BIG IMPORTANT Changes to UK Core Surgical Training (Future Surgeons, Watch This!)

[@metallicarockall]

14:02 this poses another problem - the candidates applying for CST and MSRA specialities in previous years are likely to have known about their career aspirations months in advance. Therefore leaving plenty of time to prepare for MSRA. There will still be that cohort of people this year, but now they are competing against the “CST only” cohort. There is an argument to be made these “dual speciality” applicants are now at an unfair advantage over this years “CST only” since they’ve had prior understanding and planning for taking the MSRA. CST rankings therefore may well be skewed in their favour. JCST have released their conclusions, but we need raw data, results, and a proper methodology. They know full well their “study” is poorly designed. Change itself is not the issue as you say, but it needs to be implemented in a logical and measured manner. Asking this years CST applicants to sit a “dry-run” of MSRA, and using that data to predict whether it is a viable screening tool for next years cohort would have been a perfectly acceptable solution. But of course that would be too reasonable, and too considerate of trainees 🙄

[@nelliedivani9063]

I’m sure soon they’ll introduce a “surgery by apprenticeship for physician associates” to replace all of it and just have the doctors do excel sheet audits 😂

[@E_GoingDark]

The DoE and clarinet. Amazing. Another informative video, cheers Ollie!

[@rgv2rox]

Haha always wanted to do surgery but suddenly started to have a change of interest to radiology just about a month ago. Funny how MRCS A may hold more value in a rad application than CST now.

[@esraharoon8837]

So funny, that's it's hilariously ironic

[@petertownley7296]

well explained ollie i wanted to do neurosurgery but at age 47 entering medical school would be no place for me after qualification or before it due to age so opted for neurosurgery nurse & specialise at masters degree great realistic interview if i was 30 years old may have tried but theyre making it very difficult to be a surgeon at any age with competition favours richer cohort with more time

[@OllieBurtonMed]

Probably a very wise choice! There are only around 10-15 neurosurgery trainees accepted for the entire UK each year - it's next to impossible to get into training and a war of attrition. Hope you have a good experience on the nursing side!

[@LS-cg4wj]

Thanks Ollie, this video will help many junior doctors come to terms with the changes; however isn’t there a chance that this MSRA exam becomes notoriously difficult ( threshold for pass mark increases) to pass as the competition thickens over the years as the medical student heavily prep for this exam.

[@OllieBurtonMed]

I do think selection will become more difficult. It's less about passing and failing and more being in the top X% that is required to get an interview - much in the same way as getting into medical school in the first place.

[@dr_Olga]

Thank you for the video

[@ravichhugani5557]

It is hugely unfair on foundation doctors, working through the last vestiges of Covid, who have spent money and precious time doing the things that mattered, only to find the goalposts moved 4 weeks before applications start. This 'illustrious' Committee should have announced this now, FOR THE NOV 2023 ADMISSION CYCLE.

[@Joejoejoe734]

Thank you so much for your great video. I am IMG here and lost to join the surgical trading.

[@thesudaneseprince9675]

With stuff like this and medical school admissions, I'm starting to think that there should be a minimum requirement that poople have to meet to enter medical school or a speciality that goes towards somewhat assuring that said person can do well in medcial school or a specialty (what criteria would be best for doing this,? I'm not really sure) and then once applicants meet that minimum requirement, places should randomly allocated - this fixation on so called metrocratic allocation (that often turns out to not be so metrocratric) creates such an exhausting pressure of personal responsibility on applicants to see which one will impose the most self sacrifice on themselves to have any chance of getting where they want to be - Random chance, while requiring people to accept that they might not have the job they want (and possibly make people more open to learning more about specialities, as there's no garentee they will get the one they want), seems much more humane to me

[@hussamabdellatif172]

It's mind-blowing how this exam holds more weight than the MRCS, not even having it count towards a single point is crazy

[@OllieBurtonMed]

As one of our colleagues has already pointed out, the MRCS A is now worth more for an application to radiology than to surgical training.

[@DrRussell]

@@OllieBurtonMed Madness! Who makes these decisions?

[@samiatiq3815]

@@OllieBurtonMed hey Burton can you please elaborate this point how MRCS part A exam will be more helpful for radiology?

[@jkiam11]

@@samiatiq3815 It use to give a point on the portfolio part of radiology applications, but from this cycle it has been removed too

[@malikaalibdat7079]

Damn, I feel terrible for all these applicants, years of effort for nothing. I’m just beginning this long road, how do future applicants become prepared for an expected shock like this?

[@moundherarous1034]

Thanks for sharing

[@SaschaGerstner]

Specialty training is a pain in the ass everywhere in the world in one way or another. But the NHS seems to be the most ridiculous and enslaving system in the West. So many ridiculous obstacles, extra costs, the total uncertainty of completion of training, so many years of stress, minimal social and family life and acting as a puppet for the administrators. The only thing that drives you forward is your love for the field and a very distant prospect of finally becoming a consultant. All that in a system that suffers from lack of qualified doctors and nurses and should be doing everything to facilitate your career progress. Hats off to anyone who is training in the NHS.

[@HenIchaer]

Exactly. The NHS is so ridiculous that it's putting me off from going to med school. I wish it were easier to work in the US.

[@liv0003]

@@HenIchaer Training in the US is even more competitive, and US residents work far more hours than any doctor in training from any European country. However It's also true that after residency in the United States doctors and surgeons are paid more compared to Europe but at the same time the cost of medical school is stellar when compared to any European country

[@HenIchaer]

@@liv0003 I know all that. I was merely complaining about the difficulty of the process of re-locating to the US as a doctor accredited in the UK/Europe.

[@liv0003]

@@HenIchaer Ah ok 👍 if you want to practice in the US you should do your residency in the US. It's not easy to get a spot if you are an IMG/FMG but it's still possible especially if you are looking at a specialties less competitive such as family medicine for example.

[@HenIchaer]

@@liv0003 Yeah I know, but that's the tricky part, to pass all the extra examinations and get the observership and whatnot, then the VISA... Quite a hassle.

[@JCResDoc94]

*16:20** just use a lottery. if going to do something insane & stupid & baseless: just have anyone who has met base requirements be eligible for the lottery. draw it live on a stream.* have family reactions, like sportsball picks. this is like the step1 switcheroo problem. nothing best come down to a single test, core competancy only. if it has to be a lottery, so be it. or make more places (shocking idea, i know.) _JC

[@obaidaserdar1780]

man that screws me over ....İ have basically dedicated myself to go to surgery and studied very hard to get the MRCS ...but since İ am from syria and stuck in turkey İ have been working as a doctor for migrants ...i have been applying for a year to get a surgical post without a result....now İ feel İ made a huge mistake since İ dont have any means to publish anything and cant enroll in teaching programs as a refugee

[@Coffee_Is_Life_2010]

Good evening

[@laurenhiney]

hi, thanks for the great video :) i’m a current 3rd year med student, and am gaining experience in theatre to add to my elogbook. I’ve worked with a few consultants, how does the verification process work? Do i need to print every one of the procedures for them to sign?

[@Benziboiiii]

You print a pan-specialty report and get your latest consultant to sign it (They may ask for signatures from previous consultants, or they may just trust you based on their impression)

[@je6874]

Welcome to ‘Great’ Britain.

[@peaceandtolerance557]

I’m just going to study Medicine abroad and become a surgeon abroad instead of all this nonsense and bureaucracy of limited surgical posts in the UK. It’s too expensive here and there’s no incentives

[@GrigoryTingus]

grass isnt always greener, it may not be the same but there will be different kinds of nonsense everywhere else too

[@de_cokamer]

Speaking as a doc from the Netherlands, every country has its issues indeed. Here, students are taking on a PHD program next to the last 3 years of med to get into a clinical specialty. The topics studied are often so abstract and the students hearts arent in it. Same issue here with not enough training spots for too many students.

[@Mmk12636]

How long do you think these changes will last?

[@OllieBurtonMed]

They're permanent going forward but subject to annual review.

[@JCResDoc94]

*2:45** how much of this "competitiveness" is actually genuine?* that is something we (you, in office) have to ask. no1 wants to be paid less. but the faux hoops when thr are genuine shortages. we best benefit using associate physicians & nurse-physicians (& maybe prescibing pharmacists a little?) to fill gaps & remove redtape. every yr it seems to be less & les about pt focus or clinician mental health, all to keep some prestige - that will nvr leave, bc we protect from death - & a lil wage protecting. since ive never met a starving physician, i have mixed views on that. _JC

[@OllieBurtonMed]

My genuine opinion on this is that it's not about prestige, it's about restricting the number of consultants. Consultants are immensely expensive as a resource. This is why upskilling other roles (Nurse Pracs, PAs, etc etc) is probably ultimately less expensive to the NHS - they can/will never progress to being consultants, who are too difficult to manage and paid too much. How this will gel with the upcoming boom in med school places I have no idea - I predict we'll end up with a super-saturated SHO level workforce and a whole cohort of registrars that can't become consultants either. Equally what that does to your AHP roles here I don't know, as presumably you don't need them in the same way because you have enough doctors to fill all those roles.

[@davidavalus25]

@@OllieBurtonMed hey 👋 Ollie Burton I'm an international medical dr,,done my internship,, which is known as FY1 I'll love to relocate I'll need your advice on how to get a job with the NHS and go into my desired specialty,, neurosurgery residency

[@OllieBurtonMed]

​@@davidavalus25 Hi David, what I would usually suggest is getting a trust grade SHO job or something called a junior clinical fellow post in the NHS - just to get used to the NHS system. You can apply for them via the NHS jobs website. You may need PLAB or similar (forgive me as I'm not sure where you're relocating from). Neurosurgery residency is extremely difficult to get into in the UK, which I know because I'm trying to do it myself. Normally no more than 10-15 posts per year for the entire UK. Worth trying but if the plan is to relocate for residency, definitely look at other countries where that particular plan might be easier

[@davidavalus25]

@@OllieBurtonMed what if I apply for FY2 standalone before applying

[@OllieBurtonMed]

@@davidavalus25 It wouldn't make any difference to your actual application. Anyone can apply for specialty training from any country. But a standalone F2 wouldn't increase or decrease your chance of getting into UK neurosurgery training if that's your question.

[@yearb0197]

From where can I order that ECG clock??

[@manoj3813]

So all the prizes, gold medals, awards won during med school are not gonna fetch any points?

[@OllieBurtonMed]

No

why on earth medical field is becoming so confusing in the uk I can’t see a reason for complicating that much

[@charliecarey1006]

Imagine spending all the money for courses, conferences and the MRCS part A over the last few years only to score no points for them. Have they considered people in this situation at all? The silver linings I suppose are that for the time being, all of these things are either necessary or very helpful for your ST3 applications and of course no knowledge or good experience is a waste, even if it may feel like this now following this incredibly troublesome announcement.

[@martinalexanderlewis]

CST is basically a ward job and therefore it's more appropriate to test people on management of sick patients i.e. with this type of exam. The true surgical training posts comes at ST3 which would be tested with a surgical portfolio. Makes perfect sense to me.

[@pr0fess0rbadass]

How are more and more doctors leaving yet at the same time, specialty training is becoming more and more competitive?

[@OllieBurtonMed]

Just pure backlog, because the pool of pre-specialty SHOs gets larger every year, even if a significant proportion of them leave.

[@malikaalibdat7079]

So what would you advise today’s medical student?

[@privateincognita71]

99bpm? That looks intense 😂

[@adamvahed5758]

So at what point does an intercalated degree contribute to points?

[@OllieBurtonMed]

As Jake has said, it doesn't. At the moment I believe it would still count at the ST3 level for registrar level selection - that however may change in time.

[@anuragmishra395]

Great video. Can you please advise if medical graduates having done MBBS (MB ChB) are also allowed to carry out some surgeries or they are only after completing specific training in surgery? Thanks.

[@OllieBurtonMed]

You can assist in surgery as a medical student upwards but in terms of actually being a surgeon and performing surgery you'd need to be in a surgical training programme (such as Core Surgical Training).

[@anuragmishra395]

@@OllieBurtonMed Thanks for the reply. Can you please also advise the level of surgery taught in MBBS and total duration in months?

[@OllieBurtonMed]

Well it's more about anatomy in the MBBS - you're not trained to do any kind of surgery in it. Or rather managing surgical conditions. The MBBS is 5 years but the amount dedicated to surgery within it will vary by medical school

[@anuragmishra395]

@@OllieBurtonMed Thanks. So may be not wrong to say that although BS stands for Bachelor or Surgery but hardly any surgery taught. Can you please tell about the length of surgery component in your medical school in MBBS and sorry if I am asking too many question.

[@gdok6088]

@@anuragmishra395 Ollie's reference to 'managing surgical conditions' is a very important part of BS (Bachelor of Surgery), alongside anatomy of course. So surgical management forms a very significant part of the final BS (MB;BS) examinations, albeit details of surgical and operative techniques are not examined.

[@waleedmukhtar2925]

wanted to be a doctor all my life, glad I didn't seeing people slave away at training for something just to have the rules changed last minute tells you little your effort is valued! seeing the piss poor medical response to the covid pandemic in conjunction with these stupid rules and lack of funding has made me happy that I have taken other pursuits.

[@ozzyd971]

Get strike ready!

[@Mmk12636]

Can they change this next year?

[@OllieBurtonMed]

They can change it whenever they so choose

[@chrismcgowan5180]

'the clarinet'...haha, savage

[@ayaankasif1531]

🎸I got my clarinet here 😎😎🤙🤙

[@xenne.]

so do you still have to do the MRCS

[@OllieBurtonMed]

You still need to have Part A and B to accept an ST3 Registrar post. You don't need it for CST (and never did)

[@hulk6789]

We no longer need MRCS part 1 to enter CST?

[@OllieBurtonMed]

Nobody ever did anyway - there were bonus marks for it but Part 1 has never been compulsory for CST

[@xenne.]

I mean I’ve only just started the video but should I be glad I’m moving to Australia after FY2 ?

[@richardpickard2237]

No Australia is in the middle of nowhere and full over deadly creatures 😊

[@heartshapedIeaves]

Australia’s great!

[@je6874]

A strike is imminent.

[@ea3414]

All this is just so much wasted effort. A year spent revising for another exam could have been much better spent elsewhere.

[@zaemkhan]

Like where

[@ea3414]

@@zaemkhan Being on the wards and actually progressing your skills instead of memorising patterns and odd bits of knowledge here and there that will be of no use. Or simply using the time off from your to you know...relax and take care of yourself.

[@icemanjondoe]

yawn..