practice in your hospital with best practice or clinical gu idelines. There are six main stages to the \200\230audit cycle \200\231: (1) Defi ne stand ards (eg replace cannulas every 72h) (2) Collect data (duration of placement for 50 consecu tive cannulas) (3) Compare data to standards (87% of cannulas replaced in 72h) (4) Change p ractice (present data to colleagues and propose new approaches, eg date of placement writte n on cannula dressings) (5) Review standards (replace cannulas every 72h unless fi nal dose in 2h) (6) Reaudit (repeat data collection after 3mth \200\223 has anything changed?). Wi thout reaudit the cycle is not complete and those assessing your audit will look for eviden ce of this. Why does audit matter? The aim of audit is to improve the quality of patient ca re; it allows a unit to applaud areas of strength and improve areas of weakness. Audits wil l also benefi t you as an FP doctor since they are important in job applications and interv iews and without at least one it will be hard to get an ST job. Try to do \211 2 during yo ur FP. Choosing an audit Almost any aspect of hospital/ward life can be audited. Choose something simple that interests you; alternatively look at relevant guidelines and choose one that is simple to measure. De \201 ning standards Try searching the National Library for Guidelines (accessible via w ww.library.nhs.uk); alternatively defi ne best practice yourself by asking seniors and supe rvisors about what is expected. Collecting data The simpler your audit the quicker and easier this will be. There are many ways of doing this including checking clinical notes, questionnaires, and monitoring activi ties yourself. Try to make your methods objective so that you do the same for every set of notes/subject. Compare data to standards The method for doing this depends on the type of data you have co llected; it is easy to do some simple statis- tical tests on data \200\223 seek advice fro m your educational supervisor or other seniors. Change practice Try to present your audit to relevant clinicians, eg an FP teaching session or a ward meeting; use your fi ndings to propose feasible changes to practice and discuss these with the audience. Review standards You may feel that the original standards you defi ned are still suitable; alternatively the process of auditing may have shown you that these standards need updating . Close the loop Repeat the data collection to see if the changes to practice have made a dif f erence; it is a good way to stay in touch with old wards and looks fantastic on a CV. Example audits A few ideas: \200 Are ECGs performed within 20min in ED patients with ches t pain? \200 Are drugs prescribed in accordance with local guidelines? \200 Do all pati ents have appropriate thromboprophylaxis prescribed? \200 Do patients admitted with chest pain have their cholesterol measured? _OHFP.indb 59 _OHFP.indb 59 30/05/2014 16:17 30/05/2014 16:17 60 CHAPTER 1 Being a doctor Presentations and teaching The thought of having to give an oral presentation provokes anxi ety in most of us. Being able to relay information to an audience is a valuable skill and o ne which gets easier with time and experience, though it is helped by a logical approach. T ypes of presentation There are four main types of presentation: audit/research, journal clu b (critical appraisal of research), case presen- tation, and a teaching session. When is the presentation? If you have months to prepare then you can really go to town, whi lst if you have only a few hours you need to concentrate on the essentials. How long should it last? A 5min presentation will still need to be thorough, but less detai led than that lasting an hour. The length of the presentation will also aid you in choosing the topic. What is the topic? Clarify as early as possible the topic you are to present and any specif i c aspect of the topic you should be discussing. If you can choose the topic, select somet hing you either know about or are interested in researching. Audience Are you presenting to your peers, your seniors or juniors? Are they ignorant of th e topic or world experts? This information will determine the level of depth you need to go into. Venue and means of delivery How far away is the audience, how big is the screen? (so all yo ur text and diagrams are clear). Will you use your laptop or their computer? Back up on mem ory stick in current as well as 2003 version of PowerPoint. Sources of information Do you already have books on the subject? Read about the topic on th e internet by undertaking a search with a website such as www.bmj.com. Search PubMed using keywords; recent review articles are a good place to start. If there is no information If you cannot fi nd enough information then it is likely you are not searching correctly; ask library staff for help. If there really is a lack of informat ion then consider changing the topic, or choose an easier approach to it. How many slides? This depends on how much detail is present on each slide. On average 20 \200\22325 slides will last about 30min. Slide format Don \200\231t get too clever. Slides should be simple; avoid borders and compl ex animation. PowerPoint has numerous pre-set designs, though remember it is the content of your talk the audience needs to be focused upon. Consider using a remote slide advance dev ice (< 15). Presentation format The presentation is in essence an essay which the speaker delivers oral ly. It should comprise a title page with the topic, speaker \200\231s name and an introduct ion which states the objectives. The bulk of the presentation should then follow and be clo sed with either a summary or conclusion. Consider ending with a slide acknowledging thanks and a fi nal slide with simply \200\230Questions? \200\231 written on it to invite discuss ion. OHFP.indb 60 OHFP.indb 60 30/05/2014 16:17 30/05/2014 16:17 61 PRESENTATIONS AND TEACHING Titles Give each slide a title to make the story easy to follow. Font Should be at least size 24. Ensure the text color contrasts with the background color (eg yellow text on blue background). Avoid using lots of eff ects; stick to one or two colo rs, bold, italics, or underline features. Graphics Use graphics to support the presentation; do not simply have graphics adorning the slide to make it look pretty. How much information Avoid overcrowding slides; it is better to use three short slides than one hectic one. Each slide should deliver one message and this should be in six bullet poi nts or less. Bullet points Use to highlight key words, not full sentences. PowerPoint eff ects Keep slides simple. Avoid text fl ying in from all directions and don \200\231t use sound eff ects as these distract the audience. Rehearsing Go through the presentation a few times on your own so you know the sequence and what you are going to say. Then practice it in front of a friend to check timing and fl ow . Speci \201 c types of presentation Audit/research Ensure you give a good reason why the au dit or research was chosen and what existing research has already been undertaken. State yo ur objectives, your method, and its limitations. Use graphs to show numerical data and clea rly summarize your fi ndings. Discuss limi- tations and how your audit/research may have be en improved. Draw your conclusions and indicate where further research may be directed. Tha nk the appropriate parties and invite questions/discussion. See audit/research section, b p 59/64. Journal club Begin with a brief explanation of why you have chosen to discuss the particula r clinical topic and list the articles which you have appraised. Aim to include why the stu dy was undertaken, the appropriateness of the study, the methods and statistics used, the v alidity of the study, and make comparisons between diff erent studies. Include latest guide lines and invite discussion regarding how the research may aff ect current clinical practic e. Finish with a summary of the studies undertaken, their results, and where they were publ ished for future reference. Case presentation The presentation should tell a story about a patient and let the audience try and work out the diagnosis as though they are clerking the patient for the fi rst time . Name the talk something cryptic, eg \200\230Headache in the traveler \200\231. Refer to your patient by initials only and make sure patient details are blanked on all images and t est results. Present the history and physical examination. Invite audience suggestions for the diag- nosis and management. Give the results of investigations and again invite the aud ience to comment. Give the diagnosis and discuss subsequent man- agement. Summarize with an outline of the topic and management; end with a question/discussion session. Teaching session It is helpful to base a topic around a patient if this is appro- priate. K eep the session interactive; have question slides where the audi- ence can discuss answers. Summarize with learning points; it is helpful to provide a hand-out of your slides for peo ple to take away (b p63). _OHFP.indb 61 _OHFP.indb 61 30/05/2014 16:17 30/05/2014 16:17 62 CHAPTER 1 Being a doctor Giving the presentation Equipment Ensure that the projector/computer you need will be avail - able well in advance. Ideally check it works and leave enough time to fi nd new equipment if there is a problem. Timing Arrive early and check your slides project correctly. Leave the title page projected so the correct audience attends. Speaking You need to talk loudly enough to be heard at the back of the room. This can be da unting, but a good presentation given inaudibly is more disappointing than a poor presentat ion delivered audibly. Body language Stand at the front of the audience and avoid walking into the projected image . Direct your talk at the audience, not the screen. This makes you appear more confi dent a nd also allows you to gauge if people are confused or bored. Try to make eye contact with e veryone in the room. Beginning Introduce yourself and your position, outline the topic you are going to talk abo ut, and explain why you chose the topic. This is a good time to interact with the audience; ask if people at the back can hear you. To use notes or not You should not need notes to prompt you but have them available; points on the slides should be enough. Style Keep it professional, but show you are human; it is acceptable to be light-hearted an d make the audience laugh. Pacing You probably speak quicker than you think; take your time, pause and allow the audie nce to read all your points. Questions Decide in advance if you would like questions to be asked during your presentatio n or at the end. Anticipate what questions may be asked and prepare for these. Do not be af raid to say you do not know the answer, though off er to fi nd out. Feedback Whenever possible ask for constructive criticism from someone who saw your present ation and try to learn from their comments. Consider using the presentation for a formal D eveloping the clinical teacher assessment (b p9). Summary of points for a good presentation \200 Plan well in advance \200 Keep slides si mple, avoid unnecessary graphics \200 Rehearse your talk \200 Try to stay calm and spea k clearly \200 Look at the audience, not the screen \200 Thank the audience for attendi ng. OHFP.indb 62 OHFP.indb 62 30/05/2014 16:17 30/05/2014 16:17 63 TEACHING MEDICAL STUDENTS Teaching medical students Teaching will benefi t you as much as the recipient; it will chal lenge you to fi ll any gaps in your knowledge and organize your thinking on the subject. Yo u may not feel that you know enough to teach medical stu- dents but you are probably the be st teacher on the ward for them, for two reasons: \200 You have recently passed the fi na ls exam that they are trying pass, often at the same medical school Finals are meant to test core medical knowledge; this is what you do every day when you clerk and manage a patient. Portfolio Keep a record of teaching sessions, ideally with feedback (consider using a simpl e online survey tool). At least once a year you will need to complete a Developing the cli nical teacher form assessment (b p9). Teaching principles Whatever information you are trying to convey it is important to follow a few simple guidelines: \200 Be clear about your objectives \200 Plan what you are go ing to teach to give it structure \200 Be interactive; this means that the students do so me of the work and also are more likely to remember it \200 Try not to use too much medical jargon \200 Gi ve relevant examples \200 Check the students understanding throughout and invite questio ns. Suitable patients One of the worst parts of being a medical student is fi nding suitabl e patients to take a history from or examine. You can use your patient lists (b p17) and fi rst-hand experience of the patients to guide medical stu- dents to conscious, orientated, and friendly folk or those with clinical signs. Better still, off er to introduce the stude nt. Clinical examination Off er to watch the student examine a patient and give feedback on the ir technique. You are likely to examine more patients in your fi rst month as a doctor than in all your years as a medical student so your clinical skills will have advanced very qui ckly. FP applications With all the recent changes to medical training many students feel bewil- d ered about what lies ahead. Once again you are in the ideal position to advise since you ha ve already successfully applied for the FP. Simple advice about which are the best jobs, ho w to fi ll in the application form, or even showing a copy of your own form can be a great help. Clinical approach You can also teach \200\230how to be a doctor \200\231 type skills that are rarely passed on. The trick is to choose a simple subject you know lots about, eg: \200 Managing chest pain/breathlessness \200 Fluid management and volume assessment \200 Writing in notes. _OHFP.indb 63 _OHFP.indb 63 30/05/2014 16:17 30/05/2014 16:17 64 CHAPTER 1 Being a doctor Research and academia Research Whatever direction you see your future career heading in, th e opportunity to undertake a period of research will help you gain insight into this vital area that underpins all of medical practice as well as to develop the skills necessary to u nderstand research output. You don \200\231t need to cure cancer \200\223 often the most s uccessful projects are those that set out to answer a simple, well formulated question. Academia is not turning your back on clinical medicine, but rather adding a new dimension t o your clinical experience: most academic doctors do research alongside clinical work. Ther e are many advantages (interest, worldwide conferences, really understanding your subject, making a diff erence) but pay is not one of them. There are various training routes for aca demics detailed as follows \200\223 there is no one single way in; if at any stage you wan t to do research or a PhD there are always opportunities if you look and ask. Foundation years There are small numbers of 2yr academic Foundation Programs (b p5). These are often a normal F1 year with a 4mth academic attachment in F2 (eg academic rheumatology) ; a few have academic components scattered throughout F2 F1. ST years There are also academic ST positions called Academic Clinical Fellowships. Most of these are available for entry either at ST1 or ST3 level and are 2 \200\2233yr long, inclu ding clinical rotations alongside 25% of working time set aside for academia. The fi rst ye ar will be almost entirely clinical; the purpose of the second and third years is to give y ou the opportunity to design a PhD/MD research project, generate pre- liminary data and app ly for funding. Once you successfully get funding you enter the Training Fellowship. Training fellowship This is a 3yr research project designed by your- self with the aim of g etting a PhD (or alternatively a 1 \200\2232yr MD) with small amounts of protected clinical time to maintain your skills.