Applying for specialty training

Authors: Clinton Vaughn, Tabassum Khandker, Omar Barbouti, Ali Hassan, Yasmin Akram 

Publication date:  13 May 2011


Over the past 18 months BMJ Careers has been following a group of new doctors through their training. This week we hear about their experiences of applying for specialty training posts

Clinton Vaughn (foundation year 2, Princess Royal Hospital, Sussex)

Being shortlisted for interview was genuinely exciting. Euphoria quickly gave way to reality, however, as I realised that I did not have long to prepare a portfolio, practise questions, and ensure ward cover for the interviews. Thankfully I managed to take some annual leave so as to prepare.

After 10 days of preparation a point came when I accepted that whatever would happen would happen. I couldn’t do any more. There was no point staying up late finishing off my portfolio; it was never going to be complete. I was never going to know everything. I had ruminations of being asked difficult questions and making an idiot of myself, but in the end I had to sleep.

On the morning of the interview I managed a mere five spoonfuls of cereal. I had no appetite, rather a sinking OSCE [objective structured clinical examination] feeling where I feared I would be the first man in the world to develop hyperemesis gravidarum. Thoughts of looking silly and fake in a suit and knowing that I had to do a night shift straight afterwards were running through my mind.

Arriving at the selection centre I saw a lot of confident, good looking people with very thick portfolios. If anything I should have been scared, but thank God I wasn’t. It was time to at least enjoy the experience. I had got this far. If anything, I had a rush of competitiveness: I wanted a win.

The intense days of countless preparation really paid off. That is not to say that I enjoyed it—just getting through the shortlisting process demanded effort. It was frustrating and stressful trying to pass exams while working busy shifts in accident and emergency. Postgraduate courses were expensive and genuinely tough. It was uncomfortably humbling (but essential) to have people look at my application form and verbally rip it to shreds. Practising interview technique with people who were more experienced was embarrassing, and the criticisms were often bitter pills to swallow. Also let us not forget the dreaded audit.

It was worth it in the end. I got my first choice job and deanery. (I accepted before my second choice deanery rejected me—that interview did not go well.) The best part, however, was knowing that I tried my best. Even if I got no offers I would have gone back to the drawing board, but at least I could have said I went down fighting.

I just have to complete the foundation programme now. Anyone fancy giving me a directly observed procedure assessment form?

Tabassum Khandker (foundation year 2, East Surrey Hospital, Redhill)

Applying for specialty training requires “internal reflection,” unveils a myriad issues, and can be a traumatic process. Factors to consider are: What specialties do I want to apply for? How many should I apply for? To which deanery should I apply? How do I produce a portfolio reflective of my interests if I am applying for several specialties? If I receive more than one offer, how do I choose? If I receive no offers, what do I do next?

Unfortunately I can’t provide answers to these questions, but I can share my experiences and what I consequently learnt. Each specialty has a different process, and thus each person’s experience is unique.

I applied to the London Deanery for paediatrics and general practice, with a preference for paediatrics, as I had greatly enjoyed my foundation rotations.

Most specialties have a window period for the application form, with dates varying according to the specialty. Unlike the paediatric applications, the GP application did not have free text questions, but both applications required information on, for example, audits, research, and qualifications. Despite last minute panic as a result of the GP website having problems in the final 24 hours (resulting in several hours of lost sleep), I successfully submitted both applications, and within a few days I had heard that I had been longlisted.

I passed the GP examination successfully and was given interview dates by both specialties, which had different formats, requiring different methods of preparation. At this point the process that so far had been (mostly) very smooth became rocky; a few days before my paediatric interview I became acutely unwell and consequently missed it. With that I missed the opportunity for a job offer in round 1, as it was not possible to rearrange the interview. Luckily I was able to attend my GP interview and was given an offer, which I accepted.

With respect to what I learnt from the process I realised that unless you are 100% committed to one specialty you should consider applying for a few, as there are no guarantees and you never know what life will throw at you. If you don’t achieve your first choice, or any post, there are options: applying for round 2 vacancies, taking a locum or non-training post, or working abroad and reapplying in a year.

Applying for specialty training is not painless, but that is true of most things in life worth doing—most people I know came through it with their sanity intact, and I hope those applying in future will too.

Omar Barbouti (foundation year 2, Croydon University Hospital, London)

Throughout my training I had always been attracted to the more traditional clinical fields, and consequently I decided to apply both for core medical training and surgery in London.

Thankfully at the time of applications I was a senior house officer in pathology, and not having on calls and weekends meant I had time to work on the application form. I also found myself booking onto as many skills courses as possible to try to bolster my CV as I recalled seniors during induction giving advice that our portfolios would weigh heavily in the selection process.

My applications were successfully submitted, and then the waiting game began. Christmas came and went. I found myself eagerly checking the recruitment portal every day. Then I got my first response: an interview for core surgical training. The day before the interview was very tense.

Many of my friends had attended interview practice courses and bought books with model interview answers. I chose not to. My feeling was that I would just be myself; surely they were looking for passionate individuals, not people who could memorise answers from a book.

I thought about buying a new suit but decided against it. With butterflies in my stomach I reached the interview venue. I walked into the first station with confidence and came out feeling good; the next few stations involved being grilled on my portfolio and why it lacked surgical experience—I told them I hadn’t had a surgical job in foundation year 2. I came out with a sinking heart. I knew I hadn’t got the place.

I was also shortlisted for the core medical training interview. This took place at a hotel, which seemed a little strange. The clinical station went well generally apart from my gently arguing with the panel that I would under no circumstances discharge a patient with a suspected pulmonary embolism even though they told me that this can be treated in the community. The portfolio station went smoothly. Then came the final station, which was going well until the middle of the question, when I suddenly heard a phone ring. The interviewers looked at each other, then towards me. I thought to myself, no, it can’t be; I had put my phone on silent and left it in my bag, surely, or had I? I reached into my pocket and realised it was my phone. They laughed; I was trying to switch it off, but in the heat of the moment my fingers didn’t seem to be working properly—I managed to switch it to silent but couldn’t switch it off. It felt like it had all gone wrong at this stage.

The common route may not have gone as planned for me, but the experience opened my eyes to a whole world of possibilities. I have been offered a job as a clinical tutor abroad and am also considering doing an MD. I just have to choose now.

Ali Hassan (foundation year 2, William Harvey Hospital, East Kent)

Applying for specialty training has been intense and demanding at every stage. Being wholly set on ophthalmology, I had a clear aim that I had been working towards for some time. I knew what to apply for, but contemplating a back-up plan was stressful, as nothing else appealed to me. The process began with preparing my portfolio, which I did well in advance.

Ophthalmology applications were coordinated separately by each deanery. All deaneries except London used the Intrepid online system and used the same application form. London Deanery had its own site and a slightly longer application form. I submitted an application to most deaneries.

In my opinion, application questions were robust and were clearly designed to allow for the necessary stringent shortlisting process. None of the questions were surprising, and each assessed the candidate against the published person specification. The deadline for submission allowed just over two weeks to complete and submit the application from.

Completing my application involved several rounds of editing, re-editing, and starting over, peppered with much anxiety as the deadline loomed ever closer. Having a completed portfolio served me well in answering the questions. It took a week to produce a first draft, which I promptly sent to a consultant for review. Getting a senior doctor’s perspective proved to be greatly useful. The form was finally complete one day before the submission deadline. Clicking “submit” was like finishing an exam; now the waiting game had begun.

Over the coming weeks I watched as my application status changed to “shortlist unsuccessful” four times. Each time was a blow but not entirely unexpected, considering the competition ratios; this, however, didn’t stop my stress levels increasing exponentially. Finally my disappointments were punctuated with a spark of hope when I was put on the shortlist reserve list at one deanery and then finally shortlisted at another.

My elation was short lived as the reality of the looming interview quickly set in. The next week flew by in a whirlwind of worry as I frantically tried to prepare. The interview itself was a gruelling three hour affair that involved a one hour written section under exam conditions followed by four stations in which the written answers were scrutinised by a panel. One week later I was informed by telephone that I was successful and had been offered a post. I cannot describe the relief I felt.

Overall it was a fair and exacting process, but I would not want to go through it again.

Yasmin Akram (foundation year 2, City Hospital, Birmingham)

It wasn’t exhilaration, or satisfaction, or even pride but rather a sense of overwhelming relief that I felt on receiving my offer from public health, my specialty of choice. I had had a lot of thinking to do before applications. I was swaying towards public health, but was I really ready to leave hospital medicine? And what happened to that distant dream of being a world renowned paediatrician? If I had a dollar for every time a big fat question mark appeared above somebody’s head when I told them that I was considering public health, I would now be the proud owner of a small island. Ultimately, though, you have to follow your heart, and I think public health is a great specialty. In the end I applied for public health and paediatrics, giving myself a few more months to make up my mind, deciding after receiving the offers.

I didn’t let competition ratios put me off; I believed that what was important was showing passion. My punchline of “and to be able to do that every day would be just amazing,” while ensuring that my eyes flashed as wide as possible, seemed to go down a treat. Although that’s not all I needed, it was vital I did my homework. I swapped weekend shifts (which I am painfully paying back now) and took some annual leave before the interviews. Looking at key topics really paid off in my paediatrics interview, and for both specialties it was helpful to be familiar with the royal college and faculty websites.

It was an exhausting and stressful experience. I broke my three year resolution never to touch Red Bull again and gained a few kilograms from too much comfort food, and by the end of it all friends and family were keeping a safe distance to stop me either spewing guidelines at them or gibbering rubbish in fits of stress induced rage. Ultimately, however, it was worth it. Now I just have to make sure that I fill out the acceptance paperwork and get my references in on time.

I was lucky the system worked for me, but I know some amazing doctors to whom I would trust my life who couldn’t show their best on the day and so weren’t as successful. It can be frustrating when interviewers don’t ask the right questions for you to be able to sell yourself or don’t pay much attention to the CV you so meticulously prepared. My advice to other applicants is to be aware of this, to consider back-up specialty choices, and to be prepared for the possibility of having to apply in round 2 or the following year. Good luck.

Competing interests: None declared.

The doctors’ earlier accounts can be seen on the BMJ Careers website at [Link] and [Link] .

Clinton Vaughn foundation year 2, Princess Royal Hospital, Sussex, UK
Tabassum Khandker foundation year 2, East Surrey Hospital, Redhill, UK
Omar Barbouti foundation year 2, Croydon University Hospital, London, UK
Ali Hassan foundation year 2, William Harvey Hospital, East Kent, UK
Yasmin Akram foundation year 2, City Hospital, Birmingham, UK

Correspondence to: C Vaughn  clinton_vaughn@yahoo.co.uk

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