Still waiting for the BMA to campaign harder on this. At this rate we might get full pay restoration but we'll be stuck as resident doctors for life. There should be a safety net in place almost guaranteeing or at least prioritising applicants who have applied previously and who did not get a number - especially if there is an expansion of ST posts.
There are a few things to say about this (and you're not wrong, just important to discuss properly) 1) If doctors want the BMA to campaign on something, doctors need to bring it to ARM - you/we/I can't 'wait' on the BMA to do something, it's not autonomous. It can only do what ARM policy dictates, which is determined by the voters at ARM. So if you want something, bring it to ARM and make it policy. The BMA can't and won't do that by itself. 2) 'we'll be stuck as resident doctors for life' - this is essentially the 'top down' plan. The grim reality is that consultants cost money and what the NHS wants/needs is loads of senior-registrars-but-not-consultants to staff the on call rota as cheaply as possible, or we need to switch to a more consultant-delivered service in general, like the US. Without that switch, fairly soon we will saturate our consultant tier in many specialties and there won't be an organic need for many more, certainly not as many resident doctors as there are. 3) 'prioritising applicants who have applied previously and who did not get a number' - we could do this, and as an FY4 I'm not opposed to it, but that means we will generate an Australia-like system where you will need to work as an SHO for 2-3 years at least before getting anywhere near a training number. It also somewhat defeats the purpose of selection too if the 'failures' from each round are going to get a place in future rounds guaranteed. Again I'm not opposed to it, but it would have very significant consequences.
@@OllieBurtonMed Thank you for replying and for the detail. As I understood it the BMA were pushing for post expansion whilst in talks with health secretaries and most recently - Wes Streeting, but it wasn't their primary objective (understandably). I assumed it was already on their agenda/policy but if that's not the case then it absolutely should! Completely agree with your assessment of the "top down plan". You're right to bring up the practical issue of the consultant tier saturation, this wasn't something I had considered, maybe a consultant-delivered service is the way forward, maybe not. This would constitute a huge change to current practice and would have to be evaluated and approved in terms of patient outcomes if it has any hope of gaining public support. I would personally be happy to wait a few years + be done with the entire selection process if it guarantees a space in the specialty I aspire to work in. As you know, many doctors give up on their desired specialty to pursue a more realistic (less competitive) speciality which I find incredibly demoralising. Maybe there needs to be some sort of vote or conversation opened up about this, although, this would have to come after the expansion of ST posts. For clarity I'm a medical student in my final year.
They can be tricky. Would google '[specialty] self assessment points matrix or similar words. Should usually show up one of the most recent versions of it
i did mbbs in 2017, then 4 year job, then 3 year internal medicine MD residency in nepal; now practicing as consultant in nepal. How competitive is to get specialty training for candidate like me in uk/ ireland
Hi Ollie, thanks for the insight, I am a year 1 Chester medic (1st cohort). When they refer to undergraduate prizes, would that be within your medical degree only or could you use bachelors/undergrad commendations if a grad entry medic?
I think it might vary to be honest and depends on the wording. Sometimes they say 'prior to completion of your medical degree', so obviously if you did a BSc or whatever before then undergrad would be fine.
It can only get more competitive (and will). There are two pathways that feed into UK training, which are domestic/UK graduates and international medical graduates (IMGs). Even if you assume that IMG applications remain static (which they won't), there are more UK applicants than there are training posts. This means that without expansion of specialty training posts, we're in a doom spiral where it will become more and more competitive each cycle as more people join the pool (as more people graduate each year), and more people 'get stuck' and reapply the following cycle.
@ what would you suggest someone do? It seems like there will just be an arms race to become more competitive which could impede on actual clinical work?
@@adailyfact We're already there and have been for a few years. The system as is favours those who are able/willing to get time away from clinical work to do portfolio stuff, not people who are actually good at the job. Part of the problem is how you measure 'people who are actually good at the job' - it's very hard, so we don't.
@@adailyfact Try and be as well prepared as possible, and that means doing the basics well. Try and have 1 good paper, 1 good audit, 1 good QIP etc and that makes you agile. Also be clever about designing projects such that they hit multiple specialties where possible - I'll talk more about this in the future, but I think it's key to avoid pigeonholing.
No, absolutely not - points can be picked up elsewhere. No application system is designed such that people are likely to max it out - they're designed to differentiate between candidates, so in theory it should look like a bell curve, with only a very small few that max it out.
Genuinely some of the most insightful UK medical content out there right now.
Thank you Ollie - best luck this time🤞
Hi Ollie,
You haven't got a Clue how helpful your videos are!
I cant thank you enough for doing what you do.
Glad you like them!
Still waiting for the BMA to campaign harder on this. At this rate we might get full pay restoration but we'll be stuck as resident doctors for life. There should be a safety net in place almost guaranteeing or at least prioritising applicants who have applied previously and who did not get a number - especially if there is an expansion of ST posts.
There are a few things to say about this (and you're not wrong, just important to discuss properly)
1) If doctors want the BMA to campaign on something, doctors need to bring it to ARM - you/we/I can't 'wait' on the BMA to do something, it's not autonomous. It can only do what ARM policy dictates, which is determined by the voters at ARM. So if you want something, bring it to ARM and make it policy. The BMA can't and won't do that by itself.
2) 'we'll be stuck as resident doctors for life' - this is essentially the 'top down' plan. The grim reality is that consultants cost money and what the NHS wants/needs is loads of senior-registrars-but-not-consultants to staff the on call rota as cheaply as possible, or we need to switch to a more consultant-delivered service in general, like the US. Without that switch, fairly soon we will saturate our consultant tier in many specialties and there won't be an organic need for many more, certainly not as many resident doctors as there are.
3) 'prioritising applicants who have applied previously and who did not get a number' - we could do this, and as an FY4 I'm not opposed to it, but that means we will generate an Australia-like system where you will need to work as an SHO for 2-3 years at least before getting anywhere near a training number. It also somewhat defeats the purpose of selection too if the 'failures' from each round are going to get a place in future rounds guaranteed. Again I'm not opposed to it, but it would have very significant consequences.
@@OllieBurtonMed Thank you for replying and for the detail. As I understood it the BMA were pushing for post expansion whilst in talks with health secretaries and most recently - Wes Streeting, but it wasn't their primary objective (understandably). I assumed it was already on their agenda/policy but if that's not the case then it absolutely should!
Completely agree with your assessment of the "top down plan". You're right to bring up the practical issue of the consultant tier saturation, this wasn't something I had considered, maybe a consultant-delivered service is the way forward, maybe not. This would constitute a huge change to current practice and would have to be evaluated and approved in terms of patient outcomes if it has any hope of gaining public support.
I would personally be happy to wait a few years + be done with the entire selection process if it guarantees a space in the specialty I aspire to work in. As you know, many doctors give up on their desired specialty to pursue a more realistic (less competitive) speciality which I find incredibly demoralising. Maybe there needs to be some sort of vote or conversation opened up about this, although, this would have to come after the expansion of ST posts.
For clarity I'm a medical student in my final year.
love the videos recently, can you make a video about the PGcert. worth it or not, doing it while in foundation years etc
Great video Ollie! Do you know where I can find the criteria of points for each specialty? I’ve been struggling to find this
They can be tricky. Would google '[specialty] self assessment points matrix or similar words. Should usually show up one of the most recent versions of it
@ thank you so much for the reply
i did mbbs in 2017, then 4 year job, then 3 year internal medicine MD residency in nepal; now practicing as consultant in nepal. How competitive is to get specialty training for candidate like me in uk/ ireland
The CESR/portfolio pathway is the best track for you if you are already working as a consultant. I would recommend having a look at this.
Did you say you have a PhD? And are an eyelash tech? lool surely one person cant be this talented
No PhD sadly but am an eyelash tech. Not graduated to microblading yet.
Hi Ollie, thanks for the insight, I am a year 1 Chester medic (1st cohort). When they refer to undergraduate prizes, would that be within your medical degree only or could you use bachelors/undergrad commendations if a grad entry medic?
I think it might vary to be honest and depends on the wording. Sometimes they say 'prior to completion of your medical degree', so obviously if you did a BSc or whatever before then undergrad would be fine.
@ great, thank you for the reply, hope work and your own applications continue on well
Do you think it will get more or less competitive to enter specialties in the next 10 years or is this impossible to predict as is very volatile?
It can only get more competitive (and will). There are two pathways that feed into UK training, which are domestic/UK graduates and international medical graduates (IMGs). Even if you assume that IMG applications remain static (which they won't), there are more UK applicants than there are training posts. This means that without expansion of specialty training posts, we're in a doom spiral where it will become more and more competitive each cycle as more people join the pool (as more people graduate each year), and more people 'get stuck' and reapply the following cycle.
@ what would you suggest someone do? It seems like there will just be an arms race to become more competitive which could impede on actual clinical work?
@@adailyfact We're already there and have been for a few years. The system as is favours those who are able/willing to get time away from clinical work to do portfolio stuff, not people who are actually good at the job. Part of the problem is how you measure 'people who are actually good at the job' - it's very hard, so we don't.
@@OllieBurtonMed What would you suggest people lower down, i.e. FYs and medical students do?
@@adailyfact Try and be as well prepared as possible, and that means doing the basics well. Try and have 1 good paper, 1 good audit, 1 good QIP etc and that makes you agile. Also be clever about designing projects such that they hit multiple specialties where possible - I'll talk more about this in the future, but I think it's key to avoid pigeonholing.
So are you just completely screwed for Neurosurgery ST if you didn't get win any awards while in medical school lol
No, absolutely not - points can be picked up elsewhere. No application system is designed such that people are likely to max it out - they're designed to differentiate between candidates, so in theory it should look like a bell curve, with only a very small few that max it out.
Why are you encouraging IMGs to apply for UK specialty training?