My IMT experience
I started working in the UK as a CF (non trainee) in Wales in September 2018. I applied for IMT in round 2 in March 2019.
The application procedure is simple if you follow Omar Alam’s guidelines. Before applying for IMT I had gone through these and made sure of the following
- Clear atleast MRCP 1 but I got lucky and did both 1 and 2
- Make sure I get an e-Portfolio from my hospital and fill up as many CBDs, DOPs and mini CEXs as possible.
- Do an Audit and QIP
- Do some presentations
- Make a good rapport in the hospital I work (basically come on time, know all the patients, try and head ward rounds… you know the drill)
- Attend teachings in the hospital for CMTs ( noone will stop you if you attend and I actually got attendance and certificates for it)
- Do e-learning ( I did BMJ )
- of course get your ALS
I made my folder also as per Omar Alam’s guidelines and this I spent a lot of time on. My folder was neat and tidy and appreciated a lot in the interview.
My interview was in Cardiff
There were three stations, headed by 2 consultants and a silent observer (probably someone observing your body language)
- Portofolio station: Cosultant 1 asked me to tell her what I had achieved in Medicine. I went on from never taking a gap in my career to clearing exams and being able to embrace a new system and appreciate the differences and the need of training. She asked me why the E-portfolio is important. I talked about being able to reflect and improve. Threw in clinical governance and the fact that there is always room for improvement.
Consultant 2 asked me where do I see myself in the next 7 years. I said I would want to be a consultant in Gastroenterology and drive my own Audi to a hospital where I am hopefully known to be a good doctor. ( I know its kinda cheesy but aah well… I said it)
- Clinical station
The scenario was a stroke. Consultant 1 asked me how would you approach the patient. I started with ABCDE and said as soon as I would suspect stroke I would put out the stroke call and as per the guidelines of the Board my Reg and team on call will come. The patient will go to CT. While the patient is in CT I will collect info as per past medical history bla bla to find out any Contraindications to thrombolysis. They didn’t stop me so I went to the Contraindications and said if the patient is for thrombolysis I will leave it to my reg as it is obviously above my scope and observe and learn. If not I went on with the management. I said 14 days of300mg aspirin for an ischemic stroke and then clopi or warfarin/ apixa if patient has AF.
They stopped me there and showed me an ECG and I told them it was fast AF. I said in this patient I would focus on rate control… elderly lad… they said when will you cardiovert… I said if he decompensates.
They asked me about risk factors and I told them
And in the end they said I was perfect.
So far so good. Here is where I messed up
3. Ethical station
Consultant 1 had a scenario of a brainstem stroke poor prognosis patient whose daughter had come for Turkey and had the Power of attorney and the power to make medical decisions and had asked us to put her mother on vent… now I was confused cuz this daughter as quoted in the scenario could make medical decisions. I knew giving any treatment is a decision that lies with the doctors… but aah well I went on about setting the scene of breaking the bad news and went on talking about the pillars of medical ethics. The consultant said even after u explain everything the daughter wants her mother on vent… i said well then I would escalate to reg and ask for a seniors opinion because I am a little confused of the legal situation here.