On Friday 17. 4. 2009 the students of 2nd Faculty were invited to attend a seminar given by one of our alumni, Dr Nigel Abreo, registered medical practitioner at the prestigious Guys and St Thomas's hospital, London.
The seminar was arranged by the FMSA and attended by 30–40 students as well as Vice Dean, Professor MUDr. Vizek. The format was an informal discussion between lecturer and students. Dr Abreo began the afternoon with an introduction about himself, a graduate of LF2 2003 and now working in London as an SHO in the field of Plastic and Reconstructive Surgery. It was certainly reassuring to know that one of our former students had made it back home in a competitive field and helped quell the nightmare of slogging your guts out in an alien country for 6 years only to end up as a medical rep or worse still flame grilled chef with a first aid badge.
However, whilst Dr Abreo did feel that we would all end up in jobs (as Dr's) there are certainly going to be some obstacles. For those of us looking to work in the UK there are two main hurdles that we should be preparing for now, firstly securing Foundation year positions (F1 and F2) and secondly obtaining a training post.
So to start with, getting an F1 position! Whilst the competition for places is not nearly as fierce as the training posts it's still significant but thankfully there are ways to get ahead. Perhaps the easiest way to do this is to have a look at the application form which is available at http://www.foundationprogramme.nhs.uk/pages/home and see what is required of you. Two things you should definitely be working on from at least your fourth year are clinical skills and references. Helpfully the GMC has issued a list of basic clinical skills that it expects all Foundation year doctors to be competent in http://www.gmc-uk.org/education/documents/Outcomes_for_F1_270307.pdf (page 7), it goes without saying that you should aim to work through as many procedures as you can and don't forget to document them in your log book. However don't expect that you will simply do these procedures when you turn up for practical classes, be prepared to pester your teachers into letting you practice, the passive approach will get you nowhere. On top of this Dr Abreo suggested that you be competent in the following areas, reading ABG's (Arterial Blood gas), knowledge of Audits and European Working Time Directive, and finally taking and presenting patient histories. This last point may seem somewhat obvious to you but it's very easy to become complacent about this so make sure you can take a thorough history, be aware of abbreviations and formats used in the UK (Macleods Clinical Examination provides a nice template) and practice presenting the essential points clearly and concisely.
But it's not only the specific clinical skills you will be lacking, working and studying in Prague obviously means our exposure to the NHS is fairly limited so do try and gain as much experience as you can in the UK, it will help familiarize you with the system and show that you've committed time and effort towards achieving your goal. Additionally Dr Abreo also recommended two courses which aim to give you the skills and confidence to deal with acute cardiopulmonary events, firstly the ILS (Intermediate Life Support) and secondly ALERT (Life Threatening Event Recognition & Treatment). More information can be found at the following websites.
http://www.resus.org.uk/pages/ilsgen.htm
http://www.alert-course.com
There was even some mention of Dr Abreo and his colleagues giving a tailor made course to students of the 6th year that will cover essential clinical skills and interview techniques designed to help you obtain and complete your foundation training. Unfortunately an estimated price tag of £1500 seemed to be a successful deterrent for most students.
The second major hurdle we will face is obtaining a training post (known as Core Training) and it's at this point the competition can get really fierce. Expect upwards of 300 applicants per place in competitive fields such as most surgical specialities, Ophthalmology and Dermatology. If you are thinking of applying for one of the more competitive fields then you need to seriously think about bolstering your CV now. Additional points can be scored with research work and publications, extra qualifications and time spent gaining experience, i.e. observerships. Unfortunately there are no easy ways to get observerhsips in England (unless your Indian in which case just ask the appropriate relative), you have to some how make contact with the relevant consultant and ask for a place, so start networking or hanging around ward corners (not Paediatrics). Thankfully research work is far easier to come by, most of the departments here in Motol are more than happy to accommodate students wanting to do research work so just make contact with the relevant people and put in some extra work. Whatever you decide to do, make sure you obtain some sort of documentation, there's little point doing extra hours anywhere if when you turn up to interview you can't prove it.
So basically the take home message was pull up your socks and start thinking long term. Putting in extra hours on the wards or the labs definitely wont make graduating any easier but keep in mind that most of your European counterparts spend a lot more hours on the wards than we do and the good ones will have publications to their name as well. In a few years you'll be in direct competition with them so unless a GP post in Woofferton (it's a real place) sounds appealing then you know what to do!
Additional websites that you may find useful.
- http://www.gmc-uk.org/education/undergraduate/information_for_uk_students.asp#5
- http://www.mmc.nhs.uk/pdf/FoundationApplicantsHandbook09[1].pdf
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http://www.mmc.nhs.uk/default.aspx
Finally, a massive thank you to Dr Nigel Abreo for taking time out and talking to us, it was very much appreciated and certainly gave us some useful insight into what we can expect when we return home. Also a big thank you to all involved in organising the seminar!
VR
