The advice zone

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How do I train for intensive care medicine?

Senior house officer training posts in intensive care medicine for three or six months are advertised regularly in BMJ Careers. Posts are either stand alone or typically as part of medical, surgical, and anaesthetic rotations. From time to time rotations that cover several different acute specialties are available--for example, accident and emergency, anaesthetics, intensive care, and acute medicine.

Not all posts that are advertised have been approved for training by the Intercollegiate Board for Training in Intensive Care Medicine or a parent royal college. Trainees who wish to undertake further training as a specialist registrar in an intensive care unit must have completed at least three months in an ITU post approved by the Intercollegiate Board for Training in Intensive Care Medicine.

Gavin David Perkins, research fellow, Birmingham Heartlands and Solihull NHS Trust

I am due to start my house officer year this August, and I want to know if theres anything I can do during this year to show my interest in neurosurgery?

I am unclear if you will be starting the old style house officer year or the first year of the new foundation programmes, which are being launched nationally from August 2005. These are currently on pilot in all regions. If you are doing the old style year, it may not be too late to change to a neurosciences oriented foundation programme. This could mean formal experience in neurosurgery at an earlier stage or at least knowing which neurosurgical unit you will be part of so that you can make contact straight away. Even if you are not going on the new programme, the most important thing is to decide which one or two neurosurgical units you plan to apply to for senior house officer posts.

Make contact with consultants in these units straight away, and express your career intentions. Make the initial approach in writing or by email; this makes a better impression than telephoning or just turning up, and you will then be taken seriously when you appear in person. The contact you make now will stand you in good stead when competing for surgical training posts or stand alone senior house officer posts.

The contact you make will also allow you to plan with the departmental academic lead consultant what type of audit or research you are going to undertake so you can start the preparatory work now. You will get a flavour for the current issues in the specialty, such as the international subarachnoid aneurysm trial, and you can become conversant with them as well as with basic applied neuroanatomy and neurophysiology (for example, why can there be an ipsilateral dilated pupil with a posterior communicating artery aneurysm?).

Consider attending one of the twice-yearly Society for British Neurological Surgeons or annual British Neurosurgical Research Group conferences. They will give you a good idea of the current issues and the standards required for a future presentation by yourself. Lastly, do not ignore the educational value of the post you are doing at the time, such as general or emergency medicine. A well rounded doctor is the basis for a good neurosurgeon. Also, completed presentations and publications, even if unrelated to neurosurgery, are highly thought of by neurosurgical appointments committees.

Ramesh Chelvarajah, clinical research fellow in spinal neurosurgery, Royal National Orthopaedic Hospital, Stanmore

How do I perform a telephone interview to a newspaper interested in my plastic surgery research?

Telephone interviews sound simple but have some hazards. A journalist is looking for news: something new and interesting or controversial. Ideally a pop star will have been caught in flagrante with a famous footballer in your research laboratory, and you have the photographs. You want to have your research discussed in a respectable way; the journalist wants some interest to write about. With the medium of the telephone, you can speak but you cannot see the respondents reactions or what they are writing down. Medical journalists are usually well informed, but they can get the wrong end of the stick completely.

With all medical research, the journalist will be wanting some element of medical breakthrough saves lives and some individual patients story laden with all possible emotions. It is hard not to conclude that more research work is needed and easy to forget ones sponsors. Remember that respectable research results should appear first in the professional press--proper journals and professional societies will reject material that has been placed prematurely in the public domainwithout peer review.

If the subject is of high medical drama or controversy--for example, use of fetal material, aspects of fertility treatment, face transplants--then junior researchers should leave such topics to more experienced colleagues. The ethical aspects may gain more interest or notoriety than the detailed research.

The interviewee should establish some ground rules first with the journalist; frame answers in moderate terms; remember to put in kind words about the patients who are the patient subjects of the research; acknowledge that ones work modestly stands on the shoulders of giants who have gone before; thank the fund raisers at the charitable trust; and place your current work in perspective. Will this work bring immediate benefit to patients lives? Good work: certainly; benefit: possibly one day; immediately: not really.

Before the interview, arrange a time to be rung back. Even a few minutes preparation is worthwhile. Prepare a few sheets of paper with large writing on them. Put headings on them as appropriate: nature of research, what this means for patients, remember to say this. Fill in some bare details.

On taking the call, write down who the journalist is, the periodical, what the piece is about, and where and when it will be published. Ask if you can see a draft for accuracy: this is sometimes accepted. Spell out your correct name, that of your research department or base, and mention that the work is supported by whatever sponsors.

Decide to answer questions or to make a short descriptive speech. Make three or four main points. Offer to fax or email any useful supporting documentation, such as papers or the introduction to a grant application.

Make the interview a real conversation: what does the journalist think is interesting, why does he ask that, is he sceptical or worried, are there conflicting views elsewhere? Accentuate the positive; eliminate the negative. Do not criticise anybody else. You can say, Previous approaches have had mixed or disappointing results so we have tried this.

Finally, thank the journalist for their interest and wish them well. Invite them to get back to you about any details or clarification needed. Then sit down for a few days and see if and what is published. Occasionally, national media will take up an obscure interview, especially on days with no other news. You are placing your head above the parapet with your trousers down: best of luck.

Carl Gray, executive medical director, Harrogate Health Care



studentBMJ 2005;13:89-132 March ISSN 0966-6494