Discussion post-presentation

    • After your presentation, which will last around 2-3 minutes, you have another 2-3 minutes to have a discussion about your topic, and an opportunity for the interviewers to ask you a few general questions. These are usually focussed on academia rather than clinical topics.
    • The discussion around your topic will vary and is difficult to predict. Some interviewers have disregarded interviewees presentations and simply go on to ask you about something else entirely, related to another topic in Respiratory. Other interviewers will then ask you questions about your presentation.
    • Examples of questions about your presentation:
      • “Why did you choose this topic?”
      • “How do you feel this diagnosis/treatment/procedure (that you presented) has impacted the field?”
      • “What is your experience of this test/treatment/procedure?”
      • “How do you feel (the topic you presented) is going to evolve in future? Do you know of any further developments in the area?”
      •  “Do you know of other similar developments/findings in the (area of the topic you presented) that have occurred in the recent past?”
      • “What other major studies have impacted on the (topic you have presented)?”
    • The answers to each of these questions will be individual to you and will require some research and thinking beforehand. As you can see from the previous lessons this is something you must bear in mind when choosing a topic to present if you want to give yourself a chance to score well
    • Interviewers may also want to ask you more general questions about academia. These are the sort of generic questions you can prepare for in advance of your interview. These are common questions:
      • Tell us about your research experience:
        • If you have had the time to do a lot of research: If you have done a PhD, were a researcher before going into medical school, or took time off to do an academic job, you are likely to have quite a few things under your belt. In that case you need to select the most important ones only. Summarise briefly the types of projects you have been involved with, what you did, then describe in a bit more detail the 1 or 2 more important ones and finalise by explaining your goals in academia: do you want to pursue more research projects as an academic or as a clinical doctor, are you planning time off in future to do research (PhD, MD etc.). 
  • If you have done small-moderate amount (most interviewees): If you have managed to do 1-2 posters, maybe involved in 1 or 2 publications, then you have the time to list them all and describe them in very little detail, after picking up the most important 1-2 and describing them in more detail. Describe your role, what you learnt, how it will impact your career, what you intend to do in future in terms of research and the skills you will need for that, your topics of interest for research in Medicine. 
  • If you have done no research: You might not have been heavily involved in a research project, but you can mention any form of involvement you had. Were you reviewing notes, doing data entry? Did you help write up a case report? If not, you will need to demonstrate you have been developing some of the skills needed for research, namely literature review, appraisal of the literature, and presentation skills. 
        • Did you present at a Journal Club in one of your hospitals? You probably had to do a review of the evidence available, appraise it, select the most relevant ones, understand trial design, etc.
        • Did you go to a conference, or a regional meeting?
    • Why is research important?
      • Research is important to different layers of the Health Service:
        • In general research is important to advance knowledge in the field of Medicine, to allow us to treat diseases in a better, cheaper, quicker way
        • NHS: brings reputation to the organisation (think RECOVERY trial)
        • Hospital trusts
          • Attracts money which can be used for patient care
          • Improves the reputation of the institution which can allow better staff to be hired, and attracts more patients (NHS and private)
        • Clinicians
          • Allows doctors to further develop their careers, and career interests
          • Junior doctors develop skills required to understand evidence and develop their practice according to emerging new evidence, and can attract them to the academic field which is the method in which knowledge in medicine is developed
        • Patients
          • Allows access to new and emerging therapies
    • Should all junior doctors be involved in research?
      • There are 2 slants here to tackling this question:
        • 1: Should all junior doctors be involved in research activity? Probably not
        • 2: Should all junior doctors understand the principles of research? Undoubtedly yes
      • Relate as much as possible your answer to your own experiences. 
        • Have you been involved in some research from which you learnt something you can apply in patient care? 
        • Has doing research made you pursue an academic career? 
        • Did you have to research a topic you were unsure about to improve the way you managed a patient and in so doing improved their care?
      • Explore your thoughts on these two sides of the question but here are some starting points:
        • If all junior doctors took 3 years out to do a PhD at some point in their careers there would be a large gap in the number of clinicians on the ground looking after patients. This would crash the NHS!
        • Not everyone is made for the life of an academic doctor. Many doctors prefer to work as a clinician in the front-line, managing patients and improving the service they provide. Having doctors unsuited for academia “forced” to spend time doing research that leads to very little (unfortunately most research is not fruitful!) would be a waste of everyone’s time 
        • All doctors, however, need to understand the process of research (methodology, statistics, where the knowledge gaps are) and the output (papers and publications) to be able to learn new things and adapt and improve their practice to the most up to date knowledge. 
    • What is evidence-based medicine?
      • There are numerous definitions of this. A quick google search leads you to, for example: “means integrating individual clinical expertise with the best available external clinical evidence from systematic research” (Sackett David L, Rosenberg William M C, Gray J A Muir, Haynes R Brian, Richardson W Scott. Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71)
      • There are a few steps involved in practicing evidence based medicine:
        • “Generate the clinical question
        • Find best evidence
        • Critical appraisal: appraisal of evidence for validity and usefulness
        • Apply the evidence: application of results in clinical practice
        • Evaluate the results on your patient” (from Kang H, How to understand and conduct evidence-based medicine. Korean J Anesthesiol. 2016;69(5);435-445)
      • To answer the question:
        • Explain what evidence-based medicine is
        • Describe the steps
        • Provide a situation in which you used it. It should not be difficult for you to find an occasion where you “looked something up online” to guide your treatment, or described to a patient the risks of a drug or procedure (the x% complication rate you quote comes from an appraisal of the evidence)
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