Successful Applications For Foundation Training 2012

1. Successful Applications For Foundation Training 2012 Careers Consultants University of Manchester & Dr Ella Checkley – Foundation School Careers Lead September 2011

2. Admin

3. Helping you to apply for your Foundation Year posts – 3 step process Workshops to prepare for the Application Process and Careers Forums STEP 3 North West Deanery Foundation Application Fair STEP 2 Using your portfolio to prepare for Foundation Year Application and Careers Forum STEP 1

4. Programme • Introduction • Know the process • What to do before you start your application form • Application form in detail • Checklist and Golden rules • Further sources of help available • Exercise • F2 doctors presentations plus Q & A panel

5. Foundation Application Process • FoundationProgramme • 2 year training programme • At National Level • National timeline • UK-wide single online application system –UK Foundation Programme Office (UKFPO) www.foundationprogramme.nhs.uk • Fair and open competitive process • National scoring guidance & national person specification • Applications scored by panel from your first choice Foundation • Allocation to Foundation School At Local Level • Selection of programme preferences • Allocation to a programme within a school • Pre employment checks

6. Changes to the process for FP 2012 • Applicants are required to upload documentation to support information given for educational achievement points • Educational achievements will be machine-marked. The uploaded evidence will be verified during a national verification day and the scores confirmed (note fewer than 50% of students score points) • If, as expected, there are more fully eligible applicants than vacancies, applications from individuals who cannot provide evidence of their right to work and remain in the UK will not be considered • Applicants will be allocated to foundation schools in score order. If their first choice is not available, the system will look at their second choice, and so on down their list of preferences until a space is available

7. FP 2012 – What’s new? • PRE – Situational Judgement Test (SJT) • Applicants are expected to complete the FPAS application form PLUS a one hour invigilated SJT • SJTs will: • take place at UK medical schools on either 11 Nov, 28 Nov, 9 Dec or 9 Jan. Schools will provide details of date, time and venue • give you the opportunity to practice SJT questions, which are being used for selection in an increasing number of specialties • NOT have any bearing on your FPAS score, nor on your allocation to foundation school or programme

8. FP 2012 – What’s new? PRE – Educational Performance Measure (EPM) • Medical schools will be producing an EPM score for each student as part of the PRE • The UKFPO will provide the EPM score for non-UK applicants • The EPM score will: • be calculated by your medical school using the methods they are planning to use for FP2013 • be used confidentially for the purposes of analysis • NOT have any bearing on your FPAS application score, nor will the information be used to determine your allocation to foundation school or match to programme

9. What happened last year? • 100% of UK grads were placed in programmes • Over 90% got there first choice of Foundation School • 97% of applicants from the NW got their first choice of Foundation School • All Manchester students who put NW as 1st choice Foundation School got it • Approx 60% of applicants from the NW got their first choice of programme

10. Timeline

11. How does it all work? Application form divided into 8 sections • Personal Name and address • Qualifications educational • Clinical skills self assessment of your own practical and clinical skills • Other (equality & diversity) will be used by employers to build a demographic profile of their workforce • Key questions (this is the only part the panel will see) 6 questions which will be scored • References Your references (x2) must be clinicians • Preferences You must rank 24 foundation schools( check Applicants handbook for competition ratios from last year) • Submit Confirm application is completed and all information is correct and your own work • You will be able to save your application at any time and come back to it at a later date during the application timeframe

12. What we do know: • Broad areas questions will focus on • (Note: questions are likely to be very similar to last year – no major changes until 2013) • Types of things scorers are looking for What we don’t know: • Marking criteria/mark scheme

13. Understand the background • “Foundation programmes are designed to give basic competence in professional skills like communication, teamwork and the use of evidence and data. You will be expected to demonstrate increasingly sophisticated skills in these areas throughout the foundation programme.” • “You will be responsible for your own learning.” • “You should consider every activity a chance to learn something new.” Rough Guide to the Foundation Programme, Ch 1. www.foundationprogramme.nhs.uk

14. Person Specification for 2012

15. Person Specification for 2012

16. Foundation Application 2011 6 Questions • Educational achievements • Impact of team working on quality of patient care. • Clinical situation with opportunistic learning experience • FY1 Prioritising tasks scenario • Communicating with patients - clinical situation involving challenging cultural, social or family circumstances • Two personal achievements demonstrating ability to deal with pressure and prioritise

17. Preparation well in advance • Start thinking about your application now • Think self-promotion…this is your chance to sell yourself • Read and understand the requirements of the National PersonSpecification (UKFPO web site) and Good Medical Practice • Identify any gaps in your skills and abilities – action plan! • Be proactive – seek out opps to practice/improve existing skills - Seek out opps to shadow/ expand skills and experiences • Network – meet and talk to current Foundation doctors • Document and reflect on best practice/significant learning/critical incidents – evidence from portfolio • Focus on achievements and results – develop a profile of your skills particularly relevant to Foundation Training • Practice answering last year’s questions • Identify referees and seek permission to use them

18. What about Referees? • You will need to provide names and contact details of two referees • One reference must be from a practising hospital consultant, GP or associate specialist who is able to give an opinion of your clinical skills. • One reference must be from your medical school. This might be a professor, senior lecturer, lecturer, reader, director of clinical studies or a person holding an honorary medical school contract as advised by your medical school. • You may use referees outside of the UK as long as the referee is able to comment on your performance.

19. Why Portfolio matters • As an ideas generator • Which example will enable widest coverage of all aspects of the question? • Make it verifiable • Engagement with personal reflection is a valuable skill for your future CPD… and may influence career direction

20. Documents needed to Ace the Application • The New Doctor (2009)www.gmc-uk.org/education/postgraduate/new_doctor.asp • Good Medical Practice (2006)www.gmc-uk.org/guidance • Medical students: professional behaviour and fitness to practisewww.gmc-uk.org/students • Person Specificationwww.foundationprogramme.nhs.uk • Foundation Applicants Handbook 2012 • www.foundationprogramme.nhs.uk/pages/home/key-documents

21. Application forms – the basics • Give yourself plenty of time • Read through the whole form before starting • Draft your answers in rough in word • Cut and paste but proof read • Complete all the sections – don’t cross ref • Grammar and spelling...check! • Tone - upbeat , positive and focused • Short, sharp sentences – no long prose passages • Complete and comprehensible sentences • Must be your own work • Submit in good time • keep a copy of your form!

22. Application forms – evidence based/blank box questions • Select recent, relevant examples • Quantify and be specific – analyse the event • Describe yourbehaviour, not us, we and the team, what did you contribute? • How and why? – personal insight and reflection • Focus on results – what difference did you make? What was the outcome? • What did you achieve/learn/insights gained? • Structure your answers…think CAR: Context – Action – Result

23. How is your form scored? • Questions 2-6 marked horizontally by panels of 2 initially from 1st choice Foundation School. Max 10 points.200 words • Scorers know your applicant number and the answer to one question only • A nationally agreed mark scheme is used • Whole form marked by at least 10 people • Marked by another panel if can’t agree • Random sample benchmarked with another Foundation School • Verification letter/meeting if concerns

24. Example verification request Please note that you would not have to provide all evidence listed, but just a selection. Please note that foundation schools will have their own local process for verification.

25. Appropriate example Detailed explanation Shared team goal Collaboration Motivates others Aware of own skills & limitations and the skills of others Compromises Neglects others’ views Own agenda No collaboration Dominates team Failure to share responsibilities according to skills Failure to recognise team contribution Teamwork ExamplePossible plus points Possible Minus points

26. Effective team working can have a significant impact on the quality of the patient experience.Describe a clinical case you have observed where there has been a multi-disciplinary approach to discharge planning. Describe how the interactions between the multi-disciplinary team impacted on the quality of the patient’s care. What have you learned from this experience about effective multi-disciplinary team working and how will you put this into practice as a foundation doctor? A 64-year-old man presented with ascites resulting from chronic liver failure, requiring recurrent drainage. While in hospital he became malnourished, after several failed NG-feed attempts. He wished to be discharged, believing his appetite would increase once at home. However, his wife felt unable to cope with his care. A meeting was called to discuss how to optimise patient care after discharge. The nurse presented relevant patient information. The social worker was then able to co-ordinate care between the occupational therapist and community dietician, who organised a bed and commode for the ground floor at home and monitored the nutritional status, ensuring a safe living environment. The patient, carer and each MDT member were involved and made aware of their roles and the care to be provided. The organised and consultative approach alleviated the patient and carer’s anxieties. In a multi-disciplinary team, a leader is essential to manage and communicate effectively between all specialists involved to ensure optimal care, with the patient’s health, safety, and comfort being of paramount concern. As a foundation doctor I recognise limitations in my professional competence and will respectfully utilise healthcare professionals to provide well communicated, tailored support for discharge planning; addressing patient and carers concerns. (200words)

27. You are the only foundation doctor on a busy surgical ward, and you feel under pressure to complete the tasks expected of you. A foundation doctor from another surgical team asks if you will hold their bleep for the second time this week as they want to go to theatre to observe an operation. What would your initial response be to your colleague? What factors would influence this response? If you had to hold the bleep, how would you prioritise the tasks? What additional learning needs does this situation highlight for you? My initial response would be that I regret that I cannot take the bleep, as I am already under pressure and I feel the additional responsibilities would jeopardise patient care and safety. Factors that will influence my response involve how many patients I am caring for already, the stability of their condition, my workload and the urgency of the doctor’s request. I recognise supporting colleagues is important but providing quality care is ultimately my priority. If I have to hold the bleep, I would attempt to negotiate a compromise, asking for the theatre number, so my colleague can be contacted if I require help. A clear concise hand over will be essential to differentiate stable from unstable patients. I would prioritise tasks in terms of urgency, monitoring the acutely ill more closely, utilising other appropriate healthcare professionals, to maximise work efficiency. This situation highlights the need to have good management skills. It is necessary to use initiative to prioritise tasks but also recognise when to seek additional help, to provide the best standard of care . As a foundation doctor I will also need to proactively advance my own learning by attending theatre, clinics and being involved in audits and research. (200 words)

28. What makes a good answer? • Answer each part of the question clearly and fully. • Choose an appropriate example that demonstrates what the question is looking for. • Use facts & figures to set the scene – help scorer appreciate significance to you • Describe specific actions and outline results • Explain how – demonstrate your approach (more than just listing what you did) • Assess the impact of your (others if observation) contribution • Demonstrate skills which are directly relevant to foundation training • Show an awareness of principles ofGood Medical Practice • Show apositiveattitude – willing to learn from experience/mistakes • Show - analysis - reflection - insight/learning

29. Achieved Advised Audited Co-ordinated Managed Organised Tested Taught Led Conducted Initiated Developed Prioritised Liaised Negotiated Analysed Mind your language - Use action verbs wherever possible…

30. For example… “ A group of colleagues and I took part in an audit project into outpatient waiting times. After looking at the data we found a number of weaknesses in the booking process and subsequently made changes that improved efficiency and significantly reduced waiting times” OR “I volunteered tocoordinatean audit of outpatient waiting times. I was responsible for leading a team of three colleagues . Afteranalysingthe data, we identified significantweaknesses andimplementedchanges that resulted in an average reduction in waiting time of two weeks” (Both 43 words)

31. Help available after form released • Successful Applications For Foundation Training – Slides available from NW Deanery & Careers Service website from 26th September 2011 www.nwpgmd.nhs.uk/careerswww.careers.manchester.ac.uk/students/downloads/publications/talkshandouts • Online Careers forums Friday 14th October from 6.00pm-8.00pm Monday 17th October from 6.00pm – 8.00pm Details of how to access the careers forums will be announced on MedLea. • Planning Your Medical Career: A practical guide www.foundationprogramme.nhs.uk/news/story/ukfpo-publishes-careers-leaflet • NHS Medical Careers Support Website www.medicalcareers.nhs.uk • Manchester Medical Students’ Careers Blog www.manchestermedicalcareers.wordpress.com

33. And Next . . . An Exercise How to think laterally about your answers

34. Question A Describe a clinical consultation that you have observed where the specific cultural, social or family circumstances of the patient posed additional challenges. Identify the techniques used within this consultation that contributed to this patient’s experience. What other approaches could have been used in this situation? What did you learn from this which you can apply to your future clinical practice?

35. Answer to Question A At a diabetic ante-natal clinic, a woman at 24-weeks gestation with a history of poor diabetes management came for her routine check-up. The doctor listened empathically to her social difficulties in managing responsibilities at work as well as caring for her three children. Her busy lifestyle resulted in haphazard snacking on fast convenient foods, which led to her uncontrolled diabetes. The patient felt listened to in a non-judgemental manner as she was allowed to express her difficulties freely. The doctor re-iterated the dangers of uncontrolled diabetes and the importance of treatment. He checked her understanding. Subsequently, the patient agreed to pre-plan her weekly meals to avoid unhealthy choices and lower her blood glucose. A list of low glycaemic foods could have been given. Input from a dietician would have been useful, as well as a leaflet to refer back to regarding the patients condition. I learnt that it is important to illicit and address the patients concern and involve the patient in their treatment plan. This ensures greater adherence, leading to effective care. I will provide information using various resources such as leaflets and dieticians, which can empower the patient to take responsibility to maintain their own health. (198words)

36. Question B Describe two different personal achievements to demonstrate that you possess both of these qualities, relating each achievement to a single attribute. For each attribute, give one specific example of how your achievement can contribute towards improving your performance as a foundation doctor.

37. Answer to Question B • During the course of my Masters, I was under pressure to complete multiple assignments for the same deadline. I produced a timetable to organise my time. I clearly marked days for research, planning content, writing and allowed days for unexpected delays. I stayed calm and focused on each task at hand, completing my work punctually. This technique eases the overall sense of pressure, enabling me to deliver effective patient care. I can use it in acute presentations such as asthma attacks, where I will break down and focus my attention on each aspect of care. I will immediately provide oxygen, organise blood gases, and once stable, take a thorough history and organise subsequent management. • Winning the community basketball competition illustrates my ability to prioritise. Initially, I focused on my individual passing and shooting skill but when my team were four points down and the captain injured, I stepped up to take the role. Boosting morale became my new priority, which consequently led to effective teamwork. This can help when I am on-call as a foundation doctor. I will manage the most acutely unwell, followed by the unwell and then address non-urgent jobs, constantly adapting my priorities to the changing situation. (200words)

38. Think Laterally • What would you do if .......? • What element(s) of the person specification is covered? • What if it were another element? • What else would you include then? The applicant must demonstrate: • understanding of the importance of the patient as the central focus of care • ability to prioritise tasks and information • understanding of the importance of working with others • ability to communicate effectively • initiative and the ability to deal with pressure and/or challenge • understanding of equality and diversity • appropriate professional behaviour, • an understanding of the major principles of Good Medical Practice