Getting into Radiology Training

— by Abeera Khan

Hi everyone. I have been successful in getting NTN for Radiology.

I am on Tier 2 HEE sponsored training visa, so I was exempt from RLMT restrictions. I applied in November 2018 when the R1 opens. I knew I had to have certain things in my portfolio before the application opens, so I don’t have to worry about that from Dec-Feb as this is the time you prepare for MSRA and interview.

The recruitment timelines are available on RCR website. The window period of MSRA, result dates, interview dates (subject to change) are published.

https://www.rcr.ac.uk/clinical-radiology/careers-recruitment/specialty-recruitment

PERSON SPECIFICATION:

Most important thing to go through is the person specification for Radiology. It comes up every year.

https://specialtytraining.hee.nhs.uk/portals/1/Content/Person%20Specifications/Clinical%20Radiology/Clinical%20Radiology%20ST1.pdf

It is almost same every year but go through it and ty to get maximum things you can. It does not matter what specialty you are working in.

MSRA (Multi-specialty recruitment assessment):

It is one of the important steps that you need to clear in order to get an interview slot. You can use any pool (emedica, passmedicine, pastest) for preparation. A cut off point is set for MSRA and candidates scoring above that are invited for interview as there is usually 600-620 interview slots. This year the cut off marks were 451. So, you needed to score 451 and above and be in the top 620 candidates to get the interview invite. You don’t get to know what the cut off score is till the date you get the Interview invite.

Once you get the Interview slot, you have a fair chance of getting the training number as the competition ratio is then 1:2 which is not that bad.

MSRA accounts for 33% and this is added to your interview score to make overall ranking.

I don’t know how they scale the MSRA scores. But it has equal weightage as either of the interview stations and carries 40 marks total.

Interview Preparation:

There are couple of Interview courses run in December and January. I took the following one.

https://www.radiologyinterviews.com/

They had 2 courses this year, in Early January and Late January. I opted for later one as I knew I would be sitting for SRA in early January. Interviews are in late February, so I had 3 weeks’ time for preparation after attending the interview course. They sent the manual in December which was quite helpful. Make sure you book them well in advance. I think I booked them in September/October. There were also Mock interviews conducted same way as the real Interviews.

Things to have in your Portfolio:

Start working on these from now on if you want to apply as time passes very quickly and if you are in another training, you would have to be 100% committed to that. You will be marked on 5 sections

  1. Taster week and radiology Courses
  2. Audits and QIP
  3. Postgraduate qualifications
  4. Teaching experience and teachings delivered
  5. Research (Publications and Posters)

Taster week – this is a must. You will be marked on it in interview. Spend 3 days or more in radiology department of your hospital. It would be very easy. You can go and talk to any of the consultant. I just spoke to Clinical Director of the department and he was more than happy to guide me. You can do it in your Annual leave, study leave, zero day. If you don’t get a day off, spend a weekend. I shadowed him on a Saturday on call in addition to other week days.

I wrote my experience of taster session. I did not have a formal certificate of taster session. I asked him to send me an email confirming that I did a taster session with him on following days and kept it as evidence.

Radiology Courses:

It is good to attend at least one Radiology related course. It shows your commitment to specialty.

I had 3 courses in my portfolio.

  • A&E Survival course
  • Chest x ray survival course (link below)

https://www.radiology-courses.com/

  • Essential radiology Course for Junior doctors

https://www.rcr.ac.uk/meeting/essential-radiology-junior-doctors-1

Apart from this, I had certificate of ultrasound workshops on Carotid doppler and antenatal scans I attended in my home country (as I was doing my training in Pakistan).

Make sure you write reflections on the courses you attend and how it has helped you and incorporate it into your practise/teachings.

Audits and QIP:

Again, you will be marked for this in Interview. So, the main thing is that its best to have a Radiology Audit. It will give you full marks. And its best to have at least one audit and one QIP in your portfolio.

I had one Radiology audit (closed loop) This is important as will give you full marks. Present audit and get a certificate. It can be very simple, and you can get ideas from AuditLive. It’s available on RCR website. There are hundreds of templates. You have the standards and you know what you are doing. You can choose any simple audit. It doesn’t have to be fancy and complicated. Try to do one which can be finished quickly.

https://www.rcr.ac.uk/clinical-radiology/audit-and-qi/auditlive

I did the audit on Quality of Chest X-rays in image interpretation. Following is the link.

https://www.rcr.ac.uk/audit/quality-chest-x-rays

Presented findings in Radiology discrepancy meeting and got the certificate for it.

If you need access to PACS, speak to any of the Consultants in Radiology department. There is also an Audit Lead in every department. As per my experience, people are generally very nice in the department. But you need to speak to them and let them know your interest. So, I had just gone to discuss an urgent request with this Consultant few months back and then I mentioned to him I want to apply in radiology training and he gave me access to his PACS for 2 days to collect data while he was doing procedures. Then I liaised with his Secretary who booked me in for a presentation slot in Radiology discrepancy meeting and gave me certificate for it.

I had one QIP during my Endocrine rotation on Insulin prescription which I presented in the QIP meeting at the Trust. Had a certificate for that too.

Had another audit (closed loop) I had done in A&E on sepsis.

Key point: Have one radiology related closed loop audit and one QIP in a year. They asked me this in interview (How many you have done in the last year)

Post graduate Qualifications:

MRCS/MRCP

BSC or Masters

I only had BSc from back home.

Teachings:

You will be marked for

  • Formal degree in teaching
  • Teaching course and teaching sessions delivered

I did not have any formal degree in teaching, but you can attend ‘Teach the teachers course’. Please attend that.

https://www.medicalinterviewsuk.co.uk/courses/medical-teach-teacher/teach-the-teacher-course-for-doctors/?gclid=CjwKCAjw1KLkBRBZEiwARzyE78Oop06rGahoVRYhxl59Sr5E2YXf882suGxyFiYgDlPz4ND2siH-lxoCWI4QAvD_BwE

Teaching sessions: Try to do radiology teachings. Again, it shows your commitment to specialty. You can do it in your Trust or regional.

I had 3 teachings in my portfolio.

  • ‘Chest X-ray interpretation’ delivered to American undergraduate students as a part of International student teaching programme at my trust. Feedback from the students.

The same presentation I also gave to FY2 colleagues in the trust. Obtained feedback from them.

  • ‘Vertebral artery dissection’ (again a bit of touch of radiology and importance of imaging)
  • And another teaching on a medical topic.

You need to have evidence of teaching i-e the presentation, feedback and your reflection on teaching. It’s important to have all these. Stick them in portfolio.

Don’t pick complex topics. Stick to CXR, AXR, Requesting appropriate scans for different conditions. These are the topics you can choose from radiology.

Again, you will have to speak to the undergrad department/medical education department at your trust. Trust me they are always looking for people who are interested in teaching medical students/ FY1/FY2.

Research:

You will get maximum marks (max marks 2) in this section if you have a publication in a peer reviewed journal. You can still score 1 mark if you have a Radiology poster (national/international).

No marks if you have a non-radiology poster.

I had one National Radiology poster that I had presented back home. I claimed 1 mark for it, and they accepted it. I had the poster print out in A4 size and certificate from Radiology Society of Pakistan. I was not sure if they will accept my mark for it, but they did. I mentioned it in interview.

Interview Pattern:

For last 3 years since 2017, the interview pattern has changed. It has come down from 4 stations to 2 stations.

Station 1: Understanding of radiology and Commitment to specialty

Station 2: Portfolio

The clinical and ethical bit has been removed from Interview as it is tested in MSRA.

You will be given a self-scoring sheet before the Interview begins. You will have 10 minutes for that. You will score yourself on 5 sections I have explained above. Maximum marks 10. Each section carries 2 marks.

  1. Taster week and Radiology courses (If you have both, you get 2 marks. You can easily get this)
  2. Post graduate qualifications (Full MRCP/MRCS- 2marks, First class honors BSc 2 marks, Bsc intercalated 2:1 You will get 1 mark)
  3. Teaching (Formal degree in teaching 2 marks, Teach the teachers course and a teaching sessions- 1 mark)
  4. Audit and QIP (Radiology audit closed loop and QIP- 2 marks, Non-radiology audit 1 mark)
  5. Research (Publication in Peer reviewed journal- 2 marks, Radiology poster National/International- 1 mark)

This scoring was quite detailed. I don’t remember exactly everything. But just giving a fair idea what I remember. It was very precise.

STATION 1: Understanding of radiology and Commitment to specialty  (Total Marks 40) Time: 10 minutes

Two interviewers but one will be asking questions. Each interviewer has 20 marks. Make sure you make eye contact with both. You can be asked anything related to radiology in this station. Things that will help you are

  • Spending some time in radiology department
  • Talk to some Radiology Consultants/ radiology trainees or even going through RCR website
  • Attend a Radiology interview course
  • Go through Radiology café website. It has got hundreds of questions. https://www.radiologycafe.com/

Make sure to make your answers personal and relate with your previous experience and taster session. Practise these at home. Write answers of typical questions and practise speaking them. I had answers to all questions they asked. They would fire multiple questions and if you are well prepared, you would know how to respond without fumbling much.

Some Questions I was asked:

  • What are the qualities of good Radiologist and what qualities do you have which would make you a good Radiologist?
  • Radiology training structure and exams
  • How would you prepare for the exams? (It’s important you know what resources trainees use)
  • My views on outsourcing and skill mix. Remember to give both pros and cons
  • Future challenges in radiology
  • Do you remember a case where Radiology played an important role? and couple of other questions.

STATION 2: PORTFOLIO STATION: (Total marks 40) Time 10 minutes

You hand over the self-scoring sheet given to you before the Interview. The score you give yourself is verified. (So, if you have given yourself 8 marks and it is verified and accepted by interview panel members, you will get 8+8= 16/20 marks). They will see everything in your portfolio. Make sure your portfolio is organised and you know it inside out. Keep it tabs wise.

Rest 20 marks is the global impression score. The way you answer all questions related to portfolio.

Importance of reflective practise

  • Reflections on clinical events (e.g I had seen a 5-year-old in A&E who had a fall and fitted criteria for CT Head and found to have Extradural haemorrhage) I kept that at the top of all the clinical events reflections.
  • Reflections on any interesting case (e.g I had a case where patient had wrong cancer diagnosis which they found very interesting and asked me about it)
  • Multi-source feedback (print it out from portfolio)

Make sure you print out these from your portfolio. Make sure you have few Radiology related cases you have reflected upon and keep them in front in reflections section in your portfolio. Its good to reflect even on subtle mistakes. And then what you did for that, so you don’t repeat it next time.

Make sure you have something out of your academic portfolio as your proudest achievement, and keep an evidence of that too.

KEY POINTS:

It’s doable. Many people will tell you it’s very tough to get into. It is as you need to make everything radiology related in your portfolio and take out time for it. That’s the only thing. Utilise few zero days, Annual/study leaves. Attend courses, do teachings, do audits. These are the things you would need in any job. It would add up to your portfolio anyways.

It only needs commitment and precise planning to score the maximum in Interview. Spend time in radiology department, attend MDTs, attend a Radiology discrepancy meeting.

Arrange your portfolio nicely. Print out presentations (e.g 9 slides on a page) so it doesn’t take up much space. Print coloured copies as it looks nice. I did not have MRCP/MRCS or any masters. I did not have any International publication. I had one publication back home. I mentioned it but I knew I would not be given marks for it. But The radiology poster helped me in that section. You can also get membership of ESR (European Society of Radiology). It costs £12  a year I guess. You can print off the membership certificate and stick that in your commitment section in portfolio.

I have tried to write it as detailed as possible. Hope it helps All the best 😊

 

 

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