December 15, 2016, by Editor

So you want a hospital pharmacy pre-reg?

This blog has been written by Robert Oakley, who is in his final year, about applying for a hospital pre-registration place.

And so it begins…

The most dreaded and equally anticipated event of the beginning of your career is nigh. Pre-registration.

Where do I go? How do I stand out? Will I be accepted?

Three questions that are racing through your mind amidst the chaos of 3^rd year.

It’s a tough one. But you can do it. Let’s take a walk…

Where do I go?

This is probably the most difficult question you will face but if you can nail this early it will save you a big headache when you have to make decisions. Admittedly, you may change your mind just as much as the British weather but if you can narrow your choices down to your top 4 hospitals, it helps! Once you get to the interview process, I would advise ranking where you want to go before your interviews so quick decisions can be made which will make things much easier for you.

You might want to consider the following things when deciding:

• Will I be happy there? I mean every sense of this statement and think this should be everyone’s top priority.
• Is it close to home? Will I be near my friends?
• How far am I willing to commute to work or to home?
• Location – does this fit your social scene? Think about sports or activities you love, are you able to do these? Do you want to live in a University town/city with a large student population?
• Can I afford to live there? Is there hospital accommodation available? Is it easy to move into private accommodation?
• Are there good retention rates for band 6 positions? Do they offer a clinical diploma? What could career progression be like if you stayed? (Trusts may want to keep you on after investing in your education for a year).
• What sort of hospital do I want? Smaller district generals where I might have more individual support or large teaching hospitals where I will learn within a larger group?
• What sort of clinical departments can I get exposure to? Does the hospital offer any specialist services I am interested in? Can I shadow other areas such as community pharmacy, Clinical Commissioning Groups or nursing homes?
• Do I want to specialise early or have more broad clinical exposure, can I do this via a split pre-registration?
• If living in London, am I eligible for increased salary to cover the cost of living?
• What’s the pre-reg programme like? How many weekends will you work?
• Are the people at the hospital people that I feel I could get on with?

The list could go on but I hope this provides some food for thought. The best way to find out this information would be initially to look on hospital websites to get a feel then email their pre-reg tutor with any questions you have. Another great source of information is current pre-reg students. Talk to them at open days, they’re likely to be much more honest with you but remember that you’re still on show. Visiting your hospitals of interest can be very beneficial as you will instantly get a feel for whether or not you like it. I’d strongly recommend that you attend open days and if you are able to, undertake a summer placement at the hospital(s) you are interested in.

P.S. Summer placement deadlines for applications loom around Christmas/January and are exceptionally hard to get onto. Don’t let this put you off, but get to work doing some research and make contact with hospitals you are interested in – they may even offer you a day experience. It’s hard work but will stand you in very good stead if you can prove the value of your experience and what transferable skills/pharmacy knowledge you have gained. A placement will enable you to form relationships with staff at the hospital which will benefit your application as it is like an extended interview but will also let you know if it’s right for you. Once you have the information you need from either directly emailing the hospital or searching their website, create your application and get people to give you feedback. I’d recommend getting the University Careers and Employability Service to have a look through your CV and/or covering letter/application as they can offer some excellent advice.

How do I stand out?

Application

This is what gets you the interview, and after you get the interview its contributing score will probably help you get the job. The School runs some really informative sessions on how to make this possible which I would highly recommend that you keep an eye out for. They are delivered by staff who have been pre-registration tutors or are hospital pharmacists so can give you incredibly valuable advice.

First you will need to start off with your application, which essentially is a game. Are you able to meet the job specification? Do you demonstrate the values and behaviours of the hospital/NHS Trust you are applying to? What is it about you that makes you different to everybody else and how does this make you more suited to the role? The same rules apply if you are applying for a summer placement.

Word of advice, start early. This isn’t like Turnitin. If you miss application deadlines that’s it, no second chance regardless of the circumstance. The applications website also has a habit of crashing on the night of the deadline. You have been warned!

It took me 2-3 weeks of late nights whilst I was on placement to complete my application! Get drafting it as early as possible, you can add things as you go along. It also really helps to get second opinions. Others will pick up spelling and grammatical errors you will miss. They will pick up those bizarre phrases that you think make sense in your head but read strangely. If you run it through 10 people, chances are everyone is going to have a different opinion and it’ll be a nightmare to edit. I’d recommend that you ask 1-4 people (preferably 1 from a pharmacy background and including your Personal Tutor) that know you well and are willing to support you through this process.

If you really can’t think of anything to write about, you still have time to act. Ask you friends what your best attributes are. How can you demonstrate these attributes through a scenario you could talk to someone about? Could you create yourself a scenario through a new opportunity? If you’re looking for inspiration there are many charities in Nottingham, some directly linked to patients and the University such as MacMillan or the Riding for the Disabled Association (shameless plug). Charities are always looking for volunteers and if you haven’t been lucky enough to secure a summer placement this is a brilliant opportunity to differentiate yourself. Look online, give someone a call, get cracking!

Assessment Centre and Interview

Assessment centre?! I hear you cry…

So here’s my three musketeers’ analogy:

1. The application
2. The assessment centre
3. Interview

I’m basing this on my previous experience with applying to London and the South East and Health Education England Thames Valley (HEETV).

Don’t worry, the reality is that you’re more well prepared than you think.

Assessment Centre

My assessment centre was in London and counted for my South East, London and HEETV application. My experience may not be identical to yours as I was the first year they tried the new type of system with regional applications, but I hope my experience helps.

For the assessment centre I received an ominous email inviting me to London in early September.

All assessments and interviews are in September so do not book a holiday then!

Sounds pretty simple right? So what about the experience?

1. They aren’t joking about arriving on time.
   You will be herded into the assessment centre with tens to hundreds of other students and be sitting down to sit the paper by the time specified. Leave contingency time for transport issues. Arrive early. There was also a pre-registration tutor I met at the RPS Annual Conference prowling amongst the application team. Dress smart. You’re on show. I was told to dress casually but what’s the harm in looking good? I felt much more confident greeting the pre-reg tutor I had met in a suit without the tie…
2. If you’re provided with an ID number, remember it.
   You may get this on the day or have been emailed it prior. Write it down. Memorise it. Whatever. You don’t want to be in a fluster when they say “go” and you don’t have your number to hand. Some people forgot it, panicked and wasted valuable time.
3. Calculator – bring what you’d bring to your PRO calculations exam
4. No BNF
   I know right, how am I supposed to answer clinical questions without a BNF?! You know more than you think. Preparation is key which I will elaborate on later.
5. The paper.
   Ok so this was tricky. Common pitfalls to avoid:
   • Read the instructions and the questions. You will lose marks in the calculations by putting answers to more than a certain number of decimal places  (just like with the calculations Rogo but in paper format).
   • Spend 5 minutes reading over the questions and allocate your time wisely. I had 4 questions on 3 sheets of paper and 4 answer books. Confusing. The questions are there to check your attention to detail and your ability to remain calm under pressure. Make sure you understand what they are asking and the types of answers they want. Prioritise your questions. For me, I knew that calculations would take me the longest so I did them first. After that I did the written prioritisation section then finished with only 10 minutes for multiple choice for clinical assessment and pharmacy into practice! It was intense. I finished on the dot. The beauty was I could rush multiple choice and guess if needed whereas that wasn’t an option for numeracy and prioritisation.
   • Keep an eye on the time. A stop watch would be ideal.
     Common topics you may be assessed on:
   • Prioritisation – situational judgements. Putting the patient first is a good place to start. You may have multiple things to do with little time to complete them in, make sure you rationalise your decisions.
   • Numeracy – basically the same as you will be doing in 3^rd year. There may be some extrapolation to clinical calculations you aren’t used. Don’t panic. Formulas were there, but it threw me initially. At the end of the day it’s just calculations and you will do well if you pay attention to detail and practice with your PRO resources. Try to get the Uni mock Rogos done within 30 mins max. I didn’t have time to check my answers and you get less time than you’re used to push your accuracy and ability to remain calm.
   • Clinical assessment – the only examples I can remember are OTC recommendations, counselling points about commonly prescribed drugs and what they’re used for. It’s a minefield. Some questions were simple things that a lay person would know, others required an application of drug knowledge (think counselling points, when would this drug be given) to a scenario. There was a selection of answers you had to choose from for each question just like a Rogo. I apologise this is vague but I went through this section very quickly! I honestly don’t know how you could prepare for everything. I educated guessed quite a bit of it. I think reflecting on your placements at University would help a lot. Look at the pre-registration exam, how is it assessed? The assessment centre format was a good reflection of the pre-reg exam and the clinical areas that are expected to be covered. Look at topics in the pre-reg curriculum and how the pre-registration year is assessed. That’s the best advice I can give. There was also something that I think was mentioned in a recent issue of the PJ, so keep up to date.
   • Pharmacy in practice – you should smash this. Learn your prescription requirements, it’s basically professional practice.
6. Remember your identity documents. Is your passport in date?
7. If you need adjustments, contact who you need to early

I hope I haven’t petrified you too much! I personally found the assessment centre very challenging. Others found it quite simple. Don’t get stressed revising what I mentioned, you will probably have a completely different set of questions. I think success here is gauged by your preparation, ability to stay calm under pressure and experience of pharmacy in a clinical environment. I appreciate you may be a bit panicked by the clinical but if it’s any consolation I hadn’t done any preparation apart from my placement work. Read over your Uni placement notes about certain types of drugs and conditions, it’ll all be there somewhere.

Interviews

So if you reach the cut off mark for the assessment (you don’t have to get all the questions right thank goodness!) you will be invited for interview.

Again, arrive with plenty of time to spare. I left 2 hours contingency for mine and rightly so as cattle decided to run across the train line on my way to London! I arrived only with 15 minutes to spare!

I had two interviews for two regions. The first involved two interviews, one which was a traditional question based interview and another with some tasks I had to complete with short answer questions. The second involved multiple interviews/skill testing with different assessors at around 5 assessment stations. I don’t know which one you may have, best to prepare for all. For all interviews you usually get put in a holding pen prior to going for interview. Here your documents are usually checked and it gives you a chance to chat to other candidates (which I’d recommend as you are on interview the moment you enter and it’ll make you realise you’re not the only one who is anxious!). Don’t use this time to cram. You will scare yourself and the likelihood is it won’t come up.

Recap

• Your professionalism lectures and the MEP… Think bioethical principles, knowledge of confidentiality, the multidisciplinary team etc to justify decisions.
• Recap what you counsel for in professional practice and don’t be thrown if it’s for some strange condition as long as the dose is correct in the BNF. I wouldn’t be surprised if the usual guilty suspects that have special counselling requirements come up.
• Know your application like the back of your hand and know a little bit about each hospital in the region you’re applying to. You will probably be interviewed by a hospital pharmacist of a hospital you aren’t interested in, but it helps build rapport if you ask where they are from and then mention something nice about their hospital
• Screening drug charts for the case based discussion. Think about requirements (FP10 and hospital charts) and common drugs that may need monitoring and recap dose units. A working knowledge of the NICE treatment pathways for common conditions would definitely help. Again, look at the pre-registration syllabus for some guidance.
• Learn the NHS constitution and its values. Guaranteed to get asked about this or have an incident where you can apply them
• Key changes in the pharmacy profession or reports that may affect your clinical practice or the way patients are cared for
• Keep to time. You won’t have long at each station so practice being to the point.

Remember to keep eye contact with your interviewers and be confident. You may/may not get a BNF to prepare with, I only had 1 minute with it at the assessment stations which is nothing. It’ll really help if you are familiar with the BNF layout before you go in. You could also be sneaky like I was and take your own BNF as you’ll know where to find things more easily. Bringing a ‘brag file’/portfolio of CPDs you’ve done or things you are proud of is a great way to buy some time and impress your interviewers (put up a fight if the receptionist try to take it off you!). You’ll be surprised at how much you know and even if you don’t know the answer to something, tell the interviewers that but explain how you think you might approach the problem – this is just as valuable. They know you don’t know everything but want to see how you approach things.

Will I be accepted?

Yes.

If you put some thought into your application and you prepare.

Don’t be afraid of going for somewhere that’s competitive. Someone has to get the place, why not you?

You can do it, good luck!

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