Today I’ve spent the day at the Faculty HQ in London being trained to interview potential candidates at next month’s ICM Interviews. Although it’s a complicated process with a full day of Assessment Centre testing, it can be simplified down to 5 key things all applicants should know.
Your portfolio is worthless!
The maximum score is 400 points, and the portfolio station only scores a possible 80 of those. Within this, about 50 are for the portfolio itself and the rest is from some targeted questions. As a result, you may spend hours preparing your portfolio but sadly it doesn’t have a huge impact on your overall score.
Why is this? The evidence suggests it’s the least reliable method for predicting your future potential. What you have done doesn’t necessarily prove what you will do!
That said, it’s easy to take your time over it. Without the stress of performing on the day, you can take time to prepare a smart portfolio. There are points for presentation and organisation, so don’t waste these points.
In short, don’t stress that you don’t have an M.D. in ICM – it doesn’t make you fail.
Presentation means presentation
Believe it or not, some candidates walk into the presentation station with very different ideas about this. In the past, some candidates have walked in with a blank poster and said “right, I’m going to run this like a teaching session and you’re going to work with me to fill this poster”. The simple response is “no”. You are going to present the topic and the assessors will watch in silence!
You have two sheets of paper, no more. Use them wisely. There are marks for presentation, organisation and written communication. If you draw pictograms instead of text, make sure they add clearly to your communication. Nothing written down means no point for ‘written communication’!
Reflection does not mean recollection
There is a skill to professional reflection. I can’t claim to be an expert. Read about it. Do it. Practice it. Get feedback from your local Faculty Tutor. This is a station that you can prepare and perfect. The subtly of the question will change but the overall aim will not.
The ‘recollection’ of the case should be minimal. Not more than a couple of paragraphs. The ‘reflection’ is how it changed you. A bit of emotion is good, but don’t over do it. A bit about what you learned is needed, but reflection is still more than that. What did you experience? What did you feel? What did you go away and do? How have you changed? What have you done differently since? Who have you spoken to about this? Has it impacted others?
It doesn’t even need to be clinical, which is refreshing given recent high-profile cases. One excellent answer in the past was about failing to bake the perfect cake!
Practice makes perfect
There are five stations, and they can all be practiced and prepared for:
- Clinical case discussion
- Task prioritisation
- Reflective writing
All the information you need has been posted online by FICM or Health Education West Midlands (who run the national interview process). All of these stations are based upon what you are already doing. You don’t need to be a registrar already. There is no bias towards anaesthetists. Spend time preparing and practicing just like an exam. It will be noted positively on the day.
It’s all predictable
By now, there is little you can do to improve your portfolio other than agonise over the font of your front page. Ask your tutor to go through the published marking criteria and provide them with the evidence to prove your marks. Remember, if the evidence doesn’t exist, it didn’t happen.
The clinical case will be just like any clinical case you have presented as a CBD at work – ask your consultants to give you the toughest interrogation possible about your next case you assess and present to them.
Task prioritisation is based upon a typical day in Critical Care. Four or five dilemmas of varying priority. If you’ve been involved in a medical take, surgical take or any critical care, then you know what to expect. Write down everything you get bleeped about on your next shift, then present to your supervisor how you prioritised the calls (if they had all arrived at the same time). Justify your prioritisation. Expand on your reasoning. Admit your uncertainty. Engage your (multi-disciplinary) team politely. Ask for help. Delegate where appropriate. Define a timeframe. Reassess regularly.
The presentation has already been discussed. Remember, you don’t have to know what you are talking about to do well. It’s also about how you deliver it. There will also be questions about you, the specialty, and how much you understand about the specialty. Do you know much about Stage 1, 2 and 3 training? Do you know much about your consultant’s role?
Finally, and possibly most importantly, there will be a reflective writing station. As described above already, there is ‘recollection’ and there is ‘reflection’. Practice this until you are bored! Come up with 10 examples in your life, that you can use. Some clinical and some non-clinical. Map them out. What qualities and competencies might they show? Reflect on them. Learn from the scenario and your reflection. Write all ten out in full. Ask your Faculty Tutor to read them. There are points for spelling and grammar too. Here’s a cheat… the scenario doesn’t have to be true! If you can demonstrate what excellent self-reflection is, even on a fictitious scenario, then you are likely to be an excellent clinician in the future.
- https://icmnro.wm.hee.nhs.uk/ – HEE West Midlands ICM Recruitment site
- https://www.ficm.ac.uk/careers-recruitment-workforce/recruitment-2018 – FICM Recruitment page
- https://icmnro.wm.hee.nhs.uk/Portals/7/Documents/ICM%20Documents/Assessment%20Matrix%20for%20website.pdf?ver=2017-01-20-141938-217 – Competencies Assessment Matrix
- http://www.afpp.org.uk/filegrab/Gibbsmodelofreflection.pdf?ref=46 – Gibbs model of self-reflection