Self-assessment
Clinical Knowledge and Experience
You must read the instructions carefully before completing the application.
You are strongly advised to seek senior guidance about your application before you submit it. This should help ensure that the application is a fair reflection of your career to date.
Please ensure you answer the declaration of achievements correctly. If you have no evidence for a particular criterion, please state this.
As part of the assessment process, applicants will be required to provide evidence for each of the declarations of achievement made in the application form. Applicants will be invited to upload their evidence to the verification portal at a later stage. Failure to provide such evidence may result in your disqualification from the recruitment process, so it is essential that portfolios are presented as instructed using the tables requested and clearly show evidence that was documented at the application stage.
The application form asks candidates to make a declaration of achievement in various criteria relating to the person specification. These quantifiable or measurable indicators of achievement will be used to score applicants relative to experience.
At the start of the ‘Questionnaire’ section of the application form you are asked to indicate the number of years spent in practice since qualification. You are asked to indicate which of the below categories applies to you:
• 5 years or less in practice
• Between 5 and 7 years in practice
• Between 7 and 10 years in practice
• More than 10 years in practice
Time in practice is the time between graduation from medical school and the day of interview. The only exceptions to this are statutory leave (sick leave / maternity leave) and general military duties.
These exceptions are in recognition of the fact that these periods are not usually productive in terms of training or academic achievements.
If you choose to reduce your years in practice due to the reasons highlighted above then any achievements gained during this period cannot be included in your portfolio as evidence
If you consider that there should be other reasons why your years in practice should be reduced this should be highlighted with evidence provided which will be assessed by the selection committee
The selection you make at this point will be taken into account when assessing your application at the shortlisting stage. In order to ensure a fair and balanced scoring process, your achievements will be assessed according to the extent to which they are commensurate with your time in practice since qualification. The scoring process has been designed so as to not confer an unfair advantage, or disadvantage, on applicants relative to the differing routes of entry into practice. Accordingly, applications will be scored in a manner which ensures that any distorting effects relative to time in practice will be balanced.
If you consider your years in practice should be reduced – Please give your reasons detailed in the table below.
2. Years in Practice (Post Qualification) Selection
Please indicate the selection (A, B, C or D) that best applies to you.
Years in practice | Equivalent letter | Score |
<5 | A | 6 |
5.1 – 7 | B | 4 |
7.1 – 10 | C | 2 |
>10 | D | 1 |
Please indicate the selection (A, B, C or D) that best applies to you.
3. MRCS
Successful completion of MRCS examination by offer date – please can you confirm your current MRCS exam status:
Surgical Experience and Competence
The next three sections are to be completed to indicate your surgical competence and experience.
Please remember you will be expected to justify your selection by uploading appropriate evidence to the Evidence Verification Portal. At the end of each question is a table which you will have to complete to support your selections.
To support your logbook numbers during the verification process, please upload a copy of a summary logbook for the indicative procedures in each section.
Verification panels will not search through whole logbooks looking for information, the candidate must supply the information in an appropriate collated format.
Please note letters from consultants will not be accepted as evidence of ability to carry out procedures. You will require evidence that you have competently performed and been assessed on a minimum of three cases to score in the section you are claiming together with the section below to ensure progression.
A minimum of 3 cases demonstrated in the logbook in combination with three procedural WBAs e.g. PBAs or DOPS at performed (P), supervised un-scrubbed (SU) supervised scrubbed (SS) with at least 1 PBA/DOPS being level 3 or 4 assessed by a consultant will be required to score the section (Please see handbook)
The panel expect you to demonstrate progression through the lower levels of experience. To score a certain level you must have the three procedural WBAs (one consultant signed of level III/IV) for the level you are claiming and the level below.
For example: If you are claiming level D in hand trauma, fractures you will have to satisfy the criteria above for metacarpal fractures (level D) and K wires (level C)
Level 3: Able to perform the procedure with minimum supervision (needed occasional help)
Level 4: Competent to perform the procedure unsupervised (could deal with complications that arose)
If you do not use ISCP then further evidence is required to demonstrate competence. We will expect 6 cases in a validated logbook in the section claimed and the section below to demonstrate progression.
5. Section 1 – Surgical Competence – Hand Trauma
Please make a selection (s) that describes your level of competence by considering all of the examples shown below. The selection that you make, will need to be supported by evidence from your logbook and WBAs which will need to be uploaded to the Evidence Verification Portal. This will be reviewed by Consultants.
To support your logbook numbers during the verification process, please upload a copy of a summary logbook for all the indicative procedures in each section.
Please note letters from consultants will not be accepted as evidence of ability to carry out procedures. You will require evidence that you have competently performed and been assessed on a minimum of three cases to score in each individual section.
Ideally a minimum of 3 procedural WBAS such as PBAs or DOPS at performed (P), supervised un-scrubbed (SU) supervised scrubbed (SS) with at least 1 PBA/DOPS being level 3 (able to perform with minimal supervision) or 4 (able to perform unsupervised) assessed by a consultant will be required to score in each section.
Please note: A mixed nerve has both motor and sensory elements such as the median and ulnar nerves
Surgical Experience – Hand Trauma
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There are tables to complete below for each Group to indicate your logbook experience to go alongside your judgement of your competence. Please remember that you will be expected to upload evidence to the Evidence Verification Portal to justify your selection.
6. Surgical Competence – Hand Trauma – Tendon Group
TG – Tendon Group – Please indicate the letter from the table above which best applies to you
7. Surgical Competence – Hand Trauma – Tendon Group
Name | Performed | SU | SS | Other Evidence |
A – No Experience |
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B – Nail bed repair |
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C – Repair extensor tendon zones I-VII |
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D – Repair flexor tendon zones III-V |
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E – Repair tendon zones I-II |
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8. Surgical Competence – Hand Trauma – Fracture Group
FG – Fracture Group Repair – Please indicate the letter from the table which best applies to you:
9. Surgical Competence – Hand Trauma – Fracture Group
Name | Performed | SU | SS | Other Evidence |
A – No Experience |
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B – MUA hand fracture |
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C – K wire hand fracture |
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D – ORIF metacarpal fracture |
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E – ORIF phalangeal fracture |
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10. Surgical Competence – Hand Trauma – Nerve Group
NG – Nerve Group – Please indicate the letter from table which best applies to you
Surgical Competence – Hand Trauma – Nerve Group
Name | Performed | SU | SS | Other Evidence |
A – No Experience |
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B – Suture skin wound |
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C – Digital nerve repair |
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D – Mixed nerve repair |
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E – Nerve Graft or Nerve Transfer |
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12. Section 2 – Surgical Competence – Burns
Please make a selection (s) that describes your level of competence by considering all of the examples shown below. The selection that you make, will need to be supported by evidence from your logbook and WBAs which will need to be uploaded to the Evidence Verification Portal. This will be reviewed by Consultants.
To support your logbook numbers during the verification process, please upload a copy of a summary of your logbook for the indicative procedures in each section.
Verification panels will not search through whole logbooks looking for information, the candidate must supply the information in an appropriate collated format .
Please note letters from consultants will not be accepted as evidence of ability to carry out procedures. You will require evidence that you have competently performed and been assessed on a minimum of three cases to score in the section you are claiming together with the section below to ensure progression
A minimum of 3 cases demonstrated in the logbook in combination with three procedural WBAs e.g. PBAs or DOPS at performed (P), supervised un-scrubbed (SU) supervised scrubbed (SS) with at least 1 PBA/DOPS being level 3 or 4 assessed by a consultant will be required to score the section (Please see handbook)
The panel expect you to demonstrate progression through the lower levels of experience. To score a certain level you must have the three procedural WBAs (one consultant signed of level III/IV) for the level you are claiming and the level below.
Level 3: Able to perform the procedure with minimum supervision (needed occasional help)
Level 4: Competent to perform the procedure unsupervised (could deal with complications that arose)
If you do not use ISCP then further evidence is required to demonstrate competence. We will expect 6 cases in a validated logbook in the section claimed and the section below to demonstrate progression.
Surgical Competence – Burns
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| A | B | C | D | E |
BR | Burn Resuscitation | No experience |
| Burns Resuscitation 10-19% | Burns Resuscitation 20-49% | Burns Resuscitation >50% |
E | Escharotomy | No | Yes | |||
BS | Burn | No experience | Excise/ Debride Burn and SSG <5% | Excise/ Debride Burn and SSG 5-19% | Excise/ Debride Burn and SSG 20-49% | Excise/ Debride Burn and SSG >50% |
There are tables to complete below for Burn Management and for Burn / Wound Surgery to indicate your logbook and WBAs experience to confirm your judgement of your competence. Please remember that you will be expected to justify your selection by uploading this evidence to the Evidence Verification Portal.
Please indicate which selection that best applies to you by completing the tables below.
13. Surgical Competence – Burns – Burns Resuscitation
BR – Burns Resuscitation – Please indicate the letter from the table which best applies to you
14. Surgical Competence – Burns – Burn Resuscitation
Please complete for the table below to indicate your logbook experience to go alongside your judgement of your competence. Please remember that you will be expected to upload evidence to the Evidence Verification Portal to justify your selection.
Name | Performed | SU | SS | Other Evidence |
A – No Experience |
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C – Burns Resuscitation 10-19% |
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D – Burns Resuscitation 20-49% |
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E – Burns Resuscitation 50% |
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15. Surgical Competence – Burns – Escharotomy
E – Escharotomy – Please indicate the letter from the table which best applies to you
16. Surgical Competence – Burns – Burn Surgery
BS – Burn Surgery – Please indicate the letter from the table which best applies to you
17. Surgical Competence – Burns – Burn Surgery
Name | Performed | SU | SS | Other Evidence |
A – No Experience |
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B – Excise/ Debride Burn and SSG <5% |
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C – Excise/ Debride Burn and SSG 5-19% |
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D – Excise/ Debride Burn and SSG 20-49% |
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E – Excise/ Debride Burn and SSG >50%
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18. Section 3 – Surgical Competence – Skin Cancer
Please make a selection (s) that describes your level of competence by considering all of the examples shown below. The selection that you make, will need to be supported by evidence from your logbook and WBAs which will then need to be uploaded to the Evidence Verification Portal. This will be reviewed by Consultants.
To support your logbook numbers during the verification process, please upload a copy of a summary of your logbook for the indicative procedures in each section.
Verification panels will not search through whole logbooks looking for information, the candidate must supply the information in an appropriate collated format.
Please note letters from consultants will not be accepted as evidence of ability to carry out procedures. You will require evidence that you have competently performed and been assessed on a minimum of three cases to score in the section you are claiming together with the section below to ensure progression
A minimum of 3 cases demonstrated in the logbook in combination with three procedural WBAs e.g. PBAs or DOPS at performed (P), supervised un-scrubbed (SU) supervised scrubbed (SS) with at least 1 PBA/DOPS being level 3 or 4 assessed by a consultant will be required to score the section (Please see handbook)
The panel expect you to demonstrate progression through the lower levels of experience. To score a certain level you must have the three procedural WBAs (one consultant signed of level III/IV) for the level you are claiming and the level below.
Level 3: Able to perform the procedure with minimum supervision (needed occasional help)
Level 4: Competent to perform the procedure unsupervised (could deal with complications that arose)
If you do not use ISCP then further evidence is required to demonstrate competence. We will expect 6 cases in a validated logbook in the section claimed and the section below to demonstrate progression.
Surgical Competence – Skin Cancer
A | B | C | D | E | |
SK | No experience | Excise skin malignancy and close directly | Excise skin malignancy and FTSG | Excise skin malignancy and flap closure | Sentinel Lymph Node Biopsy (SLNB) |
Please indicate which selection (A, B, C, D or E) best applies to you by completing the table below.
SK – Skin Cancer – Please indicate the letter from the table which best applies to you
19. Surgical Competence – Skin Cancer
Name | Performed | SU | SS | Other Evidence |
A – No Experience |
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B – Excise and close skin malignancy and close directly |
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C – Excise skin malignancy and FTSG |
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D – Excise skin malignancy and flap closure |
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E – Sentinel Lymph Node Biopsy (SLNB) |
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20. Audit
Please make a selection from the option list. The selection that you make will need to be supported by evidence in your portfolio and WBAs (AoA – Assessment of Audit). This should be uploaded to the Evidence Verification Portal and will be reviewed by Consultants.
Both the Audit and Re-audit need to be completed by the applicant to claim an audit cycle.
The candidate must show evidence that they performed the audit and presented it at a formal audit or governance meeting as 1st author (or 2nd author with evidence to support principal involvement)
Please indicate which selection (A, B, or C) best applies to you.
21. Evidence to support Audit
What evidence will you be able to provide in support of the above selection? [max word limit – 250]
22. Teaching and Training
Please note: the below scale constitutes a sliding scale of experience gained, make a selection from the drop-down box of which section in the table below best relates to you. The selection that you make will need to be supported by evidence.
A | B | C | D | E | |
1 | No evidence | . | Collaborator on book chapter | Lead or principle author of book chapter | Editor or author of surgical text book |
2 | . | . | eLPRAS author or web based learning resources | . | . |
3 | . | Formal departmental, regional or undergraduate teaching presentations | . | Full time (6 months or less) formal teaching role or significant formal part time role greater than 6 months | Full time teaching role (greater than 6 months) |
Please indicate by selecting the most appropriate choice from the table above that best relates to you. The selection that you make will need to be supported by evidence and uploaded to the Evidence Upload Portal. PLEASE SEE HANDBOOK FOR DEFINITION OF REGIONAL AND NATIONAL
With increasing numbers of self-published texts each book will be assessed on its merit and will not guarantee level E.
Please indicate which selection (for example 1A, 1C, 2C, 3D) best applies to you with A being the lowest and E being the highest.
23. Management/Committee/Leadership Experience
Please make a selection from the option list. The selection that you make will need to be supported by evidence that indicates what activity you have carried out in these roles.
PLEASE SEE HANDBOOK FOR DEFINITION OF REGIONAL AND NATIONAL
Please indicate which selection (A, B, C, D or E) applies to you.
Management/Committee/Leadership Experience
24. Higher Qualifications Directly Related to Medicine
Please review the table below and make a selection from the options below. The selection that you make will need to be supported by evidence uploaded to the Evidence Verification Portal. This will be reviewed by two Consultants.
All Part time MSc courses should be included in the “less than 1 year research group”, unless significant evidence to demonstrate otherwise. No points can be claimed for MRCS, FRCS or FRCS PLAST.
This section is to score applicants that have taken extra time to complete a higher degree, awards that are given on completion of standard training will not be included in this section
All intercalated degrees at medical school will not be counted in sections 9 or 10 as dictated by MDRS (GMC)
Please indicate which is the highest selection that (E highest A lowest and in which row) best applies to you.
| A | B | C | D | E |
1 | None | BSc awarded or completed (intercalated degrees do not score) | Masters with less than 1 year of research awarded | Full time masters with 1-2 years of research awarded | Fulltime MD with >2 years of research awarded or PhD awarded |
2 | . | Masters with less than 1 year of research in progress | Full time masters with 1-2 years of research writing or submitted (lab phase or equivalent complete) | MD with >2 years full time research or PhD writing or submitted (lab phase or equivalent complete) | . |
3 | . | Full time masters with 1-2 years of research (lab phase or equivalent in progress) | MD with >2 years full time research or PhD lab phase or equivalent in progress | . | . |
4 | . | . | BDS or equivalent | FDS or equivalent | . |
Please select the highest option relevant to you, with E being the highest score and A being the lowest. E.g 1-E will score higher than 2-C
25. Evidence in Support Higher Qualifications Directly Related to Medicine
What evidence will you be able to provide in support of the above selection? [max word limit – 250]
26. Higher Qualifications Not Directly Related To Medicine
Please review the table below and make a selection from the options below. The selection that you make will need to be supported by evidence uploaded to the Evidence Verification Portal. This will be reviewed by two Consultants.
All Part time MSc courses should be included in the “ less than 1 year research group”, unless significant evidence to demonstrate otherwise.
| A | B | C | D | E |
1 | None | BSc/BA awarded or equivalent | Masters with <1 year of research awarded | Full time Master’s with 1-2 years of research awarded | PhD or Doctorate with >2 years full time research awarded |
2 | . | Masters with <1 year of research in progress | Full time Masters with 1-2 years research writing or submitted | PhD or Doctorate with >2 years full time research writing or submitted | . |
3 | . | Full Time Masters with 1-2 years research in lab phase or equivalent | PhD or Doctorate with >2 years full time research in lab phase or equivalent | MBA | . |
Please select the highest option relevant to you, with E being the highest score and A being the lowest. E.g 1-E will score higher than 2-C
27. Evidence to Support Higher Qualifications Not Directly Related To Medicine
What evidence will you be able to provide in support of the above selection? [max word limit – 250]
28. Publications
In your portfolio you must complete a separate table for each of these questions using the standardised format below. Failure to list your work on this form in your portfolio will lead to your potential score being discounted during the evidence verification process. Please read the information below carefully.
Applicants are asked to provide evidence of your four “highest scoring” papers. Your overall score will be based on the total of your “Impact factor scores” for the four papers. The impact factor score will be worked out as below:
Principle authorship will get 100% of impact factor, giving the “Impact factor score”
Any other authorship will get 25% of impact factor, giving the “Impact factor score”
All papers will have to be pubmed cited and have an impact factor. If co-authorship is claimed then it will need to be evidenced from the journal itself.
Collaborative papers will be dealt with later and not included in this section.
WE ARE LOOKING AT FULL PAPER PUBLICATIONS, OTHER PUBLICATION FORMATS SUCH AS FORMAL LETTERS TO EDITOR, SHORT COMMUNICATIONS, CASE REPORTS AND TECHNICAL TIPS WILL BE ASSESSED ON THEIR MERIT AND LIKELY TO BE COUNTED AT 25% IF YOU ARE THE PRINCIPAL AUTHOR ONLY.
(Letters to the editor will not be included unless submitted to a journal with an impact factor greater or equal to 20)
Complete the table in the format below, appropriately titled, listing those publications related to medicine which are Pubmed cited. Please give the title, authorship, journal, PMID number and Impact Factor and impact factor score
A worked example will be available in the Applicant handbook.
If you are not the first author but are claiming principal authorship, then evidence must be included from the journal itself. No one below 2nd author be considered principal unless you are the senior author
IF A CANDIDATE WANTS TO SUBMIT FIVE PAPERS IN CASE A PAPER IS DOWNGRADED, THEN ONLY THE HIGHEST FOUR WILL BE COUNTED
Publications 1st Author/Principal Author in pubmed cited journal – Please give the number of publications that you have detailed in the table below.
29. Publications
For each publication enter:
30. Total Impact score
Using the table above please complete the options below you will be asked to provide the impact score as part of the Self-Assessment oriel upload
Please total your first author impact score and select the most appropriate category
31. Presentations / Posters
Candidates must provide up to four posters or presentations as first author that you have presented at a national or international meeting.
PLEASE READ DEFINITION OF NATIONAL AND INTERNATIONAL IN APPLICANT HANDBOOK
Complete a table formatted as shown below listing up to four presentations or posters for which you are the first principle author and that you have presented at either national or international level, (e.g. BAPRAS, BBA, ISSH, ESPRAS). Please add Details and dates of specific scientific meeting
For example, but not exclusively: Celtic BAPRAS, RSM, ALCOCK SOCIETY, iPRAS, Welsh Surgical Society and their equivalents are NOT counted as National or International.
Points cannot be claimed if you are 2nd author
Please be aware that one piece of work can only be scored once within the presentation and poster section irrespective of the number of times it was presented
Candidates can put five pieces of work down in case one is downgraded but only four will be scored
For each presentation/poster enter:
32. Presentations / Posters
33. Collaborative Research
We encourage collaborative research and publications. Evidence of involvement in two collaborative papers will score a single point (half points cannot be awarded).
The candidate must provide evidence of their inclusion on the collaborative author list to be counted.
One point will be given if the candidate has evidence of TWO collaborative papers
For each paper enter:
34. Collaborative Research
Collaborative Papers
35. Principle Investigator
Certificate of being associate or principal investigator in formal NIHR or equivalent trial
Certificate
36. End
Thank you for completing the Plastic Surgery Self-Assessment
Specialty Applications
This site provides data and information on the medical and dental specialty training application process to help doctors and dentists plan their applications to speciality training posts in the UK.