Portfolio 
Commitment to Speciality

 Tell me about your CV?

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This is a difficult question to summarise well in the interview.  Your answer will be one of the longer answers in the interview if asked this but should not be longer than 2 minutes. Try to highlight your key achievements within your CV and how this will make you a good orthopaedic trainee. Utilise the CAMP framework as outlined in the tips for success section. Below are some examples of aspects of your CV you could highlight and potential skills learnt

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Clinical

• Previous Orthopaedic Experience

  • Orthopaedic Themed CST

  • Prior Orthopaedic Posts

  • JCF posts

  • Trauma centre experiences

    • Skills learnt: develop orthopaedic knowledge + management of on call patients

• Courses

  • Practical skills courses attended

  • AO Trauma / ATLS / Casting Course

    • Skills learnt: improved technical skills and management of orthopaedic emergencies

 

Academic

• Publications

• Involvement in collaborative projects

• Research courses

• Oral Presentations

• Poster Presentations

• Orthopaedic Audits / QIPs

  • ​Skills learnt: understand basic research principles + methodology + good team working & leadership skills to get projects completed

 

Management / Teaching

• Teaching

  • ​Teaching courses 

  • Mentoring of juniors

  • Bedside teaching

  • OSCE teaching

    • Skills learnt: Teaching & communications skills​

• Management

  • Leadership positions

  • Management courses

  • Rota co-ordinator

    • ​Skills learnt: Organisation, team working and people management skills

 

Personal

• Charity work

• Sports and exercise

• Team working (via 360 degree feedback / MSF)

  • Skills learnt: show your an all rounded individual with work-life balance 

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What is your biggest strength / unique selling point?

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For this pick a key area of your CV you are most proud of. One good interview tactic is to state how you initially identified something as a weakness, worked hard on it and now turned it into a positive. Again the key is to link this to how this makes you a better trainee and would perform well on a competitive surgical training programme. 

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Example Answer

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"During my foundation years I recognised that the research aspect of my portfolio was considerably lacking compared to all my other achievements. I identified this as an area I wished to improve upon and undertook a research methodology course and a research based junior clinical fellowship post. I worked hard with mentors on projects and am now incredibly proud to have 4 first named publications and to have presented these internationally. 

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I now have a grasp on basic research principles and methodology. And i'm incredibly proud in the way I was able to identify a weakness and work on self-improvement whilst showing good team working skills to get projects completed. As a result I think these skills will be invaluable if I obtain an ST3 number" 

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Why orthopaedics?

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Again this question can be broken down via the CAMP structure to think about what made you want to become an orthopaedic surgeon. Try to utilise a point from each section to structure your answer. The good candidates will seem incredibly passionate as if they were born to become an orthopaedic surgeon and this question is one were you should really highlight your enthusiasm for the speciality. 

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Clinical

• Practical Aspect

  • Enjoy practical aspect of surgery

  • Learning techniques from seniors

  • Constantly improving and bettering own skills - constantly competing against myself to get better

• Impact on patients QoL

  • Enjoy that interventions can rapidly and dramatically improve quality of life for patients

 

Academic

• Evidenced based approach

• Strong research component

  • Ability to continue research projects throughout training

• Innovation & new technologies

  • Makes field exciting

 

Management

• Opportunity for teaching

  • As you advance in years have opportunity to teach those below you

  • Teaching aspect very rewarding

  • Apprentice style model - pass on learning to junior colleagues

• Team working

  • Working with others and contributing to a team ​

  • Being involved in decision making process

  • Collaborating with other specialities

• Leadership

  • Opportunity to display leadership skills​

  • Both in and out of theatre

 

Personal

• Combination of high-pressure, practical job alongside the ability to work as part of a team 

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What are your short and long term goals?

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Short Term Goals

• Obtaining SpR number

• Working on WBAs and engaging with ISCP early

• Hitting indicative numbers

• Improve technical skills 

• Build confidence in making decision on call 

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Long Term Goals

• Research involvement

• Leadership position

• Masters / Higher education degrees

• Advance teaching and management skills

• Develop teaching programmes to pass on knowledge to juniors

• Sub-specialisation (e.g. soft-tissue knee surgeon)

• Personal goals

  • Marriage / house / wife / dog etc.​

  • Sporting goals (e.g. marathan)

  • Charity involvement

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Note: In this setting the best answers have a few realistic short and long term goals that include soft skills such as teamworking and decision making. But combine this with personal goals and what you wish to achieve outside of medicine. 

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Tell me about a case you managed recently?

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In this question think of a case that allows you to demonstrate patient management, decision making and escalation. Use it to show that you are a safe and reliable trainee. It is a good opportunity to show you are engaged with the learning process and ISCP. Say how you reflected on the case and performed a CBD to maximise your learning. The STAR framework is perfect for this question to produce a structured answer. 

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Example Answer

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Situtation

"During a recent on-call I was presented with an elderly female who presented with a fusiform little finger that she was unable to flex. She had presence of all four kanavel signs and the pain and erythema spread to the palm and to the thumb. I recognised this as a potential horseshoe abscess."

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Task

"I performed observations and bloods. I identified that this patient was clinically septic with raised inflammatory markers and this was a surgical emergency."

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Action

"I initiated initial sepsis management with IV abx, elevation in a bradford sling and medical photography before escalating to my senior. I referred immediately to our tertiary local plastic centre and stressed the importance of the situation"

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Response

"The patient was transferred for an urgent flexor sheath washout at the appropriate centre. This case led me to revise my hand anatomy and learn about the ulna and radial bursal communications which I was unaware of before. I completed a CBD with discussion with on-call consultant afterwards. I now examine the thumb / little finger in cases of potential flexor sheath infection of these digits". 

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What will be your biggest challenge as an ST3 starting out?

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The key to answering this question is to choose a challenge and state your action plan for how you are going to manage this as an ST3. This shows your ability to recognise a potential complication and plan a management strategy in advance. 

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Workload and Time Management

• ​Orthopedic training can be demanding, with long working hours and a high patient volume. 

• Balancing clinical responsibilities, paperwork, research, and personal life can be challenging.

• Management strategies

  • Create a structured schedule and prioritize tasks 

  • Break down larger tasks into smaller, manageable segments.

  • Utilize time management tools such as calendars, to-do lists, and digital apps 

  • Delegate tasks when appropriate and collaborate with colleagues to share the workload.

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Steep Learning Curve

• Orthopaedics is a complex field with a vast array of conditions, surgical procedures, and techniques.​. 

• Starting out, you will face a steep learning curve as you acquire knowledge and develop clinical skills. 

• Management strategies

  • Actively engage in continuous education and attend conferences, workshops, and seminars to enhance your knowledge and skills.

  • Seek mentorship from experienced orthopedic surgeons 

  • Establish a study routine

  • Dedicate regular time for self-directed learning.

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Decision-Making and Responsibility

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• Increased level of decision-making and responsibility t

•  The ability to make sound clinical judgments, interpret investigations, and choose appropriate treatment plans will develop over time.

• Management Strategies

  • Develop a systematic approach to clinical decision-making

  • Staying updated with evidence-based guidelines 

  • Reflect on your decision-making process and learn from your experiences, both positive and challenging.

  • Participate in MDT meetings 

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Surgical Skills Development​

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• Dexterity required for various procedures. 

• Orthopedics involves a significant amount of surgical procedures.

• Acquiring and refining surgical skills is a critical aspect of your training.

• Management Strategies

  • Actively participate in surgical cases and seek opportunities to assist and observe senior surgeons.

  • Attend surgical skills workshops and courses to enhance your technical abilities.

  • Practice surgical techniques on simulators and models to improve your dexterity and hand-eye coordination.

  • Seek feedback from senior surgeons and actively incorporate their suggestions for improvement.

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What is your biggest weakness? 

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This is one of the difficult questions to answer well. Firstly do NOT say you are a "perfectionist". You need to pick a weakness and use it to your advantage, talk about how you are working on improving this weakness, aware of it and have an action plan for the future. At the same time do not pick something that makes you look like an unsafe practitioner. 

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Examples of potential weaknesses

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1. Balancing Competing Prioritises

   • Difficult to manage work-life balance as registrar

   • Juggling audit / research / operations with personal commitments

   • Action plan: organisational and time management skills, task lists, productivity tools​

2. Adapting to new techniques / keeping up to date

   • Keeping up to date with new techniques / tools

   • Staying up to date with literature

   • Goes with above. Little time for reading through whole journals with other activities

   • Action plan: Attending courses (e.g. saw bone), attend conferences, read review summaries in journals​

3. Team working under pressure

   • Surgery has challenging scenarios under high pressure​

   • Important to maintain team working whilst concentrating on task at hand

   • Can be difficult in early SpR years

   • Action plan: MDT involvement, MSF / 360 feedback, reflective practice, communication skills courses

4. Emotional Resilience 

   • Being over critical of performance is something that numerous registrars experience​

   • At same time increased levels of responsibility can lead to more emotional involvement in cases if they go wrong

   • Important to recognise this impact 

   • Ensure work on personal well-being

   • Action plan: self-care routine, keeping up with exercise, mentoring from seniors, reflective practice

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What will you do if you don't get an ST3 number?

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Key point is to outline that your are aware of weaknesses and committed to the speciality. Show that you have thought about potentially not got getting a number, what you would do in this circumstance and show your commitment and resilience by saying you would come back stronger neck year. 

 

Key steps

1. Get feedback sheet from interview

   • Identify key areas of weakness for next years interview

2. Improve portfolio

   • Attempt to gain extra points

   • Higher Degree / Teaching qualification (PG CERT)

   • Masters Degree

   • More publications / research involvement

3. Research fellow / Locum Registrar jobs

   • In local area

   • To attempt to further improve orthopaedic clinical skills and knowledge

   • Improve decision making and competence ahead of ST3 number

 

What are your interests outside of medicine? 

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The are a vast array of things that you could say here. Most importantly be honest and have something you can speak passionately about. Then to conclude your answer thing about how this positively influences your work as a registrar, how it is beneficial to your well being and how you will continue this during training. 

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Examples: 

1. Exercise & Sports

   • ​"Outside of work, I enjoy practicing yoga and participating in local basketball leagues. Engaging in physical activities helps me maintain a healthy work-life balance and enhances my focus and endurance."

2. Volunteering work

   • ​"In my free time, I volunteer at a local community health clinic, where I provide medical assistance to underserved populations. It's fulfilling to give back to the community and broaden my understanding of healthcare challenges beyond the clinical setting."

3. Creative pursuits (e.g. painting / photography)

   • ​"I have a passion for photography and enjoy capturing moments that convey emotions and tell stories. This creative outlet helps me maintain a balanced perspective and brings a fresh perspective to my work in orthopaedics."

4. Travel 

   • ​"I love traveling and immersing myself in different cultures. Exploring new destinations allows me to broaden my horizons, appreciate diversity, and adapt to unfamiliar situations—a quality that I believe is valuable in the ever-changing field of orthopaedics."

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When were you last stressed / put under pressure? 

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Here it is important to think of a personal example. Use the STAR framework to structure your answer. Show that you were able to manage the stress outlining your management strategies. Then apply this to how you plan to cope with stress during your registrar training. 

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Example Answer

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Situation

"Due to COVID the run up to MRCS Part B had been delayed and I had struggled balancing in catching up on operative experience whilst revising at the same time. I neglected personal well being and doing my normal exercise regime which led to be being over stressed as a result. 

 

Task

"I reflected on this prior to the interview and thought about management strategies to improve when revising this time around" 

 

Action

" I developed my time management and organisational skills. On sunday evening i would plan meals and times in week to exercise. Including evenings which I’ll work and evening which I’ll relax. I kept up with exercise routine and utilised WBAs to maximise my learning at work."

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Response

"As a result I become a lot more focused and efficient at work as a result. Focusing on ISCP requirements during working hours led to more time to revise at home. This strategy I will take forwards to exceed in my training as an ST3"

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