1. Commitment to specialty Flashcards
Why do you want to do BBT?
Experience a more varied core training, future career conviction
Training to date -> not tried…
Favourite placements so far have been A&E, palliative care and acute medicine, due to mix of ages and pathologies.
Patients are more complex and don’t just have one problem (e.g. older person in ED example)
As clinicians we have to match this variety
Why would you be a good BBT candidate?
Fulfil desire for varied core training
Training so far -> certificates of merit
I love variety, what I have realised so far is patients are not straight forward (take A&E patiet example) and how BBT would make me a more well rounded holistic medic
Not my back up, have spoken to 4 BBT traines in scotland and that training sounds ideal to me, especially the rotational time to cross those community/hospital boundaries. Even my curent placement in the hospice has taught me experiencing other areas is crucial to develop my learning and BBT would let me try things like seeing how GP’s work with comminity palliative care team, how specialist pain teams at beaston help patients, and even psychitry input
Why do you want to train in Scotland?
Grew up in ayr
Chose UoG
Relatives
Partner and flat
Loved training so far
Opp to go further affield
Taken time to speak to scottish BBT trainees and all given great feedback
Rural placements (elective)
Talk me through your CV
Clinical
Uni
Rural elective -> inspired by my supervisor who had had a varied training pathway starting as an ortho reg, then ED, then rural GP and he was a more passionate and more capable doctor thanks to his varied training
FY (don’t mention certificates of merit)
Hospice and CTF
Academic
Intercalated
This taught me statistics and medical writing -> 1st author paper published
Presentations (national poster and international oral presentation upcoming)
Lab based projects
These taught me to work with people from different backgrounds e.g. paediatric consultants, biomedical scientists, statisticions, interesting to spend time working with such a diverse group of people who approach clinical and research scenarios from different perspectives.
The project allowed me to do oral presentation in regional lanarkshire, and national poster presentation and to meet colleagues from all across the UK with fascinating projects, including some BBT trainees, who were doing QI project in a variety of areas which has taught me there is always room for improvement.
Palliative care gamification project - has taught me valuable communication and teamworking skills that would definitely benefit me in BBT going to Prague
Although not committed to a specialty, commutted to training as shown on CV (MRCP, PILS)
Personal
Social, friendly
Need time to switch off -> music
In summary, I am a well rounded person who loves variety at work and this has been my motivation for applying to BBT
tell me about yourself
Clinical
- uni, training so far, CTF year and how adaptable it is making me
Academic
- working with different clinicians, statistics, public spearking
Personal
In summary, while I am not yet commutted to a specialty I am commutted to my training and have dont a lot of extra things like exams and courses to better prepare me for BBT, and it is not a back up it is my first choice of training.
What are your weaknesses?
High expectations of myself
Not delegating work
Can you expand on your leadership and management experience
Management role as FY1 representative
- raising rota issues
- meeting with chief residents
- supporting colleagues subject to bullying and racism
- took from that how to contact safeguaring department and escalate concerns appropriately
- keen to continue developing management skills in BBT rotations
Leadership skills on weekly basis
- in teaching fellow role. A lot of admin and making timetables, being adaptable with my own teaching, communicating with consultants about students attending clinics.
- Given me opportnity to see how others lead and adapt my own leadership style, as a naturally quiet and reserved person, shown me you don’t have to be loud and domineering to be a good leader and to be respected by your learners.
Can you give an example of a time that required use of good communication skills?
Debriefing after simulation, student made error
Had training so far on feedback and we need to encourage students to bring up what they felt went well/could do differently.
Challenge was to correct without shaming or embarrassing or making the student nervous to participate in simulation again.
Taught me transferrable skills in life if working with colleagues who you notice have made an error or are doing things incorrectly.
Can you give an example of a time that required dealing with an error?
STAR format
Dealing with student taking blood wrong
- situation
- task: assess patient and get actual blood sample to guide clinical management, and address student error
- action:
- reflection: duty of candour, and also to explain in a sensitive manner to student the error they had made, and to think about how to communicate in future so rather than asking student ‘can you take bloods yourself?’ I should instead say ‘talk me through the process’
Putting cannula in wrong patient
- situation
- task: had to then put cannula in correct patient
- action: duty of candour had to apologise to patient when they returned to x-ray
- reflection: always checking patient details with CHI/name at bedside… and how I get consent and not accepting implied consent when patient holds arm out for blood test/cannula,
Describe how you meet our selection criteria for BBT
Clinical
- Graduated
- FY rotations
- not yet tried paeds/psych/GP
- I’ve used study days and taster weeks in my training so far e.g. PILS, and rural elective as community facing care
Academic
- very academically minded, and as not yet committed to 1 specialty but showing I am committed to my training I have done projects relating to breast cancer, paediatric IBD, lab based which has led to me working with people from different clinical backgrounds. I have enjoyed this mix, so would continue to enjoy the mix of BBT. Keeping in touch with these different researchers and academic clinicians would be something I would consider in my 10% rotational time.
Teaching - has made me adaptable and expanded my knowledge of all specialties at junior postgraduate level which will benefit BBT, and working with colleagues from all backgrounds to see how they approach clinical dilemmas (Psych consultant on sim courses, GP’s vs paediatricians in teaching sessions on rash in the child etc).
Difference between audit/QI/research
Audit - assesses current clinical performance against a guideline e.g. are we prescribing the right first line inhaler formulation for asthma?
QI - actually making a change, i.e. are we assessing chest drains daily on the ward according to BTS guidelines, then making an implementation like sticker or education, and then re-assessing to see if an improvement has been made
Research - adding to a body of knowledge, over long term will improve clinical practice but more about data gathering
Who is someone who inspires you
Richard Brown
Discuss a project you are proud of
Palliative care escape room
- topic I struggled with as junior
- first use of gamification in palliative care in Scotland as per literature search
- improving knowledge of generalist palliative care
- been helpful for IMG’s, improved communication skills, improved junior drs confidence in medicine and surgery, and going to present as oral presentation at international conference
- would love to continue this passion for teaching in BBT
Can you describe an audit you have done and what you learned from it?
Review of time taken for blood culture bottles to reach lab in NHS GGC. From time of taking sample to it arriving in incubator target time is <4hrs.
In hospitals with lab on site this was taking 16hrs, leading to poorer patient care as patient on empirical therapies for longer before culture results and targeted therapies available.
Main reasons were educational -> lack of education around how BC guide treatment, false idea that can’t pod culture bottles as will smash and need porters.
Learned that continued education is key to patient safety.
Can you describe a QI project you have done and what you learned from it?
Chest drain
- importance of educating colleagues when new to a complex department, and this is something that is done well according to senior BBT colleagues
- small interventions can have a big impact on patient safety
