Specialised Foundation Programme (16 Aug 2023)

SPEAKER_02 0:00

If you enjoy listening to career conversations, why not become a member of the Royal College of Physicians of Edinburgh? Our membership provides you with access to the RCPE educational portal with live evening medical updates, and you have options to view the symposia both in person or online. If you would like to learn more about this, please go to the Royal College of Physicians of Edinburgh website. My name is Dr. Marilena Giuniudi, and I am a member of the TMC. Today I'm joined by Dr. Risha Markham, who's an academic FY1 in Hull, and Miss Javera Turree, who's a final year medical student in Leeds and has successfully got a place to start academic foundation training in Leeds come August. So as you've guessed, this episode is based on the formerly known Academic Foundation Programme, which is now known as the Specialised Foundation Programme. So welcome to both of you.

SPEAKER_01 1:16

Thank you so much, Marilena, for introducing us. It's great to be here.

SPEAKER_02 1:20

Thank you for inviting me as well. Great. So I think what we should probably start by doing is if you could both talk us through kind of the application process that you went through. Now I think it's really important to point out to our listeners that this can change year on year. So it's really important that you check the foundation programme website. And I'll make sure that there's a link in the footnotes of this episode to that. But obviously, Rishab, you applied the year before Javera. So why don't we start with your experience of the application process and then we'll see how that changed slightly this year?

SPEAKER_00 1:58

Sure, as Marilena said, I applied in 2022. So when I applied, the process was essentially three steps. The first part was ranking the deanery that you wanted. So we had a maximum choice of two deaneries. And then the second step was to do the interview based on whether or not you were shortlisted. And then the final step was ranking your preferences according to which specific placement or combination of rotations that you wanted. And obviously that's changed this year. So when I went through the process, I wanted to stay in Yorkshire because that's where I trained. And so my first choice was Yorkshire, and my second choice was London. So I applied for both of these deaneries. And when it came around to the interview time, the shortlisting is based on your deciles, which is essentially the performance at medical school, and your SJT score, which is an exam that you take in your final year, which is based essentially on ethical principles. And that will give you a shortlisting score, which they use to decide whether or not to give you an interview. Luckily, I was able to secure an interview for Yorkshire. And the interview was also divided into two parts that both happened on the same day. The first part was an academic interview, which essentially asked you about your academic interests, your academic experience so far, any research that you've done so far, any teaching experience that you have so far, and essentially what your future goals were. And the second part was a clinical station where they gave you a scenario similar to an Osler where you were expected to act as if you were a foundation doctor and talk through how you would go about assessing an unwell patient and then discuss with the assessors your management plans. And based on your performance at the interview, you would be given a score, and this score would be used then to allocate you based on your preferences, but at the final third step of the allocation process. And I was lucky enough to do well on these steps and secure a place at Hull as an academic foundation doctor. And it's how I went through it.

SPEAKER_02 4:20

That's great. So can I just clarify in the first stage of the process, were you asked to fill out any white space questions or SCV? Or was there any part of uploading a portfolio as part of that process, or was it literally just your university deskile and your SJT?

SPEAKER_00 4:40

That's actually a great question, Marilina. And I forgot to mention, yes, there were white space questions, which I think were also changed this year. But when I went through it, there were about 10 questions that we answered, I want to say. And they were each about 200 words or so based on different aspects of your current career, your future prospects, similar to the questions they asked you at the interview, but essentially based in writing. And you would also get points for any research that you've done so far that you've published, any presentations that you've delivered at academic venues or settings, and also poster presentations as well, I believe. And yeah, those actually form the shortlisting criteria in addition to the DESLs and SJT score that I mentioned.

SPEAKER_02 5:26

Great. Okay, thank you for that. So obviously, Javu, you applied this year, so for the sitting to go into 2023. How was the application process different for you?

SPEAKER_03 5:37

So I applied also two schools, the first school being Yorkshire Humber, and the second being Northern. And the process actually differed for both of them. So I'll speak about the process for the Northern School first. So initially, on the Oriel application, everyone has to fill in, regardless of whether you want an SFP job, there's some white space questions, and you only fill these in if you're applying for the SFP. Now, the Northern School were using the white space questions on the Oriol platform in order to score the applications alongside the DESIL. Whereas the York and Humber School, they sent out an email and asked all the applicants to fill in the white space questions after they submitted the application. So initially on the Oreo application, everyone fills in, you state your preference for the two schools and whether you want to apply and fill in some whitespace questions. But my advice would be to check on the school websites whether they're using the whitespace questions on the application form or whether they'll be sending anything additionally. Now for Northern after this, the white space question answers and your decile scores, as well as things like Rishab said publications, presentations. There's also an option to fill out and document on the Oreal application form. This formed a score, and based on that, people were invited for interview. So that was for the Northern School. For the Yorkshire Humber school, this differed. So after you stated the preference for Yorkshire Humber, they sent out an email to all of the applicants. In this email, they sent out their own white space questions, and these were very similar to the ones on the Oriel platform, but there were some minor differences. And they also sent out a scoring matrix. Now this replaced the interview stage for Northern. And in this scoring matrix, there were things like leadership, team management, presentations, publications. And what was interesting was you could score yourself on two matrices. Long matrix was very leadership and management focused, and more skills. And the other matrix that you could score on was very academic. So you could calculate your score on each matrix and obviously pick the matrix, score yourself on the one which you scored the highest on. And this replaced the interview stage. So this score from the matrix combined with your decile score from your examinations that medical school formed essentially the ranking. And then from there, people offered jobs.

SPEAKER_02 8:13

Okay. So thank you for sharing that. And I think that's so important to highlight that you know, if you're interested in looking at one of these jobs, it's really important to check what the local rules are. Obviously, the application process changes year on year, but it also changes in between deaneries. So it's really important to just keep checking on the updated guidance. And obviously the timelines will change, but for both of you, did you have to apply for the AFP or SFP, however you want to call it, before the actual clinical foundation jobs came out, or was it at the same time?

SPEAKER_00 8:52

So if I start first, in terms of the initial application, they happen around the same time. It's obviously because the academic or specialized foundation program has extra steps, they do happen in between. So when I started, I had to submit my initial application around late October, I want to say, or late September. And we had up to November to complete or finalise our ranking preferences for the SFP. And our interviews were done around early to late December based on the dates you were allocated. And then you got your final scoring in early January and were allocated a place on a rolling basis between January and February. And you were given three days to accept that. So obviously, this is a lot earlier than the regular foundation program, which happens around April usually. So if you do get a place with the SFP, you get that offer a lot earlier. And if you choose to accept it, you automatically withdraw from the regular foundation program. I'll let Javeri explain how the timeline differed this year.

SPEAKER_03 10:03

So the timeline was essentially the same this year. I think the main thing to highlight to prospectives of applicants is that the timeline is a lot earlier. And for me, this was very close to finals, which I had in January. And you accept a job a lot earlier than the other medical students who aren't interested in SFP. I accepted an SFP job in Yorkshire Humber before I sat my SJT examination. But the timeline was largely the same.

SPEAKER_02 10:32

And I guess that's quite similar because many moons ago I also did what was then an AFP. So I guess that was quite similar for me about seven years ago. What I think is really important to point out as well is that one of the benefits of it happening earlier is that if you are unsuccessful, because unfortunately you can only apply to two schools, that doesn't preclude you from having a normal clinical job. And that's the reason that it is earlier. So for anybody hoping to apply for one of these jobs, don't think that you can only apply to this and then not a clinical job. This is in addition to a clinical job.

SPEAKER_00 11:13

Yeah, absolutely, Marilyn. I think I completely agree with you, which is why I would encourage anyone even remotely interested in SFP to apply. Don't let the application process sort of intimidate you or prevent you from applying. It's a really good opportunity and it's not something that you would be at a disadvantage for doing. If anything, it might prepare you better for foundation program.

SPEAKER_02 11:36

Yeah, and I think it's also very important to say that you don't need to have lots of prior research experience. You are going into this as an F1 who wants to learn about research. And it's very important if you are applying to just show how much you want to gain those skills and learn from, you know, some basic skills that you may have acquired during medical school. But this program isn't necessarily for people that have done lots of publications, published lots of papers. And I guess that would bring me on quite nicely to my next question for both of you, which is why you decided to apply for this program. Rishab, shall we start with you again?

SPEAKER_00 12:15

Yeah, sure. Like you said, Marilyn, I think the program is geared more towards people interested, not people with experience. So I actually had no publications before I applied and still managed to secure a place. I think that's testament to the fact that if you do show an interest in the program and what it offers, and you have a plan of what you want to make happen with the opportunities that it provides, that's what the examiners or the assessors are looking for, really. So what drove me to apply essentially was because I'm hoping to become an academic surgeon. And I think having that four months of protected time to conduct that research is a huge opportunity and not one that you'll get during the regular foundation program, I think. And it makes a huge difference in terms of the opportunities you get as well. Telling people, potential supervisors, especially that you're an academic doctor means that it opens doors for you. And I think that's a really good opportunity when you're trying to secure research opportunities or find a network with other academic doctors. That's one thing. And the other thing was that actually when I applied, there were no cardiothoracic placements, which is something I wanted to do during my foundation program that were offered in the regular foundation program. So, in a way, it was like I could combine both my clinical interests in cardiothoracics as well as my interest in academia. And those were the two big reasons I applied, really.

SPEAKER_03 13:47

And Javier, how about you? Yeah, so similar to Rishad, I always enjoyed surgery. From like first year of medical school, I was in theaters. And what I noticed was that other surgeons were obviously very adept at operating and also very competent in reading trials about their surgical innovations. There was a sort of gap, especially in cardiothoracics, of surgeons publishing good quality data and research articles. The data was there in these large centres such as Leeds, nobody really does anything with it. And I really wanted to combine an expertise in academics and surgery. Me and Richab are both on the Society of Cardiothoracic Student Committee. So I guess we have this similar. Also, I wanted to prepare for FT1 applications. So I think the process of interview and like scoring on matrices is very similar to like co-surgical training and also some other competitive run-through specialty applications. So for me, I saw this as an opportunity to practice because if I applied and didn't get a place, I don't think there was anything to lose. And I thought that an interview or scoring myself will allow me to identify my weaknesses. And that way I had two years to work on things that I maybe didn't have as much experience in. Again, I didn't have any publications when I applied. And you do get a lot of points for things like volunteering and extracurriculars during medical school. So these all count. Even there's points for participating in sports and competitions. So this is why I decided to apply for SFP. Okay.

SPEAKER_02 15:22

And obviously, for those that don't know and you we've hopefully sparked an interest for SFP now. SFP is the usual foundation program. But instead of one of your rotations being clinical, it's four months dedicated to research, and during which time, depending on the school in which you're in, you may also have some on calls. Now, I remember when I applied, the research was pre-fiemed. So I got the academic vascular surgery job. Now, a couple of years after I had gone through the scheme, they changed it so that you could actually approach a supervisor yourself so that you could go into the area of research that you are potentially interested in. How has that worked with both of you? Has it gone back to it being a preset theme, or is it down to yourselves to find a supervisor?

SPEAKER_00 16:19

That's a good question, actually. And I think the answer is variable. It depends on the deanery. Again, like you said, I don't think there's anything called pre-themed, but there is a difference between deaneries in the sense that, for example, in Yorkshire and Humber, we're allowed to approach any supervisor who works within the trust we're employed in and ask them to be our academic supervisor for the project that we're interested in doing. Whereas I believe in some deaneries, there are pre-selected projects that students can rank, preference, or approach the supervisors, but it would have to be from that pool of projects that have been what sort of created. Correct me if I'm wrong, that might have changed this year, Javera.

SPEAKER_03 17:06

You're all correct, it's the same. You can self-design depending on what you're interested in. And I think this is a big benefit because for me, I'm not sure about you, Rishab, academic work is always very interesting and more fun, I think, when it's a topic you're interested in. And having that self-design element gives you a bit of independence with it. So me and Rishab, I think we have our own networks and ideas with what we're doing with our projects. But the um school do email out a list of researchers that are affiliated with the local universities. Over here, it's the University of Leeds, and they send you their contact details so you're able to sort of organize your own project depending on what you're interested in. And the university gives you those contacts and connections. But I think in the northern deanery, there was um set projects to pick from. So it does differ depending on which school you apply to.

SPEAKER_02 18:02

And I think it's also important to say that actually it doesn't necessarily have to be clinical research. Some deaneries may offer medical education research. Depending on the deanery that you go to or apply for, they can offer postgraduate certificates in either health and research or medical education. So they're all benefits that you can have as part of doing this program. And the other thing that I think is quite important to say is you may apply for this program and actually realize that research isn't for you. That's not a bad thing. You'll have still gained skills and experiences which you can take forward. And there are lots of people who trial the academic route and either, you know, dip in and out of it or say, I've tried it, it's not for me. This is all about gaining your initial exposure to academic medicine.

SPEAKER_00 18:53

Absolutely, I completely agree, Marilyn. Like you said, they offer a lot of external benefits apart from just the protected research time. So in Yorkshire and Humber, depending on whether you've selected an education leadership or research SFP, you're allocated to a different PG set that you're allowed to do, and it's all funded by the health education arrangement. So I, as a research SFP candidate, I'm currently doing a PG set in health research and statistics. It's a great opportunity to learn a lot of academic skills that you're not really taught in as much detail at medical school. And it's something that will supplement the work that you do during your academic block as well. And is something that will definitely help you whether or not you're going to be an academic researcher going forward, I think.

SPEAKER_02 19:47

And I think that's testament to say that they really don't expect you to have much prior research experience. Otherwise, they wouldn't be offering this program.

SPEAKER_01 19:56

Absolutely, yeah.

SPEAKER_02 19:57

Okay, so Rishap, have you started your research project yet? Do you have a plan of what you know your research block may look like?

SPEAKER_00 20:09

Yeah, luckily enough, I have a very supportive mentor at the cardiac surgery center in Hull, who I worked with even as a medical student while I was at the Hallyok Medical School. So I was lucky enough that while I was applying for the program, I had asked this mentor of mine to support me during my research. And we'd had a few discussions about various topics that I was interested in and what kind of research I wanted to do. So my plan essentially during my early years was to try and broaden as much kind of research experience I would get. So try and do different sorts of research, you know, whether it's cohort studies, clinical research, research in a lab. So most of the work that I'd done before I started my foundation program was in lab-based research and literature reviews and sort of desk-based work. Whereas I wanted to sort of dip my hand in clinical research. And I was able to, you know, discuss this with my mentor, and we were able to come up with a project that he'd also been wanting to work on. And essentially, what the project is, we're looking at a drug called a protonin that is used in cardiac surgery, and we're evaluating its outcomes in cardiac surgery. And I was lucky enough to get this research funded as well. And like I said, being an academic doctor opens a lot of doors. So when I approached certain people for funding, they were very open to provide that for me. And having a supportive mentor obviously helps. So I think takeaways for people listening to this is try and find a supervisor early in a research field that you're interested in. Talk to them about any ideas you might have already, talk to them about what they're doing. And try and pick something that interests you. Because I think doing research is hard work at the best of times, but doing research that you're not interested in is a lot worse. And yeah, I think following these tips, finding good mentor makes a huge difference in what you can achieve with your research.

SPEAKER_02 22:18

Thank you for that. And how about you, Jabri? Obviously, you're a little bit further behind in the process, but how has it worked for you, or have you started potentially finding a supervisor, or are you just leaving that until you hit the ground running in August?

SPEAKER_03 22:32

So I've worked with quite a few different surgeons at the moment. I think I'm interested in a project related to thoracic surgery. But throughout medical school, although I've not published anything, I've been involved with some clinical research in the thoracic surgery department in Leeds. So I think I've forged those relationships. So I will probably use those going forward. And I think it gives me a good foundation to sort of work from. So my advice would be to medical students try to dip your toes in research, even if it's the very basics and you aren't really doing much other than data collection and literature reviews. It's a really good starting point to build later on. I think other sort of advice I'd give to medical students who may be a little bit earlier on who are thinking about doing an SFP, even later on at an ACF, think about what you will score for or what will look impressive interview, because unfortunately they are quite competitive SFP jobs because obviously there's not as many in number compared to the traditional foundation jobs. So things you score for are prizes and awards and also sports as well, as I mentioned, and also teaching. The way I got my teaching experience was just volunteering to teach some BLS to the medical students in the below. You also get points for things like QIPs and audits, which you can just do in the department where you have your medical school rotations. Maybe if you set aside a few hours every week, this is really feasible and quite easy to do if you keep at the forefront of your mind that you need to get this to document in your portfolio. And lastly, leadership roles are always really beneficial in these applications. And there's something good to speak about interview. And you can get these through applying to committees, medical school committees, different specialties, and they're also great with socializing as well. So I think they're my main tips for medical students who are thinking about applying for an SFP job.

SPEAKER_02 24:27

Great. And I guess the only thing that I'll add is that if you know it's one of those things that you've decided about quite late, having gone through the ACF, which is the Academic Clinical Fellowship, and a bit later on, people just want to see that you have an interest and that you want to learn. So it's never too late to get involved. Even if you don't have the connections that Rishab and Javir are very lucky to have, if you go knocking on doors, telling people that you're very interested and then you really want to work and you show commitment, then you will still be able to get to where you want to be. I think research is all about teamwork and about wanting to go that extra mile. Because it is a lot of work doing that on top of your clinical commitments. But as long as you're willing to do that, you will be able to find mentors and support out there. So I guess I have nothing else to add. You guys have been great. And I think given all your top tips, good luck to anybody that's applying. Keep your eye on the website, and I hope you tune in for more episodes of Career Conversations. And we also have clinical conversations brought to you by the TMC, where we cover common diseases and common clinical scenarios that you may see when you're on the wards. Thank you so much for listening.