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Specialties inmedicine
The CCT can be awarded in numerous specialties shown as follows.
Aselection of subspecialties are also shown with bullet points:
Acute internal medicine
Allergy
Anaesthesia
• Obstetric anaesthesia
• Pain management
• Paediatric anaesthesia
Audiovestibular medicine
Aviation and space medicine
Cardiology
Cardiothoracic surgery
• Congenital cardiac surgery
Chemical pathology
• Metabolic medicine
Child and adolescent psychiatry
Clinical genetics
Clinical neurophysiology
Clinical oncology
Clinical pharmacology and therapeutics
Clinical radiology
• Interventional radiology
Community sexual health and
reproductive medicine
Dermatology
Diagnostic neuropathology
Emergency medicine(EM)
• Paediatric emergency medicine
• Pre- hospital emergency medicine
Endocrinology and diabetes mellitus
Forensic histopathology
Forensic psychiatry
Gastroenterology
• Hepatology
General internal medicine
General practice
General psychiatry
• Liaison psychiatry
• Rehabilitation psychiatry
• Substance misuse psychiatry
General surgery
• Breast surgery
• Colorectal surgery
• Upper GI surgery
• Vascular surgery
Genito- urinary medicine
Geriatric medicine
• Orthogeriatrics
• Stroke medicine
Haematology
Histopathology
• Cytopathology
• Forensic pathology
Immunology
Infectious diseases
Intensive care medicine
Medical microbiology
Medical oncology
Medical ophthalmology
Medical psychotherapy
Medical virology
Neurology
Neurosurgery
Nuclear medicine
Obstetrics and gynaecology
• Gynaecological oncology
• Materno- foetal medicine
• Reproductive medicine
• Urogynaecology
Occupational medicine
Old age psychiatry
Ophthalmology
Oral and maxillo- facial surgery
Otolaryngology (ENT surgery)
Paediatric and perinatal pathology
Paediatric cardiology
Paediatric surgery
Paediatrics
• Child mentalhealth
• Community childhealth
• Neonatal medicine
• Paediatric oncology
Palliative medicine
Pharmaceutical medicine
Plastic surgery
Psychiatry of learning disability
Public health medicine
Rehabilitation medicine
Renal medicine
Respiratory medicine
Rheumatology
Sport and exercise medicine
Trauma and orthopaedic surgery
• Hand surgery
• Spinal surgery
Tropical medicine
Urology
Vascular surgery
20
53SPECIALTIES IN MEDICINE
20
For more details on the career options available to doctors, including all of the above, see So You
Want To Be ABrain Surgeon?
(Eccles S etal.), Oxford University Press,2009.
54 CHAPTER Being adoctor
Your curriculumvitae
What is a CV? This is a Latin phrase which means ‘course of life’. In
modern days it means a document by which you advertise yourself to a
potential employer:a summary ofyou.
When will Iuse a CV?You will need a CV for many of the jobs you
will apply for after graduating. If you join a locum agency, they will use your
CV when nding you work. You should also upload your current CV to
your ePortfolio in advance of every annual review.
What is included ina CV?The most important information to in-
clude are your contact details, a list of your qualications (those already
acquired and those you are studying for), any outstanding achievements,
a summary of your employment to date, and the details of your referees.
Publications, presentations, prizes, teaching, and leadership experience
also typically feature.
CV philosophyYour CV should not be a static piece of work— it should
evolve with you and reect your changing skills and attitudes. It is important
to keep your CV up to date, and from time to time reformat it to freshen
it up. Use your CV to demonstrate how you have learnt from your experiences rather than just listing them; a potential employer will be much more
impressed if you indicate you learnt about the importance of clear communication while working at a holiday resort, than by the actual job itself.
Getting helpHR departments and educational supervisors can give ad-
vice on writing a CV, and often you can nd people’s CVs or templates on
the Internet by searching for ‘CV’. Try to keep your CV individualized, so
do not simply copy someone else’s template.
Before writing your CV Ascertain what a potential employer is
looking for when sending in your CV; check the essential and desirable
criteria and try to echo these. You need to alter the emphasis in your CV
to match the position you are applying for, eg highlighting your communication skills or leadership experience.
LayoutYour CV should look impressive; for many jobs hundreds of CVs
are received and yours must stand out. It needs to be clearly laid out and
easy to follow. The key information relevant to the post should stand out
prominently. Think about the layout before you start writing.
LengthTwo sides of A4 paper are ideal for a basic CV (and an optional
front page); add more as your career progresses.
Remember For most jobs, the candidates applying will have very
similar qualications and so the only way you may stand out to be shortlisted for interview is via your CV. What makes you dierent?
Personal details Name, address which you use for correspondence,
contact telephone numbers (home, work, mobile), and email address
are essential. You must state your type of GMC membership (full/ provisional) and number. Stating gender, date of birth, marital status, nationality,
and other information is optional.
Personal statementThis is very much an optional section. Some feel
it gives you an opportunity to outline a little about yourself and where you
see yourself in 0yr; others feel it is an irritating waste ofspace.
EducationList your qualications in date order, starting with the most
recent or current and progressing backwards in time. Indicate where each
was undertaken, the dates you were there, and grade. Highlight specic
courses or modules of interest. GCSE and A- level results are less important once you have graduated.
Employment and work experience List the placements you
have undertaken during the F and F2 years starting with the most recent.
Include the dates, specialty, your supervising consultant, and address of
the employer; consider adding key skills that you attained.
InterestsAn optional section which gives you a chance to outline what
you like to do outside of medicine. Awell- written paragraph here can
show potential employers that you are interesting as well as intelligent.
Publications If you have not yet got your name in print, try to get a
letter in a medical journal (E p. 62). If you have got publications, put the
most recent rst; ensure they are referenced in a conventional style (see
Mwww.pubmed.com for examples).
Referees Your referees should know your academic record as well as
your ability to interact with others. State their relationship to you (such
as personal tutor) and give contact address, telephone number, and email
address. Ensure they are happy to provide a reference, give them a copy
of your CV, and tell them when you are applying forjobs.
Headers and footersHaving the month and year in either a header
or footer shows the reader you keep it up todate.
PhotographsSome people include a small passport- sized photograph
of themselves near the start of their CV; this is optional but not necessarily recommended. Why should your physical appearance be of relevance for selection for any job outside perhaps fashion andmedia?
The nished CV Use the spell- checker and get a tutor or friend to
read over it to identify mistakes and make constructive criticism; be prepared to make numerous alterations to get itright.
Technical pointsUse just one clear font throughout. To highlight text
of importance use the underline,
your CV use good-quality white paper and a laser printer if possible.
bold, or italic features. When printing
The covering letterWhenever you apply for a job, you must send a
covering letter with your CV and application form. This should be short
and to the point. Indicate the position you are applying for and briey say
why the job appeals to you, and highlight why you are suitable for thejob.
55YOUR CURRICULUM VITAE
56 CHAPTER Being adoctor
Post- Foundation ProgrammeCV
Name: Charles J Flint
Address: 4 Abbeyvale Crescent
Home: 0 442 985
Mobile: 0968 270 250
Email: charles.int@mcburney.ac.uk
Date of birth: 2 June 998
GMC number: 0223 (full)
Personal statement
I am an outgoing doctor with an enthusiastic yet mature outlook. Ihave
strong communication skills and experience of working independently,
both as a team member and leader. I am conscientious, trustworthy,
quick to learn, and to employ new skills. My long- term aim is to practise
an acute specialty within the hospital environment.
Education
206– 202
University of McBurney, McBurney’s Point, McB 8PQ
MBChB: 202
BMedSci (Hons): Upper Second Class, 209
Employment history
5 Dec 23– to date F2 to Dr Fungi, Microbiology
3 Jul 23– 4 Dec 23 F2 to Dr Golfer, General Practice
3 Apr 23– 30 Jul 23 F to Mr Grimshaw, General Surgery
5 Dec 22– 2 Apr 23 F to Dr Mallory, Gastroenterology
3 Jul 22– 4 Dec 22 F to Dr Haler, Respiratory Medicine
McBurney’sPoint
McB 7RH
McBurney Royal Inrmary
Feelgood Health Centre, Speakertown
McBurney City Hospital
McBurney City Hospital
McBurney City Hospital
Postgraduate clinical experience
During my Fyear Ideveloped my clinical and practical skills and became
condent with the day- to- day organization of emergency and elective admissions in both medicine and surgery. Since commencing F2 Ihave built
upon these skills and now appreciate the wider role of the doctor in the
smooth running of acute admissions and liaison with the community teams
prior to, and after, hospital discharge. Formal skills Ihave include:
• ALS provider(2022)
• Basic surgical skills, including suturing and fracture management.
Research andaudit
• I am currently involved in a research project comparing capillary
blood gas analysis with arterial blood gases in acute asthmatics
• I undertook an audit of antibiotic prescribing on surgical wards to
investigate whether patients were being managed in accordance with
trust guidelines. Ipresented the data at a departmental meeting and
repeated the audit after 2months, demonstrating increased compliance
• During my SSM Iresearched the role of caeine on platelet function.
Interests
I am a keen rock and ice climber and have continued to improve my
grade since leaving university. Ihave organized several climbing trips to
Scotland and one to the Alps. Iam interested in medical journalism and
have spent a week in the editorial oce of the International Journal of
Thrombophlebitis.
Publications
• Flint CJ. Letter:Student debt. Students’ Journal 2022;35(2):0
•
Flint CJ and West DJ. Multiple sclerosis in social class three. Journal of
Social Medicine 2022;2(9):8
• Lee S,
Flint CJ and West DJ. Caeine as an activator of platelet
aggregation. International Journal of Thrombophlebitis 2020;54(3):99.
References
Dr Ian Haler, Educational Supervisor, Department of Respiratory
Medicine, McBurney’s Medical Centre, McBurney’s Point, McBurney,
McB 7TS Tel 0 924 9924 ext 2370. ian.haler@mcburney.ac.uk
Box .9 The paper portfolio
Some interviews require a folder containing physical evidence of your
achievements. The following structure is a guide; the exact contents
will often be dictated by the specic application and points may even be
awarded for the organizational skills demonstrated by your portfolio.
Curriculum vitaeAt the front or the back, print on high-quality paper.
Copy ofapplication formFor interviewers to refer backto.
Degrees and qualicationsDiplomas, PGCerts, BSc, MSc, MD, PhD,etc.
Prizes, awards, and grantsLocal/ national, undergraduate/ postgraduate.
Oral and poster presentationsLocal, regional, national, or international.
Books, abstracts, and other publicationsFirst/ last author or co- author.
Teaching experienceSmall group, lectures, or courses (with feedback).
Clinical audit and quality improvementResults, reports, and presentations.
Commitment tospecialtySkills, membership exams, experience,etc.
Courses and conferences attendedLocal, national, or international.
References, testimonials, and feedback Feedback/ testimonials from pa-
tients and colleagues can show reective practice and professionalism.
Research projectsGive a summary, your exact role, and any reports.
Logbook ofpractical proceduresIncluding supervised and unsupervised.
Work place-based assessmentsNotable DOPS, CBDs, and CEXforms.
Management and leadershipTrainee representation, committees,etc.
Reective practiceTo demonstrate that you learn through reection.
Achievements outsidemedicineShows that you are well- rounded.
57POST-FOUNDATION PROGRAMMECV
58 CHAPTER Being adoctor
The F3 year
In 209, 65% of FY2s did not proceed straight into training programmes.
This jump o the training treadmill is known colloquially as the ‘F3’ year.
Goals Are you taking an F3 to improve your CV? Get experience in
a particular specialty? Try out a new lifestyle or country? Earn more
money? There are many options; dened goals will help narrow them
down.
Types of jobs
Clinical fellowA nebulous job title. Most positions involve clinical commit-
ments on the wards and the on-call rota. Speak to incumbents and scope
out any possible changes—the expectations and role can change annually. What else can the job oer? Protected time for CV development? A
funded teaching qualication?
Locum Many doctors spend time out of programme doing locum shifts
(E p. 40). Advantages include the exibility of no xed contract (work
when you want, where you want, shift availability permitting) and potentially increased earnings. You will be restricted to locums commensurate with your training level and prior experience. Broadly, locums
are available through internal sta banks or external agencies. Both
have application processes. Be mindful of lack of sick leave and pension
contributions.
TeachingSome roles also entail teaching commitments. Some even pro-
vide access to funded postgraduate qualications.
Research Some roles allow participation in clinical or basic scientic re-
search. Completing a postgraduate degree is another alternative. Will
you learn skills or produce CV-enhancing publications and presentations?
Is a year enough?
Heading abroadWorking in Australia or New Zealand after the FP
is popular. Clinical roles follow a slightly dierent nomenclature with
‘registrar’ posts being roughly equivalent to post-Foundation jobs in
the UK. ‘Resident medical ocers’ describe doctors working at a level
equivalent to the FP. The annual rotations in Australia and New Zealand
start in January or February. The application and planning process can
be lengthy: for almost all UK graduates, a visa and registration with the
Medical Council of New Zealand or Australian Medical Council will
be mandatory at the very least. Recruitment agencies can help with all
aspects of the process.
Before applyingThe advice for any job applies (E p. 52). Specically,
speak to people doing or who have done the job recently. Is protected
time truly protected? What makes the job more attractive than starting
a training programme? For competitive specialties, does the job have a
reputation for successful assistance with specialty applications?
2
2
Health Education England, ‘The F3 phenomenon: exploring a new norm and its implications’,
available at Mhttps://www.hee.nhs.uk/sites/default/les/documents/F3_Phenomenon_Final.pdf
Pitfalls It is worth noting that some specialties now have application
scoring handicaps based on number of years spent out of training (eg
trauma and orthopaedic surgery
22
). You may take a pay cut when returning to a training programme, especially after more lucrative locum
work. Whatever work you do make sure you are appropriately indemnied. Do not neglect your portfolio or ongoing professional development. Annual appraisal is mandatory for all of those working with a
GMC licence. Local revalidation teams can help organize appraisals—
initiate this process early. Do not get caught out—a whole year to improve your CV sounds attractive but the application for specialty training
often takes place late in the year before the specialty post would start, ie
only a few months after most people would start their F3 year!
59THE F3 YEAR
22
Health Education England, ‘Trauma and orthopaedic surgery 2022 national recruitment
self-assessment scoring system, available at Mhttps://www.yorksandhumberdeanery.nhs.uk/sites/
default/les/2022_self_assessment_scoring_system.pdf
60 CHAPTER Being adoctor
Interviews
Interview preparationEmployers must allow you time o to attend
the interview itself; try to give them as much notice as possible. Look at
the recruitment website for information about the format, questions, and
what to bring; try to talk to previous applicants and arrangemocks.
Interview dayArrive at the interview with plenty of time, allow for all
sorts of delays on the roads or train, even if this means you have to read
the newspaper for an hour. Relax and be yourself with the other candidates before you are called in; most of them will have similar qualications
and experience as yourself and will be just as nervous. Dress smartly in a
simple suit and tie for men and suit for women (trouser or skirt). You will
normally receive specic instructions as to what documentation to bring,
which you should follow exactly; as a minimum, bring a copy of your CV
(E pp. 54–5) and a summary printout from your ePortfolio (Ep. 8).
The interview Relax. The worst that can happen is that you are not
oered the job, which is not the end of the world. The format of interviews
varies, but there are usually 2– 3 interviewers; introduce yourself to each of
the panel and wait to be oered a seat. For some posts there will be a series
of panels, each with a dierent brief (eg CV verication, clinical scenarios,
personal skills), and you will rotate between panels. Take a few moments
to think about the questions before answering and ask for a question to be
rephrased if you don’t understand it. Always make good eye contact with all
members of the panel and be aware of your own body language.
Common questionsImpossible to predict but likely to include ques-
tions about your portfolio, relevant clinical scenarios, and current medical
news/ issues. Many questions have no correct answer and will test your
communication skills, common sense, and ability to think under pressure:
• Talk us through your portfolio; what are you most proud ofinit?
• What is missing from your portfolio?
• What qualities can you oer our training programme?
• Why have you chosen a career in. . .?
• What do you understand by ‘clinical governance’?
• Tell us about your audit. Why is audit important?
• If you were the Secretary for Health, where would your prioritieslie?
• How would you manage. . .[specic clinical scenario]?
• Where do you see yourself in 5, 0years’time?
• If you were the CT in the hospital alone at night and you were
struggling with a clinical problem, what would youdo?
• Tell us about your teaching experiences. What makes a good teacher?
Clinical scenariosInterviewers should not ask you specic medical ques-
tions (eg ‘What is the dose of. . .’); they can pose scenarios to discuss your
management of a situation. These often focus on key issues such as communication, prioritization, calling for senior help when appropriate, multidisciplinary
teams, and clinical safety. For some specialties, a few formal OSCE- style stations may be included— you should be told about this in advance.
Results and feedbackIf you are unsuccessful, try to obtain some verbal
or written feedback about how you could improve your CV or your interview
skills. Remember, there are always medical jobs so you will nd something.
Membershipexams
To progress beyond the ST years you will need to complete the membership exams of your chosen specialty and meet the appropriate level of competency. The exams are dicult and expensive (though often tax deductible,
E p. 43). Most membership exams take place two or three times a year.
You need to apply about 2– 4mth before each exam. In the past, Foundation
doctors have received advice not to sit membership examinations— this may
well allow focus on other areas of development but you may then miss early
opportunities to start building this aspect of yourCV.
MedicineRegional examination centres throughout UK and overseas; all
centres use the same exams. The MRCP has three sections:
• Part Written basic science, £448, ≥2mth after graduation
• Part2 Written clinical, £448, <7yr sincePart
• PACES clinical skills, £657, <7yr since Part.
You need to have already passed Part to apply for a medical ST4 post,
and pass all parts of MRCP in order to commence such apost.
SurgeryRegional examination centres throughout UK and overseas; all
centres use the same exams. The MRCS has two parts, you are permitted
six attempts to pass Part A, and four attempts to pass partB:
• Part AMCQ (Applied Basic Sciences and Principles of Surgery in General),
£550, eligible from graduation
• Part B OSCE, £997, eligible after PartA.
To enter an ST3 position in surgery you need to have completed the
entireMRCS.
General practiceYou need to be a GP registrar to take the MRCGP
exams. There are three parts and no time limits though the GP registrar
post is a year long; 0% fee reductions apply to associate RCGP members:
• AKT (written exam),£459
• CKT (clinical skills) OSCE stations,£352
• ePortfolio similar to the FP portfolio. Access costs £29.40 per year.
You need to complete the MRCGP to becomeaGP.
Other membership exams inthe Foundationyears
Emergency medicine (MRCEM) Three- part exam (two written and one
clinical) required to apply for ST4. The rst written may be sat as early as
F, but all parts must be passed within 7yr of passing PartA.
Anaesthetics (FRCA) Full primary (MCQ, OSCE, and viva) exam only
open to anaesthetic trainees, though F and F2 doctors can attempt
MCQ component. Applications to ST3 are only permitted when all
parts of the primary FRCA are passed.
Obstetrics and gynaecology (MRCOG) Three exams (two written, one
clinical skills) typically taken during specialty training.
PathologyMRCPath normally completed duringST.
Paediatrics (MRCPCH) three written papers (attempted in any order after
graduation); clinical exam after 2mth paeds experience and passing all written.
Radiology(FRCR) Can only be attempted after gaining trainingpost.
Psychiatry(MRCPsych) Dierent requirements for part A(GMC registra-
tion), part B (psychiatry training), and the practical (24mth experience).
61MEMBERSHIP EXAMS
62 CHAPTER Being adoctor
Continuing your education
Educational requirements You will be assessed throughout the
FP to ensure that you are developing as a doctor and learning new skills.
This will be done by Foundation assessments (E p. 8), your ePortfolio
(E p. 8), meetings with your clinical supervisor, informal feedback from
ward sta, presentations, and attendance at teaching sessions. These assessments should not be dicult but it is essential that you completethem.
Study leaveF study leave is only for mandatory teaching, however F2
study leave is more exible, including taster weeks in specialties of your
choice. You may be allowed study leave for specic courses but this will
be at the discretion of your clinical supervisor and policies vary widely between Foundation schools.
Study expenses F2s may get a study leave budget of £300– 400 per
2mth though again this varies by Foundation school. Check with your
postgraduate centre.
Postgraduate courses There are hundreds of these and the costs
range from free to >£000 per day, most are about £00– 50 per day.
During the FP years, Advanced Life Support (ALS) is no longer mandated
but is a useful course. Check the BMJ advert section for potential courses
and try to speak to other people who have done the course.
Exam planning Once you have decided on a career plan (E p. 53),
you will need to consider taking the appropriate membership examination. Membership exams are dicult and expensive but essential for
career progression, so start early. See E p. 61 or the relevant Royal
College website (E p. 629) for more detail.
Getting published Having publications on your CV will give you
a huge advantage when applying for jobs. It will be far easier to understand what sort of thing journals are looking for if you read a few regularly.
There are many ways to get your name in print and you don’t have to
write a book (which is not great for the sociallife).
Book reviewsGet in touch with a journal and express interest in reviewing
books for them; you don’t have to be a professor to give an opinion on
whether a book reads well or is useful.
Case reports If you see something interesting, rare, or just very classical
then try writing it up. Include images if possible; get a senior co- author
and ensure you obtain patient consent in line with the journal’s policy.
FillersSome journals have short stories or funny/ moving one- liners sub-
mitted by their readers. Write up anything you see which others might
be interested in; ensure you obtain patient consent.
LettersIf an article is incorrect, fails to mention a key point, or has rele-
vance in another eld then write to the journal and mention this; it might
be worthwhile asking a senior colleague to co- author it withyou.
Research papers If you have participated in research make sure you get
your name on any resulting publications. If your audit project had particularly interesting results you may be able to publishit.