Securing specialty training is a crucial milestone in securing a job in the specialty you want. So once you’ve achieved this, you can relax until registrar applications open right? Wrong… write Dr Edward Gee and Dr Sammie Jo Arnold

The deadline for submitting specialty registrar jobs will arrive much sooner than you think – this is not the time to take your foot off the gas.

Below is advice based on our own and others’ experience. We were lucky enough to be successful in our first applications for the registrar training program, so I hope to be able to provide some useful advice that might afford you the same luck.

Step1: Information is power, become powerful!

The first thing you need to do is download, and spend time reading, an up-to-date personal specification.

Spend a few evenings or the weekend studying this, you must be able to prove, with examples, that you meet each and every one of the ‘entry’ and ‘selection’ criteria by the time of application, roughly February of CST2. Not very far away.

You will see that you are expected to spend a certain amount of time in the specialty you have chosen and other ‘relevant’ fields. Check early that you are on target to gain the necessary experience over the next two years. If not, this can potentially be rectified if spotted early enough. If you leave it too late you may not be eligible to apply for registrar training jobs. There may also be certain courses that you are expected to attend and these book up early.

Seek out the recruitment timetable for the year online, print it off, stick it on the wall and mark these key dates on a wall planner or in your diary. These dates arrive extremely quickly.

Step 2: Take a long, hard look at yourself

From now on it is imperative that you become very organised and efficient. Be honest with yourself. If, like me, everything is left until the last second, deadlines are more of a start-date and being late is a way of life, it is time to stop. Realise that very few people are naturally organised, it takes conscious effort.

The way I learned to be more organised and not drown in a sea of forms, emails and outstanding deadlines was to force myself to do things immediately, and completely, in one go. Don’t spend too much time contemplating the task, as this is time wasted. Most tasks can be completed in the time it takes to deliberate them. Send emails immediately from a smart phone and have a regularly-updated “to do” list. If you decide to do something, do it straight away.

Be self-aware, if you are delaying something and making excuses or putting something off realise early and rectify this. This new way of thinking should start today with downloading the personal specifications.

Step 3: Get a spotter

It is important to get help from others. The most effective way to do this is to get 2 people who can help and guide you throughout the process, one at your level and one more senior in your specialty. See them like spotters.

The spotter at your level will need as much help as you do, so form an alliance and have regular progress reports. Make sure this is a give and take relationship and feel comfortable giving each other feedback and constructive criticism. This person should be your new best friend (right up until you walk into the interview room). This can be invaluable at maintaining motivation and pace of progress.

The senior spotter should be someone that you get on with so they have a vested interest in you achieving your goals. A registrar is best as they have been through the system recently and understand the process.

Step 4: Start beefing up your CV

If you have not written a professional CV, get on with it. This can be completed in an afternoon and should contain as much information as possible. It will require multiple overhauls and should be shown to someone senior at each stage, so get a copy down on paper and start waving it under noses.

People will give differing and contradicting advice about how to write a CV and that is not the aim of this article. The truth is, there is no one set way, so feel free to take certain advice from each person and make it your own. Keep in mind that this is the only information the interviewers get about you and they have five minutes to peruse through it, so make it absolutely fool proof to navigate with a large contents page and very bold titles. The litmus test is to give it to your Nan; if she can find the publications section in less than 10 seconds, you’re on to a winner.

Do not sell yourself short, if a lot of time and effort went into a piece of work, audit, paper, teaching session or something went extremely well, include details. Do not miss this chance to show them everything you’ve done.

If your CV is not brimming with publications don’t panic there is still time. There are also other ways to improve your CV and show commitment and skills other than paper writing. If your CV is too full of papers at the time of your application it’s possible you could be seen as a trainee who’s never on the ward, but in the library writing papers. Remember your job is to be a senior house officer and you should be doing this extremely well, extra things are extra.

Papers:

• However long you think it will take to write a paper, triple it
• However long you think it will take to get it published, triple it.

Once the main bulk of a paper is done you may relax, thinking you’ve only got to “finish the referencing off…” In my experience the mean time to submission is approximately three months.

Cases are usually rejected a few times with advice on improvements prior to resubmission. Each resubmission and reply takes a few months. The start of CST1 is the time to put in hard graft and lay foundations for papers.

If you haven’t completed and submitted a paper well before the end of CST1 there is no way it will have been accepted by the time you come to apply for registrar jobs.

When thinking of paper ideas, do not over-reach. Remember you have an extremely tight schedule within which to complete any papers, submit them, do two or three re-writes and, once accepted, wait for it to be published.

Audit:

You should have at least one audit completed per year. It is important to perfectly represent the audit cycle. Closing the loop is imperative. Study the audit cycle before embarking on an audit and once again, don’t overreach. An audit does not have to be overly impressive and ground breaking.

Presentations:

Each piece of work you do should produce a presentation. Look up dates for national and international presentations. Submission deadlines for presentations can be several months before the conference so start this early.

Step 5: references

A major part of your application for registrar jobs will be your references. People rarely think pre-emptively about their references. Think about what you want your reference to say about you and how you are going to make sure that you are all those things. Essentially this means working very hard at your job and doing extra to show willingness, initiative and commitment to the specialty.

Step 6: Prepare for the biggest interview of your life

As Interviews loom in CST2 it is a good idea to prepare accordingly. Get as much knowledge from others that have gone through it as you can. Interview courses can be useful, especially if you do this early.

The interview should be prepared for in fine detail, it is baffling that some people do not prepare for an interview. You need to understand that this is far more important than any exam you will ever sit. Every time you are unsuccessful you have to wait a year to try again and that counts heavily against you in the scoring.

Step: 7 Hang in there

Do not feel rejected and downhearted if you are unsuccessful in your registrar applications. It is an extremely competitive field and it is difficult to know exactly why certain people are successful and others aren’t. Realise that the vast majority of candidates going for the job have prepared just as well and want the job just as much as you do.

Each time you are unsuccessful is an extra year and unfortunately this counts heavily against you, which means a lot needs to be done in that year to counteract this and bring you back into a competitive position.

Decide quickly what to do with this extra year that will be most useful for you. These jobs will also be highly competitive so apply quickly.

In summary, be efficient in everything you do and be an expert at spinning plates with several things on the go at once. Don’t leave it too late, you need to be working hard from the start of CST1. Be realistic about how long tasks take, especially publications. Don’t start something unless you intend to finish it and use as much help as you can get.

Dr Gee is a specialty registrar in Trauma and Orthopaedics and Dr Arnold is a core trainee year 2 from the North West Deanery.

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