The 2023 specialty recruitment webinar was held on Tuesday 11 October 2022.
This webinar provided updates and information on the 2023 specialty training recruitment round. A recording of the webinar is available below.
Video: 2023 Specialty recruitment webinar - 11 October 2022
Good evening everybody. Welcome to this specialty recruitment webinar.
My name is Jonathan Howes, and I'll be chairing this evening's webinar. So today we're going to have a presentation on the
2023 recruitment process. We have two of our national recruitment managers here to give you an overview
of the process and then answer any questions that you may have. We have received a few advanced questions, but please feel free
to add further questions to the live Q&A as we go through.
Tonight for obvious reasons, we're not able to sort of answer individual questions on an open webinar, but we will ensure we answer every
question, and every question will be published on our website as we did last year, over the next few days.
So if we do run out of time, I think we've got about an hour for today's webinar. If we do run out of time, don't worry.
We will capture those questions and answer them all before applications open.
Okay. Without further ado, I'll hand you across to Clare Wright, the National Recruitment Manager, who will take you through the application process.
Over to you, Claire. Thanks, Jon. Evening everybody. So, over the next couple of 15, 20 minutes, I'm just going to take
you through the process for 2023 recruitment and hopefully answer some of the questions that you might have.
So the general principles for this year's recruitment process is that you should all be aware of the selection process in place before you apply.
Where application numbers exceed interview capacity, shortlisting processes may be adopted by specialties.
Due to an increase in numbers over the last few years, we're no longer able to interview all eligible applicants as we were previously.
If self-assessment is used by the specialty you're applying for and the score achieved contributes to part of the final selection score,
your evidence must be verified. So there'll be a separate process for that. It won't be undertaken during the interview itself, but you'll
be given instructions on how to partake in that process. There won't be any face to face in person interviews for the duration
of the 2023 selection process, and all interviews will be undertaken digitally either using a single panel interview or where possible multiple
mini interviews, but still online. So the main changes for this year's recruitment process, we have removed
interated degrees from person specifications and scoring criteria. And the reason for that is around widening access and participation.
So we're aware that some universities offer Intercalated degrees, some don't. We have a lot of overseas applicants where intercalated degrees, not
part of their medical degree. And so therefore we felt in the interest of fairness, we shouldn't be giving points for having an intercalated degree.
That said, the learning that you get as part of doing the intercalation will still count.
So such as research skills, publications, presentations, anything that comes from that period of intercalation will still count elsewhere in the scoring criteria.
So it hasn't been a wasted time if you have undertaken that. We've also decided to remove named courses from scoring criteria.
So we took the step last year to take them out of person specifications. They're now out of scoring criteria as well.
So you will no longer be scored against specific courses. There may be generic requirements in there for you to of undertaken.
For example, if you're applying for emergency medicine, courses related to emergency medicine, but they won't be spec specific, so you won't have to spend
huge amounts of money undertaking courses to get points on a scoring criteria.
We've removed the need to prove aptitude for practical skills. For example, manual dexterity from the person specs.
And the reason for that is that as we're not doing face to face skill stations at the moment, there is no way of proving that through the selection process.
So therefore we've removed it from the person's specifications. Core surgical training is going to use the multi-specialty recruitment
assessment for the first time this year as part of their selection process. And that will be used for shortlisting and for 10% of the overall selection score.
That has to go to our programme board for final sign off on Thursday of this week. It's been through all the other governance routes so far and has had approval
for that to happen for this year. And the final thing we've changed this year is around the attainment date for membership exams.
So one of the things that we noticed from person specifications is that different specialties asked for membership exams at different times.
And it was particularly confusing where specialties had multiple entry routes from different specialties, each requiring a different time for
the exam to have been completed. So for this year, we've said that all membership exams have to have been
completed and passed by the offer deadline for the recruitment round that that specialty is advertising in.
So for specialties that advertise in round one, you'll need to have completed the full membership exam required by the 30th of March 2023.
For specialties advertising in round two, the dates the 20th of April 2023. For specialties advertising in round three, which is our autumn round for
February start dates, you'll need to pass the exam by the 23rd of October 2023.
So each specialty has a lead recruiter and they're responsible for recruitment to the specialty.
The lead recruiter is always an HEE local office, who recruits to all posts in each of the participating nations.
The applications will be made through the lead recruiter advertisement, regardless of which region you wish to work in, and they'll be able to answer specifics
about the specialty selection process. It's really important that you familiarise yourself with who the lead recruiter
is for the specialty that you want to apply for and you can get that information from the Oriel website.
And so we open for 2023 recruitment with round one on the 2nd of November, and
this is specialties generally at CT1 and ST1 level, but there are some run through specialties that will recruit at ST3 or even ST4 within that round.
So the advertisement will appear on the 2nd of November. The applications will open the following day from 10:00 AM and they will close
at 4:00 PM on the 1st of December 2022. It's really important that you allow enough time to complete your
application, because it's always busy in the last few days, and I think every year we have 60% of applicants trying to submit in the last 48 hours.
So despite all the performance testing that we put the system through, it will slow down if there are 10,000 people trying to submit their
application form at the same time. So make sure you allow plenty of time. Interviews for round one specialties will be held between the 3rd of January
and the 17th of March, and initial offers are expected to be released by no later than the 30th of March 2023, but some specialties may release earlier if
they've completed their selection by then. So, round two, which is ST3, ST4 specialties, they will advertise on
the 16th of November, and applications will open on the 17th of November, closing on the 8th of December.
The interview window for round two is from the 3rd of January to the 14th of April, and initial offers will be released by no later than the 20th of April.
As with round one, it could be earlier, if specialties are ready before then. So in terms of planning and making your application, it's really
important that you decide which specialties you wish to apply for. We have competition ratios on our website for previous recruitment rounds, which
give you an idea of what the competition has been in specialties previously. It doesn't give you an idea of what's going to happen this year, but it
will give you a historical idea. The website I've put there is our new website, but it doesn't actually go live until next week.
So, in the meantime, if you use the old specialty training website, you'll find all the competition ratios on there.
You can apply to as many specialties as you like subject to eligibility, but you must review the person specs before you apply it to ensure that you are eligible.
It's really important that you read all supporting information before commencing your application, including application guidance.
Now, there's generic application guidance that covers all specialties, but specialties will also release their own specialty specific in
relation to that particular process. So it's really important that you find both of those bits of guidance and read
them all, and all applications will be made through the Oriel recruitment portal
and the address for Oriel is on screen. When doing your application, it's really important that you pay attention
to demonstrating the requirements of the person specification as that's ultimately what you'll be assessed at.
As I've already said, ensure you allow plenty of time to complete the application, familiarise yourself with the deadline.
If you are applying for a specialty that requires you to undertake self-assessment as part of the application form, ensure that you
choose the appropriate option for you. Each option in self assessment generates a score and later in the process you'll be asked to provide
documentary evidence to justify the score that you've given yourself. So it's important that you score something that you can actually
go on to justify later on. Ensure you submit everything that needs to be submitted at the time application.
And again, I'll advise that you have a look to see what's needed before you start your application.
Particularly if you are applying through a route that will require to have a certificate of entry to readiness for entry, especially train So crest form,
because your application, if you need one of those, won't let you submit without it. Double check your application before submission.
Mistakes cannot be corrected later. There is no mechanism to go back into your application form, either from yourself or from the recruitment office at a later date.
So double check it before you press a submit button. And finally, make sure that you access your Oriel account regularly
throughout the selection process. There are lots of time based activities as part of recruitment, so offers
have a time associated with them. When you're advised to submit things for self assessment, all
that kind of stuff, you'll have a deadline by which you need to do it. So it's really important that you access your Oriel account regularly, although
emails will also be sent to you because they go in external to the system. There's no guarantee that they can be delivered because of firewalls.
So the most accurate way to ensure that you're getting all of the information sent to you is to go into your Oriel account.
So the multi-specialty recruitment assessment is used for I think 10 or
12 specialties at CT1 and ST1 level. So it's a computer based test. It consists of two components, professional dilemmas and
clinical problem solving. Applicants who are applying to specialties that use the MSRA will be
sent details on how to book a sitting of the MSRA, after the application window has closed and after long listing for that specialty has taken place.
So if you have applied to a specialty that sits the NSRA, don't worry, you don't need to do anything at this point in time.
You will be contacted by the recruitment office around about mid-December. So don't worry about if you haven't heard anything before then.
If you're applying to general practice or core psychiatry, your appointment
will be solely on the basis of the NSRA. There is no interview process. That's completely nsso, nothing else, but other specialties
use the NSRA to contribute to a percentage of their final selection. So the test is flexible and it allows specialties to use it in different
ways, and each specialty that uses it does use it in a different way. Different percentages counter towards their final selection
score, that kind of thing. You only need to sit the MSRA once. So even if you're applying to multiple specialties that use it as part of your
selection process, you don't need to sit it multiple times, just one sitting will cover you for all those specialties.
It's been shown to be a reliable and valid way of assessing a large number of candidates in a standardised way with limited
clinical and administrative resource. And that's why a number of specialties have chosen to use it as part of their process.
This slide here shows the specialties that will be using the NSRA in 2023.
You can see I've added core surgical training on there, who plan to use it for the first time this year, subject to final approval on Thursday of this week.
Self assessment verification. So this is a process that's been in use for probably the last couple of years.
So it was brought in around the pandemic times, because we couldn't
do portfolio assessment because we weren't seeing candidates face to face. So self-assessment allows for you to score yourself in your
application form, but then present evidence to show what you've done. So a bit like the old portfolio station but done virtually.
As I said already, evidence to support the scores that you give yourself and your application form will need to be verified. And if you're applying to a specialty that uses self assessment, you'll be sent log
in details for the self assessment portal. This is the area where you'll be asked to upload all of your documents,
at that particular moment in time. The deadline for submission will be set. So it's important and really essential that you engage with the process
because once the deadline is passed, you won't have the opportunity to upload anything to support your score.
Each specialty will determine tags for evidence. So when you do the self-assessment, you'll realise that it's split into
different domains and they will ask you to upload your evidence against a particular domain or tag.
Some specialties might even give you a maximum number of pieces of evidence that you can upload. But as I say, you need to look at guidance to understand exactly
what the requirements are. When you upload your evidence attached to a particular tag, after deadline has
passed, assesses will be given access to review and score your evidence.
Your scores could be increased, they could be decreased, or they could remain the same. And you'll be informed of your verified score by the recruitment office,
and you'll have the opportunity to appeal that if you feel that you've been incorrectly scored. There will be certain parameters that you need to fit within, and the recruitment
team will make you aware of those. You cannot upload additional evidence for the appeals process.
So the evidence that you submit initially will be the evidence that will also be used in appeals.
So, training offers. So if you are successful through recruitment and ultimately get an offer
of a training post, this offer will be made through Oriel based on your rank
and stated geographical preferences. Offers received in any other way are not valid, so you must
check Oriel for your offer. You won't be offered a post if you haven't ranked for anything in your
preferences or even if you leave some geographical preferences out. You'll never receive an offer for something that you haven't
ranked, even if it means that you are bypassed and somebody lower than you gets an offer instead.
You'll be given 48 hours to respond to your offer and you'll be able to accept or decline it and up until the whole deadline, you'll have
the opportunity to hold as well. The 48 hours is exclusive of weekends, but will be inclusive of bank holidays.
If you choose to hold an offer, you can only hold one at any one time. So if you hold one offer, you then receive an offer for another specialty,
and you try to hold that as well. Your initial offer that you held will be declined. So it's important so that you can only do one at a time.
Once you accept a post, you'll receive no further offers from any specialty within the recruitment round, and you'll be automatically withdrawn from
all of the specialty applications. If you decline a post, it means that you won't receive any further offer from that
specialty, even if one of your preferred posts become available at a later date. But you may continue to receive offers from other specialties.
The important message there is that if you don't want a particular geographical location, don't put it in your preferences.
So you never have to decline a post that you don't want. You can also upgrade your offers.
So if you get offered something that isn't your first choice within a particular specialty, you can opt in to be upgraded into one of your preferred options should
they become available at a later date. So I've given you a slide here, which gives you an idea of application numbers.
So we've had quite a big increase in application numbers in the last few years. You'll see that between August 2020 applications and August 2022,
we had almost, well, 10 and a half thousand more applications. But the posts available has also increased slightly as well.
So we are expecting another increase this year, if the trend continues.
So it's important to note that and know that the competition is high. So think about that when making your application choices.
This slide shows how applicants behave in terms of number applications submitted in 2022.
So the big blue blocks that you can see are the applicants that only submitted one application within that recruitment round.
So for round one for CT1, ST1 specialty, that's 65% ish of applicants
only submitting one application and 70 odd percent for round two. So your ST3, ST4 applications.
What's important to know is that most applicants don't submit many more than two applications. So you can see on both that we are up to sort of almost 90% on
round two and 85% on round one. So applicants do tend to limit their choices, but it is just worth
remembering what the competition is, so I can't really stress that enough. And then finally, I've just put a further information slide on there.
So the specialty recruitment website, I've given you the new link because that is the one where all the 2023 information will be.
The new website goes live on the 18th of October, but in the meantime, all of the 2023 person specifications are still on the old website,
so the specialty training one. Specialty specific websites will also exist and they will give
you information specifically about the individual processes. And it's also worth looking at royal college websites because they often
have information on recruitment as well. Thank you very much. Thank you, Claire. I think that's the end of the presentation.
So we will go to some questions that are in the chat. The first question I have is when will the self assessment for core
surgery training be released? Claire, I think there's some further webinars on core surgery, is that correct?
Yes. There's two webinars planned for core surgery recruitment, one on the 31st of October, which is around the use of the MSRA and one on the 2nd of November, which
is around the portfolio verification. So there will be more information available then.
Okay, thank you. Vacancies for ST3 O and G last year continued to increase up
until July, with some doctors unable to join due to visa issues.
What are the solutions this year? So each year we do ask specialties to put as many of their vacancies they
know, obviously, to ensure they're all there before offers are made. But every year we do get late vacancies.
Not as many as we had last year. I think last year was slightly different due to covid extensions and a few other reasons.
But there's always a few that are after initial offers.
And what we try and do is fill as many vacancies as possible and offer as many applicants. So we try and get as many across as we can at the start.
But there was always a few. Last year we're hoping was an anomaly where the vast majority posts should already be there.
Visas, somewhat out of our control. We work very closely with the home office, because each nation issues visas
on behalf of all appointable applicants. And we are working with them to make sure they hit their service level
agreements on responding to visas. Again, last year was difficult with the Ukrainian family visas also taking priority.
It did mean some visas were delayed, but we're hoping for better in 2023.
Moving down, when will the assessment for the TNO ST3 specialty be released?
I'm assuming we don't have a date on the webinar, but that can be one question we answer on the website afterwards.
If I think I understand the question right, it's asking about when their
self assessment will be released. So it's going through final approval at the moment. It's normal to release it around the time that the adverts go live, so you
should expect to see it in the next probably two or three weeks time. Thanks Claire.
Another one linked to self assessment and MSRA. Will we upload our self assessment before or after the MSRA, if it goes ahead.
So I think it depends on the specialty. So I think for, so if I'm assuming it means core surgery.
So for core surgery it'll be used as a shortlisting tool. So people that get through the MSRA will then be contacted to
upload stuff for self-assessment. So you won't be having to upload things unnecessarily. You'll know that you are part of the ongoing recruitment process.
So you're not doing it if it's not needed. So that's for surgery. Others might be slightly different, but that'll be outlined in their guidance.
Yeah. Okay. I'm an international medical graduate and I have a crest form for 2021.
Will that be valid for this year? Alana, do you want to answer this one?
Yep. Can do. Yes. It will be valid for this year. Okay. That was an easy answer.
Thank you. Interesting question here. I'm applying for an academic clinical fellow in TNO.
Will I need to still sit the MSRA? Claire or Alana, do you know that one?
It depends on what level you are applying for. I'm assuming from the question that you're probably applying for a TNO ST1 ACF.
In which case the relevant benchmarking specialty would be core surgery
because TNO doesn't point on its own. And so therefore, yes, you will have to sit the MSRA as it will be part of the
overall core surgical selection process. Okay. Thank you. We've got a few questions on self assessment.
I think we've already answered. When will the MSRA be sat?
Do you give the dates for the MSRA? No. So it's in January, I think off the top of my head it's probably the
second and third week of January. Alana, did you have something further on that one?
No. Okay. If you get an offer, can you hold it for the following year?
Claire. So you can only defer your entry for statutory reasons.
So if you are on maternity leave, paternity parental leave, sick leave,
that kind of thing, you can't just defer it for the following year. You will need to reapply again, unfortunately.
Okay. Thank you. With the increased number of applications
and increased medical student places, are there plans to increase the number of posts?
So I can answer that one broadly. We are expanding training posts for this year.
So I think this is going to be an extra thousand posts in specialty training this year, with further expansions in 2024.
So we are looking to expand and that workforce planning is underway even for 2025, onwards.
Yes we are looking to expand. I still think specialty training will be competitive as it always has
been, but we are cognizant of needing to increase training posts because obviously England is under doctored.
Well, the four nations are under doctored. So we are looking to increase a number of posts. Claire.
Sorry, I just wanted to come back in on something earlier. So we mentioned about the webinars for core surgery being the 31st of
October and the 2nd of November. Sorry, I wasn't clear. So the 31st of October and the 2nd of November will give you more and in depth
detail, but the likelihood is that, well, in fact definitely, information relating to how the surgical selection score will be made up, will be released
before then because applications open at the beginning November. So you'll need to be aware of that before then.
So although there will be more detail from 31st October, once the decision is made finally on Thursday that the NSRA will be used, there will be more information
available to you pretty soon after that. So, I'm sorry if that wasn't clear earlier.
Is that purely for core surgery, Claire? So how it'll be used in core surgery will be published after the decisions
finally ratified on Thursday? Yes. Okay. Thank you.
Is there a plastic surgery webinar and if so, when is it happening?
There's not one purely for plastic surgery. Okay, thank you. If we complete MRCS part A in January and have part B in May, will we still
be able to apply for ST3, Claire?
No, unfortunately not, because you would have to have the full MRCS by the April date that I outlined in the presentation, I think 20th of April.
If you sit the MRCS in May, you won't get the result until June. So that's too late, I'm afraid.
Thank you for that clarity. What happens to the over 20,000 applicants who may not get an offer?
So Claire, can you just confirm, was it applications or applicants? Was that 20,000 Claire?
It was applications. So, that wasn't unique applicants. So, as I said, 65% of CT1s and about 70% of ST3, ST4 applicants
only apply to one specialty. But with the crossover with other specialties, obviously you can only ever accept one.
So the actual number of applicants is less than the number of applications. Okay. I'm just making sure I'm not missing any questions out.
Can I have a crest from outside the NHS, or is it better to
get it from within the NHS? Claire. So you can get a crest from anywhere in the world.
If you have it signed by somebody not in the NHS and who isn't currently
registered with the GMC, then you will need to provide evidence of their
standing with a statutory regulatory body. So it could be from anywhere in the world, but you would have to show the equivalent
of whatever the GMC is in that country and that'd be your responsibility to get that evidence, to provide with the crest.
As long as you meet the requirements for three months whole time equivalent in the three and a half years prior to the start date of the post.
Any post anywhere in the world can be used for a crest. Okay. We have a question around, again, MSRA and core surgery and it being
only sort of three months notice. People have been studying for a long time in the MSRA for none core surgery
post, could they have an advantage where candidates who've been building that portfolio for CST for a number of years could be at a disadvantage due
to the little notice for the MSRA exam? How would you answer that one, Claire? Alana?
So I think it's important to remember that you mentioned there that people have sat the MSRA for other specialties, previously.
So I think last year, 35% of applicants to core surgery also sat the MSRA for other specialties.
Everyone who's applied will also have been working on their portfolio because at all points everybody's trying to apply for CST will have been expecting to
have to do self assessment verification. So everyone's in that boat. What I would say about the NSRA is that the expectation is that you
shouldn't have to revise for it. It's a situational judgment test, which you shouldn't need to revise
for at all and the clinical problem solving part is F2 doctor level.
So the level you're at now, it's generic, it's not specialty specific,
so it shouldn't be anything that you shouldn't be able to do. It's general competencies really, so you shouldn't be needing
to revise for months for it. So I appreciate, it's probably quite worrying with three months to go, but
we took this decision based on the fact that the application numbers mean that
less people can ultimately be interviewed and that this is the farst way to make sure that people can progress through the recruitment process because we don't feel
that the previous process was that people would do a self-assessment score and then there would be shortlisted out on an unverified score and only a certain number
would be invited to upload documents. This gives a verified way of getting down to that number that then gets verified,
which obviously previously we didn't have. So we actually think this is the fairer process for applicants to core surgery.
Thanks, Claire. So we listened to feedback in regards to the self-assessment last year, but also
in speaking to our surgical colleagues at the college and the recruitment committee
it's around, in creating the capacity to interview as many people as we can and we're hoping to have interview slots for over 1200 I think applicants for core
surgery, that would not be the case if we had to go back to verified self-assessment scores, where that clinical time would also be needed to verify those.
So we are trying to maximise getting as many interviews as possible, but understand, it is a change relatively short notice and still
subject for final ratification at the programme board on Thursday. Someones asking around the evidence for the MSRA, I believe there is
information already on the website, but I think we can commit to putting further information on the website, especially around the surgical
evidence that you've just highlighted. Claire. Yeah, as you mentioned, we've already put a statement on the website
about the governance route for, and the benefits of using the MSRA. What we do have is we have some data around the people that sat
the MSRA, I think the last three years, certainly I think 2022,
2021, and it might be 2020 and 2019. So people who applied the core surgery, who also sat the MSRA for different
specialty and the correlation between their performance in the MSRA and their performance at selection.
So we have some data around that. We are going to publish that in the coming weeks to show
you how the decision was made. Okay. And someone's just asking for clarity on what we're saying, it will definitely
be used or is it still to be confirmed? So the proposal from the core surgery training committee is to use the MSRA for 2023.
There is a final ratification from the four nations on this Thursday
and after that date, we will hundred percent confirm whether that is now happening, the MSRA in core surgery.
But, the likelihood is it will be. Will you refund fees out the MSRA question banks, if you reverse
the decision to use CST, Claire? So one thing I will say is that nobody should be paying for MSRA question banks.
There are no paid question banks that are written by people who write MSRA questions.
We are aware that there are lots of people that sell MSRA question banks, but they have nothing to do with writing the actual questions.
So please do not pay for any of those questions. When you're invited to attend for the MSRA exam, you'll be given a
link that you can look in advance on. It's actually on the GP NRO website. There are some sample questions on there and some ideas of
how the questions are written. That's the stuff that you should be looking at and that's free of charge. So we would not advocate you paying for any sample questions.
There's another question on MSRA being validated. I think you've picked that answer up and we'll publish
that information on the website. A question around offers.
If you hold or accept an offer in one specialty, will you not be able to receive offers from other specialties?
Claire. So if you hold an offer, you'll continue to receive offers from other specialties.
It's only if you accept an offer, then you will not receive any other offers in that recruitment round at all.
But if you hold or if you decline, you will carry on receiving office from other specialties. Thank you.
Will there be any run through pediatric surgery post this year? Claire is it too early for that information?
So indicative numbers on the number of training post per specialties will be published when applications go live.
As we mentioned earlier, they are somewhat subject to change as we try and increase the number that are available.
And it all depends on trainees completing, et cetera. So there's always a slight moving number, but those will be confirmed
obviously before offers are made. But we try and give you both competition ratios for the last few years because generally they tend to be similar and those that we're
predicting to be vacant for the 2023. Is there a webinar for emergency medicine?
Don't think there's a specific one for emergency medicine. What specialties are you using the mini interview format for this year?
And is that for CT1 or ST3, ST4? So we know that anesthetic CT1 will be using the multi mini interviews and we've
had a few other medicine specialties for ST3 that have said they will be using the
multi interview format, but we are still awaiting answers off other specialties.
Okay. Thank you Alana. I've just had another question, whether all interviews will be face
to face this year, and I think that everything's face to face or are there any exceptions this year? There will be nothing in person.
Nothing at all. Okay. We have an applicant who's eligible for both core surgery and ST3.
Is there an issue if they apply for both? No. If you meet the person specification for both and you're
eligible, you can apply for both. It won't affect you at all.
Okay. I've completed core medical training too, but then went to do a PhD and
have got all the competencies for ST4, will I be eligible to apply for an ST4? Will it be an IM3?
So I think that what I'd advise you to do is to look at the person specifications. I have a feeling that if you have done core medicine previously, you have to
do top up IMY3 to get the competencies. But as I say, I would advise that you look at the person spec for the
specialty that you're looking to apply for and the guidance from the lead recruiter because that would be the best place for you to find that answer.
Okay. If someone is subject to a fitness to practice investigation, may he or she continue to apply for specialty training?
As part of the application process you can make a declaration on fitness to practice and submit evidence where appropriate, and that will be
picked up by the recruitment teams. But you can carry on with your application.
There's nothing stopping you from applying. Again, with core surgery, what percentage does it count for the overall application?
Claire, was that 10%? Yeah, 10%. Okay.
Thank you. Can we improve the MSRA scores in subsequent years or is it just a one time exam?
You need to sit it once per year, but if you apply this year, you don't
get a post and you apply again next year, you'll need to sit it again. If you're applying for general practice, there is an option to transfer your
score over from one year to the next. But for all other specialties, you'd need to resit it the following year. And I think if the specialty you're applying for advertises twice within
the same year, which some do, I think you can choose to reset the MSRA if you want to, or carry your score over.
Someone's asking as it's meant to be F2 expected knowledge, is there a syllabus? I think they've heard that previous exams have been very pediatric dominated.
Perhaps most F2s would not know that. So you mentioned there were test questions and test examples
there, that are available? Claire. So there are some sample questions available on the GP NRO website.
We have question writers from each of the specialties that participate within the MSRA.
So I gave all the specialties earlier, but I think you'll find them maybe the
odd pediatric question in there, but there's certainly won't be dominated by pediatric questions because none of the specialties that use MSRA are pediatric.
Okay. Will there be any new IST post this year, run through programmes for surgery?
Claire you're shaking your head. Is that a no? Yeah, so the pilot's been put on hold for an now I understand.
So there were none this year and there won't be any for 2023. The evaluation of the pilot has to happen before that can
be taken forward any further. Okay. Is there going to be a specific webinar for internal medicine training?
So, I think the only specialty that's planning webinars as far as I'm aware are core surgery, and I think that's because obviously there's quite a significant
change to the process this year. For all of the specialties, the process is going to be very similar to what it
has been in the last couple of years. So I would advise that if there isn't a webinar as such, that you have a
look at the guidance documents that are released by the specialty, that will be specific to that process.
And if you have any questions, there will be contact details on there of where you can go to, to get further information.
And if in doubt, you can always come into the MDRS team and we can forward your questions on, to get responses for you.
Okay. Question around holding an offer. How long can you hold an offer? What's the timeframe?
So each recruitment round has a whole deadline within the round.
So I'm just going to get the dates in front of me here. So if you are applying in round, I haven't got the date in front of me.
It's normally, I think around, Aprilish time, mid to late April for round one.
Okay, so 4th of April for round one, and I think it's the beginning of May for
round two, but if you do hold an offer, then you need to make sure that you go back into Oriel and make a firm decision on it before that whole deadline passes.
So it's the 4th of April for round one and 25th of April for round two at 1:00 PM on both days.
But if you don't go back in, you just leave your offer as held, once that deadline passes, the Oriel system will automatically assume that you don't
want that offer and it will decline you. So if you do hold an offer, you can hold it for quite an amount of time.
You can change it. So you can choose to decline one and hold another one as it comes along.
But after the whole deadline, or at the whole deadline, you need to have made sure that you've made a firm decision on that offer.
So if you want it, you go back in and you click accept. Otherwise you will lose that offer.
Thanks Claire. Will MRCSA be removed from shortlisting matrix for core surgical training?
Is that one of the courses you mentioned earlier, Claire, for exams? So, we haven't had the final scoring framework through for core surgery yet
for review, but I think the understanding of the MDRS recruitment group is that for CT1, ST1 specialties, we shouldn't really be scoring against membership exams
because a lot of people in the foundation will not have the opportunity to sit those at that time or get study leave for it.
So I don't think it'll be in there, but as I haven't seen the final draft yet, so I can't confirm that.
Okay. Thanks. Will ACCS have the same interview for all or will it depend on the theme you
choose such as the emergency medicine, anesthetics, or acute medicine? It would depend on stream.
So, you either apply for ACCS emergency medicine and you sit that interview or
if you want ACCS anesthetic, you have to apply to the core anesthetics route and it'll be the same interview, which you can be considered for both core
anesthetics and ACCS anesthetics. And the same for ACCS internal medicine, if you apply through the IMT application.
And then you'll be able to preference either core IMT or ACCS internal
medicine posts as part of that process. And linked to that, so ACCS, I think it's AM, is that the same application as IMT and is it
included in the IMT competition ratios? Claire's nodding. So, it is.
If an international medical graduate is switching training programmes do they
need a crest or is it a letter from the TPD or postgraduate dean, if they're
applying to a different specialty? So if you are applying for a different specialty, if you're
applying for a different specialty at CT1 or ST1 that needs you to prove your foundation competencies.
If you're already in a training programme, at the point that you apply and you hold either a national training number or a Deanery reference number,
there is no need to do anything at that point in time it will be deemed that you have satisfied the requirements of foundation competencies previously and
therefore don't need to do it again. If you are applying for a higher level training post and it's a different
specialty, you can just reapply. You don't need anything, you just need to meet the eligibility
criteria of that specialty. If you are in a specialty and you are looking to apply for the same specialty
in a different region, there is a form that you need to complete, just to make your current training programme aware that's what you are doing.
So they can factor that potential vacancy into their vacancy numbers.
Okay. A further question around the number of vacancies available for each specialty. Is there a date we're hoping to publish the number of posts per region?
So there will be indicative numbers available at the time that vacancies go live. So, beginning of November, but as I say, they are indicative, so the
actual firm vacancy numbers won't be available until nearer the offer date. So normally it's around the middle of February that we manage to firm the
dates up for round one and probably middle of March for round two.
Sort of further priority question on sort of academic interviews,
especially in the surgical specialties. So if they have to sit the MSRA for clinical benchmarking, do
they have to score high enough for interview or just pass the MSRA? There'll be a threshold cut score that's required for core surgery and they'll
need to reach that threshold score. A couple of questions linked around; will there be more surgical components
to the MSRA this year as it's being used for core surgery training?
I think it's because the questions are relatively generic. There may already be some specific around surgery, but not more
than perhaps there already was. So neurosurgery has been using the MSRA for a number of years anyway, so there
will already be some questions in there that have been written by surgeons. One of the requirements of joining the MSRA is that the specialty provides
item writers for future years. Now obviously, there's not time for core surgery to participate in item
writing for this year because the questions go through a series of checks and tests before they're ever put into pilot mode or then ultimate test mode.
But they will be part of that writing process for future years. But there are already surgical questions in there because
neurosurgery have been using the MSRA for I think about six years. Thanks.
An MSRA question again, but this time clinical radiology, will there be directly offering the top, I think it was 55 applicants last year
or has that been removed for 2023? We don't know that level of detail at the moment. I think that would depend on cut scores, I'm assuming.
Core surgery training, is it a UK wide selection process or are there
separate processes for each nation? So it's a three nation process.
Northern Ireland do their own local recruitment and follow their own process. But the national process will be for England, Wales, and Scotland.
Okay. Do all offers for all specialties come out at the same time?
So there is a deadline date in each recruitment round by which
all specialties have to have made their first iteration of offers. But as I mentioned in the presentation, if specialties are ready to offer
before then, they can release them before and that's why it's really important that you have a look at the specialty specific guidance because
they'll give you a date of when they're planning on making their offers. So if they offer at different times and you'd rather wait for an offer from
a different specialty, you have the opportunity to hold the offer anyway until you hear from somewhere else.
Thanks. What percentage of portfolio and interviews will it be for core surgery?
So I think you said it was 10% for the overall score for the MSRA, do
we know the breakdown for the other parts of the interview process?
If my maths is correct, it's probably 90%, including the interview and
the portfolio station, but we don't know the split between them. Yeah. I have a feeling last year it was 60 40 self-assessment.
So self assessment was 40 and 60% interview. I can have a quick look and I should have the answer in about two minutes time.
Okay. Can always respond in chat. Thanks Claire. Is Northern Ireland using the MSRA for their core surgery training?
Northern Ireland aren't one of the nations who partake in the national core surgery recruitment.
So we wouldn't be able to say. The best thing to do would probably be to look on their
website and I can post a link. Thank you. Just looking at some more questions.
If you do an F3 or an F4, could you still apply for ST1 in cardiothoracics
and core surgery training? So, is there an upper limit of experience in core surgery
or ST1 cardiothoracic Claire. I would advise to have a look on the website at the persons specification.
I think there is an 18 month upper limit for experience, but if
you look on the website, all the persons specifications are on there and it will tell you on there. Okay. I am an out of sync foundation trainee due to finish in December.
Will that affect my application? Again, is that a similar question, Claire in regards to person spec?
It depends on the reasons why you are out of sync. If you're out of sync because of a statutory period of leave within your
foundation training, then you will be able to apply for, be appointed to and delay your entry to speciality training by the same amount of time.
So if, for example, you are out sync because you had six months maternity leave, then you would be able to delay your start date by six months.
If it's not for a period of statutory leave and sick leave, parental leave, anything like that, then unfortunately, if you're not able to start in August, then
you wouldn't be eligible for the posts. Okay, Thank you Claire. Someone's asking whether you said there were no interviews
for GP and psychiatry for 2023? Yep, that's correct. No interviews for GP and core psychiatry.
Okay. Thank you. Scoring system for core surgery training.
Have we already answered that one, Claire? I'm just looking now, I'm trying to find the actual percentages.
I can't find them, but we can answer it as one of the questions that we've published after the webinar.
Okay. Further question here, around less than full time, do you do that
before or after you accept a post? So you should put it on your application form that you wish to be considered and
you should also go through the mechanism of confirming your eligibility for less
than full time, with your current region. And then if you are appointed to a post, obviously you'll be appointed to
a full-time post and then you can apply to be a less than full-time trainee in that post at that point in time.
But you need to confirm your eligibility and put it in your application form when you apply.
Thank you. The number of posts that are available for individual medical specialties. So indicative posts I think will be available as applications are open,
which will be then firmed up as we go through the processing closer to offers. Obviously competition ratios and the number of posts over the last
few years are already available and will give you a good indication of what to expect in regards to the vacancies.
I now have the core surgery scoring, if you'd like me to give that. Yes, please do.
10% of the final selection score will be from MSRA. 30% will be from the self assessment verification, and the rest, so
60% will come from the interview. Yeah. Thank you.
Claire. Can you explain the 18 months experience for core surgery training
and do medical attachments count? So it's any post, anywhere in the world, training or service, but observer
posts, so clinical attachments don't count as part of that time but you need to make clear on your application form that it's an observer post
and that you didn't have hands on training or experience at that time.
Okay. Four minutes to go see if there's any final question.
What's the breakdown of the scoring system for radiology? Is that published or will soon be published, claire?
It'll be published. Yeah. So you just need to keep an eye out on the specialty website to find that information.
Okay. Does NHS experience help you in applying for applications if you're
an overseas medical graduate? I think we ask for commitment to the specialty, but don't necessarily
ask for NHS experience in any person spec . No, that's right. So you don't have to have NHS experience, but one of the things we will ask you
in your application form is if it's going to be your first post in the NHS, would you want additional support to help you settle into the NHS?
I think one of the things that we've found with some trainees is that it's a very different culture to the health systems that they're used to.
And so they need some time to settle in. So there's an option there that if you are coming to the NHS and it'll
be your first post that just make it clear on your application form that you would like some additional support if that's what you would want.
Someone's just asking can you confirm the differences, if you're not a current trainee at the time of application.
So if you are applying for CT1 or a ST1 post, there are various ways that you
can confirm your foundation competencies. They're all in the guidance document, but just for ease here, if you're a current
foundation trainee, you don't need to do anything else at the point of application. Obviously, you're going to need to have completed foundation successfully
and got your FPCC before you start. If you have completed foundation in the three and a half years prior to
commencing the post that you're applying for, then you just upload a copy of your FPCC to your application form
and you don't need to do anything else. If you have completed foundation previously, but your FPCC is signed
more than three and a half years before the start date, then you will need to do the crest and anybody else also needs to do a crest.
The only other option for not doing a crest and not having done a foundation is if you are currently in a specialty training programme, so
you hold either a national training number or a deanery reference number. If you're in that situation, then you will have proven your foundation
competencies on entry to that programme and therefore don't need to do it again. But it is all in guidance documents, so rather me rabbiting
on, you can probably get it from there and it'd be more succinct.
Thanks, Claire. I think we're about at time now for this webinar. I acknowledge that a lot of questions are coming through around the MSRA
and core surgery, understandably. So we've mentioned there'll be two specific webinars on core surgery that
will be published over the next few days. That will include clinical people and recruiting people specifically
involved with with core surgery. We will also publish all the information around the selection process for core
surgery and the evidence of how MSRA has become the chosen method for shortlisting
for core surgery on our website. So it's transparent for applicants to look at and obviously we'll
direct people for all the wealth of information and questions that are on the MSRA that's already there.
Any questions that we've not managed to go through, I think there's about 150 that we've had through tonight, so I don't think we've answered all of them.
We will put them on our website over the next few days and answer them all.
Any individual queries that people would like to make to individual recruitment offices, please do that. The teams are there ready to help as applications open.
So, thanks to Alana and Claire for answering all the questions.
And thanks to everyone for joining this webinar. It will be on specialtytraining.hee.nhs.uk as a recorded, I think YouTube
video and that's where you'll find all the questions. Again, thanks all for your time and have a good evening.
Questions asked at the webinar and corresponding answers are available on the Oriel Resource Bank.
Video: Core Surgical recruitment 2023 and the Multi-Specialty Recruitment Assessment (MSRA) process - 31 October 2022
Okay, good evening everybody and thank you all for joining us today,
which is the first of two webinars that I'll be delivering, on behalf
of core surgery recruitment. So my name's Seni Mylvaganam.
I'm the chair of core surgery training advisory committee, or also known as CSTAC.
And I'm also chair for core surgery recruitment and chair the committee that delivers that.
Um, the webinar today, Is aimed at providing you all with an overview
really of what core surgery recruitment is, what it aims to deliver, and the
framework with which we will do that. And quite importantly, because of the changes and the response
to changes, it will provide a rationale, for the changes for 2023.
Now this webinar will be recorded. So those of you who have not been able to join us live, uh, in due course, it will
be posted on the HEE YouTube website, and I think we will sign post to that site
as well fromthe MDRS website as well. So if you want to, um, search for it through that, you would
be, you will be able to find the link to, to see this webinar. So please do, um, inform any of your colleagues who have not been able to join
us this evening, um, that that is a way of, of seeing this, uh, Now just by means
of some housekeeping, which I'm sure you'll all be very much aware of being used to, um, attending virtual events.
Um, I think you'll all be on mute in terms of when you came into the platform, but you will all have access, um, to the Chatbox function.
So if you do have any questions, what I would ask you to do is to please populate them in the chat box and we've got some members of the HEE team here, which will
look at those, collate those into themes. And at the end of the presentation, we will try to answer as many of
those as possible if we haven't already done so in the presentation.
We've also got some colleagues from the MSRA work psychology group here as well.
Um, so they will also be able to add in, in terms of additional, um, information I may not have.
Um, if you have questions around, I believe also the HEE team are going
to put in the chat box a form as well for you to use to complete.
If you have any further questions, any particular additional information we can take away and perhaps, put live up in terms of our applicant guidance.
Um, then please do feel free to, to add them there. And also if there's any particular additional information that isn't
currently published about the MSRA that you'd like put on there, to help you with, your application.
Again, please use that form and we can pass that on to the MSRA team.
Okay. So, um, I will now then, uh, start off with the presentation
and we're going to start really, um, looking at the principles and governance around what we aim to do.
Now if we look at selection goals with regards to, uh, what we want
from core surgery recruitment, what we aim to do is to select the most
able candidates with an aptitude for and ability to be trained as surgeons.
So we wish to do that and select, um, from the most able applicant pool,
um, and look to, uh, and who will enter core training on completion of foundation training or equivalence.
So it's really looking at those individuals, um, at that level of training, which is our applicant pool, and try to select
the most able from that group. What's important here is it is not a selection of surgeons in training.
Also, what we aim to do is to recognise an interest, a career in surgery.
We wish to, as all recruitment teams wish to do, is promote equality and diversity and really widen the participation pool of those
entering into core surgical training. Now, we also wish it to be a consistent and transparent process, and also,
again, as part of what we are asked to deliver, we aim to deliver a selection process that limits the requirement of clinicians taking time away from
service and service commitments.
So let's talk then about the governance. Who is it that makes decisions about core surgery recruitment,
uh, and how is that delivered? Well, in terms of the government, um, the recruitment processes, Into post-graduate
training are agreed by the four nations of the UK through the Medical and Dental
Recruitment and Selection programme. So this is the MDRS Recruitment Group.
Ultimately it is HEE in England, but this oversight group across the UK
that are responsible and accountable for the delivery of core surgery, uh, recruitment and all recruitment.
What you have for core surgery is the core surgery recruitment steering group. So I'll, I'll call it the CSRS here for, for want of a quick, um, acronym.
And it's the responsibility of this group to advise MDRS on proposals for delivering core surgery recruitment.
That group is, um, consistent and made up of representation from CSTAC.
Which is the trade. So this, this is a group comprising the head of schools of surgery, of
all the, uh, deanaries across England. So, um, if we go back to the governance and this is really the
governance around the delivery of, um, core surgery recruitment. It is the CSRS group that advise MDRS with regards to, um, the delivery of
core surgery national recruitment. Now that CSRS group is represented by members from CSTAC the training
advisory committee, core surgery TPDs, surgical specialty SAC members.
So that's members from each of the 10 higher surgical specialties, uh, COPS, which is the confederation of post-graduate schools of surgery.
So that's a group comprising the heads of schools of surgery in each of the regions.
And we have a couple of representation from there as well as lay and ASiT and BOTA reps.
So moving on from there, uh, we'll look at, um, really then the review of
2022 recruitment, because that really informs what the changes have been for
2023, uh, and therefore, um, why it is that we've had to make those changes
and where we've come with regards to, um, core surgery recruitment. So 2022, uh, was the second year of virtual delivery, the first
being in 2021 as a result of covid. The framework was unchanged from 2021, so it comprised of a portfolio
self-assessment to shortlist, and that self-assessment score provided us with
a pool of applicants, which equated to our interview capacity plus 15%.
Um, and it was that interview capacity plus 15%. That was progressed to portfolio verification and that was necessary to
validate those self-assessment scores. Now, after those portfolios were verified by a team of US consultant
assessors, um, applicants were then shortlisted based on the number we had
available for our interview capacity. What was retained from 2022, which was also there from
2021, was the appeals process. So once candidates and applicants had been identified, um, uh, to be shortlisted,
uh, all applicants, uh, were given the opportunity of appealing the verification scores they received for their portfolio.
Upon conclusion of that appeals process, we had that final applicant number that
progressed to a single station interview, and subsequent to that, offers were made.
Now what were the changes from 2021? So, although we used the same framework, what we did find was that we received
quite considerable feedback, both from applicants and assessors regarding the portfolio domains, what was assessed, how they were assessed,
and what the scoring criteria was. And because of that significant feedback, we undertook a major review and rewriting
of those domains with the CSRS group. And that included our ASiT and BOTA and lay representatives that then gave us our
nine domains that we used in 2022, as well as descriptors around, uh, the scoring
and the evidence required for that. Now in addition, because of the experience gained from delivering,
um, these, uh, assessments virtually, HEE were comfortable and allowed us
to increase our interview capacity. So that was done significantly from 2021 to 2022.
So what did that look like in numbers? Well, if we look at this and we look at the total number of
applications, we receive slightly less applications in 2022 than 2021.
But actually the number that we were able to invite to portfolio verification increased by about 50%.
So from just over a thousand to just over 1500.
And it actually meant that we were also able to interview a lot more candidates. So 884 in 2021, but actually 1,259 in 2022.
And then as a surrogate marker, really, how well do we do with our portfolio domains? We looked at the number of appeals, and I, I'm, I'm not able to show you the,
the exact numbers, but what I can tell you is that from 2021 to 2022, there
was a dramatic reduction in the number of appeals, despite there being over
almost 500 more applicants progressing to that portfolio verification stage.
And so having the appeals process open to them. So that told us in some respects that a lot of things we were doing, um,
were palatable and were acceptable. And also what we found was that from 2021, where for the first time we
didn't have a hundred percent fill rate, we actually restored that in 2022.
And one of the key things around that was, was around behaviors of the, of, of applicants who received offers.
And in 2021, it wasn't simply that there weren't, wasn't enough offers being made, but actually we found a lot of applicants declining offers.
And there seemed to be, uh, a pattern where applicants were actually applying to
multiple specialties, and it was geography that was trumping everything else. Um, so this idea of southeastern London centric now introducing the commitment
to specialty domain, uh, and beefing that up, which was really important to us from 2021 to 2022, seemed to give us the candidates that had that
true surgical interest and perhaps helped us achieve that 100% fill rate.
Now, what did it take to actually deliver 2022 recruitment? And this is really crucial to understand.
Well, we talk about it in terms of consultant days. One consultant giving one day of their time is one consultant day.
So in the portfolio verification phase, we actually needed around 180 consultant
days to be able to assess those 1500 portfolios to verify the scores.
For the appeals process, we needed around 24 consultant days to deliver that.
And then for the interview process, we needed a further 180 consultant days.
So you can see that we're looking at nearly 400 consultant days to deliver core surgery recruitment.
Now that completely dwarfs every other surgical specialty and many other specialties, uh, for that matter.
So when we looked at 2022 recruitment, what were our successes? What were actually our weaknesses and threats?
Well, firstly, we achieved that a hundred percent fill rate. Really important, uh, as a marker of, of success, of, of recruitment.
We were able to significantly increase the number of applicants where their portfolio was verified and also the number of applicants that were interviewed.
So we gave as much opportunity as meant to as many candidates as possible to
have multiple forms of assessments. So we were able to, um, hopefully then identify those most able
from that applicant pool. And also we had significantly reduced appeals and queries to HEE, which again
gave us some surrogate market that we were certainly on the right track with regards to the portfolio domains, how we were assessing them, and indeed the clarity of
the information provided around evidence. Now, what were our weaknesses and threats?
Well, the number one thing we found was that there was a significant reliance on quite a fragile assessor capacity.
I take you back to this notion of 400 consultant days.
Well, firstly, to give you some context with that, where we had face to face interviews and face to face recruitment, the portfolio, um, was
integrated in the interview phase. We didn't have this portfolio verification phase, which introduced
another window where assessors were required and actually almost double the number of consultant days needed compared to previous recruitment
rounds in the face to face arena. Now, What we found with this assessor capacity was that there was a very
significant threat that that recruitment in 2022 was not able to be delivered.
Despite having, um, a very strong response to a call for assessors
and interviews, both for the verification and the interview phase. We had a lot of individuals and assessors who just weren't able to fulfill that
commitment, uh, in those two phases, and we were having to bring in and identify
substitutes very late in the day in terms of how close it was to that, either
verification day or that interview day. And certainly for the portfolio verification, there was a significant
burden on individuals in the CSRs group to take on, uh, many additional
portfolio verifications outside of normal working time so that we could deliver, um, that phase in a timely manner so that interviews could also
take place, uh, at the correct timeline. Now, the second thing we found in terms of weaknesses or, or, or threats
was really that the portfolio domain assessment, consistency and fit for purpose was still being questioned, uh, with some feedback received from
applicants and assesses around some of those domains and some of the consistency of scoring of some of those domains.
So when we looked at 2023, recruitment, 2022s review was pivotal in deciding
how we went about, um, delivering that. And priority number one was to identify a resilient framework for
delivery of core recruitment in 2023. And I can not underestimate how significant a threat we had that
we were not able to deliver on core recruitment last year because of that reliance on assessor capacity, um, which was quite fragile.
Now, priority number two was to continue to improve the portfolio and interview assessment.
Again, looking at specific markers of consistency of scoring, ensuring we widened participation and not discriminate, uh, um,
individuals, particularly this argument around paying for points. And also that it allowed us to differentiate candidates across a breadth
of knowledge, skills, and behaviors. So therefore, uh, particularly in the interview phase, looking at how we
can deliver that so that the most able candidates can continue to score points, um, so that there's, uh, a much broader range of what you can assess and examine.
Okay, so when we looked at 2023, recruitment, again, to give you some
historical context, this came really in terms of the significant increase
in applications that core surgery has had over the last few years. So if you look at 2019, cause surgery had 1,690 applications, fast forward
that to the last two years and certainly 2022, we had 2,300 applicants.
So we're looking at 800 to 900 increase 2021 to 2022 compared to 2019.
And that's come in the space of simply two to three years. So that's a significant increase.
Now this far outstrips our ability to interview and our interview capacity,
and so shortlisting is an essential tool for core surgery recruitment.
What we have used was portfolio self-assessment, but portfolio self-assessment required verification for that quality assurance that we
were progressing and shortlisting, um, the most able applicants.
And this added that additional step in the virtual recruitment framework. And as I've spoken about, added significant demand to the
consultant day's requirement. And so because of that very significant threat to, to our ability
to deliver core surgery recruitment, we have to ask the question, are there alternatives to the current shortlisting mechanism that we have?
And that's where we went out to MDRS uh, a and we went out, uh, to look for alternatives.
And what came back was the MSRA. Now, the MSRA, multi-specialty recruitment assessment is something that has been,
um, around, uh, for a number of years, has been utilised by other specialties, and it has been presented forward as an option to core surgery in the past and
also to the higher surgical specialties. Now, just by means of what it is, um, the test comprises two papers
there's a professional dilemmas paper. And what that paper does, um, is assess, uh, is an assessment
mapping to the GMC GCPS, the generic capabilities in practice.
The second paper is the clinical problem solving. Which is is an assessment mapping to the foundation curriculum, generic
knowledge, and that's 50% of the score. Now, if I take you back to our aims of core surgery recruitment, and that
is to select the most able candidates from the eligible applicant pool.
Now that eligible applicant pool are those individuals who are in foundation who will complete foundation training or foundation training equivalents.
In addition, we wish to select candidates who have the, who have the ability
to prosper in core surgical training. Now when we look at the GMC GCPs, that is the one element of the curriculum which
is common to every single curriculum. It progresses from foundation and into higher into core surgery curriculum
and higher surgical curriculum. So therefore, when we look at the professional dilemmas paper and it
assesses those, uh, competences, it is an insight into, uh, suitability for surgery.
because those competencies will simply be built upon in core surgery and then in higher surgical training.
Now when we look at the clinical problem solving paper, it maps to the foundation curriculum, generic knowledge.
And this again, aligns to our aims of recruitment. It is not a, um, a recruitment of surgeons in training.
We want to ensure we widen the participation, uh, pool of those applicants coming into surgery.
And so it is appropriate to assess individuals to the level of knowledge and opportunities for training that they have had, and that is by all
applicants foundation training. And so to assess them against the competencies gained in the foundation
curriculum allows us to identify the most able candidates, those who have shown the greatest ability to, um, comprehend and assimilate the
curriculum they're currently undertaking. And that does give you an insight into actually their ability to succeed
and thrive in the next curriculum, which would be core surgical training.
So the second thing about the test is a, it is a free to take online or test
centre test, and there's a 10 day window, I'll explain at the end of the piece really, um, the timelines around that.
Now, it is currently utilised by number of specialties for different purposes, including neurosurgery in recruitment.
And so it's not the same as saying the MSRA will be used the same way in every specialty.
And I will explain exactly how we are using it. And there are a number of equality and diversity checkpoints that do
exist with further evaluation ongoing. And the MSRA team undertook a very large piece of work around equality,
diversity, and inclusion, uh, from 2020's recruitment, um, which they will
be looking at publishing in due course. And there are just some, uh, issues just around making that, um, uh, available in
the public space, which will be addressed. So there will be further information around that equality and diversity
element, which I know has been, has been a concern raised. And finally, there are free sample questions available to
applicants to provide a familiarity with the question style. Now, individuals who are quite savvy Will, will know that that that
information out there is already there on the GP National Recruitment Forum.
Uh, and that those sample questions are simply a, a small number of sample questions, allowing that familiarity to be present.
For applicants taking the test, what I am, uh, informed by the MSRA group
is there will be a much larger bank of questions around a practice paper.
Um, that's going to be, uh, released prior to all applicants taking the exam, uh, for this recruitment round.
So there will be, um, additional materials there for all applicants to use.
Uh, and on that note, Both ourselves in recruitment and the MSRA group, uh, do
not advise applicants to pay for, um, any additional question, banks or any,
um, uh, external companies looking at preparing you for the MSRA because those
questions are not approved by the MSRA steering group and may not actually, uh,
be representative of how those questions, uh, will appear in the actual test and, and what is being examined and assessed.
Um, and that's really important because that also aligns to our aims of recruitment, which is ensuring that widening of participation,
ensuring everybody has an equal footing, uh, in terms of, uh, going through our recruitment.
Okay. So just a little bit more on this before we come onto our rationale about the MSRA in core surgery.
Um, just because I know that this may be new to many people. Um, so the professional dilemmas paper, what it does is it measures
an understanding of situations that arise for doctors in the NHS during a foundation placement.
Uh, and the judgment is in choosing more or less appropriate responses to that specific situation.
So it doesn't require specific knowledge, of experience in specialty training, but does assume general familiarity with typical primary and secondary care work.
So it shouldn't matter whether you have or haven't undertaken a variety of placements or not in your foundation training to actually
be able to answer these questions. And the test covers three core domains, which are linked to those GMC GPCs,
which are found in every single uh, foundation, core and higher curriculum. So that's professional integrity, coping with pressure, empathy, and sensitivity.
Now it consists of 50 items and there are 95 minutes in which to complete that paper.
Then the clinical problem solving paper. Um, so this is clinical scenarios that require an exercise of judgment
and problem solving skills to determine appropriate diagnosis and management of patients.
So it's not a test specifically of knowledge, but actually your ability to apply that knowledge.
It is based on foundation level clinical competence and test that higher level
of knowledge, census of medical, uh, knowledge that you will gain. Now again, what you'll find in this test is that the settings may vary
considerably from primary care to different secondary care placements. They are very wide reaching and it should not need you to be, have had a placement
in any of those specific specialties. Um, to be able to undertake this test and perform well in this test,
it consists of 97 questions and it's to be completed in 75 minutes.
And just to sort of elaborate on that point, uh, which I know was a concern, raise that if you hadn't done, let's say, for example, a pediatric
placement in foundation, that you'll be disadvantaged if questions sit in a community pediatric environment or a hospital pediatric environment.
One way of looking at that was really looking at the schools, um, and the mean schools that have been achieved by the MSRA in all the
specialties that currently use it. Um, and those specialties are very wide ranging from neurosurgery
to to to general practice. Uh, and what we find when we looked at those schools and those schools were
given to us is that generally the mean school, uh, across specialties, there is
very little variation and, and deviation. And in fact, our neurosurgery, um, uh, applicants tend to score amongst
the highest of all of the, um, uh, applicants who take the MSRA..
And the other point, which we wish to probe, which we asked of MSRA was well, okay, um, if we are introducing this, Is there, uh, a lead time to it?
Is there, um, that if you know that the MSRA is coming and you take more time to prepare because you knew about it in foundation, you
know, one or in medical school, does that mean you score more highly? Well, actually we didn't see that.
And in every other recruitment that has used the MSRA, when we've looked at the mean scores, the mean scores do not change from the first year of
implementation to any subsequent year. And practically, all of the specialties that have introduced MSRA into recruitment
didn't have an, a previous pilot year. They, they introduced it. Um, so you might see that, that that perhaps would've been the case.
But, but it isn't that there isn't a, a significant change or, or, or increase in that mean score.
And do you remember that, that, that with regards to the MSRA um, it is a test to determine, um, your competence against your fellow applicants.
And it's there simply to allow us to shortlist. Okay.
So now let's look at how do we validate this for core surgery? How were we allowed, um, to, to say, well, okay, we have faith in this process
and, and can actually use it, um, in, in a, in core surgery recruitment.
Well, what we did was we sought to test a specific hypothesis, and that was
really the null hypothesis, that the MSRA test was non-inferior to the current
portfolio assessment that we used to shortlist applicants into core surgery.
Now, it may in time prove to be, um, uh, a better way of shortlisting.
We don't have that data yet, but certainly for us to introduce this, we needed to establish non-inferiority.
And how could we do that? Well, actually we could do that because there has been a defacto pilot of
the MSRA and that's because when we look at 2019, 2021, 2022 recruitment,
we can see that a very significant number of applicants to core surgical training have also sat the MSRA test because they are assumed intended to
also to apply to other specialties. And you can see that that number totals nearly 2000 applicants who
have taken the MSRA test and gone through core surgery recruitment as
it has stood for the last few years. And you can see that number is a third of candidates last year
that had already taken that test. So we were then able to actually undertake statistical analysis of those individuals
who took the test and map them against how they did in core surgery recruitment.
And we looked at those who were invited to interview and those who are not invited to interview.
So this was testing on null hypothesis. Is it non-inferior to what we have right now to shortlist candidates?
And what we can see is the mean score of the MSRA for those who are
invited to interview is significantly higher for those who are not.
So that score of 514 versus 474, that is statistically significant.
And what I've shown you there is the analysis, um, of 2022.
But actually we saw exactly the same trends when we analysed 2020 and 2021's
recruitment, um, uh, uh, applicants.
So on that basis, and with that statistical test applied, we were able
to show that the MSRA test could be used as a shortlisting tool because
it was essentially identifying the same pool of applicants that our
self assessment of portfolio and subsequent verification was doing.
And, and this just gives it to you in a, in a more diagrammatic form. And, and what you can see really here from 2021 and 2022 was that when
you look at those who were actually invited to interview and those who are successful at interview, it.
It's significantly a different population to those who are not invited to interview.
And do you remember that we are, um, shortlisting about half of the applicants, um, uh, that we receive.
So we are providing a natural buffer to, to, to, um, uh, not only those
who are likely to be interviewed successful, uh, but actually that cohorts who are currently being shortlisted.
So because of that defacto pilot and therefore our ability to actually show validity to this MSRA for shortlisting, we were able to propose to implement
this, um, into 2023's recruitment.
Now what we want to do with 2023 recruitment as always, is we want to retain multiple modalities of assessment.
So we have multiple opportunities to assess an applicant's performance. If you can view an applicant in multiple different ways, that eliminates
error, it eliminates a bias to poor performance on a particular day, and hopefully then gives you the most rounded view of that applicant to be
able to assess their suitability for, um, uh, for success in recruitment.
Now with that in mind, the MSRA is only one component. It allows us to shortlist still to a very large number of applicants, uh, and
only half of those will ultimately be successful in in, in achieving offers.
Therefore there is still a very significant waiting that we wish to apply to the portfolio, which will be retained and the interview to
measure that applicant suitability for core surgical training once we've got that shortlisted group.
Okay. Uh, and then just to speak a little about our second priority, which
was to continue to improve the portfolio and interview assessment.
So to do that, we undertook a further review of the portfolio domains. Now there were some things MDRS mandated we needed to, uh, assess,
review and remove, which is common to all specialty recruitment.
But moreover than that, we looked at the appropriateness of assessment of some elements within the domain, but also how consistently could you verify the evidence
and actually how could you compare evidence in particular domains when they can often be very, very contrasting.
So there are changes therefore to the portfolio assessment. And the second webinar that I'll deliver on Wednesday night will go through all of
this in a lot of detail, but what's really important to say about the portfolio
assessment for 2023 is we are not asking for any additional achievements.
In fact, what is happening is that there are multiple elements being stripped out of what is required for the portfolio assessment, but no candidate will be
asked for additional achievements. So you won't be having goal posts changed late in the day with regards to suddenly
a new piece of evidence that's required. So let me take you through just a little bit about those changes, which we
will elaborate much more significantly on in, in the webinar and Wednesday. So firstly, the MDRS mandated changes.
The first one is that we are not permitted to use any named courses and in fact, courses themselves raised a lot of debate in every iteration of
our reviews of portfolio assessment. Uh, and so we have removed all courses from any portfolio that needs, um, uh,
portfolio assessment, no MRCS Part A.
So again, that's come from MDRS, but actually that's. There's been a very strong opinion from heads of School and core Surgery T PDDs
around this in terms of not including the MRCS part A, uh, in portfolio assessment.
And the principle reasoning behind that has been that, that it perhaps encourages a practice we don't want to encourage, which is individuals
to take the MRCS, and then perhaps if they fail it, burn attempts at that,
which can then become an issue that's picked up when applicants enter core surgery training, uh, and they have less attempts remaining to, to undertake it.
So in any case, MRCS Part A has now been removed, uh, as a point scoring element of the portfolio.
In addition, MDRS have asked us to remove all intercalated degrees, and
again, that looks at differential opportunities with intercalated degrees only being offered at some universities.
. Now, what we've done beyond that in the CSRS group is that we've looked at all degrees, uh, and we've removed them from the portfolio assessment.
Um, there are a number of reasons behind that. Um, and in part it goes back to the utility of what are we
assessing and what do we place the greatest value on assessing? Uh, and it's important to be aware that we need to ensure that when we deliver
recruitment, uh, it's a fair process for international as well as UK graduates.
And ensuring that we have that consistency of what a degree is internationally to what a degree is in the uk, um, has always been a challenge, uh uh and also,
Uh, in terms of certain degrees, uh, and is that a differentiating element?
It, it's not a significant differentiating element in terms of the applicants in previous recruitment rounds.
Um, so there are a very small number of individuals who score on, on additional degrees, um, but it's not a differentiating
element, so we have removed that. Secondly, we've also removed the prizes section.
And again, there was a lot of inconsistency, uh, around, or certainly variation around what prizes were offered by applicants in previous recruitment
rounds, and therefore inconsistency arose around how to assess those.
And although a specific prize is going to be retained in one of the domains, uh, we are eliminating the prizes section as actually point scoring.
Nextly from a leadership and management domain. Again, this was a very challenging domain with regards to consistency
of scoring where there was a very significant variation in what
evidence was being put forward for leader leadership and management. And it was felt that actually assessment in a portfolio, uh, was
not the most appropriate way to assess leadership and management. And so that has been removed from the portfolio assessment and will
now be integrated into the interview assessment with a slight variation,
uh, in the interview question that all candidates will be asked to prepare.
And then lastly, what we have done off the back of all of that is then amalgamate the domains and include the presentation achievements within multiple domains,
um, to allow for, uh, a more slick, uh, portfolio that applicants will then be
able to upload and hopefully minimise the amount of evidence and therefore the labor required to actually upload that.
So therefore, for 2023, the four domains that will be assessed are,
number one, commitment to specialty. Number two, quality improvement in clinical audit, number three,
presentations and publications. And number four, teaching experience and training qualifications.
Now, I will go through all of that in a step by step, um, uh, approach
in the webinar on Wednesday. Okay, so, The reason this is all done is that the aims of the portfolio is to allow
us to assess applicants across a breadth of achievements, um, that determine their suitability for core surgical training.
We want that consistency of achievements where, where they may vary and certainly evidence may vary.
And we need that to be fair across UK and international applicants.
We want the portfolio to be discriminating between applicants in terms of allowing
those who fast fire level achievements to gain a greater points than others.
Um, but we also want to ensure that it widens participation so there isn't, um, points gained because people have had differential opportunities.
We want it to be a fair and transparent process. And the appeals process, there is a really important element of that.
Um, but we also wanted to recognise that interest in a surgical career.
And that's why the commitment to specialty domain remains. Um, and I, we believe that's a really important part of ensuring
that we have those who are interested in a career in surgery. Ultimately, uh, within that pool that that's, um, selected.
The portfolio changes do assess achievements that are open to all foundation doctors or equivalent.
That's really important for widening participation. It does ensure a breadth of achievement can be assessed.
So do remember that when you are looking at the domains and the scoring? We do not expect all candidates to be scoring at higher levels of each domain.
We actually want that separation of schools to allow those who have had greater achievements to score differential.
We've done it to improve that consistency of assessment, as I've spoken about already, and also to ensure that we widen participation by eliminating,
um, differential opportunities from allowing people to score differently.
Now with that in mind, with those two key priorities of having a new system
for shortlisting as well as changing the portfolio, uh, and ultimately
the interview phase, we put forward, uh, a proposal to actually return
the portfolio assessment into the interview phase and to make this part of the multi station interview.
So therefore bring it back to how it was when it was face to face. We felt the importance of this was that the portfolio assessment could then
allow within that station applicants to then be interviewed about their portfolio, to allow them to actually defend their portfolio and the
evidence that they have, um, presented. And we thought that added to that fair and transparent assessment.
And certainly a multi station interview, um, feeds into what we want about multiple
modalities of assessing candidates. Now, when we put forward that proposal, uh, and that proposal was put forward
initially in the summer of, of this year, uh, MDRS um, wanted us to go back
and rethink a, around the portfolio assessment, uh, and the multi station
interview because they didn't feel that, uh, perhaps that was deliverable. And so as part of that, the refinement of the portfolio, the reduction in
the need of evidence, um, MDRS finally approved the framework for 2023's
recruitment at the end of September, 2022. And, and that's really important as a timeline, um, uh, to, to let you
be aware of, uh, because without that final approval, one can't really then
be able to, one's not really able to then, uh, communicate what 2023's
recruitment will look. And actually MDRS uh, approval came with a stipulation and that was that
they wanted us to pilot the portfolio verification phase as it is now with the
reduced slim down domains and reduction in evidence that will be required.
To do that pilot, they wanted us to maintain the verification phase.
Now that was something you wish to avoid to try to reduce that demand on consultant days.
But what we've been able to do, because the domains are less and the evidence
required is less, but also because the MSRA will be used as the shortlisting
tool, there will be a smaller number of portfolios to verify than 2022.
And we also, uh, believe that time taking verification would be much shorter.
So although it hasn't fully achieved the goal, which we wanted, which was to almost eliminate the need for consultant assessors in the, uh, in
a verification, um, phase, it has significantly reduced the demand for 2023 of consultant assessors.
So, Lastly then we also looked at the interview.
How would we wish to approach that again, to align to our priorities of continuing to evolve it, to make it fit for purpose, transparent and fair?
So the aims of the interview, uh, were to assess a surgically relevant breadth
of knowledge, skills, and behaviors based on foundation, competences based on what you would expect of a foundation doctor.
Um, but also allows to differentiate that applicant ability in those domains through a progressive assessment.
So that means allowing for scenarios that allow for candidates with that, um, additional ability, uh, to continue to score in terms of
how they go on and manage, uh, um, uh, patients in those settings.
And also we wish to maintain that multiple opportunities for applicants to showcase their knowledge, skills, and behaviors.
So not simply ask the single question. And as you, as you'll be aware from pre recruitment rounds, there's always
been two clinical questions in the clinical element of the interview phase.
So what do we change to, to align to those aims? Well, firstly, the assessment of leadership and management achievements,
um, are now being done through interview. And that's because of our belief that that can be better assessed, more
fairly and consistently outside of portfolio evidence we'll also be refining
the clinical questions to allow for exploration of applicant competence
beyond simply that acute management. Um, and that initial setting, which you often have in, in the,
um, uh, uh, clinical interviews.
We also. To again, to increase that transparency, that consistency, but also help to, uh,
maintain an appropriate, uh, interview pool is to engage and include senior
trainees into that 2023 recruitment. So there will be trainee interviewers in that recruitment
paired with consultant interviews. And ultimately our aim by 2024 is to deliver a multi station assessment.
So a portfolio phase that sits, uh, during your interview where hopefully we
will also be able to allow applicants to defend their portfolio in an interview.
Okay, so having discussed therefore then, uh, through the presentation, um, the aims
of core recruitments, why, uh, based on our review of 2022 recruitment we needed
to change and our process and our, uh, review of information and validation to
allow us to do that, I'll now just deliver for you what 2023 recruitment looks like.
So the application window will open at the end of this week, and that will be stay open for a month individual.
Then individuals then be asked to submit that application on the Orial system, and at the point of submitting their application, they
will also be asked to submit their self-assessment score for their portfolio.
No evidence will be required at this stage, but they will be asked to submit their self-assessment score.
Once long listing has been completed, which is based on eligibility criteria,
an invite will then go out to all long listed applicants to book their MSRA
test no later than the 20th of December.
That test window will then be from the 5th of January to the 17th of January.
Now on the 31st of January, the evidence upload portal opens and
all applicants will then be asked to upload their evidence to support
their self-assessment score. That portal will be open, will remain open until the 10th of February.
We will then have the results of the MSRA.
And then the verification of those portfolios by the 23rd of February.
So the aim is, is that with the result of the MSRA test, we will
have the top 1200 applicants.
That is our interview capacity for 2023. It will then only be that those 1200 applicants whose evidence will
then be taken forward to be verified based on that MSRA test score.
And that top 1200 applicants, all of those applicants will then be invited to interview.
So just to be clear, from the MSRA. Applicants will move forward into a portfolio verification phase and the
interview, the portfolio verification will then give you the portfolio score,
which comprises 30% of the final score and the interview, both the clinical
comprising 30% and the leadership and management section, or, uh, comprising
30%, therefore gives you 90% of the score.
Your MSRA test will then give you the final 10%, and it is based then
on that final score following your interviews, which will take place between the 9th of March and the 22nd of March that we will then start
to release offers for core surgery.
So, um, I'm really sorry about the, um, the, it glitch in the middle of all of this.
Uh, but I have finished us just about on time. Um, and I'll open now for, um, uh, any questions.
So, uh, if you have completed that in, in the chat box, I think our he team will then now, um, sort of bring that together in themes and, and then I'll try to answer
as many questions I as I can, um, uh, for however long we, we have, um, remaining.
So I'll just stop presenting at this point. Um, and hopefully I'll, I'll be back on main screen.
Um, so Alan, would you like to, um, just feel those questions?
Yep. Thanks amy um, so a lot of that, um, so some of the themes coming out, uh, ran
about the discrepancies and obviously lack of transparency, um, in terms of notifying
assets and boater, um, the, in conjunction with the statements that have been
released with, uh, introducing the MSRA.
Okay. Um, so I, I mean there there've been a number of, um, conversations
that have taken place both with, with asset and botta around this. And following the release of this, um, uh, I don't think the detail of
which, um, would be, would be sort of appropriate to, to be discussed. Um, through here, all we can say is that, um, there are, um,
training representatives, um, on. The MDRS working group that approved it.
Um, there are training representatives at the core surgery steering group,
um, uh, and things, um, Moved within that summer timeframe based on
some of that validity, um, that, um, data that we were able to use. One of the challenges we very much faced was that the data that was
given to us, um, uh, there were embargoes around how that could be shared, whether that could be shared in fact wasn't able to be shared.
And I think, um, some of that was very challenging. Um, but, but certainly that data.
Is going to be shared and, um, has been shared in a more complete
form, um, with asset and boater, a as soon as we've been able to. Um, so I, I, I think that's perhaps what I would say around that.
Um, and of course there is, um, there was a statement, um, released, um, by the
heads of the four, um, nation, um, um, heads for, um, recruitment in response
to the asset, uh, letter, uh, that that came out addressing, uh, those, those,
um, a asset issues and, and, uh, and data will be shared publicly, um, around,
uh, a lot of what we've spoken about tonight really, and, and some of the stuff that I've actually presented already.
Thanks. And, um, some of the other questions coming through are, I suppose about
implementing the sra, I suppose, um, a month before application's open.
So trainee's not giving notice, um, to the changes to the application process.
Yeah, so I, I, I think part of it is one actually getting that final approval that the, that recruitment process, uh, is exactly that recruitment process.
Um, and, and so we didn't get that final approval, um, until September to allow us to do that.
Um, we've got the validation of using the MSRA. We've, uh, also got, um, um, um, the, the, the knowledge around what it's there for.
So the MSRA um, there will be, um, uh, um, materials there to support applicants
with regards to taking the test. The test is in January, um, so it's still another two and a half months away.
Um, the test is, um, a test really that.
The scores, as I've said earlier in, in the, in the presentation, um,
if you, if, if core surgery follows every other, recruitment, um, are not going to change significantly.
So the scores that this cohort are going to take and the mean scores are, are, are, are going to predict to be very similar to the schools that next
year's cohort will take, who have had an additional year knowing about the MSRA.. And I think that reflects to some extent around, um, how much you can prepare
for, for, for this test, uh, and how much you need to do to prepare for that test.
I appreciate that actually any new test comes with it, that anxiety around it, and, and all of us, uh, inherently would want to prepare as much as possible.
Um, some of the, the, um, and certainly the, some of the, um, the data around it is that, uh, although you do require familiarity with it, um, um,
preparation isn't, isn't the same as preparing for the MRCs or preparing for, for, um, um, tests that you might
call is traditional. Um, um, and, and we've implemented as, as has every other recruitment
in terms of not having a year of, of sort of having it as a, as a pilot or alongside our current recruitment.
Um, and that's, that's because we've already had a de defective pilot of 2000 applicants have already taken it.
We've gone through course surgery over the last three years.
Um, and some of the other themes are coming up again, It's about the, obviously the announcement of the MRSA so late and the impact it'll have on
people's mental health and wellbeing. Yeah, I mean, I think that, that, that's a, that's a very much a, a very big, um,
question and a very big thing that, that feeds into mental health and wellbeing.
Um, so I, I, I can't answer specifically on that. What, what I will say to you is that if.
If the 2023 cohort behaves like the cohort of the last few years, um, a third of
your colleagues who are taking, who are going into core recruitment will already have been preparing to sit the MSRA test.
Um, so a very significant, um, uh, bunch of, of applicants.
Um, and, and, and sort of, um, peers of yours will already have been preparing or, or being aware that they're going to take that test.
Um, it is a test that. Hopefully, um, as I've said, it is a test that certainly for the professional
dilemmas paper, um, there isn't, there isn't a lot of preparation around it. Hopefully it tests and it does test your competencies you will
be acquiring through foundation. Um, and it's not a chess test to achieve a certain score.
There's not a pass mark. Um, it's a test to actually allow us to shortlist.
So it's a test to see how you compare against your peers. Um, and, and, and that's what it's there for really.
Um, because shortlisting is, is absolutely essential. Um, and, and without this, if we use the 2022 recruitment framework,
one of the biggest threats is that we wouldn't be able to deliver 20, wouldn't be able to deliver recruitment.
Uh, and I think if recruitment recruitment just fail, Next year and we weren't able to actually deliver it.
And so we had no offers to be able to, to, to give out for 2023. I think the impact of that would be, would be much more sizeable.
And I think, um, so a couple of other points, like I, so someone you's asked about, uh, what is the rationale for taking out the MCRS
part a exam on the portfolio? So that was mandated to be taken out by MDRS, so it wasn't a decision from us.
Um, but also, Part of the rationale was that, um, it was strongly opposed by
all heads of schools of surgery and all core surgery TPDS um, because it was
encouraging a practice of individuals, um, almost, um, perhaps being forced or,
or feel obliged to sit the MRCS Part A whilst they're in foundation training,
which is effectively what, what the vast majority of our applicant pool is. Um, and the, the offshoot of that was there a significant number of individuals
coming into core surgery who've had single or multiple failures of MRCS part A prior
to them being in a core surgery training environment where there is the support available to take you through that.
Um, and, and so many individuals burn a lot of attempts and that can cause a lot of issues and make it very high stakes in the future.
The part A, the. Um, so, um, uh, for, um, actually for a lot of wellbeing issues that, that
our, um, core surgery programmes have. Um, there was a lot of, um, uh, um, planner really to, to not have that.
Um, but, but that's, but that, that ultimately, that decision was, was made for by, uh, made for us by MDRS.
And I think just a couple of other points is, um, I think some
people have raised the issue about obviously revising for the MSRA. Um, like there's been highlighted that no one really needs
to revise to sit the exam.
Yeah. So, uh, again, it, it is challenging that the way the Ms r a steering
group, um, write those questions that what, what it tests, certainly in
the professional dilemmas paper, they certainly need to have familiarity. Um, and as I've said, additional resources will be made available to all
applicants prior to them sitting the, the test in January to help with that. Um, so that, that there is, there is a familiarity certainly that, that, that
should, should be sort of acquired. But from a revisional point of view, it that there shouldn't be a.
There isn't necessarily something to revise, um, for the, for the, um, for the clinical paper.
Um, uh, it should be, um, an assessment of what you're already gaining in foundation
competencies in your foundation, um, uh, educational programmes that, that
cover all elements of the, of, of, um, uh, knowledge skills, behaviors.
And it is set at that level. It, it, it is set at a level that one would expect of a foundation doctor.
Um, so, so again, it, it very much I think will appreciate that, that,
that any diligent individual is going to try to invert a commerce revise. Um, uh, but it should minimise the need for that and more about
really about the familiarity of how those questions are being asked. Um, uh, with regards to being prepared for the test.
Um, a final theme to come out was, um, in terms of the changes to the process.
So why do you look at, um, I think in terms of consultant days when looking at
the overall kind of recruitment process, Why do we look at consultant days?
So I, I'm, I'm not sure I understand it, but, but I, I think as I said, the, the
overwhelming drive for the need to change from, from last year's recruitment to
this year's recruitment is that we found, um, as every single specialty recruitment
has found, um, that actually consultant assesses, um, to come out, to be able to
deliver a recruitment process as large as ours, um, has posed huge challenges.
When we put consultant days, we just, that's probably the best way to reflect the amount of consultant time that's given.
So when I talk about 180 consultant days, it's not 180 consultants, um,
because some will offer more than one day, but actually that's the amount of time they're taking away from.
The NHS clinical practice, and one of the demands that MDRS place on
us is to find the most efficient way to deliver recruitment that limits the time, um, um, consultants have away from their clinical practice.
And that's a mandate to all recruitment programmes. But moreover than that, we found that delivering such a large recruitment
process, you know, assessing two and a half thousand applicants, 1600 at
at portfolio, As I say that dwarfs every other surgical specialty. Recruitment needs a large number of assessors and where you can recruit a
large number assessors, but actually, uh, if, if we're not able to deliver that for a variety of reasons and consult assesses aren't available, um, at short
notice where they have been, um, getting substitute is incredibly challenging.
Um, and actually we weren't able to do that on all days. And therefore the, the, a lot of the workload then went back onto the, the
steering group to do a lot of portfolio verifications in that window, uh, in evenings and weekends to actually deliver.
All of the portfolio verification, and that's not a sustainable or resilient process. Um, and, and, and those individuals give up a huge amount
of time additionally to do that. Um, and, and you can't rely on that year on year.
Um, um, and the trend generally is, is that we're getting less and less engagement with regards to, um, assessors for any recruitment
process across any specialty. Um, so we needed something more resilient because if it fell down, recruitment
falls down for us, and then we're not able to offer any posts for start of August,
2023, which would be an absolute disaster. So I, I think that's the really absolute key thing at the heart of
why we absolutely had to do something differently for 2023 recruitment.
Um, and, and, and, and that the consultant days was just a way of telling you about how much, um, uh, of a need we had for that time from our consultants
who, who give their time up freely.
Thank you Seni. Um, I say all the other questions, uh, that people have posted.
Um, these will be downloaded and we'll be producing an FAQs and we'll aim
to circulate a link to those FAQs, um, to across our various contacts.
Um, and also this webinar will be made available on the ae uh, YouTube sites.
And again, obviously we'll circulate the link for that as.
That's great. Thank you Alan. So I, I think, Idon't know if it was just me, but I think you were cutting it out a little bit. That might have been on my end or I don't know if everyone else was, was,
was, was experiencing that, but, but as Alan said, um, we will look at all of everything on the chat box, um, put out, uh, something from the FAQ's
perspective around answering those. Um, uh, and, um, if you do have anything more that you wish, um, as I said at
the very beginning that you wish to be included, that gives more clarity around recruitment for this year.
How it, in terms of the process or around the MSRA and the information that's available, ready about the test itself and, and, and resource materials.
And please do also put that in, into those forms and, and, and we will, we will try to address that.
Thank you, Seni.
Video: Self assessment process and guidance for the portfolio - 2 November 2022
So good evening and I welcome you all to the second of our two webinars
that we've delivered this week around core surgery recruitment for 2023.
The webinar today really focuses on the portfolio assessment and we hope I'll
be able to take you through step by step that assessment and what evidence would be submitted and the scoring criteria.
My name's Seni Mylvaganam. I'm the chair of the Core Surgery Training and Advisory Committee, and I also chair the Core Surgery Recruitment Steering Committee, which advises
NDRS, which is the governing body that delivers all specialty recruitment.
Now in the first webinar, we talked about the rationale for reasoning
and therefore validation of the changes made from 2022 to 2023.
That webinar was recorded and we will be giving you details about how to access that if you missed it.
And the key messages really from that webinar was that there was an absolute priority to change core recruitment from 2022 because there was a real
danger that if we delivered the same framework, we would not be able to deliver core surgery recruitment because of the demand on assessor capacity
and the resilience of that demand. And so that then stemmed on to talk about why we changed and the rationale for that.
So I will leave all that with the first webinar and we'll move on now to talk about the portfolio assessment where we have made some
changes, again with the validation given to you in the previous webinar.
So before I start, I'm just going to go through the timelines and the
process for recruitment for 2023. The advert is now up online on Oriel and applications can be
submitted from 10:00 AM tomorrow. So we've got an application window from the 3rd of November
to the 1st of December. All applicants will be invited through Oriel to submit their application,
and at the same time, they will be asked to submit their self-assessment score for their portfolio.
There will be a process of long listing that will take place following the application window closing, and then no later than the 20th of
December, all applicants will be invited to book their MSRA test slot.
That test slot and that test window will be between the 5th of January and the 17th of January, and more information around that is provided, but you can book
that at a test centre or take it online. On the 31st of January,
the portal will open for all applicants to upload the evidence to
validate the self-assessment score they have previously submitted. That will remain open until the 10th of February.
We will receive the results of your MSRA test by the 23rd of February
and during the time from the closing of the portal for evidence from the 10th of Feb to the 23rd,
we will also be verifying the portfolio evidence.
What I will say is the MSRA tests will be made available to us so that we
will only be verifying the top 1200 applicants from that MSRA test because
all those applicants will have their portfolio evidence verified and all of them will be invited to interview.
The invites to interview will come out on the 23rd of February, and during
that time between the results of MSRA and verification being released, there
will be an appeals window open, which will then close on the 28th of February.
The interview window will be the 9th of March to the 22nd of March, and subsequent offers will be made from there.
So talking now about the portfolio assessment, the first and most important
thing I need to convey to you is that although the portfolio assessment and the domains have changed, there are no additional achievements that will be asked
of you for the 2023 portfolio assessment.
In fact, the portfolio has been trimmed and slimed down, but no new achievements
will need to be evidenced for you. The changes to the portfolio in part have been mandated by MDRS changes,
which will apply across all specialty recruitments, not just core surgery, and then some additional that us in the steering group have also commended.
So the MDRS mandated changes are that there'll be no named courses.
The MRCS part A will not be permitted to be used as part of scoring system
and that no intercalated degrees can be used as part of a scoring system.
Additionally to that, we have submitted further changes which include that no degrees will be used in the scoring system.
We will not have a prizes section though, as you will see, a certain prize will
remain in one of the domains, and also the leadership and management domain from the
previous iterations of recruitment will no longer be assessed in the portfolio.
But we will assess that in a slightly modified interview question at the interview phase.
We have also amalgamated domains and included presentation achievements within multiple domains, as you will see as I go through those four domains.
So the four domains that I should be going through are, number one, commitment to specialty,
number two, quality improvements in clinical audit, number three, presentations and publications and number four, teaching experience
and training qualifications. Now what I will say is that at the end of each domain we will then
break out to look at any questions that you will have submitted. And as always, we would ask you to submit them in the chat box.
And we will look at those questions relevant to that domain before we then move on to the subsequent domains.
So firstly, some generic portfolio guidance for you.
Any achievements that are submitted, we set a timeline as to when they can be achieved, and that must have been undertaken after commencing medical
school or your first undergraduate degree. So that's the starting point for which any achievements will count.
As we have said, you are invited to submit a self-assessment score with your application and the window for uploading that evidence
will then be subsequently opened. I would ask you to look at the scoring criteria in each of the domains
and select the single achievement that would award the highest score.
This is important because we are asking you to submit that one single achievement against each domain and in order to make sure this is fair, but also appropriate
in terms of assessor time, any further achievements or any further evidence
based on a second or third achievement will not be looked at and considered.
So in the relevant domains, only one achievement will be assessed. And there are also limits placed on the evidence uploaded.
And this is really important. We try to be as explicit as possible in the guidance so that one, it
reduces the burden on you, of evidence that needs to be submitted, but also the burden on assessors.
So any further evidence uploaded beyond that stipulated will just not be considered.
Once you've submitted your evidence, you'll no longer be able to edit or amend that evidence.
And that's particularly true if you submit any appeals. Now, the evidence upload window, it's really important that will be open
prior to the results of the MSRA. So everyone will upload their evidence, but only the top 1200
applicants from the MSRA school will actually have that evidence verified and be invited to interview.
So domain one, this is the commitment to specialty domain. And what I've got in front of you here is actually what is in the
self-assessment guidance for applicants. So we'll just take a look at this and take a look at the different
subsections that are going to be scored. So this will be familiar to you from the previous year's
recruitment, if you have seen that. So number one, we're looking at operative experience.
We've slightly changed that scoring criteria to, again, expand the breadth
of scoring that applicants can achieve and expand the number of cases.
And the reason for this is we'd like to ensure that there is that breadth of scoring to help differentiate candidates who may have achieved more or less.
So you'll see now that actually there's eight points, with eight points being delivered for, being given to individuals who have an
involvement in 40 or more cases. And this is from a verified log book, and I'll go through after
this slide, the evidence that's required to obtain those scores.
The next is the attendance surgical conferences. And again, that scoring is wide to give us separation of applicants who
may or may not have undertaken more or less in terms of surgical conferences.
Then there's the surgical experience. So the top scoring here, three points is one of two achievements.
The first is undertaking elective in a surgical specialty and the second is
undertaking a surgical placement during their foundation training or equivalent, which we've set as a minimum of 12 weeks.
Now, in addition, we've maintained the covid derogation here.
So the intent of a surgical placement is acceptable, but if due to any covid redeployment, the full 12 weeks we're not undertaken in a surgical
department, that will still be acceptable to give you those full marks. So let's now look at the evidence that we require, and you'll find that in brackets
I'll be putting the number of pieces of evidence, therefore, that we require. So we'll start with the confirmation of surgical experience, and
we're really looking at one single piece of evidence here. So this is a consolidation report for each specialty to include a summary
sheet of the consolidation report that can be generated through the e-log book.
It must detail the number of procedures undertaken and the date
range the operations are undertaken. It must be signed by a consultant to include their full name and
GMC number, or their national medical registration equivalent.
These are all mandatory elements of what must be on the consolidation report,
and this is to ensure fairness of that evidence that's submitted, that it is a true and accurate reflection of what's been undertaken by the applicant.
The date the consultant validated the summary sheet must also be there. And it's also important to say that any supervision status that includes assisting
is included in that log book number. So the only thing that's not included is observed.
And again, it's important to say we do not need your entire log book output that comes from the e-log book.
It's simply that consolidation report. So if you have it in multiple specialties, so general and plastics, there'll be
more than one consolidation report. But if it's in simply one of the specialties that you generate that
consolidation report, then it will be that single sheet of evidence with that information that we have requested.
So then let's look at the evidence for confirmation of surgical conferences.
Here I put up to three because up to three surgical conferences will qualify for points, but it's one single piece of evidence for each conference attended.
And the evidence that's required is a copy of the conference attendance certificate, detailing your name, the name of the conference, and the organising
body and the date of the conference. Now, what many conferences have in that attendance is that they will
have registered for CPD points. So if that is there, it is appropriate that that should also be visible
on your attendance certificate. And then now the evidence for that confirmation of either the surgical
elective or the surgical placement. Or the surgical taster.
So it is one of these three noting that the surgical taster gives you two points where the others give you three.
So you'll only submit one piece of evidence here. So in the surgical elective, what is required is a signed letter or
document on an official letterhead by your educational supervisor.
And it must include the surgical placement and hospital, the dates that were undertaken, and the name of the supervisor with either their GMC
number or their corresponding national medical registration equivalent.
So those are mandatory pieces that should be on that evidence.
The same also applies where we look at the surgical placement. We've detailed that signed letter or document on official letterhead and those
three specific elements that must be present, which then correspond to actually
what we want from the surgical elective. And the same applies to the surgical taster.
So please do look at that carefully and make sure your evidence does include all of those elements.
So that ends domain one, so I'm just going to pause there and I would ask our
HEE colleagues, so I think it's Alan, if there are any questions in the chat box about domain one now, we'll try to answer those before moving on to domain two.
So the first question I have is conferences organised by university societies, but sponsored by one of the rural colleges.
Do these claim points for the conference section? They do. So if they've been organised by a particular organising body, and you have
all the evidence and if there are even CPD points attributed in which they may be, if
they're associated with the Royal College, then of course they do, they do count.
Conferences we understand can be virtual or in person.
But it is a conference. So what we had for some people last year was people submitting this
for an online webinar, which was an hour or two hours of time, and that's not necessarily a conference.
Where there is a little bit of gray there that's an important distinction. The next question is for the e-log book, will we get four points
if some of the procedures were only observed and not necessarily assisted as long as they are over 40?
So, as we've said, the observe do not count, so everything assisted and above.
So unfortunately anything observed will be knocked off your total of procedures,
but observe really is that you haven't scrubbed up. So if you are scrubbed in that operating environment, you
will inevitably be a assisting. Next person's asked can we use ARCP certificates as evidence
of surgical placements? These surgical placements are deemed in your foundation and if you look at what we
wish for, we want to try to keep it very standardised and so we are not permitting
variations because variations create a lot of inconsistency with regards to scoring and scoring for our assessors.
So we've made it quite clear that it is that single signed letter or document by your educational supervisor.
So we are sticking to that so we're not permitting any alternate evidence. Can I count a conference if it is attended on the 30th of November
before applications close? But they have not been issued a conference certificates.
So what you would need to do is to make sure that at the point of
submission of your application, all achievements have been banked. So if you are submitting your application on the 1st of December, and you've been to
a conference on the 30th, that's perfectly acceptable, because you have done that.
I don't think that you should be submitting that evidence if you are
submitting your application prior to the conference because you may then run into trouble, for example, if that conference is canceled, if you're not
able to attend, et cetera, et cetera. So even though you may have a commitment to attend it, it must be
what you have attended at the point of you submitting your application. Next one is do virtual conferences count?
Yeah. So as I said, virtual conferences do, but be very aware of the virtual webinar, which is one or two hours, which we did have a few or try to submit.
That will not count as a conference. Can your educational supervisor be non-surgical?
Yes, there can be. Because your educational supervisor in foundation may be with you over the whole
year and it's simply them to confirm that you have been in that surgical placement.
So, of course, yeah. Do conferences attended during medical school count towards the three needed?
Yes, they do. So if you remember at the very start of the presentation, I said the clock starts
ticking in terms of your achievements that can count from your first undergraduate degree or starting medical school.
So, yeah. Again for conferences. Does it matter if it's regional versus national?
So we've not stipulated that. Have to bear with me with the medical jargon on this one.
Does c y s t o s o c p y procedure count. Cystoscopy.
It does, although what I would say is you probably wouldn't be assisting in a cytoscopy, so unless you performed it as supervised, I would say that
that wouldn't count if you're just assisting a cystoscopy because that's a procedure like any endoscopy.
Another person has asked if we have multiple consolidation reports signed by different consultants from different specialties, can
this be collated as one single pdf, submitted as one piece of evidence?
So what I would say is that the output from e-log book only gives
you consolidation report when you drop down to an individual specialty. So plastic surgery, general surgery, et cetera, et cetera.
So it will give you multiple consolidation reports if you submitted procedures that are deemed to be within the database for that particular specialty.
So what I would say is yes, when you've assigned those, you can upload those as a one PDF with more than one page, of course.
Rather than submit it as several individual pieces of evidence. Yeah, there's a few questions. So it's about educational supervisors.
So, submitting piece of evidence does it have to be signed off by the current educational supervisor or if they've done a previous
placement, can they submit evidence? So it's the educational supervisor that is able to sign off that you have done
that surgical placement or you've done that elective or you've done that taster. So if an educational supervisor is able to do that, that they are
confident because they're putting their GMC number to it, then that can be that educational supervisor.
Okay, so domain two is the quality improvement in clinical audit. So what is new here is that we've revised some of the scoring for what would be
attributed to your achievements, but also, as I mentioned earlier, we're bringing presentation scores into multiple domains.
And therefore what you'll find is two tables that are within domain two of scoring.
I'll take on the left side of the slide first of all. And this is actually your achievement in the quality improvement
project or clinical audit. So you will see that the scoring is 8,6,4,2, and the differentiation of eight
is that you are leading in all aspects of that clinical audit, which means you have
come up with the project, the question, you've devised the methodology, you've
collected the data and presented it. And it is surgically themed.
So the notes there tell you about exactly what that is. And the important aspect about this is that you must have been involved in
two cycles to qualify for anything more than two points on that scoring scale.
So you'll only be eligible for the points four, six, and eight if you can show that this is a closed loop audit or QIP.
And then the specific differences then between each of those is your level of involvement.
So from six to four, it's a contributor versus lead and the top as if it's surgically themed.
Two points will be awarded no matter how significant your involvement is in
the audit, if it only was one cycle. Now once you've submitted that evidence and had that achievement, you can then
qualify for presentation points provided
that you have done a closed loop audit. So if you score only two points in domain one because you have been involved
in a clinical audit or QI project, which is one cycle, you'll not be
eligible for the presentation points. But if you scored four or more, then you'll be eligible for the
presentation points, which are five, three, and one, depending on where you have presented that.
And that is divided into national, regional and local. And in the appendix, we try to describe as well as we can, what
counts as a national, international, what's a regional and what's local.
So let's now just go into what evidence is required for that.
So what's important to say here, which is a slight difference to previous years, is that you can use the same quality improvement or clinical audit
and put it forward in the publication domain if it can score in that domain.
So for example, if you've done a QIP and it's subsequently got published, you can submit the quip in this domain for points and submit the
publication in the publication domain. However, you cannot submit the QIP for presentation points elsewhere if
you are also submitting them for the presentation points here in domain two. And that'll become more clear when we go to the publications
and presentations domain. So what are the evidence that we require? So in brackets here, I've got two.
So there'll be two pieces of evidence that are required. So firstly, we would want a copy of your audit presentation that outlines
the scope of the audit and the impact. So that is what did it look to achieve?
What were the findings and what were the improvements that this delivered?
Or just a summary of the project detailing that scope and impact of the project.
So if you've done an audit report that is valid instead of an audit presentation.
As long as those elements of what you've done, the scope and impact are
actually described in that evidence. That's evidence number one.
Now you'll see the and here, so this is the second piece of evidence. And the second piece of evidence now confirms what you've put
down in your audit report or your presentation, which is a letter from your supervising consultant stating your level of involvement, and
that it satisfies the requirements described in the points table.
So that you have been the lead or that you've contributed. The letter must be signed.
It can be a digital signature, but it must reproduce the physical signature.
So it can't be a digital X, and it must include, as we quite consistently
say across all pieces of evidence, the name of the consultant, their GMC number, or national medical registration equivalent, and the date.
So please look at all of that. We do want, and we'll expect all of that for your evidence to score.
Now then, if you're looking to get the presentation points, so this means you've scored at least four or more in your QIP.
A copy of your audit presentation must be provided. So if you remember from the last slide, you can either submit a copy
of your audit presentation or report on your audit, or we do need the audit presentation if we're going to score you for the presentation points.
And so there's an and again, a letter of acceptance from the meeting where it was
presented, confirming the project title, the presenting author, and the date.
Now, what will also be acceptable here if you do not have that letter of acceptance, is a copy of the meeting programme displaying the
project and the presenting author. That's domain two.
So I'll just pause there and I'll hand back to Alan for any questions around that second domain and the evidence.
So, we've got a few questions here. Will assigned letters stating I presented my QIP regionally, nationally
account for evidence of presentation. Or is it strictly a letter of invitation?
So again, what we're trying to do is to minimise variation in all evidence
because that is the most fair for all of you in terms of your appraisers consistently scoring that evidence.
So what we require for your presentation, I think the question was on presentation, is that you must give a copy of that audit presentation.
And then you must give us a letter of acceptance from the meeting or the meeting programme.
That is all that will be accepted. For the additional QIP audit presentation points, the guidance doesn't say
if there needs to be a poster or presentation, are both acceptable? Yes.
So, if it's been presented as a poster, then that will be acceptable.
But we do need that same evidence of letter of acceptance here,
because it won't necessarily be in the meeting programme. So, yes.
Can two people work on an audit as joint leads? And then how many leads are allowed on an audit?
So I think you just need to question what it means to be a lead. So I'll just go back to that.
So, to be a lead, you must have been involved in the inception of the project,
planning it, data collecting, data, analysing, implementing the change, and then doing that second cycle.
So in practicality, it's very unlikely there's more than two people that
will have had that kind of executive involvement of that audit or QI project.
So it may be possible that there are two individuals that have done that level of leading of the audit.
But what's really important is then the evidence of your supervisor to say that
you did have that level of involvement in your audit, which is the letter which we've asked to be submitted.
Can a QIP or audit be an education project, eg teaching surgical trainees?
So, it can be. Just need to be careful around that in terms of what that is and if you're
using it there, then when we come to the teaching experience that you're not using it there as well and it needs to be a QIP.
So there needs to be a proposed question, a standard, what you are doing, a review
of that, and then implementing change. So that can be done in any arena and it can be done in the education
arena, but it just needs to adhere to all of those principles. And then your supervising consultant because it will be registered as a,
an auditor QIP, will need to obviously provide the evidence that you were lead or
however much your involvement was in that. Somebody's asked, where do we state national versus regional
conference, a consultant letter or copy of the presentation? So it should be in the letter of acceptance from the meeting.
So the meeting letter of acceptance will be letterheaded with the meeting that you
are accepted to present at, or the meeting programme will give us that and that
will give us the validation of if it's a national meeting or a regional meeting.
So just read out a few more and then before moving on to the next section.
When you say presentation points, does a poster at a national conference constitute top points?
So, it does. Provided it meets all the same criteria.
So your first author and you have that letter of acceptance to say
that you did attend and present it. If I was a lead in one QI project but presented a different QI project
at a national level, can I get four points for that or do I need to have presented the project that I was lead of?
The presentation points here relates specifically to your QIP that you've submitted. If you have another, then you can use that to score in the
presentation and publication section. So again, when we go through that, that might become more clear to you.
It'll only be presentation points for the QIP that you have submitted. Ok, and I think that probably leads on quite nicely to going on and talking about
presentation and publications domain. So we'll do that. And Alan, if there's anything else, I think we'll just come back.
Okay. So presentations and publications, It's a really busy slide. I'm sorry about that, but there are a lot of scoring points here
and levels of scoring points. So I just wanted to try to put that onto a single slide.
So what you'll find here is that much of the descriptors are similar to the previous year.
What we've tried to bring this as an amalgamated domain, really with presentations and publications.
So what you'll see is the scoring tops out at 10 and goes down to zero.
And at 10 there are two different levels of achievement that will give you that 10 points.
So this is where we have brought across a particular prize. So 10 is I've won a prize for delivering an oral presentation at a
national or international meeting that convened by an accredited institution.
Important here, this is oral. So it doesn't include oral poster presentations, which are
scored at a lower point scale. The second 10 points is I am first author of a PubMed cited publication,
or one in press that doesn't include a case report or editorial letter.
And we have given descriptors referencing the definition of what
is a first author and also co-authors as well, and collaborative authors.
So as you'll see, as you walk down the scoring scale, it allows for achievements either in oral presentation, in a publication, in prize winning
for either an oral presentation or a poster presentation, or for first
author in two or more posters, which can be orally or delivered as a display.
All first author where it's case report or editorial letter, which is scored lower than the original article.
There's also scoring here if you've written a book chapter, and then also scoring if you are a cited collaborative author.
So quite a lot on the point scale, please do look at that carefully and see what your achievement matches most appropriately.
There are lots of different achievements here that can score sometimes the same points.
Just a bit of clarification around that and this is all in the guidance notes.
Oral presentations referred to will be with or without slides in front of an
audience of healthcare professionals. Can be anything related to medicine, typically a case or case series,
research or other topic, we would normally expect it to include a Q&A
session after your presentation. Poster presentations refer to are given with one poster or a poster slide, and
sometimes a very short oral explanation. So that's the difference between an oral poster presentation and it may or
may not have a Q&A session afterwards. If a poster is shown without that accompanying oral presentation, you
can still claim the points in line with the relevant point scoring. All the presentations require either personal or virtual
attendance at the meeting. If you've used a QIP for presentation points in domain two, then you cannot use
it again to score for presentation points. But you can use it if a publication was delivered with that same project.
The publications are accepted for points if they've been accepted by a PubMed catalog journal or if you provide acceptance for that publication without
amendments and evidence of the PubMed status of the journal is also provided.
So that leads me on to actually talking about then, what evidence do we ask you to submit.
So for oral and poster presentations, there will be three pieces of evidence
that we're going to ask you to submit. Number one, a copy of your presentation slide or poster presentation,
including that title and including the name of the first author or
author list to include the applicant, if you are not the first author.
And number two, a copy of the letter of acceptance of that oral poster
presentation or a copy of the event programme, which actually sites the
presentation and includes the name of the presenter, the institution
convening the meeting, and the date of the meeting or presentation. And then number three, your certificate of attendance at the event.
So all three are mandatory to give the evidence, to score the points there.
If you are a claiming a prize, in addition, the following is also
required, and that is a copy of the prize certificate or signed letter from
the institution conferring the prize. If it is a regional, local meeting,
a letter from an educational supervisor with that above information is acceptable, but that will not be acceptable for a national or
international meeting where there will be a letter conferring that prize to you. So for all published articles, as first author or co-author,
we use the ICJME criteria. A link to that is in the applicant guidance.
So please look at that to determine whether you are, if you're unsure about whether you are a first author or a co-author or
actually a collaborative author. A copy of the article, including the PubMed ID, is required and a letter
of acceptance for publication from the accepting pub med catalog journal,
and that must include one name of the applicant as the first author, confirmation of acceptance for publication without alteration, name
of the accepting journal, date of acceptance and title of article. Now for articles in press, so these haven't already been published,
what we require is that letter of acceptance for publication from that PubMed catalog journal to include the name of the applicant, confirmation
of acceptance, name of journal, date of acceptance, title of article,
and also a statement confirming that the journal is PubMed cited.
So if you are a collaborative author on that scoring system, then the evidence that is required is one, a copy of the published article to
include one, the title of the article, the name of the journal, the PubMed
ID, and the article page where the collaborative authors are cited.
So often with collaborative authors, there's quite a large number of them, and there will be a page where you're all cited and we would
want to see that in the published article evidence that you submit.
For a book chapter, what we require is one, the front and back cover of the
book to include the title of the book, the publishing house, and the ISBN number and the contents page showing the chapter and the applicant as the author.
So, although we're talking about a lot of evidence here, actually you'll only be submitting one of these because your achievement will only be one of
book chapter, collaborative author, a publication, an oral or poster
presentation plus minus at prize That's presentations and publications.
So I'll stop there. And Alan, any questions there? Yep. So we have a fair few.
So I'll start with this one. So if you have oral presentation first, or for publication, do you submit both?
So you can only score once. So if you are a first author, it's a PubMed cited publication, and
it's not a case report or editorial. You'll score 10 points.
If you have won an oral prize, prize for an oral presentation, you score 10 points. So you just submit the single piece of evidence that gives you the highest score.
So there's a couple of questions about publications. So if I've submitted publication to PubMed but hasn't been indexed
or hasn't been given a PubMed ID, will I still score points?
Yes. So if you look at for articles in press, we want a letter of acceptance for the publication from that PubMed catalog journal.
So you'll know that the journalist PubMed catalog, because you can search that. We want those six elements of evidence, with that letter of acceptance.
And if you can actually give the PubMeds catalog for that journal, then that
gives you the statement confirming that the journal is PubMed cited. So yes, it will count, but that's what we need.
Another one is, can you clarify the fact about electronic signature must be a reproduced version of physical signature?
So a lot of consultants are now signing letters online using a Adobe where they can type instead of drawing.
Is this an acceptable signature? The reason we put this in is that questions are raised about
literally an X being placed. So if individuals are using that Adobe function, it will have a
validation to that signature. So that's a validated digital signature, which actually has their name and
that, so that is acceptable, but simply an X is not acceptable and
that's the reason why we put that in, to really sort of firm up that. Does an email of acceptance count or does it need to be an official letter?
It needs to be that letter of acceptance for publication. So often the journal will send that to you electronically.
But that does need to be there and that should be there, in terms of the
confirmation of your letter of acceptance. Somebody's asked, do certificates of presentation rather than the letter count?
So when we look at the presentation and for all oral and poster presentations,
we need a copy of the oral presentation. So that's important. And a copy of the letter of acceptance that you have presented that.
So that is what we are asking for and certificate of attendance. So there's three things that you must provide and that's what we will require.
Somebody's asked, does all in brackets Wales count as national? We've given some guidance on this, in terms of what is regional and what isn't
and the guidance sits with actually a deanery level as being regional.
So we are looking at something that's open UK-wide, nationally as a national meeting.
If a meeting has been organised in one of the four UK nations and is open
to applicants or attendees from all four UK nations or internationally,
then that is a national meeting. If it is a meeting in Wales for Welsh delegates, that is equivalent to a
meeting in the West Midlands deanery, for example, for West Midlands delegates. So that is deemed regional.
One here. What constitutes an accredited institution? So what we would want is an institution ideally that has got CPD
points attributed to its meeting. And that is the most secure way in terms of you ensuring that's
an accredited institution. It's difficult to give a very blanket explicit thing other than that, because
some institutions may not have had that. But if there are online institutions for profit, sort of web-based
institutions, then you will know that that isn't accredited institution.
But certainly if an institution has held a meeting with CPD points, it has been accredited.
Make this the last one, I think. So somebody's asked if you have presented a poster presentation at a
national conference, but did not win a prize, is the maximum number of points just 1 So you presented a poster?
So what was the criteria that they had said? Sorry, say that again? A poster presentation at a national conference, but did not win a prize.
Okay. So if you look at what I'm putting up here, I've delivered an oral presentation.
So, that is oral with slides. If it's a poster presentation and it's just a single poster
presentation, then unfortunately it does sit at that lower end.
So, it doesn't qualify for any higher points.
It's the second poster presentation that then qualifies for the four. So I would certainly look at, is there any other achievements
you have that score higher? Shall we move on then to the final domain?
So the final domain is teaching experience and training qualifications.
So two elements amalgamated into a single domain. And so what we've got is scoring on the left hand sign for teaching
experience and scoring on the right hand side for training qualifications.
So separate scoring, and you will get a score for each of those if you submit evidence for each of those.
So when we look at teaching experience, it's very much slimmed down from last year, and it's just three scoring levels, 10, six, and two.
And it refers to, at the highest point scale, worked with local or even
regional national educators to design and organise a teaching programme. And we stipulate that that must be a series of sessions defined as four
or more to enhance organised teaching for healthcare professionals or
medical students at a regional level. And again, please see the appendix for how we define regional.
So if it's more than that national, then of course that also qualifies. And we put some additional guidance notes here into what we kind of expect.
So it's the ability to identify a gap in the teaching. Worked with educators, you've actually designed, organised, and delivered
that teaching programme and so that means you'll have had input into the programme objectives and outline the sessions that have been delivered.
You then drop down, if you've done the same, but it is at a local level
and then drop down again if you have provided regular teaching, again, four sessions or more, but not been involved in that design element and leading that.
Then when we look on the right hand side, this is very specific to training qualifications.
So again, we use the ISCED level, and that's important because for international
applicants we need that equivalency and the level goes from a masters or above
scoring the highest points to a PG diploma and to a PG cert, and then to having had
substantial training in teaching methods that should last at least two days.
So a two day course, for example. But it could include a module which forms part of a teaching qualification
or master's level programme. So if you've registered into a master's level programme and you haven't quite done
the PG cert, but you've done sufficient training to meet that two day stipulation,
you will get that lowest point scale and that can be delivered virtually.
Okay, so now let's look at the evidence that we require for that domain.
So first of all, evidence of formal feedback is required for all teaching
experience and no matter what point score you're going to be attributed, we do need that formal feedback.
And that formal feedback describes either evidence of senior observation
or feedback from delegates. This could be observation of a teaching assessment, developing
the teacher assessment form or actual individual feedback.
So therefore there's the or which is the collection and analysis of participant feedback forms.
So one of the two is deemed suitable evidence that you have had formal feedback.
Now, that formal feedback does not need to be submitted as evidence,
but you must present that to be reviewed by your consultant.
From there, the evidence that is required is listed and may just be the single piece of evidence you submit.
And that is a letter from your consultant confirming your involvement in designing
and organising the teaching programme as we've elaborated in the additional
notes and the letter must be signed. Again, that electronic signature is permittable with the caveats we've already
discussed and must include that consultant name, GMC number, and dates of activity.
And or you can submit a letter from the consultant confirming your involvement in delivering the teaching and that that participant formal feedback
has been reviewed as acceptable. So that's important that you either get a letter confirming your involvement in the
programme and a letter about your formal feedback or actually put all that together so that both of that is commented upon by your consultant who is assigning that.
Now, just to kind of elaborate, because it's often a point of contention about what is local, what is regional.
We have given additional notes, but what we deem as local is delivery of teaching within a single department or a single hospital site.
So what we know is that some trusts have two or more hospital
sites and it is deemed regional if your delivery of teaching does span two or more hospital
sites or trusts or a foundation school or a regional association.
All post-graduate degrees and qualifications, as I said, must adhere to that ISCED classification.
And again, you've given the links to that in our additional notes. So what do we require?
So requirements of evidence to give you the points in the degree section here is number one, a copy of the degree or post-graduate qualification
certificates to include the applicant name, the awarding institution,
and the date of the award or so as I say, there's two or's here, so you'll just need to submit one of these, a copy
of the certificate confirming attendance at that substantial training and teaching
methods, which is a minimum of two days to include the applicant name, institution,
and date, or a copy of certificate confirming attendance in teaching
methods to include again, the applicant name, institution, and date of award.
That's domain four. So I'll just pass back to Alan then for any questions there.
There's quite a few questions coming into the chat at the moment.
So I'll start with the latest one I've managed to find. So somebody's asked, what is the rationale for removing extra degrees, interrelated
degrees, but keeping teaching degrees? So, part of that's been mandated, so that has been mandated to be removed
from all specialty recruitment. So interated degrees, for example. That is a mandated thing that no specialty recruitment will actually be allowed to
score for and what we are looking for is differentiating elements in terms of
trainees performance in that post-graduate environment, that foundation environment,
which is where they're coming from. So what we found is that in terms of additional degrees, we're looking at
how that has that particular relevance for the domains we're looking at. And we've prioritised teaching experience and training and teaching as an essential
component for all trainees that's in their core, in their higher specialty,
and then ultimately the product at the end when they become consultants. So this is a marker to tell us about those individuals who are achieving
in that element, which is an important part of being a surgeon and then ultimately a surgical trainer.
So we've prioritised that. One of the challenges around other degrees is again, the
idea of consistency of degrees and what qualifies for what.
And we must be fair and consistent for UK graduates and international graduates and international graduates, it's almost impossible to provide comparisons for
some of their undergraduate degrees to UK and actually then ascertaining the value of those and the value of those moving forward in surgical training.
So a lot of this is to try to maintain consistency of scoring so that it's
fair to all applicants that there's that consistency of scoring for assessors, but also looking at those elements that will be important as a
consultant in surgery and as you're training in surgery and actually those
that can be measurable consistently. So moving on to some about teaching, so does delivering a teaching programme
to medical students from two different universities count as regional. So again, I think there's some discussions about what constitutes
local and regional if it's trusts, but based at two different sites.
Yeah. So that if it's two different sites, that's regional. So, yeah. So it is really only if you're delivering that teaching in a single
hospital site or single department, anything more than that, you take yourself out to the local level.
Someone's asked, how would you like us to present formal feedback from students?
So, as I've said there, formal feedback does not need to be submitted as evidence,
but must be reviewed by your consultant. So what evidence do we require? It's that letter from a consultant confirming your involvement in delivery
of teaching and that formal feedback has been reviewed as acceptable. So it's a comment on the letter from a consultant.
We do not need that formal feedback submitted. A gain, there's a number of questions about teaching
experience and when this was done. So does it have to be done? Does teaching experience have to be done within the last clinical
year, or can it be done prior? Yeah, so at the very top of the piece, as I said, where does the start point?
Where is the clock ticking from? The clock starts ticking from your undergraduate degree, first
undergraduate degree, or medical school. So if you meet the criteria for teaching experience that we've tried to be as
explicit as possible, that achievement can happen in your undergraduate career.
Can your evidence of teaching without consultant review?
Yeah. Your evidence of teaching must have a letter from your consultant
confirming the involvement. As I've said, in this presentation already, we are trying to be as
consistent as possible to be as fair to all applicants that they will all be scored consistently by all assessors.
So there are certain criteria's evidence that we are asking for without any deviation from that.
So as I've said here, you do need a letter from a consultant confirming your involvement in designing and organising that teaching programme
even in your undergraduate career you will have a particular individual who will be a consultant in that department or faculty who will have helped and
supported you doing that programme. So there will be an individual who will be able to do that
and confirm that involvement. So I've got a couple of questions about training qualifications.
Then there's some generic ones I'll probably just go through. So does the PG cert have to be in medical education to count?
So, this is about training qualifications. So as we put in the scoring table here, teaching specific
post-graduate qualification, that is what we are counting. So it must be a PG cert in medical education, training, teaching, et cetera.
Another person's asked, I've completed a fellowship in of higher education academy, normally awarded after completing PG cert medical education, but they won't receive
the PG cert in time of application. Does the FHEA count as PG qualification?
So you would've had your PG certificate confirmation from your
awarding body once it was awarded. You may not have had the actual degree come through, but you would of had confirmation of that.
So if your degree qualification hasn't come through yet, there will
be some formal correspondence from your institution confirming that they're conferring that award onto you.
And if that is there, then we need that with the applicant name, the awarding institution, and the date that they awarded that.
So then just finally, key points about the portfolio evidence.
Choose the highest scoring achievement to submit. Submitting more than one achievement is not acceptable, so don't chance it and
just put multiple achievements, assuming we'll look at all of them, and we will give you the points for what we have felt is the highest score you need to do that.
We won't look at any further achievements over and above the first one.
Read the instructions carefully, the guidance notes, and check off the evidence submitted against each of the requirements.
We try to really focus on the clarity of that. There is no deviation.
We're limiting any gray. That's the evidence that we require. So please do submit that evidence.
Take care with your evidence submission, focusing on the clarity of the presentation, the information required.
So really do try to make it as easy for any assessor looking at it. They can pick out those element.
And then do not submit your QIP achievement to double score if you've used it for presentation points in domain two, then do not submit the same
for domain three because it will not be awarded the presentation points there. So we'll go on to sort of any final generic questions.
So, there is quite a lot of questions obviously concerning about scoring criteria, probably based about people's own experiences.
So some of the generic ones is, when do we get access to the documents? So just to say the document is now live on the core surgery advert,
which has been published on Oriel. Another person's asked, does all your evidence have to be completed before the
first December when applications close? So, what you would need is you would need to submit your self-assessment score.
That is then your commitment to saying that you have the evidence to
back up that self-assessment score. All I would say is that if you feel that you've got that score or
you need that final sign off, or certainly in terms of signing off your logbook, that may not be done.
But you know that that evidence is there on the log book and it's just a case of signing it off. Okay? But just be careful in what you're doing because you will not be able to
change that self-assessment score and you will then be looked at to see what evidence is there to match that self assessment score in the verification.
So somebody's asked, why can't we upload more than one piece of evidence and if a reviewers underscore them incorrectly for that piece of evidence,
can they not review their second piece of evidence for that criteria?
So we've tried to give as greater clarity as possible so you will know how we
will mark and score these achievements. If you are sitting in the grey, you know you're going to be at risk if you haven't
got the evidence that we have asked for. We will not look at further achievements.
And this goes back to partly trying to minimise the burden for
yourself in submitting multiple, but also the burden on assessors. And that's a really important part of what we talked about in webinar one,
which is that the burden on the assessors for what we have done in the previous
round meant that if we did the same thing this time around, we just couldn't deliver core surgery recruitment.
And that is a disaster all round. So we are aiming at minimising the evidence, but also making sure that it's
fair what we're asking of you, so you know exactly what you will be scored on. And that clarity is there and we've tried to eliminate any areas
where there's been lack of clarity. So got a couple of questions from foreign applicants and asking if some of their
teaching evidence would be acceptable. That's been completed abroad? So if you've undertaken, so we, you know, if you are undertaking teaching
and it's in another country, then as long as it meets the criteria,
so that you either designed it or that you've been involved in regular
teaching, which has been to healthcare professionals or medical students. You've given four or more of those sessions.
And examples of those could be bedside classroom teaching, act as a mentor, et cetera.
And then you can submit the evidence, which is a letter from your consultant confirming your involvement in that.
And that formal feedback has been reviewed and that is acceptable. Would two different local teaching programmes count as regional or is
it just two times local programmes? So if you have done a teaching programme and you've delivered both in the same
unit, Then that's a local programme. If you delivered that programme and it's in multiple hospital sites,
then you come out of that local area. But if it's just a different programme, but you've delivered it at a single site, again, that's local.
This is the last question. If I'm teaching at university, is it acceptable for the letter to be signed by the vice team of the university, not a consultant?
Yeah, that's acceptable. Okay. That's it. actually. Okay, well thank you very much everybody for your time and as I
said, we'll distribute out to you where this recording will be for your
reference and for those colleagues who've not been able to attend today. Okay? Thank you. And all the best.
Page last reviewed: 26 October 2022