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Core Medical Training

Hi guys,

I was searching this forum and couldn't find anything/much on CMT. I thought it may be a good idea to start a thread on CMT where everyone can share their thoughts on CMT in UK eg. deanery with good training + teaching, training structure, workload etc.

I apologize in advance if there are any existing threads on CMT.

As we all know, it is time of the year where foundation trainees are mostly preparing for CMT application. Just a brief background about myself - I am currently an F2 in Wales. My rotations in F1 and F2 are all based in DGHs in the same health board. Don't get me wrong, I have been having a lovely working experience so far and everyone is so nice eg. good seniors support, good teaching etc. However, I was just wondering if it is beneficial/necessary to get some experience in city hospitals during CMT?

Also, inevitably the next big question will be whether to go for CMT in England/Wales/Scotland. I am more inclined to move to England but I am also considering to remain in Wales. The deaneries that I am interested are as follows:

A) England - London, East Midlands, West Midlands
B) Wales - South Wales (mainly Cardiff)

I am well aware that the areas I am looking at are highly competitive but never try never know? I am trying to brush up my portfolio as much as I can now and hoping that having recently passed my part 1, it will slightly boost my application.

It will be great if anyone can shed some light on the training structure, teaching, workload or even any advice on ranking the deaneries on Oriel!

It may be worth taking note that I am hoping to specialize in Dermatology. There are currently no dermatologist in my healthboard and I am struggling to get projects done. As far as I am concern, north London and Cardiff have good dermatology training. I am aware that it may be too late but I am hoping to get as many projects done during my CMT year.

Thank you for your time! :smile:

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There might be some competition when it comes to higher specialist training but is anywhere really competitive for CMT? This table suggests that London and Oxford are the only places in which there might be another doctor chasing the same post. Remember that a number of doctors apply to CMT as a back-up alongside ACCS, Academic Clinical Fellowships, etc. Another group won't satisfy the basic eligibility criteria (e.g. trained overseas and unable to demonstrate foundation competencies, etc). Most regions will be interviewing well under one "true" applicant for each available place.

Well done on passing Part 1 early. Some people struggle getting all three exams done by the end of CMT and it's a common reason for having to extend training. Are you going to crack on with Part 2 Written and PACES?
Reply 2
Original post by MonteCristo
There might be some competition when it comes to higher specialist training but is anywhere really competitive for CMT? This table suggests that London and Oxford are the only places in which there might be another doctor chasing the same post. Remember that a number of doctors apply to CMT as a back-up alongside ACCS, Academic Clinical Fellowships, etc. Another group won't satisfy the basic eligibility criteria (e.g. trained overseas and unable to demonstrate foundation competencies, etc). Most regions will be interviewing well under one "true" applicant for each available place.

Well done on passing Part 1 early. Some people struggle getting all three exams done by the end of CMT and it's a common reason for having to extend training. Are you going to crack on with Part 2 Written and PACES?


Fair point! Different people are telling me different things which got me really confused! Guess I will just have to get all the paperwork done and score as much as I can for the application.

Thank you! Yeah, most definitely! I still have a week time to think about taking Part 2 in Nov. And again, some regs told me to go for it and some said I need more time to prepare for part 2. I don't really know what to do. Part of me think that I am being overly ambitious to even consider taking it in Nov but part of me just want to give it my best shot and get it out of the way. As for PACES, I will only attempt it mid CT1 or towards the end of CT1 when I have more clinical experience!
My view on exams is to sit them early. I kind of get the "wait for experience" message but, on the flip side, your clinical rotations will make a lot more sense if they're based on a firm knowledge base. It feels too late to be reading books just before an exam and having epiphany after epiphany along the lines of "oh so that's why I do things this way" and "that must be what Dr X meant when he said...". I'd personally get them done asap if I were

You probably are a little more likely to fail at each stage with less experience and preparation time but that's only really an issue if you're stretched financially.
Reply 4
Original post by MonteCristo
You probably are a little more likely to fail at each stage with less experience and preparation time but that's only really an issue if you're stretched financially.


I thought it was the exact opposite? That people who take exams later are more likely to fail. I'm sure that's something I've seen @nexttime say before
Original post by Ghotay
I thought it was the exact opposite? That people who take exams later are more likely to fail. I'm sure that's something I've seen @nexttime say before


The OP's comment was in line with the "received wisdom" about when to attempt the various components of MRCP.

That is, do Parts 1 and 2 ASAP, then wait until you gain more clinical experience before attempting PACES.

"In general, the data suggest that pass rates are highest when candidates:

make their first attempt at the Part 1 Examination within 12 to 24 months of graduation

make their first attempt at the Part 2 Written Examination within 36 months of graduation

delay their first attempt at the Part 2 Clinical Examination, PACES, until 36 months after graduating

pass the Part 2 Written Examination before attempting PACES."




https://www.mrcpuk.org/mrcpuk-examinations/advice-guidance-and-preparation/choosing-right-time-take-your-mrcpuk
Original post by Zodiac88
Fair point! Different people are telling me different things which got me really confused! Guess I will just have to get all the paperwork done and score as much as I can for the application.

Thank you! Yeah, most definitely! I still have a week time to think about taking Part 2 in Nov. And again, some regs told me to go for it and some said I need more time to prepare for part 2. I don't really know what to do. Part of me think that I am being overly ambitious to even consider taking it in Nov but part of me just want to give it my best shot and get it out of the way. As for PACES, I will only attempt it mid CT1 or towards the end of CT1 when I have more clinical experience!


You should take part 2 asap - there is lots of overlap with part 1 that you will only forget.

I would also do PACES as soon after part 2 as you can. Again, there is knowledge overlap. The experience bit is limited - PACES is more like a med school osce than actual clinical practice. The downsides of failing are financial only really, so you don't lose much. You are more able to get study leave as a CT though and you can revise with friends easier, so waiting for that is also not crazy. Take part 2 though.

Original post by Ghotay
I thought it was the exact opposite? That people who take exams later are more likely to fail. I'm sure that's something I've seen @nexttime say before


https://www.mrcpuk.org/mrcpuk-examinations/advice-guidance-and-preparation/choosing-right-time-take-your-mrcpuk
Reply 7
Original post by nexttime
You should take part 2 asap - there is lots of overlap with part 1 that you will only forget.

I would also do PACES as soon after part 2 as you can. Again, there is knowledge overlap. The experience bit is limited - PACES is more like a med school osce than actual clinical practice. The downsides of failing are financial only really, so you don't lose much. You are more able to get study leave as a CT though and you can revise with friends easier, so waiting for that is also not crazy. Take part 2 though.



https://www.mrcpuk.org/mrcpuk-examinations/advice-guidance-and-preparation/choosing-right-time-take-your-mrcpuk


Original post by Chief Wiggum
The OP's comment was in line with the "received wisdom" about when to attempt the various components of MRCP.

That is, do Parts 1 and 2 ASAP, then wait until you gain more clinical experience before attempting PACES.

"In general, the data suggest that pass rates are highest when candidates:

make their first attempt at the Part 1 Examination within 12 to 24 months of graduation

make their first attempt at the Part 2 Written Examination within 36 months of graduation

delay their first attempt at the Part 2 Clinical Examination, PACES, until 36 months after graduating

pass the Part 2 Written Examination before attempting PACES."





https://www.mrcpuk.org/mrcpuk-examinations/advice-guidance-and-preparation/choosing-right-time-take-your-mrcpuk


You two are so in sync :biggrin:

Fellow members of team night shift, or just night owls?
Original post by Ghotay
You two are so in sync :biggrin:

Fellow members of team night shift, or just night owls?


Terrible sleeping pattern...
Original post by Ghotay
You two are so in sync :biggrin:

Fellow members of team night shift, or just night owls?


Working hard i see!

I am currently painting a room in my house. For some reason.
Reply 10
Original post by nexttime
Working hard i see!

I am currently painting a room in my house. For some reason.


In medical admissions. Two patients in the unit, one coming in at 9am. It's a hard life :wink:

You enjoy!
Clinical experience is overrated for PACES. The stations are not really reflected by your average medical take. I can't say this with absolute certainty as I've only ever spent one day working in medical admissions (as an FY1), although that didn't stop me passing PACES. I know others who passed without much more experience of medicine than I had. I don't think doing it early is mandatory by any means and, if anything, would be frowned upon by a lot of seniors. I would get MRCP out of the way asap if I were a medical trainee, though. PACES will make you a much better doctor and you might as well benefit from that throughout CMT rather than just at the end.
Reply 12
Original post by nexttime
You should take part 2 asap - there is lots of overlap with part 1 that you will only forget.

I would also do PACES as soon after part 2 as you can. Again, there is knowledge overlap. The experience bit is limited - PACES is more like a med school osce than actual clinical practice. The downsides of failing are financial only really, so you don't lose much. You are more able to get study leave as a CT though and you can revise with friends easier, so waiting for that is also not crazy. Take part 2 though.



https://www.mrcpuk.org/mrcpuk-examinations/advice-guidance-and-preparation/choosing-right-time-take-your-mrcpuk


Right! Thanks for the advice. I think I have pretty much made up my mind to give it a go in the Nov session. I have only a month or so to prepare. So I guess I better start now than waste even more time thinking about it. The only downside is I will be on weekend nights before the exam.
Reply 13
Original post by MonteCristo
Clinical experience is overrated for PACES. The stations are not really reflected by your average medical take. I can't say this with absolute certainty as I've only ever spent one day working in medical admissions (as an FY1), although that didn't stop me passing PACES. I know others who passed without much more experience of medicine than I had. I don't think doing it early is mandatory by any means and, if anything, would be frowned upon by a lot of seniors. I would get MRCP out of the way asap if I were a medical trainee, though. PACES will make you a much better doctor and you might as well benefit from that throughout CMT rather than just at the end.


Yeah. I get what you mean. Even for part 2, some of the seniors are thinking that I am overly ambitious for trying to take it next month. I completely agree with you that PACES will definitely benefit me during my early CT years. But let me try to get part 2 out of the way first! Thanks again for the wise words and guidance! I think I will try to clear part 2 next month. If I don't, I will just take up some extra shifts to cover the cost for the next attempt! As a few of you mentioned above, I have nothing to lose!
I think the idea that CMT is competitive is something of an illusion. Loads of people apply and then never take up the posts. I'm doing CT1 in IMO the most generically desirable location/hospital within my deanery (excluding obvs the fact people have specific reasons for wanting to be in other locations) and was worried about not getting where I wanted. In actual fact, they had to go through round 2 recruitment and only narrowly filled all their posts at the last minute. Against all my expectations I got my top choice of jobs.

Whether that'll be the same this year I'm not sure, but the uptake isn't anywhere near as great as competition ratios suggest - so many people put CMT down as a back-up and then either take an alternative - radiology, paeds, surgery, whatever - or just decide sod it and take an F3 year. If that's re-assuring at all haha. Obviously aim high! But if anything I think they're struggling to recruit. Not sure about London, of course, that does sometimes buck trends.
Reply 15
Original post by seaholme
I think the idea that CMT is competitive is something of an illusion. Loads of people apply and then never take up the posts. I'm doing CT1 in IMO the most generically desirable location/hospital within my deanery (excluding obvs the fact people have specific reasons for wanting to be in other locations) and was worried about not getting where I wanted. In actual fact, they had to go through round 2 recruitment and only narrowly filled all their posts at the last minute. Against all my expectations I got my top choice of jobs.

Whether that'll be the same this year I'm not sure, but the uptake isn't anywhere near as great as competition ratios suggest - so many people put CMT down as a back-up and then either take an alternative - radiology, paeds, surgery, whatever - or just decide sod it and take an F3 year. If that's re-assuring at all haha. Obviously aim high! But if anything I think they're struggling to recruit. Not sure about London, of course, that does sometimes buck trends.


Ah I see! Yeah, that is what I feel too! There's loads of vacant CMT posts everywhere. But I was a little worried when I had a look at the stats published. But glad to know you got your top choices.

That is reassuring to know that the stats included people who applied for CMT as backup or for the sake of applying. Guess I will just have to go with what I feel and hope for the best!

Thanks for your input! :smile:
Reply 16
Out of curiosity..who are the people getting CMT in Oxford? Are they all superstars on paper, or can one get a spot by doing very well in the interview?
Original post by ssu101
Out of curiosity..who are the people getting CMT in Oxford? Are they all superstars on paper, or can one get a spot by doing very well in the interview?


Its really not that competitive. The ratio was only 1.87 : 1. this year, with some being backup choices etc so the actual ratio being lower. And then it doesn't take much effort to score a good few points on the pre-interview scoring and overcome the small amount of competition you face.
Reply 18
I would assume that figure of 1.87:1 is for Thames valley region in general and not Oxford correct?
Original post by ssu101
I would assume that figure of 1.87:1 is for Thames valley region in general and not Oxford correct?


Yes it is. However, given that in most regions CMT is split 1 year DGH 1 year teaching hospital, I'd imagine the significant majority of rotations have a year in Oxford.

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