Respiratory medicine is a varied, exciting and challenging specialty.
It is concerned with the diagnosis, treatment and continuing care of adults of all ages with a wide range of respiratory and related conditions.
The respiratory specialist is at the forefront of the hospital acute services including intensive care, and at the same time cares for a large group of people with a variety of chronic disorders, including both in- and out-patients.
Respiratory medicine - trainee characteristics
Respiratory medicine will particularly suit trainees who:
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are highly motivated and enthusiastic
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enjoy dealing with a large range of different diseases and with diagnostic and therapeutic challenges
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enjoy practical skills
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are able to work within a team and have good time-management and ability to prioritise
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enjoy both the excitement of acute medicine and the management of chronic conditions
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are able to communicate effectively, and are empathic, patient and sound clinical decision-makers.
Working/training in an ST3 respiratory medicine post
Respiratory medicine involves both acute and chronic care and also involves being able to deal with significant diagnostic and therapeutic uncertainty.
Broad scope and interaction
There are a huge number of different respiratory conditions - including, among others, pulmonary infection, airways disease, cancer, interstitial lung disease, autoimmune diseases, sleep related breathing disorders, pleural disease and a significant interaction with many other specialties within the hospital and primary care setting.
This also includes significant interaction with intensive care medicine (ICM) and, indeed, there is a requirement to undertake some formal ICM training as part of the curriculum. For further details please refer to the Faculty of Intensive Care Medicine website.
Variety of practical procedures and training
There are a large number of practical procedures, including chest drain insertion, pleural ultrasound, bronchoscopy, interventional bronchoscopy and thoracoscopy.
The ability to work within a multidisciplinary team with cardiologists, rheumatologists, radiologists, pathologists, cardio-thoracic surgeons and oncologists is essential.
A good sound training in general internal medicine (GIM) is vital to success as most (but not all) consultant appointments are in respiratory medicine with some GIM.
In view of the significant number of practical procedures in respiratory medicine, good manual dexterity skills are an advantage.
Research opportunities
Respiratory medicine is a specialty that attracts a high level of opportunities for research; in fact, research during training is encouraged. Many trainees will obtain higher degrees such as MD or PhD.
Less-than-full-time training
Respiratory medicine has a long tradition of supporting less-than-full-time working amongst both trainees and consultants. We welcome applicants whose personal circumstances mean they wish to train flexibly in this way.
Competition for posts
Gaining a training post is usually competitive, so previous inpatient and outpatient clinic experience in the specialty, and some experience of related practical procedures, is desirable (but not essential) before application.
Medical Care
Find out more about respiratory medicine and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
Further information
Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for respiratory medicine in 2019 is South West Severn.
If you have queries specifically regarding your interview or feedback, please contact the region at which the interview is being held.
| Health Education South West (Severn) | ||||||
|---|---|---|---|---|---|---|
| Postal address | Vantage Office Park, Old Gloucester Road, Hambrook Bristol, BS16 1GW |
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| email address | [email protected] | |||||
| website | www.severndeanery.nhs.uk | |||||
General / application queries
For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Specialty Recruitment Office via email at [email protected].
Eligibility
This specialty uses the standard ST3 eligibility criteria, and does not accept candidates from any alternative training routes.
Please visit the am I eligible? section of this website for further information.
Single transferable score model
This specialty uses the single transferable score model which is a variation of the single centre model. You will apply for all posts nationally, however if invited to interview you will be given the option of a number of different venues at which you can book your interview, as opposed to all interviews being held at the same centre.
Regardless of which venue you select for your interview to be held, you can still be considered for all posts available in the specialty nationally.
Lead regions
This specialty will still employ an overall lead region seen in the 'Who do I contact?' tab above, which is responsible for managing all aspects of the recruitment process (from application admin to inviting to interview to making offers) on behalf of all regions nationally.
Flexible portfolio training
New for 2019, this specialty will be participating in the ‘flexible portfolio training’ scheme, in the East Midlands, South West and North West regions. This protects one day a week (or 20% time equivalent across the year) for the trainee to engage in project work that will aid their professional development in medical education, quality improvement or clinical informatics respectively. This is an opportunity to acquire and develop key skills and engage in meaningful project work, in a different environment, alongside time in training that will be the springboard to a consultant career.
Further details about the scheme, and the regions where this is available can be found by visiting the website https://www.rcplondon.ac.uk/projects/flexible-portfolio-training or by emailing [email protected]
It is possible that there could be changes between now and the interview period. Please bear this in mind when reviewing the information below, although in most cases it is not expected this will change, or any changes will be minimal. You are advised to check back in closer to the time of interview. The date at the foot of this page shows when the page was last reviewed.
Interview content
You will spend approximately 10 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 minutes.
Click on the relevant stations below for more information on the content of the interview.
Please note that this is subject to change, and will be confirmed by the date of interview.
Station 1 is where your application form will be reviewed.
This review will include all of the documentation you have brought along (see the interview preparation section) being reviewed and verified, to ensure that all content on your application form is correct.
Your evidence will usually be reviewed prior to the start of the station by one or both of the interviewers. Sometimes there may be a third interviewer present at station 1 who will be checking the evidence of the next candidate.
The main areas for discussion here, and on which you will be assessed, will be your suitability and commitment to both CT1 and to the region at which you are being interviewed, as well as your achievements to date.
Prior to arriving at station 2, you will be given a clinical scenario to review. Upon arrival at station 2, you will be asked questions relating to this scenario.
The clinical scenario will be relatively brief (two/three sentences), so once you have read this, the remainder of the pre-station time will allow you to undertake some short preparation (just mental preparation - this does not mean making notes, etc.)
Scenario considerations
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved.
There are some points you should consider when reviewing the scenario and preparing for discussion:
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what steps you would take
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any potential treatments possible
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any further information you would gather
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how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario
Of course, you should take into account any other factors you deem appropriate, using your experience and professional judgement.
Areas for assessment
One mark will be awarded to you based on your suggestions and responses to the clinical scenario.
The second assessment carried out here will be on the communication skills you display.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers at the station.
This station will feature assessment of an ethical scenario; and you will be required to give a presentation which you must prepare in advance, on a given subject (see below).
Station 3 of the interview is divided into three main parts - a presentation and discussion of it, plus a further discussion on an ethical scenario.
Presentation
Upon arrival at station 3, you will need to give a presentation on the following topic, for no more than three minutes:
'An interesting recent development / research finding in respiratory medicine'
When preparing your presentation, please bear in mind the points below:
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Clarity & relevance most important - Select a topic that is relevant to respiratory medicine, and which you can present with clarity. This is more important than trying to impress by choosing a subject that is esoteric or complex. It should be relevant to your application where possible.
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No aids/resources - There will be no projectors or laptops for PowerPoint, no OHPs, flip-charts, etc. You are welcome to use prompts on small cards, but these should be for your own use only, and should not be given out as hand-outs.
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Three minute time limit - Your presentation must last for no more than three minutes. Please note that you will be stopped after three minutes so as to allow further discussion to take place, so try and get your main points across before then. At the same time, bear in mind that interviewers will be assessing the level, depth and content of your presentation, as well as expecting some structure.
Interview nerves will be taken into consideration.
Post-presentation discussion
Once your presentation is finished (interviewers will stop you at the three minute-mark), interviewers will discuss it with you and ask further questions relating to the items you raise and any further points.
This discussion will take place for (approximately) another three minutes.
[collapse]Ethical scenario
The second assessment area will be the ethical scenario. As with the clinical scenario at station 2, this takes the form of a hypothetical situation, described briefly in text form, details of which will be given to you before arriving at station 3.
However this scenario focuses less on a clinical situation, and deals more with consideration of the moral, ethical, legal (etc.) issues which may arise in a particular situation.
Familiarise yourself with Good Medical Practice
Please note - assessment at station 3 is underpinned by the principles of GMC Good Medical Practice.
Interview scoring
Appointable - automatic
If you are awarded a score of at least 3/5, for all marks given to you at your interview, then you will automatically be classed as appointable.
If your 12 interview scores contain one or two marks of 2/5 (and the rest 3/5 or above), and you receive a total raw interview score of 36 or above, then you will automatically be classed as appointable.
Not appointable - automatic
If any of the 12 scores awarded to you at interview are 1/5, this will reflect poor performance and an area of major concern.
If three or more of your 12 interview scores are of 2/5, this will reflect several areas of concern across your whole interview.
Should your interview assessment falls under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable .
Total score calculation
After interview, a weighting is applied to the scores in each area, and a score derived from your application form is then added to give your total score. This score determines your ranking which is used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.
Please note that this is subject to change, and will be confirmed by the date of interview.
Application score calculation
The initial application score is used to shortlist applications. At interview this specialty reviews achievements from the application form against the re-scoring matrix in the document below to calculate the score which will contribute to the total score.
Whilst some achievements do not directly contribute to the re-scoring matrix, they will form part of the interviewers’ assessment in station 1 when awarding their score. In particular, quality improvement and teaching normally form a major part of the questioning in this station and as such are likely to significantly influence interviewers’ scoring; which will affect both the total score and determination of appointability. Thus these two domains should not be overlooked or considered any less important in any application.
| Int. 1 | Int. 2 | Weighting | Max score | |
| Station 1 | ||||
| Evidence | / 5 | / 5 | x1.6 | / 16 |
| Suitability for specialty | / 5 | / 5 | x1.2 | / 12 |
| Station 2 | ||||
| Clinical scenario | / 5 | / 5 | x1.6 | / 16 |
| Communication mark | / 5 | / 5 | x0.8 | / 8 |
| Station 3 | ||||
| Presentation research | / 5 | / 5 | x1.6 | / 16 |
| Ethical scenario | / 5 | / 5 | x1.2 | / 12 |
| Raw interview score | / 60 | |||
| Interview score (including weighting) | / 80 | |||
| Evidence score - scored at station 1, based on achievements claimed on the application form | / 20 | |||
| Overall assessment score | / 100 | |||
As part of the process of applying to ST3, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.
To this end, we have published data dating back to 2013 (where this is available), based around four main areas:
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Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.
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Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.
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Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.
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Post fill rates - the number of posts filled by region.
We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.
Round 1
| Year | Apps. | NTN posts | LAT posts | Total posts | Comp. | Unique* |
|---|---|---|---|---|---|---|
| 2018 | 204 | 88 | 2 | 90 | 2.3 | 55% |
| 2017 | 217 | 112 | 2 | 114 | 1.9 | 44% |
| 2016 | 216 | 111 | 1 | 12 | 1.9 | 45% |
| 2015 | 222 | 108 | 32 | 140 | 1.6 | 45% |
* the percentage of unique candidates that only applied to this specialty (out of the 24 PSRO-coordinated specialties)
Round 2
| Year | Apps. | NTN posts | LAT posts | Total posts | Comp. |
|---|---|---|---|---|---|
| 2018 | 84 | 36 | 1 | 37 | 2.3 |
| 2017 | 73 | 32 | 1 | 33 | 2.2 |
| 2016 | 66 | 36 | 1 | 37 | 1.8 |
| 2015 | 56 | 35 | 32 | 67 | 0.8 |
Provisional post numbers
Specialty vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts.
It is the intention that initial post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Numbers will be updated as and when notifications are received from each region and will be checked later in the round when programme preferences are open for selection.
Numbers subject to change
Please be aware that it is not uncommon for vacancy numbers to change throughout the round.
More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. On average post numbers rise between 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.
It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.
Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.
Round 1 Interview dates & post numbers
| Region | NTN posts | LAT posts* | Interview date(s) |
|---|---|---|---|
| East Midlands † |
4 |
0 |
London and KSS North West South West Scotland
|
| East of England |
10 |
0 |
|
|
London and KSS |
Kent, Surrey & Sussex 10 |
0 |
|
|
London 10 |
0 |
||
| North East |
5 |
0 |
|
| North West † |
Mersey 4
|
0 |
|
|
North Western 4 |
0 |
||
| South West (lead) † |
6 |
0 |
|
| Thames Valley |
3 |
0 |
|
| Wessex |
5 |
0 |
|
| West Midlands |
10 |
0 |
|
| Yorkshire & Humber |
3 |
0 |
|
| Scotland** |
9 |
1 |
|
| Wales |
5 |
1 |
*English LATs
Please note, English regions do not recruit to LAT posts.
**Scotland post numbers
If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish deaneries is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.
Please note that whilst we endeavour to keep the Physician ST3 recruitment website up to date, the SMT website will always be the more accurate one where they differ.
† Regions taking part in flexible portfolio training
Trainees will be able to preference posts with or without the 'flexible portfolio training' option where available. For further information on the scheme, and the distribution of regions to each pathway, please visit https://www.rcplondon.ac.uk/projects/flexible-portfolio-training