Tea & Tales

This year has been a whirlwind of reflection, frustration, and growth as I navigate the complexities of medical specialty training. I’ve always been driven and ambitious, with my sights set on a career in surgery. But the path to achieving that dream has been far from straightforward.

The Changing Landscape of Surgical Training

When I first decided to pursue surgery, the process was portfolio-based. I worked tirelessly throughout medical school to build a strong surgical portfolio, knowing it would be my ticket into training. Fast forward to today, and the system has shifted dramatically. Now, it’s all about the MSRA exam; a test originally designed for GP training. Your score determines whether you even get an interview, and only then does your portfolio come into play.

For someone like me, who doesn’t always perform well in exam conditions, this change has been particularly challenging. I scored above average, but it wasn’t enough to secure an interview. It’s frustrating to know that years of hard work and dedication are essentially overlooked because of a single exam.

The Bigger Picture: Oversubscription and Bottlenecks

The medical field is facing a massive oversubscription for specialty training places. With more international medical graduates applying and a limited number of jobs available, the competition is fierce. Many of us are stuck in a cycle of applying for short-term roles (like F3 and F4 positions) while trying to break into our desired specialties.

This lack of stability has been one of the hardest parts of the journey. I’m approaching 30, and like many of my peers, I’m starting to think about starting a family. But without a stable career path, it feels like my personal life is on hold.

The Emotional Toll

The stress of constantly applying for jobs, facing rejections, and balancing it all with a demanding day job has taken a toll on my mental health. I found myself feeling envious of colleagues who secured training places, even though I knew I had worked just as hard, if not harder.

One of the most difficult moments was during my psychiatry placement, where a colleague got into surgical training. Everyone kept saying, “Charlotte, you’re amazing! How did they get in and not you?” While their words were kind, they didn’t change the reality: I was still without a job, and it felt incredibly unfair.

Exploring Alternative Pathways

I started looking into alternative pathways, like the CREST route, which allows you to bypass core surgical training if you have enough experience. I approached a hospital where I’d previously worked, and they were keen to have me back. However, I was told that as a British graduate, it’s important to follow the standardised pathway. While the CREST route is an option, it’s not viewed as favourably for someone in my position.

A Call for Change

I can’t help but feel that the current system doesn’t adequately differentiate between candidates. The MSRA exam is a hoop to jump through, but it doesn’t reflect whether someone will be a good surgeon. I wish there was a way for consultants to vouch for candidates, guaranteeing them an interview based on their experience and suitability for the program.

Moving Forward

Despite the challenges, I’ve managed to secure a job for the next year. But I know I’ll have to go through this process all over again. The longer it takes to get into specialty training, the harder it feels to achieve the stability I need in both my career and personal life.

This journey has been tough, but it’s also taught me resilience. I’m hopeful that the system will evolve to better support candidates like me; people who are passionate, hardworking, and committed to their chosen specialty. Until then, I’ll keep pushing forward, one step at a time.

If you’re going through something similar, know that you’re not alone. It’s okay to feel frustrated, but don’t let it define you. Keep working hard, and remember that your worth isn’t determined by an exam score or a job title. You’ve got this.