So you want to be a cardiologist? 2012 update part 2 ...

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So you want to be a cardiologist? 2012 update: part 2

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Published: 16 May 2012

Commentary speaks to the people at the forefront of the cardiology specialty training year 3 (ST3) application process in the UK in a series of three articles: Drs Liz Berkin, Sarah Clarke, Grant Heatlie, Andre Ng, Raphael Perry and Ian Wilson

How many candidates applied in 2011 and how many of them were successful?

Liz and Ian: Overall, 337 individual candidates made 607 applications (270 candidates submitted two applications to cardiology) for about 40 jobs. The initial application to post ratio was 15:1, but because some applications were multiple and post numbers [including locum appointments for training (LATs)] increased to about 90 during the round, the final candidate to post ratio was 3.7:1.

Were there any patterns with regard to which deaneries received the most and least applications?

Liz and Ian: As always, some deaneries were more oversubscribed than others, as shown by the application patterns on the RCP's ST3 recruitment website. We can give two bits of advice here: as the financial adverts say, past performance does not necessarily predict future performance (just publishing the application patterns will probably change them next year) and never apply to a deanery (or specialty) in which you would not actually be prepared to work. If you do feel that absolutely nothing but cardiology is suitable for you among the 29 varied and interesting medical specialties, think seriously about where you apply, especially if your application score is not in the top quartile.

A few posts were available in the second phase of the recruitment round in 2011. How does this come about when cardiology remains so oversubscribed?

Liz and Ian: Some deaneries did not interview quite enough candidates. Recruiting clinicians tend to assume that an applicant who applies to their deanery definitely wants that post, when, in fact, around half of the cardiology applications were `back-up' applications (that is, to a second-choice deanery) and candidates may even have used cardiology as a back- up application, preferring another specialty instead! Deaneries thus need to interview more candidates than there are posts available.

The other major factor in determining whether posts remain vacant is that they can become available at any time during the training year as current trainees complete training or leave for other reasons (for example, out-of-programme research and experience or maternity leave). If this occurs at a late stage in the recruiting round, the reserve list of appointable candidates may have dried up. Last year the number of cardiology posts doubled during the recruitment round, and this means that there are almost always available posts in round 2 during the summer and autumn.

Are any changes to the ST3 selection process planned for 2012 or is it too early to tell?

Liz and Ian: Further medical ST3 specialties are joining the RCP-coordinated recruitment programme. We will restrict the total number of applications to RCP-coordinated specialties to six (very few candidates made more than six applications in 2011). The fewer back-up applications are made, the greater the interview capacity for trainees lower down in the application score ranking, and widening interview availability is key to improved and fairer recruitment. Any developments will be published on the RCP's ST3 recruitment website.

What makes a candidate stand out on paper?

Raphael: Clinical skills and number of procedures, publications and research pedigree, as well as skills outside of medicine.

Andre: Higher degrees, published papers, evidence of commitment to the specialty, good and relevant achievements outside medicine, and an aptitude for cardiology, especially in terms of practical skills.

Liz and Ian: A decent score in as many different domains as possible is key. The domains that receive marks at the shortlist stage include additional undergraduate and postgraduate degrees, prizes, a postgraduate exam relating to CMT or equivalent [usually MRCP(UK)], presentations, published papers, audit and teaching.

Sarah: Evidence that candidates have gone the extra mile to ensure they have a rounded CV and have tried to get involved in the subject ? for example, by undertaking an audit or writing a case report. Presentation is also key ? spelling mistakes

stand out for the wrong reason!

What attributes does a prospective ST3 candidate need to have on paper to seem `well rounded'?

Grant: Good pre-cardiology training in general internal medicine (GIM), including other specialties, an ability to deal with acute medicine, clear progression towards a cardiology pathway and willingness to do more than the basics ? for example, audits, case reports and involvement with cardiology services, such as taking on the administration of fellow core medical trainees or a service within a department.

Liz and Ian: I don't think you can determine how `well rounded' someone is from their application. Although we encourage candidates to quote non-medical achievements, we are very circumspect about marking these. How, for example, would you compare grade 8 piano with a gold Duke of Edinburgh award, charitable work overseas or bringing up a family? I don't believe you can or should. We are interested in whether other achievements have resulted in some transferable organisational/leadership skills that make them a better clinician.

How does a candidate show commitment to a career in cardiology?

Sarah: Undertake work experience, an elective course or audits, write case reports, join a research programme and publish papers.

Andre: One way is to take up a LAT post in cardiology, but taking a higher degree [Doctor of Medicine (MD) or Doctor of Philosophy (PhD) in a relevant subject] is the best way to show commitment.

What are your top tips on getting published?

I don't think you can determine how `well rounded' someone is from their application ... We are interested in whether other achievements have resulted in transferable organisational / leadership skills.

Andre: Write well. At an early stage, be aggressive and `cut throat' in getting even the smallest thing published. If you are more advanced, you need to work with a good supervisor on a good project that addresses an interesting and important question.

Grant: Work on short, simple and achievable projects. Don't try to revolutionise cardiology. Consider every single patient as a potential case report and ask yourself: `where is the paper in this patient?'

Is it better to conduct research before formal cardiology training or during training, when the individual may have a better idea of which subspecialty they are interested in?

Sarah: I think that it depends on your aim. If you are not offered training posts, a research degree will certainly bolster your chances by demonstrating ability and commitment. If you are already in a training post, I think the optimum time is just before subspecialty training, because you will be doing something that you enjoy, that is most likely to be relevant to your future career and that is most likely to help you achieve a subspecialty consultant post.

Grant: I think during training is preferable, as you can try to develop your research around your area of interest in cardiology.

Raphael: It depends on the previous experience before ST3. If you are coming straight from CMT year 2, research is better done after core cardiology. If you have completed LAT or fellow posts first, research to aid entry to ST3 may be better.

Liz and Ian: It is generally better to undertake research within the training programme, when you have had more exposure to cardiology, as you will know where your interests lie and will be able to ask a more relevant research question. However, this may be difficult to achieve in practice, and a higher degree may become a prerequisite for entry to ST3.

Dr Niki Margari, F2 doctor, Severn Deanery, and Dr Aung Myat, specialist registrar in cardiology and British Heart Foundation clinical research training fellow, West Midlands Deanery and The Rayne Institute, St Thomas' Hospital, King's College London

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Part 1 | Part 3

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Related topics: Education and training Related specialties: Cardiology Commentary: Features Commentary issues: Online only Commentary themes: Medical careers and training

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