Yesterday, I went to Edinburgh to be interviewed for the Core Medical Training programme.
You may remember that when I applied to CMT last year I was offered a job in the frozen North. I did a lot of hand-wringing, but in the end I chose to try my hand at having a year out and not being in a training programme for a bit and staying in the West. (Spoiler: I made the right decision. I also made the inevitable decision. I live here.) For the last six months I have been essentially pretending to be a haematologist and then intermittently at the weekends pretending to be an acute medic. And that makes for a lovely year but probably not for an actual career plan, so back I’ve gone to job applications and putting back together a fortunately already mostly together portfolio and the reading and rereading of my own audit data.
I’m bypassing the whole bit with the hand-wringing this time around. I did it briefly when I was going through the application form, and then simply didn’t list the jobs that I didn’t want to take.
The thing to know is that everyone says that everyone gets a CMT job. The other thing to know is that that is bullshit. The competition ratio in Scotland was 2:1 in 2014. Now, don’t fixate on the number. It doesn’t reflect the fact that some people who have applied to this specialty have also and preferentially applied (for example) to paediatrics or for a job in Australia, but it does reflect the fairly fundamental point that there are less available CMT posts than there are applicants for them. And anyway, the third thing to know is that getting a CMT job is not the same thing as getting a CMT job in a town you’d be happy to live in for two years.
I say all of this because everyone said to me last year that everyone gets a job, and while they were saying it I knew but was unwilling to express out loud to most people the fact that my interview had gone badly.
I say it had gone badly: I was pleasantly astonished to discover that I hadn’t been ranked as an unappointable candidate, based largely on my performance in the clinical scenario.
Me: The patient has a supraventricular tachycardia.
Interviewer: And how would you like to treat that?
Beth: As he is haemodynamically stable, I am going to try to reverse it first using a Valsalva manoeuvre so I would get him a 50ml catheter tip syringe and ask him to blow into it*.
Interviewer: It doesn’t reverse, so what are you going to try next?
Beth: Oh. Hell. I’ve forgotten the name of it.
Beth: It begins with an A. It isn’t adrenaline or amiodarone or atropine. Obviously I’m in resus so there are other people around for me to ask and I would look it up if I weren’t sure. Oh, hell. IT BEGINS WITH AN A.
In a lot of ways, if I’d not realised that it had gone badly I’d have had to start asking questions about my lack of insight.
It got better from there, but you have to admit that that’s a low bar to set**.
And in my own defence, when a patient really did go into SVT three weekends later I didn’t forget the name for adenosine.
The best I am willing to say about this year’s interview while I’m still on this side of job offers being made is that it went less badly than last year, in that I at least managed not to forget the names of any resuscitation drugs or lose control of the situation to the point that I had to shout, “CARDIOVERSION!”, or, for that matter, shout.
* For my non-medical audience, you should know that this really is a real thing.
** In the first station of my medical school finals, the patient / mannequin who had, as I later learned, placental abruption, told me that she’d really rather I didn’t “have a look down below”, and I forgot that I was meant to be an FY2, not a medical student, and said, “okay, never mind, sorry”, and never found out that she was haemorrhaging out of her vagina, and even I’ll admit that that was worse. And you wonder why I sometimes wonder that they let me be a doctor.