Preparing for CCT (1 Apr 2026)

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Dr Aoife Duignan (AD): Hello and welcome to this episode of Career Conversations, brought to you by the Royal College of Physicians of Edinburgh Trainees and Members Committee. My name is Eva Deichmann and I'm co-chair of the Trainees and Members Committee and Registrar in Geriatric and General Medicine in Edinburgh. And today I'm delighted to be joined by Doctor Kat Ralston, who is a physician and geriatrician working in West Lothian, to talk to us today about preparing for CCTV. And thank you for coming to join us today. There's lots of things that people might think about in their run up to CCTV. I suppose one of the first points that might start to trigger beginning to consider that you're approaching the end of training is when you start to complete your peer or penultimate year review. And I don't know if you want to talk about that to begin with.

Dr Kat Ralston (KR): Yeah, sure. So, my peer I thought was pretty informal and to a degree, I think it's helpful. It highlights the outstanding areas that you need to focus on in Sd7, and it helps you plan your sd7 year. So, if you have an opportunity to have a sit down, look through everything in your curriculum and portfolio and then meet with your TPD, it kind of just helps plan out what you need to do in that next period of time. And what I would say is that you should have capacity to choose your options in S7 on what you're doing, and this should be based on your peer. So, this might be different for different people in different areas, but I felt like I had pretty much complete control over. Choosing what to do in my final geriatric medicine block. I did a community practice in geriatrics to meet the gaps in my curriculum, and I basically kind of wrote my own rota to ensure I met all the criteria. So, I think the more senior you get, the more you have license and opportunity and treated sort of as an adult to, to get the things you need to get done. I would just say sort of be organized yourself. So, I would contact ahead of specific placements, even with your peer. So, contact your educational supervisor in the CD who's in charge of the placement that you're going to, to tell them that in advance. So, take control of your own learning and what you need to achieve, and then you'll get what you need done. So just be a bit organized yourself. They're not going to read your peer. You know, you need to tell the CDE what you need to do. So, you don't get stuck on a rota. That's not going to be relevant for you. And the only other thing I'd say on your peer is if you would like to act up, and we'll talk about that a little bit later, and I would recommend it if you'd like to act up, add it on your pier because then it's very likely to happen. So, it adds extra weight to your acting up application.

AD: Perfect. It sounds like great tips in terms of, I suppose, the practicalities of preparing for your pier. Did you have to sit down with the curriculum and your portfolio and figure out where you were, or how did you prepare for that?

KR: Yeah. So, from memory, there was a form that I had to fill in that basically guided you through all the different areas in your curriculum. So, I sat down with that form and with my portfolio and just went through where I thought I had the gaps and it sort of quite involved. You do that and then you and your TPD kind of review that together. I write a plan for your final year, so it is a bit of work, but I think it's helpful to sit down and just have a think about it, because then it gives you much more control over your specific year and making sure that you're going to meet all your requirements.

AD: And I suppose obviously in geriatrics, you were also completing internal medicine training. Was that a separate process for each curriculum or did you do it all in one go?

KR: Yeah, it was two separate ones. No, I think about it. My geriatric one was in person and my internal medicine one was remote and online. The internal medicine one was less intensive. I'd say your specialty. One had more areas to fill in on the form, and it was more detailed. And what they should do is then put this on your portfolio. So, there's an electronic version of your peer, which then gets referred to in your final art piece.

AD: And I suppose that variation that you experienced even within one deanery might highlight that there probably will be some variation across the country and how people experience their peers. So, it's worth speaking to colleagues who've gone through it already.

AD: Yeah, I think speaking to people who are a year ahead of you is only going to be helpful or a couple of years ahead just to work out how it works, where you are and what's been helpful for them. So, I suppose your peer will be around nearer after your penultimate rupee, but for your final rupee. Was there anything in particular that you felt you needed to prepare for or have in place that was different from other recipes?

KR: Yeah, I think that the pressure is kind of on for your final EP. I think your mind is quite focused at that point and your PA should help with this, but I would have your arcp decision aid in your mind from the start of SD seven and have a look at it. And what you don't want to miss is there's a final column called CCTV on the far right, and you need to meet those criteria as well as the criteria on your year, SD six, seven or eight. So just make sure you're looking at both of them and that you're going to meet both criteria. And there might be things like patient survey that you maybe haven't got done. I would highly recommend getting them done and SD five, SD six, but just have a look at the things you might have missed earlier on in training and make sure you're meeting your criteria for your key projects and things like that. So, for example, I think this has changed with the new curriculum. You had to have a community focused key project quite easily have missed that. And I think probably by this stage you feel a bit sick of the portfolio, to be brutally honest. But you need to just accept the fact that you need to engage in it, and that's how you're going to get through your KT. So, it's at the end of a long road and it's the final hurdle you're getting to. So just grin and bear it a little bit and just engage in it as much as you can. I would say make sure your personal library is really organized. Make things really obvious to find. Split things up into folders and you'll have your arc P every year. You'll have folders specifically for each year. So, your folder things that you need. We had like a supplementary info form which divided how much general medicine and geriatric medicine you've done. That'll be different in different places, but just so they can make sure you have the right amount of time in each one, your absence and story declarations and then your logbooks. So clinical activity procedure logbook and teaching attendance. And I just had Excel spreadsheets for each year. So, I had one spreadsheet, two, three, four, five, six, seven all in one and just updated it every year. So just try and be as organized as possible and make it easy for them to pass you. You don't want to make it hard. And the only other thing I would say is that it would be sensible to make your completion folder in your arcpy at the same time, because you're already in your personal library and in your ePortfolio. So, this is a folder that you need that no one really tells you about to complete training and CCTV after you've done your final arcpy. And there's helpful guidance on this on the Royal College of Physicians website, but essentially you need your ALS certificate. If you've accelerated, you need confirmation of that and the dates you need your completion date calculator, you need your peers, you need a CV, which might surprise you if you've not done a CV for quite a few years. So, a CV and then your exam certificate, so your MRCP and SW. So, if you're already doing all your organization bits for your final P, I would do your completion folder at the same time because the process is exiting. talk about in a little bit. Is there longer than you might think? It doesn't finish at your final art piece, sadly. Some useful tips about giving your portfolio a final bit of love before you're ready to part ways with it. I'm always quite envious of the anaesthetic trainees. They get little donuts that kind of finish in a full circle every time you get your home module signed off, and you'll see like a little bit of satisfaction. We don't quite get the same, although you do get the little traffic like now, which might help a little bit to give you that extra little satisfaction as well as internal satisfaction when you get things completed.

AD: You mentioned acceleration or that some people might consider acceleration and the evidence you might need to put in your folder. Would you mind talking a little bit about acceleration?

KR: Yeah. So, I did accelerate. And the reason I did this is I'd taken a year and a half out of program to do medical education as a fellow in med ed. And why did I do it? I think I felt ready. I felt like I didn't need to do all that extra time. So, I kind of accelerated by six months. And I suppose a secondary reason was that I kind of knew when some consultant jobs might be coming out. And this cannot be the reason that you say you're going to accelerate, but obviously it might come into your decision making that you know, or factors in your life that would be helpful to CCTV a little bit earlier. But I think the key reason really is, do you feel ready to eat a little bit early? I think it's up to six months that you can accelerate your training. So really that final like half year out of program, I did fifty over fifty of clinical and of med ed. And I thought, I think I could probably count that as a year. So, in that six year, I did fifty percent clinical, fifty percent med ed, but I did my portfolio as if I was doing one hundred percent clinical. And I think that helped as evidence. I'd say there's no rush to complete training, that you're going to be a consultant for many, many years. And when you actually, like visualize a pie chart of your student years. Your foundation training IMT and consultant. The consultant part is like a massive part of that pie chart, so actually don't feel in a rush. It's really only if it feels right for you. Often it might be people who've taken significant time out who've, you know, maybe had more life experience, you know, had children through training or done programme time or research and maybe just don't feel like they need that, you know, they can cut down a little bit and still feel ready. I would say that your ePortfolio needs to be pretty perfect to get through acceleration. I think the decision making around it is probably becoming more tight, just from what I've heard. And I would say that you need to have been overall above expectations or achieving more than the average trainee for you to be able to accelerate. So if you're thinking about it, think about it early. There's only two times that you can accelerate from memory. One is early on in sort of S4, if you've done maybe less local requirement for service trainings and things that you want to count, or S2 six you can't accelerate T7 if it's too late. So just think ahead and think about how you're going to show that you are more qualified than the average person to complete your training a bit earlier.

AD: That's really helpful. And I was thinking about whether it's the right thing for you because you have had additional experience or have had time out of training where you feel you've gained equivalent skills. One question that I've heard people think about when they're figuring out whether they would like to accelerate their training in some areas of the country, you'll have your time divided between your specialty and general medicine, whereas in other places they're more intermingled. Was the time for you taken from just your specialty or general medicine, or was it a little bit of both?

KR: So, it should be equally split. So, I had three months taken off general medicine and three months off geriatric medicine. So, if you do work in a place where your placements are split, like is the case in southeast Scotland, then you would expect it to be an equal split.

AD: That's really helpful for people to consider in terms of the time that would be remaining left in their training. You mentioned earlier as well about acting up. Would you mind explaining a little bit about what acting up is and how it went for you, or what you thought of it?

KR: Yeah. So, acting up is when you're in your final year of training and you can have a three-month period within the last year before CCTV, where you are essentially doing the consultant job on the consultant rota with supervision. I would definitely recommend it. I think it's a really helpful, potentially one of the most helpful parts of training you'll probably do. I probably wouldn't recommend being in the first trimester of pregnancy while you do it like I did and feeling fairly rubbish, but even then, I thought it was extremely helpful. So I was working at a different site from my current job when I was thinking about acting up, and I'd heard that if you know where you might want to work, then it is helpful to act up where you're going to work, which makes perfect sense because you get to know the people, the processes. You can have everything set up, and every hospital is very different in terms of how their consultant teams and consultant roles work. So, I would really recommend trying to act up where you think you're going to work. There's obviously going to be uncertainty because the timelines don't match up. Like you have to apply for your acting up before the job applications and things. So, it doesn't matter if you act up somewhere where you don't work ultimately, but if you can make that happen, that is ideal. And what I would say is I acted up in the final three months of training. And if you can, I think that's best because it's a bit odd to go back to being a registrar after being a consultant. I know that some people have had to do that if there's been a few s7's in the same department and that's fine, but if you can, I would choose the final three months. So, then you just kind of seamlessly go into your consultant job and the resident doctors know you as the consultant. Otherwise, it's just a bit strange. Like I said, get it on your PR if you want to do it. So, it helps your application. And this might be sort of Scotland centric, but you apply via an out of program request. We're acting up. So the criteria is that there has to be like a consultant vacancy in the acting up unit with funding, and you have to have confirmation from the clinical lead in that unit that they support you to act up, and they should give you a job plan for the acting up period. You need to speak to your education supervisor, and they need to be supportive, which generally they will be. And if you are changing sites or even if not, actually you have to be released from your current rota. So, the clinical director of the place that you're working needs to release you. Now. They need to have a really good reason not to release you. And I had no problems with this, so I changed hospitals to act up in my chosen site. But it's worth speaking to people in advance to get all these things lined up, because you can imagine that's quite a few criteria to jump through the hoops, and your approval is via your TPD and the postgraduate dean in Scotland. So, I would say you need to submit your application six months in advance, minimum three months, but six months would be better. So, when you're acting up, you have a named supervisor and you should always have a named contact that you can ask questions of, including someone on call during on call periods. So, you might do another consultant on call, but they should be available on the phone, or someone should be available on the phone for you to call. So that's kind of mainly the forms and how to apply and the kind of logistics of it.

I guess thinking more about the experience itself and the practicalities. So, you shouldn't be on a register. You should only be on a consultant router. So, if you find yourself on nights for hospital or night, like, no, that shouldn't happen but just advocate for yourself. You're not there to register you. There's a consultant. I thought it was super supportive environment to do the consultant job and kind of ease into it while feeling like I had people to ask questions of. So, I thought it was great. So, I guess one of the things I was probably most worried about was like managing the acute take because my job was General Hospital. So, I do geriatrics and also general medicine oncology. And my tips for that would be I would get in like half an hour early from handover just to quickly look through. Track is what our computer system is, just to quickly look through the computer and have a quick look through what patients might be in me. I'm seeing have a look at A&E. I didn't look at things in detail. I write notes or anything. I think it's just feeling a little bit more prepared when you're going up, particularly looking at like the high dependency unit and who's in that. So that if there's things that you're like, I actually have no idea how to manage whatever random thing that's there that you can have a quick think about it before you go up. And I would say set time limits for yourself so that you ward round is really rapid and you feel you have much less time as a consultant than as a registrar actually, and you need to get round in time so that, you know, the resident docs can get the jobs done so that you can tell the site manager what's happening, etc.. So, I would say like by half ten, I have to be finished in this bay kind of thing. So, I would know that actually, if I wasn't making that, I need to hurry up. And that means that it's a bit less stressful if you actually think about by the end of this bay, it needs to be this time. And I would say to achieve that, the acute take is really just for decision making. Are they sick? Are they staying? Are they going home? So not the minutia of they need like an anaemia screen or thyroid function. Or you can write those things down if you want and they'll get done in the downstream wards. If they're staying in, you know, the minutia is going to get done. It's kind of like, what is the pathway of this patient? What word do they need to go to? So that's one of my tips. And I would say, use your colleagues, use the registrar. It's okay to show vulnerability and show that you're not perfect and to ask the room what they think and to get people's opinions. That's absolutely fine. And that's normal. And it's also fine to ask your consultant colleagues what they do. And you'll find that when you're a consultant, there's a lot more conversations that happen between consultants about what to do than you think there is. You think the consultants coming in knowing everything. And actually, you know, they've probably asked their colleague before they've come or after to say, what do you think about this? Or I'm not quite sure if I did the right thing here. So, I think it's just humanising to realise that that is what is happening. You know, we're not infallible and actually it's safe to get people's opinions and ask the room. So don't feel like as a consultant, you need to be. No one can question me. That's not safe. You need to invite your team into decision making and have an environment that allows someone to say, I think you might have missed this blood test or scan result or something. I say that's really important. And also, we can't be perfect. This comes back to the minutia versus the big decisions like where I work. You've got like seven minutes per patient max. So, you can't be perfect. You need to just make the decisions and accept that there will be a degree of less than perfect there, but that is fine as long as it's safe. The other thing I would say is it can be helpful to prep the people that are coming on the wardrobe with you. So, this is how I like my documentation. That can save a lot of time. So, I like to have the functional baseline in the problem list. This is the way I want things set out. I always say I want to write an impression. So, I think you can't check everyone's notes no matter how much you want to. And the notes won't be as good as your own written notes. As a registrar, you have lovely notes. And then as a consultant, you look back on the notes and you're like, oh God, like that doesn't reflect what happened, but you can't have that level of control. So, the things I always check are the impression and the plan. Those are the most important things. And I try and write my own impression because if you have a colleague the next day, the impression bit is the most useful bit than anything else. And the plan obviously, to make sure the things that you've asked for are going to get done and then like try and have a process for things that easily forget, like make sure, you know, I've checked the chest X-ray, the ECG, and are they on DVT prophylaxis for every patient? So, a little kind of mini checklist. So that's kind of the post war driving tips. And then on the take itself Self. It can be busy and you might feel like you have to post to everyone before you go home. Sometimes that's not possible and that's okay. So, if it's busy, I will prioritize the people that are sick because they're the people that I might get called about at three in the morning, and the people that I think I can get home. And actually, if there's other people there that I don't have time to see, you know, it's important that you get home on time as well. So just think about how you're going to prioritize your workload on the tech itself. And because you're kind of a trainee still, even though you're in this sort of acting up role, it's kind of up to you how much you discuss cases. Well, where I worked, it was up to me. Certainly, no one was sitting down with me and saying, let's go through every patient that you saw on the ward round. And I think actually that could be unhelpful, because if you ask two consultants to go through their patients with each other, they will probably make different plans from each other. And that's okay. That's not one's wrong and one's right. It’s just people have different styles and different decision making and that's fine. So, I think manage expectations with your supervisor and decide what you want and what's going to be helpful for you. So, I kind of said, I'm just going to discuss things that I'm not sure about or if I want to debrief. And that was really helpful. I didn't go through every case that I saw because if other people are suggesting that you do different things, then that can feel really unhelpful and kind of disempowering as a consultant. So that is kind of my acting up top tips.

AD: That is really helpful from that. I think a lot of people would be very keen to have a period of time acting. I suppose that will vary, and it set up a little bit depending on what deanery you're working in, or if you have perhaps procedural skills that you need to acquire before the end of training. I suppose people might need to balance what their needs are. But certainly, I agree that everyone I've spoken to has said that they find it a really valuable experience. And I suppose also worth bearing in mind that if you're less than full time, that the period of time can be pro-rata as well, rather than it just being a three-month set calendar block. Certainly, in Scotland in terms then of the practicalities of CCT, which I'm not sure if we defined earlier, but is that your certificate of completion of training. There are understand from you and from other colleagues, lots of administrative and other tasks that need to be done to actually get the piece of paper and join the specialist register. Would you mind talking us through what's involved in that? Because I understand that it's more than one might imagine.

KR: Yeah. I think no one really tells you about how to CCT. You think you've got your final app and it's all grand, and then there's like multiple other steps that you haven't considered. And usually, you find out about it just by people telling you who are your heads or something. But I would say just alongside this, you're going to be thinking about where you might want to work. I've already talked a little bit about that, and I'll maybe start with that. So, I've just got a couple of tips of what I learned from that process. And then we'll go into the practicalities. So, I would say have a think about it pretty early, like SD six would be a good time to think about where you might want to work. Departments are planning their jobs, you know, a couple of years in advance and things like that. And they need to go through a financial approval process that can take a long time. So, if you think you want to work somewhere, let them know they're not going to advertise a job unless they think there might be someone who will apply who they would like to work in that department ideally. So, letting people know early is really helpful. And don't worry about speaking to more than one place. In fact, that is completely normal. It feels really odd if you're speaking to the clinical director in multiple different hospitals, almost like you're cheating on ones of hiring with another. But it's important to understand different places. And even if you think, oh, I definitely want to work one place, you know, it's always worth speaking to several places and scoping out what jobs might look like and things. So, it's totally expected and don't feel strange about that. And I think the decision-making process is really difficult. I find to decide where you might want to work, and I guess it kind of comes down to like what your values are and thinking about what can change and not change in a job. So, your job plan can change and does change over the years. And what you start with might look totally different in ten years’ time versus like the two things that don't change or don't change a lot are the location of the hospital. You can't change that. So, your commute and also like the people that you're working with. So, I would think really carefully about those things and try and balance up what's important to you with those considerations. And just to say, like, I sort of had a mentor like coach, which I got through NHS scheme where we work just to try and work out what might be right for me. And I find that really helpful. So just think about what resources might be available and just speak to your friends, your colleagues, other trainees to get a sense for what job you might be looking for. So that's just a very brief thinking about job situation. And it is tricky. And I would also think about having a holiday between Keating and your job starting. So, you can have up to three months off before losing your employment rights, such as maternity leave, things like that. So, you're probably not going to have an opportunity like this for some time. I had two and a half weeks off, which was great. I probably could have taken more actually in hindsight, and one of my friends is starting another department has gone to New Zealand and is having a lovely time. So just have a think about that. You deserve it after getting through your training.

AD:  It's a good tip and I think it's never any harm to have a holiday in the future. And I suppose the practicalities of applying for jobs are also going to depend a little bit between specialties. And I know some specialties. Generally, in our region, there's been more competition for jobs than in others, which may also affect the decision making that people have about where they're applying or what specialties they're applying for. I think if people want some more tips about applying for consultant jobs, the recently appointed consultants committee have also recorded a podcast as part of their Consultant Conversations podcasts about applying for consultant jobs, which we might also find helpful to have a listen to as well. And so, I suppose that brings us back to some of the more mundane parts of applying for CCTV, as opposed to the less exciting to think about what you might do in the future.

KR: Yeah. Also, the recently appointed consultants on the RCPE education portal had a one-day symposium on applying for consultant jobs and choosing consultant jobs, and I found that really helpful and watched it when I was sort of trying to make decisions and things. I'd also recommend that. So just one more thing to say is that absolutely like some specialties, very limited consultant jobs, some specialties. Lots of job availability. And it will change where you are. And I think that that just underlines speaking to lots of different Departments is useful. But the other thing to say is that you can have a period of grace if you haven't secured a consultant job by the end of your training, and that's quite common. You can have up to six months paid in a registrar role. You need to apply for it. So ideally six months’ notice via your TPD minimum three months, and you can act up in that time. You have to do a registrar job, not a consultant job. There's also, of course, like locum consultant jobs that you can do that wouldn't be in your period of grace. You'd have to resign and start a locum job. But don't panic if you haven't got a thing sorted by the end of training. There is a period of grace options that you can do to tide yourself over while you're finding your job.

AD: Okay, I suppose if someone's thinking about a period of grace or considering accelerating, it might be worth trying to figure out whether you'd prefer to just not accelerate and take that pressure off and finish your training, and then have that further potential of six months. Unless you had a real reason that you wanted to conclude your registrar life.

KR: Yeah, I think look at what the opportunities are, where you are and within your specialty in terms of when you think consultant jobs might be coming up and the clinical director departments will be able to help with that as well as just, you know, speaking to people who work there. You know, there's lots of money here and there that people can bring together if they know someone's interested. So, I think that just underlines the importance of having those conversations early. Okay. So, the practicalities that so I mentioned before that you need to do this completion folder and that's on your E-portfolio. And that's so that the JRC, PTB can approve your CCT and you can get on the specialist register. So, the next bit is about how to get on the specialist register. So, you need to do your completion folder. And then you need to email an email address the JRC PTB. You can find it on the completing training page. And what you need to tell them is your GMC number, your training number, your CCT date, and crucially, if you have a job, the date of your job starting. I'm going to sort of quote our mutual friend Sarah Bartlett, who wrote This Idiot's Guide to CCTV, which really helped me. And I'm sort of slightly plagiarizing her here with this as well. So, there's a long wait time for this. It doesn't fully appear that there's an organized process for this to happen, so you need to chase them up. And then knowing you have a date of a job starting, generally, it should be a little bit quicker than if you don't have a date of a job starting. So definitely get that in. And I had issues with my completion date calculator in that the copy that they downloaded was different from the copy that I uploaded, and it was just a massive faff, and it only got started about a week or two before starting, which feels a little bit tense. What helped was I phoned them and actually phoning them was much more helpful than emailing constantly, because it pretty much got sorted out once I'd been on the phone a couple of times. You cannot start your consultant post until you are on the specialist registrar, so it's really important to get it sorted. We had advice if it was two weeks before and you've not heard anything, then phone them and they'll sort it out. They will then contact the GMC when it's all gone through, and then there's a form to complete on the GMC to be added to the specialist registrar. I think I did the form myself separately ahead of this time, and you can do it, and I'd probably just recommend doing that so that there's less steps in the process after that. They will also contact the GMC as well. And then only then once you're on the specialist register, do you get your contract and then you can start work.

AD: Is there a fee to pay to join the specialist register as well?

KR: Yes, there's a fee. I can't remember how much it is, but it's a substantial amount and there's no escaping it. So unfortunately, you have to suck it up and pay the fee. But these things, you can claim them on your tax returns. The BMA have like good guides to that. And I think if for some reason it doesn't go through there is like a convoluted process department, depending where you could be employed as a locum for a short period of time before it started. But you really just want to avoid that if you can. So, my top tips would be get all your ducks in a row right away. So, you want to have your completion folder ready by the time you hear about your arc P. Email them straight away and then just call them if you're not getting anywhere. And the only other thing I would say is sort of it is a nightmare. Even if you're staying in the same hospital. But my experience of it is a nightmare to keep your email the right sort of access into the electronic records and things. So, if you're staying in the same trust, I would try and contact it in advance and say, I'm staying on, I'm not leaving as a registrar and try and keep things going as much as you can. Even though I did this, I still lost my email for about three weeks when I was a consultant, which is a total nightmare. So just be prepared for problems there and it can be really frustrating but just try and advance to inform it that you're not leaving and that will make the transition much easier.

AD: Definitely. I think it's always stressful. I mean, these are, I think, one of the things you were touching on as well About the, I suppose time frames for getting everything signed off with the GMC made me realize that you really don't want to get an outcome five at your s t seven P if you've got a tight turnaround on the other side so you can have everything nicely lined up for your last P is probably quite helpful.

KR: Yes, I would definitely agree with that. So, the process is very slow. So, you don't want any more time added to that to make it even more tight. Yeah. Agreed.

AD: Well, I think that hopefully is a pretty good summary of all the things that people might need to think about as they start through from their p r right the way through to reaching the end point of their training and hopefully then starting a consultant job, if that's what they want to do as their next step. If you have any final words of encouragement or thoughts for anyone about to go through that process.

KR: I think that it is a bit of a faff, and we've done your portfolio for years now, and you might feel a bit sick of it, but it is like the final push and being in smelting is great. I really enjoy it. You have much more flexibility and control over your life, and it's really rewarding and also much more kind of supportive and doable than you might think when you're in training. So, I would just say get through it and good luck for everyone listening to get through their final arc and it is worth it at the end.

AD: Perfect. Well, thank you so much and thank you to everyone who has listened to us and joined us today. If you have any suggestions, we always welcome requests for topics for future podcasts, and we hope you enjoy listening to the rest of the Career in Clinical Conversation series. Have a lovely rest of your day.