Medical Specialties Watch

RR97
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I'm starting to think about what to specialise in - quite like cardiology, potentially plastic surgery and then potentially general practice so quite a difference between them!

I wanted to find out what the work life balance is like in terms of cardiology and plastic surgery? Also, I don't know much about what 'a week in the life' is like when you're between ST3-ST8 for cardio?

Also, what constitutes as competitive with regards to the specialties? I had a look at the competition ratios for 2017 so for cardiology it was somewhere around 2.5/2.6 I think - that doesn't sound so bad but then I've heard cardiology is quite difficult to get into? (I know plastics is quite difficult and the competition ratio is quite high so that's fine haha)

Would med school deciles be something they look at?

Also, how much research is involved in plastics/cardio? I've read around online and it says a lot of people (two thirds?) end up taking a few years out to get involved in research and I'm not sure if this is standard practice or if it's something people do out of interest.

Would appreciate any advice Thanks!
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*pitseleh*
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(Original post by RR97)
I'm starting to think about what to specialise in - quite like cardiology, potentially plastic surgery and then potentially general practice so quite a difference between them!

I wanted to find out what the work life balance is like in terms of cardiology and plastic surgery? Also, I don't know much about what 'a week in the life' is like when you're between ST3-ST8 for cardio?

Also, what constitutes as competitive with regards to the specialties? I had a look at the competition ratios for 2017 so for cardiology it was somewhere around 2.5/2.6 I think - that doesn't sound so bad but then I've heard cardiology is quite difficult to get into? (I know plastics is quite difficult and the competition ratio is quite high so that's fine haha)

Would med school deciles be something they look at?

Also, how much research is involved in plastics/cardio? I've read around online and it says a lot of people (two thirds?) end up taking a few years out to get involved in research and I'm not sure if this is standard practice or if it's something people do out of interest.

Would appreciate any advice Thanks!
What stage are you at the moment?

Can't really help with the specifics as none of those are specialties/domains I've applied for. But before I made my applications I did look at the ranking criteria for lots of specialties including GP. Med school deciles only seem to be used for foundation applications, unless you've come top 10% (or whatever your med school classes as a distinction) in which case you would get some brownie points for that. Other than that, points seem to be awarded for some variation on: QIPs/audits, teaching experience, courses/conferences, commitment to specialty (e.g. taster days), other degrees, prizes and publications.
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RR97
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(Original post by *pitseleh*)
What stage are you at the moment?

Can't really help with the specifics as none of those are specialties/domains I've applied for. But before I made my applications I did look at the ranking criteria for lots of specialties including GP. Med school deciles only seem to be used for foundation applications, unless you've come top 10% (or whatever your med school classes as a distinction) in which case you would get some brownie points for that. Other than that, points seem to be awarded for some variation on: QIPs/audits, teaching experience, courses/conferences, commitment to specialty (e.g. taster days), other degrees, prizes and publications.
Halfway through third year at present!
Right okay - and with regards to teaching, courses etc is that something that should primarily be done throughout med school or after?

Also what have you applied for if you don't mind me asking?
Thanks
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UKCATrocks
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Once you are a doctor, no one cares about your medical school grades. Cardiology is competitive because often people will have done a PhD before applying and that would confer them more points. Other specialities like psychiatry, GU Medicine are less competitive because they are either not well known or people dislike some aspects.Things are changing anyway, for example now all those doing a medical speciality will also be trained in acute medicine. That means more on calls and the medical registrar job is well known to be the hardest.For surgery you will need to be a lot more academic but if you love the speciality you will just get into it.I would suggest first going through medical school and then see what topics you liked.
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RR97
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(Original post by UKCATrocks)
Once you are a doctor, no one cares about your medical school grades. Cardiology is competitive because often people will have done a PhD before applying and that would confer them more points. Other specialities like psychiatry, GU Medicine are less competitive because they are either not well known or people dislike some aspects.Things are changing anyway, for example now all those doing a medical speciality will also be trained in acute medicine. That means more on calls and the medical registrar job is well known to be the hardest.For surgery you will need to be a lot more academic but if you love the speciality you will just get into it.I would suggest first going through medical school and then see what topics you liked.
What exactly do you mean by trained in acute medicine? Also with regards to the PhD, is that something a LOT of people do or is it something SOME people do, reason being if it's the norm to do a PhD then it would certainly influence my decision to pursue cardio.

I'm struggling at the moment since I feel a lot of my peers are starting to get experience related to the field they want to go into, be that surgery/obs&gynae/paeds etc. I haven't done anything field specific and I don't want to start getting experience after I leave medical school because that only gives me around 2 years to get involved in things related to my specialty of choice, hence the early questions.

So far at med school I've enjoyed cardio and have enjoyed going to cardiology clinics + having a go at interpreting ECGs. I haven't had hands on experience with plastics because the Trust I am currently at doesn't offer it but my next placement will do so I'll be trying to go to theatre there to see if it's something I like - I have been into theatre for other procedures and I do enjoy it, just not sure if it's 100% something I'd like to do.

Thanks for your reply btw
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*pitseleh*
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(Original post by RR97)
Halfway through third year at present!
Right okay - and with regards to teaching, courses etc is that something that should primarily be done throughout med school or after?

Also what have you applied for if you don't mind me asking?
Thanks
Ah - in that case, yeah, unless you get a distinction for some part of your degree, no-one will ask about your decile (as in, there's not even a space to mention it on the core training application forms). It does make a difference for foundation applications though (which deanery you end up in, and how likely you are to get your top choice of rotations).

With regards to courses/conferences/teaching - if you get the opportunity in med school, that's great, not least of all because they're often cheaper (if not free) for med students than qualified doctors. But unless you're going for something very competitive, it's not essential. I did lots of teaching in med school (revision groups for younger years, mock OSCEs, clinical history practice sessions and stuff), but didn't go on any courses. I'd say the majority of people don't do a whole lot of extra-curricular stuff before they graduate (at least, they didn't at my med school).

I've applied for psychiatry and acute med.
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Asklepios
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(Original post by UKCATrocks)
For surgery you will need to be a lot more academic
Lol good one
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UKCATrocks
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(Original post by RR97)
What exactly do you mean by trained in acute medicine? Also with regards to the PhD, is that something a LOT of people do or is it something SOME people do, reason being if it's the norm to do a PhD then it would certainly influence my decision to pursue cardio.

I'm struggling at the moment since I feel a lot of my peers are starting to get experience related to the field they want to go into, be that surgery/obs&gynae/paeds etc. I haven't done anything field specific and I don't want to start getting experience after I leave medical school because that only gives me around 2 years to get involved in things related to my specialty of choice, hence the early questions.

So far at med school I've enjoyed cardio and have enjoyed going to cardiology clinics + having a go at interpreting ECGs. I haven't had hands on experience with plastics because the Trust I am currently at doesn't offer it but my next placement will do so I'll be trying to go to theatre there to see if it's something I like - I have been into theatre for other procedures and I do enjoy it, just not sure if it's 100% something I'd like to do.

Thanks for your reply btw
Acute medicine is basically medical emergencies. So, even if you are a dermatologist they will expect you to do some general medicine relating to other specialities during on calls.

But certainly if you want to get into a training programme for certain specialities you should start thinking about projects you can do now
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ecolier
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(Original post by UKCATrocks)
Once you are a doctor, no one cares about your medical school grades.
Sorry but that's wrong. If you have won a prize, or been in the top 20% of your course you will be eligible for additional points all the way to registrar level competitive entry ST3 (which applies to OP).

Cardiology is competitive because often people will have done a PhD before applying and that would confer them more points.
Also, all the people I know did not do PhDs prior to applying to ST3 cardiology. They all got in. Competition really isn't as bad as it's made out, especially because people apply to many specialties bumping up the ratio.

Other specialities like psychiatry, GU Medicine are less competitive because they are either not well known or people dislike some aspects.
They won't be "not well known" by the time you apply as an F2 - if you wanted to do it you would have known. After all you would definitely have studied psychiatry or GUM as a medical student!

Things are changing anyway, for example now all those doing a medical speciality will also be trained in acute medicine. That means more on calls and the medical registrar job is well known to be the hardest...
I am the RCP associate clinical tutor for my hospital, and I honestly hope that things will change for the better. Many junior doctors love being the medical registrar and taking responsibilities, Making all CMT doctors do CT3 is potentially a way of making all registrars work better. Plus there are still some specialties which acute medicine is not part of the training, for example dermatology or us (for now).

(Original post by RR97)
Halfway through third year at present!
Right okay - and with regards to teaching, courses etc is that something that should primarily be done throughout med school or after?

Also what have you applied for if you don't mind me asking?
Thanks
To OP - you have plenty of time. You will be able to get into CMT pretty easily, cardiology is not that hard to get into. Stick with the cardiology doctors, get an audit or two, see if you can attend conferences or publish a case.

PS Give neurology a chance!
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(Original post by ecolier)
Making all CMT doctors do CT3 is potentially a way of making all registrars work better.
Its a way of forcing unwilling people to be the med reg anyway, if that's what you mean!
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RR97
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(Original post by ecolier)
Sorry but that's wrong. If you have won a prize, or been in the top 20% of your course you will be eligible for additional points all the way to registrar level competitive entry ST3 (which applies to OP).



Also, all the people I know did not do PhDs prior to applying to ST3 cardiology. They all got in. Competition really isn't as bad as it's made out, especially because people apply to many specialties bumping up the ratio.



They won't be "not well known" by the time you apply as an F2 - if you wanted to do it you would have known. After all you would definitely have studied psychiatry or GUM as a medical student!



I am the RCP associate clinical tutor for my hospital, and I honestly hope that things will change for the better. Many junior doctors love being the medical registrar and taking responsibilities, Making all CMT doctors do CT3 is potentially a way of making all registrars work better. Plus there are still some specialties which acute medicine is not part of the training, for example dermatology or us (for now).



To OP - you have plenty of time. You will be able to get into CMT pretty easily, cardiology is not that hard to get into. Stick with the cardiology doctors, get an audit or two, see if you can attend conferences or publish a case.

PS Give neurology a chance!
Thanks for the advice! Do you know much about plastics by any chance?
As for the neuro - as soon as I can recite those pesky sensory and motor pathways in my sleep haha!
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(Original post by ecolier)
Well to be fair, if they applied to CMT they sort of know what's coming...
There at least used to be a large number of options following CMT that didn't require being med reg! Said options being very popular with many more applicants than places, of course. I also think there are quite a few people who apply as they don't know what to do next and subsequently end up elsewhere - not sure what the stats are but it'd be interesting to see.

A senior medical SHO on-call at a DGH at night is similar to med reg anyway. Lots of us (when I was CT2) were carrying reg bleeps, so the logical step is making everyone do a year more...
Sure that will be common, but there is a difference between doing a few shifts in preparation and doing an entire extra year. Personally, for example, i have no problem being the med reg (and given the ahem quality of some med regs I've worked with kind of feel like I've fulfilled the role on a couple occasions already)! However, I have absolutely no desire to do it long term. 2 months ok - the responsibility might even be fun. One full year prior to even being a reg... no.

I think its pretty clear this is a year that is aimed at increasing the number of med regs. The less cynical will see it as a way of increasing confidence prior to becoming a reg so that people don't change their speciality choice just to avoid it. The cynical might point out the number of rota gaps filled by just adding all CMTs to the rota for 1 year would be huge. Either way its not of interest to me - hugely glad I'm avoiding it!
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RR97
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(Original post by ecolier)
Depends on what you mean by "much"?

And don't worry about those pathways, you'll have plenty of time to learn at work!!



Well to be fair, if they applied to CMT they sort of know what's coming... A senior medical SHO on-call at a DGH at night is similar to med reg anyway. Lots of us (when I was CT2) were carrying reg bleeps, so the logical step is making everyone do a year more...
Just general things like work-life balance/'entry requirements'

Also with regards to the discussion you're having about CT3 - what exactly is this? It isn't something I've heard of - I was under the impression it's F1, F2 --> CT1, CT 2 and then ST3-8?
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(Original post by RR97)
Also with regards to the discussion you're having about CT3 - what exactly is this? It isn't something I've heard of - I was under the impression it's F1, F2 --> CT1, CT 2 and then ST3-8?
They're trying to change Core Medical Training to 3 years rather than 2, so it would be CT1-3 then ST4 onwards. There are some specialities where CT3 already exists e.g. ACCS.

It looks pretty certain to go through, although so did the plan to make GP training 4 years before than fell through so we'll see
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Helenia
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(Original post by ecolier)
I can help with the basics. The work-life balance will be pretty much on-par with other surgical specialties. CST is demanding and you have to do on-calls for your specialty + acute surgery. I am not sure if, as a plastics registrar, you would be on the general surgical rota. Work-life balance is (relatively) good, for surgical specialties. "Entry requirements" is the same as for all other specialties - make sure you have a good few publications, presentations, experience to show you were / are interested, good surgical e-logbook!
Plastics SpRs are not on the gen surg rota. Plastics SHOs (which can be FY2s or CSTs) do often cross cover, either for gen surg or other smaller surgical specialties like ENT/max fax. My impression is that their on-calls are not too bad - probably lots of calls for advice but not a huge amount of late night operating. The cases can be loooooong and very fiddly though, you have to be incredibly dextrous and very, very patient!
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(Original post by ecolier)
It is certain to go through Starting 2019 - so those in the position to apply to CMT in March 2018 if you want to avoid the new system (and the unavoidable chaos which will certainly follow - see MTAS 2005) then apply!!
I remember being told the same about GP training

But yes everything i have heard is that it will go through.
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(Original post by ecolier)
GPs cannot afford that extra year of training, plus we (would like to think we) are more organised!!
GP trainees get protected teaching days. CMTs do not. QED.
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Helenia
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(Original post by ecolier)
Good to know. Plastics and neurosurgery are certainly the delicate dull surgical specialties.
Fixed

Partly joking, of course, I'm sure actual plastic surgeons find it very interesting. But from an anaesthetic perspective a lot of it is very straightforward, usually in relatively healthy patients, (e.g. a DIEP flap breast reconstruction - body surface surgery, usually in relatively slim, youngish patients, not physiologically demanding in any way, but takes 8-10 hours) so there's a lot of sitting watching them stare down a microscope. Plastics trauma is a bit more interesting.
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RR97
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Thank you for all your help and advice guys, really appreciate it!

Last question (probably haha) - with regards to a medical specialty, before you get to the stage of being a consultant what is the working life like i.e. anything after F2? I'm not particularly clear on what it entails (how many on calls, working hours etc) as haven't had much opportunity to work with registrars - mainly either with F1s or consultants. Would be grateful if you could shed some light on that
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ahorey
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(Original post by RR97)
Thank you for all your help and advice guys, really appreciate it!

Last question (probably haha) - with regards to a medical specialty, before you get to the stage of being a consultant what is the working life like i.e. anything after F2? I'm not particularly clear on what it entails (how many on calls, working hours etc) as haven't had much opportunity to work with registrars - mainly either with F1s or consultants. Would be grateful if you could shed some light on that
Best not to think about that. Focus on the early years

Life starts off meh in F1/2 and then is good at consultancy levels.

It will always get better
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