Building a Portfolio for Psychiatry ST4 Applications

Love them or hate them, it’s impossible to get away from portfolios when you’re committed to training in any specialty of Medicine.  We could be forgiven for assuming that our illustrious e-portfolio gives us all the structure we need to build a brilliant CV, but the two processes are, actually, very different.  If candidates are to get the best from their portfolio when attending for interview, then some forward planning can take you a long way.

Process

Health Education England’s North West Office is responsible for the ST4 national recruitment drive and it is well worth checking out the documents on their webpage, a full 12 months in advance, as you prepare to submit your own application.

Self-assessment criteria within Oriel are now used as a means through which candidates appraise their own portfolio, which provides the basis for discussion, once in the interview.  This article is designed to help you start thinking about the various categories and how you can optimise your points in this area.

Quality not quantity

The allocated 20 minutes, whilst in the interview, actually passes very quickly and you will probably find that you have more than enough material to pass your time.  Aim for a standard A4 ring binder, the contents of which should be a short, punchy and a glowing report of the things you are most proud of about your career and your greatest achievements.  Not a lever arch tome of your entire career history and dull ARCP assessments, that can be seen in any other candidate’s e-portfolio.  As a general rule, keep it recent and only use evidence within your CT years.  The exception is if you have additional evidence relevant to Psychiatry e.g. medical school prizes in the field, for example.  Remember, interviewing is a boring task, panels want to wowed and see things that are out of the ordinary.

Know your portfolio

Once the questions start flowing, you will be expected to know your portfolio like the back of your hand, with regard to how it meets the criteria and person specification.  The interviewers will ask you to present your evidence to confirm your self-assessment score and it is a good idea to practice with peers beforehand, so that you can do this smoothly and seamlessly, particularly as your portfolio will be across a desk and upside down.

It goes without saying, but we all fall into the same trap.  Keep the boring bits at the back; everybody will have a GMC licence, medical degree, ARCP outcomes etc.  Although these shiny certificates make us feel better about ourselves, they earn you few points and you don’t want to waste valuable time discussing them.  That said, keep your biggest achievements at the front, so that more time will be devoted to their discussion and your enthusiasm will, automatically, shine through.

What should I use from my e-portfolio?

Competencies are assessed through work-placed based assessments (WPBAs) and these are validated at ARCP.  Don’t be tempted to over-use these in an interview, as they are a tick box exercise and, actually, say very little about you as a person.  Interviewers are particularly interested in anonymous feedback, for obvious reasons, so make-sure you include you the two most recent rounds of multi-source feedback, so that you can give one to each panel member.

In terms of other assessments, try to take a couple of interesting fully worked examples e.g. something you worked through from beginning to end and undertook additional learning, such as a linked CbD and reflection, so that you can provide context, show appraisal and evidence your commitment to lifelong learning.  Ideally, use recent examples, as they will evidence progression, particularly if they highlight features from the ST4 person specification.  This is far better at showcasing your skills then multiple, random assessments and allows you some control, in drawing attention to your best attributes.

Creating a good CV

There is no excuse for having a dull-looking CV.  Use colour, boxes, anything you are comfortable with, while remaining professional, to make yourself stand out.  My interviewers used a copy of my CV to pick out what they were interested in and ask further questions.  Again, don’t focus on the monotony that everybody else will have, but on the extraordinary that makes you different. Make clearly marked sections such as achievements, teaching, clinical audit etc. that make the information easily accessible.  The interviewers want to give you points for everything they can, so make it easy for them to find the information they are looking for.

Personal development plan

This often throws people, as they think their PDP should be full of grand gestures – it doesn’t!  Make a simple table with each line split into three and a few good points of where you are currently.  In the first, put your aim, which can be relatively simple i.e. QI experience, completing psychotherapy requirements, audit etc.  In the second box, document what you have done and keep a timeline.  In the third, note what you still need to do and your prospective timeline.  Some people love PDPs and use them all the time, others, like me, only churn them out at interviews to evidence what they’re up to.  Done well, they demonstrate organisation and excellent evidence that you can actually achieve what you set out to do.

Clinical governance, audit and quality improvement

Make sure you understand the difference between these three before going into the interview and have an example of each.  Audit and QI are terms that are used interchangeably, but have very different meanings, in practice.  You should aim to have a decent example of each for discussion, but also have a list of things you’ve been involved in over the years.  Many Trusts now have their own QI courses, so look at enrolling on these, so that you can demonstrate commitment to learning.

Interviewers are particularly looking for examples where you have demonstrated initiative, leadership and followed a project through to the end i.e. closing the loop or creating organisational change.  Your examples can be relatively simple, so long as they demonstrate good process and a good understanding of the procedure.  If you do not have a good example of each in your portfolio, then make it an objective to work on in your personal development plan, as soon as possible.  Take every opportunity to present posters at regional, national or international conferences, to increase your chance of winning commendations or prizes, which will earn you extra points.

Teaching

Make a list of all the teaching you have done and the titles of the presentations.  Everybody will have done journal club and case presentations, as part of their ARCP, so try and highlight any additional teaching experience that you have.  If you have done a teaching course, then make sure that it is highlighted.

Pay particular attention to examples of teaching other healthcare professionals, particularly if you can combine it with other areas, such as QI e.g. nurse education lectures relating to the identification of stroke following an untoward event on the ward.  Initiative and helping peers is positively looked upon, so think about setting up revision lectures/sessions for your CT colleagues to help them through exams or volunteer with the medical school for delivering sessions to the local medical students.  If you have done teaching at a regional level, make sure you highlight that too.  Make sure you showcase some feedback from your teaching, particularly if you can get somebody senior to assess at the same time.

Academic publications

Not many people come through CT with a strong example of an academic publication.  You can go about getting letters published, or being involved with others’ research, but the big points are for publications where you are the first author.  If this area is of particular interest to you then think about ways in which you could achieve a paper.  For example, I approached my Drugs & Therapeutics Committee for any data that they had collected, which they wanted statistically analysed and written up.  I went on to write the paper, publish as first author, present as a poster and win a national prize.  One endeavour, therefore, won multiple points.  As research takes up a significant chunk of time, you need to ensure that you get the most yield from your efforts.

Management and Leadership

Another area that is challenging for the majority of CT candidates and not necessarily expected.  Some Trusts now offer courses to their trainees and it is well-worth considering one of these to tick the box and start you thinking about the process.  Try to engineer examples by combining categories again e.g. supervising junior doctors or other colleagues doing data collection on an audit that you are leading on.  Carrying audit and QI through to clinical change can also be an excellent example and permit you experience at managerial / board level.  Alternatively, consider taking on a role as a representative within the Trust e.g. rota manager, BMA, QI, which allows you to showcase your skills at working with peers and higher organisational powers.  Make sure you collect evidence of these roles, so that you can enclose a certificate in your portfolio, which will then prompt further discussion.

Conclusion

Ultimately, all candidates are going to be nervous when they attend for interview and that is completely understandable, but the portfolio station does not need to be your enemy.  In actual fact, it can be completely the opposite, as it gives you the opportunity to show case your talents and best achievements, while maintaining control of the conversation.  The key is to know your portfolio and see its development as an ongoing commitment, rather than something that is only thought about at certain career points.  For further details of what is expected check out www.nwpgmd.nhs.uk/st4

Written by Kristina Engelbrecht

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