Reading, Riting, and Radiology

It’s been a while since my last update; my rota has been hectic recently, but for the first time in ages I have two free weekends in a row! Not that I’m complaining of course; it’s very tiring but I really need the money for my birthday holiday.

One thing I seem to be doing a lot of at the moment is teaching, which is really really weird. Trogdor’s is a large teaching hospital and there are only a few weeks of the year when we don’t have students in the department. When I first started there were a handful of third years dotted around, some of whom were extremely competent (which was quite intimidating actually!) so it was nice for me as I was still finding my way around. I wasn’t “given” a student until a few months in which was even better, but the first time I had to “teach” I was super nervous. I was a student myself only recently, so memories of good (and bad) teaching experiences are still fresh in my mind and while I know what kind of teacher I would like to be, it is very dependent on the student. A genuinely enthusiastic student is a pleasure to teach, regardless of current knowledge or ability, but I dread working with someone who would rather be somewhere else as it’s a constant uphill struggle.

The students that I have worked with so far have been a mixed bunch ranging from absolutely excellent, to worryingly deficient, but I think that’s the most I shall say as I know some of them read this blog!

We’ve also had some first year medical students shadowing us this week which has been an interesting experience! Being first years their medical knowledge is very limited so some of them struggled to even point out some basic radiographic anatomy, which is fair enough I guess, but it made their time in radiology somewhat baffling! The department has been fairly quiet as well recently so I couldn’t even show “my student” how to x-ray a patient, so I x-rayed a box of gloves instead! After that I opened the teaching file on PACS and showed them some of the interesting images that the department has accumulated over the years. When that got boring I resorted to showing them things like this:

To infinity and beyond!

Aside from educational endeavours, it’s been an interesting few months; five months to be exact! How time flies… I’ve finished my training rotation (when new people start they are rotated through the different areas such as A&E, fluoroscopy, theatre etc as a shadow so they can become familiar with protocols and equipment before being expected to cope alone) and am well into my shifts. My night shifts so far have been pleasant- busy, but not horrible. I’ve imaged a fair amount of trauma too, which is exactly what was lacking in my student years; down south it’s mostly broken hips and strokes, but here we get more things like stabbings, shootings, car collisons and industrial accidents. Resus can be a very exciting place for someone like me! I’ve seen everything from degloved feet to abdominal stabbings, and one thing that always amazes me is the different reactions from the patients.

One which really sticks in my mind is the lady who had ripped a huge flap of skin about the size of her foot off of her shin. It was down to the bone (hence the x-ray to rule out bony injury) and there was adipose tissue all over the place, but she was so calm and composed. She didn’t even flinch when I removed the dressing that was obscuring her wound, and while I would have screamed the place down if someone lifted my leg to put an imaging cassette beneath it, she laughed and apologised for making a mess! Certainly makes a change from the usual tirade of abuse A&E patients send our way!

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10 Week Update

I haven’t blogged in a while, partly because I’ve been busy / exhausted, but also because I worry that if I blog about specific events, even with details removed, patients and colleagues may potentially be able to identify themselves if I write about it straight away, and that would be unfair and unprofessional. But mostly, I’m lazy and can’t motivate myself to write after a day at work.

So I’ve been working for 2 and a half months now, and honestly, I’ve really been enjoying it. There are some stark differences between working in Hampshire and London; most noticeably, budget. I’d mentioned before that the imaging equipment was different to what I’m used to, but it extends beyond that. The rooms in general could do with a refurb; the paediatric room is quite an intimidating place for an adult, let alone a 5 year old with a broken leg. There’s also a dearth of basic accessories such as positioning pads and cassette holders; this doesn’t necessarily affect patient safety or the diagnostic quality of the resulting radiograph (assuming that the radiographer is determined and caring enough) but it can affect patient comfort, and it can also make the task for the radiographer much more laborious and require some significant creativity.

That said though, having the newest fanciest kit doesn’t solve everything; our fancy DR system in Resus decided to stop working on the morning of the Vauxhall helicopter crash, when we were on standby for some of the casualties. It turned out to be a very quiet morning in the end, but nerves were certainly frayed when one of the A&E rooms packed in at the same time! This all happened during my fortnight’s “training” in A&E (I’m still rotating through the various modalities so I can get a basic understanding of equipment, protocols, and working practices). Unsurprisingly, this was my favourite time period so far, and I can’t wait to get back round there.

So far, my shifts have been nice and easy; 9-5 every day, no weekends, but that all changes this month. Luckily I’ve only got one evening shift, one weekend long day, and two weekday long days in February, but it steps up further in March with night shifts thrown into the mix too.

So… what other news? Well I received a dose badge, but then that expired and I wasn’t on the list for a replacement so now I’ve got a temporary one; my markers finally arrived from the USA but apart from my A&E fortnight I’ve hardly used them; and I’ve received half of my uniform (the trousers) and when I collected them my colleague, who accompanied me to find out about hers, demanded that they give me a plain white tunic to tide me over til my proper ones arrive. Hopefully this will mean fewer incidences of being called “The Student” by consultants.

After all this behind-the-scenes waffle you may be surprised to hear that I have actually encountered some patients in my 10 weeks of employment, so here are some anonymised excerpts of the ones who have, for various reasons, stuck in my memory:

The 6 year old who barely even winced when I moved his obviously fractured arm to a more lateral position- brave kids like this just make me even more annoyed at perfectly well yet uncooperative adults who scream the place down over a slight sprain or bruise.

The elderly lady with multiple myeloma who had been booked in for a skeletal survey (a long list of x-rays covering basically the whole body, to assess the formation of any lesions in the bones) who not only repeatedly apologised for taking so much time (!) but also told me about the horrible experience she’d had at another hospital. Apparently the radiographer there shouted at her when she misunderstood his instructions and she cried on the bus home. I hope I’ve managed to show her that those types of radiographers are in the minority.

The young teenager who came into Resus following a collision with a vehicle; she sustained several injuries (luckily none were life threatening) including losing all of her front teeth only a day after having her braces removed. She was understandably devastated and kept apologising to the trauma team for crying. I think she made a lasting impression on all of us.

The gentleman who refused to take his necklace off for his chest x-ray and got very aggressive at the mere suggestion of doing so, telling me that if he takes it off “and something bad happens, it’ll be your fault” whilst standing 6 inches away from my face. More on this in a future post.

The father of the tiny baby on NICU who was born so premature that her lungs had barely formed. I felt awful asking him to step out of the room while I x-rayed his daughter, especially as he cleared his throat and tried to hide the fact that he’d been crying when he returned.

I’ll try to be more regular with my updates in future; I’ve got a few radiology related posts to write on a number of different subjects which have been on my mind recently.

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I Can No Longer Tell Left From Right

Just over three years ago, in a lecture shortly before our first clinical placement, we were given three vital radiographical items: our uniforms, a dose badge, and a set of markers. Three weeks into my first post, and I’m now devoid of all three.

My uniform is currently on order, and may not arrive for a few months (some staff members have been waiting since August) so I’m still mooching around in my student tunics; luckily there are no Portsmouth students at Trogdor’s so it doesn’t look too awful. My dose badge (this measures the amount of radiation we’re exposed to) is also on its way. And yesterday, I made a terrible mistake which has led to a painful loss…

An essential part of any radiographer’s inventory is a set of markers. X-ray images are 2D representations of 3D structures, and as such it isn’t always possible to be 100% certain what orientation the image is supposed to be in; looking at a chest x-ray you could be fairly sure that the heart is on the left hand side, but conditions such as dextrocardia remove any certainty. Extremity images (such as knees, hands, feet etc) can be very easily flipped by the processing software, making distinguishing left and right nearly impossible. This has huge medical and legal implications (you may have heard horror stories about surgeons amputating the wrong leg; improperly reported x-rays can contribute to these disasters) and as such, it is a legal requirement to physically denote which side of the body is which. We do this using markers: a simple L and R made out of metal which can be placed on the patient or the imaging cassette.

My markers and I went through a lot together, and as such we were parted several times, but until yesterday we were always reunited. My R frequently visited many a ward after being taped to an in-patient, and I once had a patient return to the department after discovering my L stuck to her hip whilst getting into her car. For these reasons (and others) I stopped using tape to secure my markers, and instead I chose to attach them to each end of a disposable tournequet; some people use ribbon but I personally find this a bit grim as it’s difficult to clean and ribbon is quite slippery, a problem when you’re hanging it over a wall stand. The tournequet is rubbery so it stays put, can be wiped down in between patients, and can be easily replaced when it gets soiled.

But yesterday I made a mistake. It was my first day in theatre so I wore scrubs instead of my tunic; and at the end of the day I was tired and had broken my routine so I put the scrubs into the laundry bin and went home, forgetting that my precious markers were in the pocket. This morning upon opening my locker the terrible realisation dawned on me… But it was too late.

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Week One

Week One was good; two days of mandatory (pronounced mandAtery by one of the speakers) training, most of which was useful and necessary, although I’m not quite sure why we were addressed by the chaplaincy and not the resus team. I suppose the resus team were busy training people on how to save lives. I discovered during these induction days that I won’t have a proper uniform for at least 3 weeks, so it’s lucky I didn’t ceremoniously burn my student tunics in May.

I asked the IT governance person if there was a specific social media policy, but she didn’t know (!) so I’ll just try to maintain anonymity as much as possible for myself, my colleagues, and most importantly, my patients. To this end, I have renamed my employer King Trogdor’s NHS Trust, or Trogdor’s for brevity. If you know me in meatspace I would therefore ask kindly that you respect my anonymity lest I burninate your village.

So on Wednesday I was finally allowed in the department. Apparently for a while I’m going to be supernumerary (sounds nicer than “surplus to requirements”) so I’ll be shadowing people in each area til I’m adequately trained. The thing is though, everyone there seems so approachable and lovely that I doubt I’d feel unable to ask for help at any point, which is nice. The atmosphere is completely different to anything I experienced whilst on placement, and I can’t help but make comparisons as I’ve got very limited experience of working in a diagnostic imaging department.

So another comparison I can’t not make is to the equipment. Quite frankly, up until now I have been spoiled by DR systems (I’ve written a post about equipment here for non-rads) as that’s pretty much all I’ve used. Both placement sites were fully DR (including mobile equipment!) and one was even completely paperless so we didn’t even get the physical referral forms. Trogdor’s is all CR with the exception of the resus kit. This, I’ll admit, scared the crap out of me at first. The main difference for me, is that when you’re performing a difficult examination (or when you have a difficult patient) using DR equipment, repeat images are really really easy to correct.

Say you’re doing a Y-view shoulder, and after the first exposure it turns out the patient is over-rotated, you can see both the image and the patient in front of you, so you move them slightly, retake, job done. Your eyes are on them the whole time. With my current CR situation, you take the first exposure, remove the CR cassette and exit the room (leaving the patient alone) to process it. Need to move them 10 degrees? You’ll either need a photographic memory or a patient who is able to follow instructions and stay still.

I did one on Friday, and the patient was obviously in pain, so when I returned to the room to repeat the Y-view she had sat down on the other side of the room, not that I could blame her. She had fallen earlier in the week and developed a decent bruise on her upper arm; she didn’t think anything of it at the time, but the pain was keeping her awake so she went to her GP who sent her to us for imaging. She was fairly mobile and able to rotate her arm well, so I didn’t expect to see any pathology, but after staring at the axial image for a few minutes I noticed a line through the anatomical neck of the humerus. This was my first “red dot” here so I was a bit pleased with myself I’ll admit, and as there were plenty of staff around I took the patient round to A&E myself so I could see what the standard procedure was for these cases.

So the first week has definitely consisted of a steep learning curve, but not an insurmountable one, and things will no doubt become easier with time. And now I’m one week closer to pay day, which is (unfortunately) as much of a big deal to me.

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Day One

Well not only did I survive the induction (two days of mandatory training on general hospital policies and procedures) but the first day in the department didn’t kill me either! It was certainly a shock though; I’ve recently become very aware of how limited my experience has been so far. During my course I worked at two placement sites, one of which had been officially opened a month before my first placement, and the other had an upgrade to its imaging department not too long ago. Therefore, I had become accustomed to a certain environment. The equipment at my new hospital is different to what I’m used to (I’ll go into detail in a later post) but I already feel like I’m getting to grips with it. The people are different as well- everyone’s so friendly! I’m not saying that previous colleagues have been unpleasant, but the attitude in large departments can sometimes be colder as people come and go so regularly, especially students. However this is a site with over 7,000 staff, and it’s not like that at all here; I’ve had people go out of their way to introduce themselves to me and make conversation. Even the patients seem more cheerful, but it’s possible I’ve had a lucky streak.

Let’s see how long it lasts! Bring on day two…

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Radiography Equipment (For Non-Rads)

I was chatting to a friend recently and realised that I was talking gibberish with terms like CR and DR, so for non rads, I’d just like to briefly describe some current equipment in terms that should make sense; in conventional projectional radiography (eg not CT, MRI, ultrasound) there are three main types of kit, and as pretty much everyone has a camera now, that’s what I’ll compare it to.

 

Film

Now I’m quite lucky as I’ve never had to develop a film radiograph; if I’d done A-levels and gone to uni straight afterwards that’d probably be different. This is a fairly easy comparison to make to photography as both have used film for the majority of their lifespans. You have an x-ray tube, a film plate, and the patient in the middle. The exposure would be made, and then the film would be developed while the patient waits.

 

Computed Radiography

Here, the plate is replaced by a digital cassette which is processed by a machine rather than dunked in noxious fluids. Cassettes are about a centimetre thick and come in a variety of sizes depending on what anatomy you’re examining. Cassettes are passive technology, and as such, if they’re dropped you won’t necessarily lose your data. Think of them as the old digital cameras which stored photos onto a floppy, but didn’t have a screen; you don’t have to wait to get the pictures back from Snappy Snaps, but you do have to take the disk out and put it in your PC before you can see if your thumb is obscuring that gorgeous sunset.

 

Direct Radiography

Same tube, same patient, but a digital receptor rather than a plate or cassette. These can be super-fancy; they’re usually connected to the radiography system wirelessly, meaning that as soon as you take the exposure the image appears on the screen in front of you. Unlike plates and cassettes, you can repeat images using the same receptor as it doesn’t store the data after it transmits it. Unfortunately, as it uses active technology, it’s not as small or light as a cassette and if you drop the receptor you’re dropping few thousand pounds’ worth of not terribly robust equipment. Not a good way to impress your manager. This is sort of like a modern digital camera with a screen and wifi connectivity.

 

This won’t pass any radiographical equipment essay marking criteria, but hopefully it will clear up a few of the terms I’ll be using in future blog posts.

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The End of Unemployment

Work starts tomorrow, well, two days of induction / mandatory training, then work starts on Wednesday. I can’t wait. It’s been two and a half years of training (read: working for free on placement) followed by five months of absolutely nothing except being a financial drain (three months of job-hunting, two months of waiting for occupational health to do their job). It’s been both excruciatingly boring, and hideously depressing, so when people tell me I should enjoy my “time off” or that I won’t be so eager in a month, I try to bite my tongue and keep my reaction to myself.

Anyway, expect more radiography-based blogposts soon. Assuming my employer’s social media policy allows for such things.

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RadTips: Further Interview Scenarios

I keep remembering things so I’ll add to this post as they re-emerge in my brain. Similar posts can be found under the RadTips tag.

Some other questions which have come up are of the following type:

How would you perform an OM30 on an uncooperative patient?

Now, I’m something of a pedant, I’ll freely admit that, so when I was asked this, I answered with two questions: how uncooperative are they, and why are they uncooperative? Personally, I don’t think that you can answer the question without knowing this information. Are they drunk? Aggressive? Confused? Suffering from dementia? Drunks can sometimes be reasoned with, as can aggressive patients (in my experience, a new face can sometimes be all it takes to reason with an unfriendly patient) but if they are suffering from neurological problems which they cannot control then you’re probably out of luck (and if they’re suffering from neuro problems due to head trauma then they should probably be going to CT anyway; their facial injuries can be assessed that way). Inappropriate or excessive movement which cannot be prevented is bad; if there’s no chance of getting a diagnostic quality image (the whole point of the damn process) then don’t waste your time. But why are they unable to keep still? Have they been sent round to radiology before having analgaesics? If so, don’t be afraid to send them back! If that was your mum with a facial bone injury, would you be happy for her to press her face up against a cassette without painkillers?

These questions apply to any “uncooperative patient” scenario; before going into robot-mode and rattling through the positioning, make it clear that you would not perform the examination unless you genuinely think you can get a diagnostic quality image. Don’t be afraid to send a patient back for analgaesics, sedation, or even just a coffee to sober up. And never ever put yourself in a position where you feel threatened by a patient.

It’s 2am, you’re working alone when you get a bleep for a trauma series, a NICU portable, and a femoral nailing in theatre. What do you do?

Once you’re done panicking, ring theatre, and tell them you’ll be there after the trauma series. Ask NICU what it’s for, explain the situation and ask if they can wait. It’s probably for NG tube placement, so as long as they don’t desperately need to feed them, they can hold off for a little while. The point of this question is to show both initiative and reasoning; it’s not necessarily about getting the answer right (although you probably ought to) more about proving you’re capable of thinking clearly under pressure. Practically, the trauma series comes first, this should be obvious. The patient’s life is at risk, they are the most urgent in the queue. Theatre is next; this isn’t a planned elective, it’s a trauma call and they can’t do it without imaging. They can, however, prep the patient etc while you finish the trauma series as long as they know that’s what you’re doing. Then, once you’ve got your breath back, trot off up to NICU and see if the feeding tube is in the right place.

The point is, the trauma patient has unknown injuries which could kill them; the theatre patient’s injuries are known, but serious and need treating immediately; and the NICU baby is being constantly monitored and unlikely to starve in the time it takes you to get to them. You need to not only show your reasoning with this, but also demonstrate your communication skills; it’s pointless getting the order right but then fail by not telling theatre or NICU what you’re up to.

Sometimes they like to hit you with something crazy like trauma theatre, #NOF, and a pile up on the motorway- 6 patients with injuries varying from #wrists to c-spine- ambulances are on their way. I’ve never had this in an interview, but my answer would be:

  • Call 2nd cover and ask them to come in. Tell them to avoid the motorway!
  • Tell trauma theatre what’s happening and that another radiographer is coming in.
  • Tell A&E that I’m currently on my own, but that cover is on its way.
  • Ask the A&E referrers to send the patients in priority order.
  • Get the #NOF done if possible while the ambulances are still en route, if that’s impossible, send the patient back to A&E where they’ll be more comfortable. They can sleep and have access to analgaesics if necessary; their injury isn’t life threatening, and their comfort is paramount.
  • Send the 2nd radiographer to theatre when they arrive.
  • Explain the situation to the porters so that they’re able to help.
  • Let A&E make the decisions and prioritise your patients, and examine them accordingly.
  • Ask the 2nd radiographer to assist when they’re done in theatre.
  • Get the #NOF done (if it wasn’t done earlier) once the serious injuries have been examined.

This is a similar concept to the previous question: it’s all about communication. Speak to theatre, A&E, 2nd cover, porters, etc etc. If you explain why you can’t be in theatre right away they won’t be thrilled, but at least they’ll know why. Instead of letting the A&E referrals line up, get them to send them to you in an order of their choosing; they know best.

I’d love to hear some opinions on answering these scenarios; would you say something different? These are heavily based on my (very limited) experience, so I’d be really interested in any new input.

Thanks!

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RadTips: The Interview

My post on job hunting and making applications is here.

Ok, first off, not all interviews are the same. The ones I’ve had have varied greatly; the majority involved a series of questions on knowledge, followed by a “tell us about yourself” bit, and then some image interpretation, however one was just an informal chat about me (no fact-based answers at all) and there are even some places which get you to position and image a phantom.

See who’s on the interview panel; do some Googling. If it’s John Smith, who wrote an article in Synergy last year about OPG for trauma, expect an OPG image to come up. If it’s Jane Jones the head CT tsar, revise your cranial bleeds. If you have any friends or contacts within the department, find out what kind of interview it is if you can. If you have any really good friends, maybe even find out what kinds of images they tend to use; are they mostly skeletal trauma? Head CT? Chest pathology? Seriously, it’s competitive out there, use any advantage you have, just don’t take the piss.

 

The knowledge questions tend to be on the following types of subject:

  • What is IR(ME)R? State the roles and responsibilities
  • What are the HPC’s CPD standards?
  • What is Clinical Governance?
  • What is a Clinical Audit?
  • What is the Data Protection Act?
  • What is NICE/NIHCE?

These are just a matter of learning by rote, unfortunately. There isn’t really a shortcut. Condense each answer into a series of points and get them into your head.

 

The personal questions can vary a lot, but there’s usually:

  • Why this hospital?

You need to do your research. Perhaps this is a placement site you’ve really enjoyed, or it’s a massive teaching hospital with loads of scope for personal development. Mention other points, such as outstanding infection control (if true!), what kind of Trust is it? If they’re applying to be an FT then you ought to mention this and state why it’s a positive move.

  • How has your degree/placements prepared you for a radiography career?

Quite simple really, have you done night shifts? Rotated between all the modalities? Have your placement sites been dramatically different? Big yourself up.

  • How would you apply your personality to radiography?
  • What do you most enjoy about radiography?
  • Give us an example of your teamworking skills
  • Give us an example of how you dealt with a difficult situation/patient

 

The only way to pass the image interpretation aspect is to practise. Go through some old OSCEs and familiarise yourself with pathologies and how they appear on radiographs. You’ll need to be able to describe anatomy as well as point out fractures; if you’re given a normal elbow image, they may ask you what fat pad signs you would expect to see if there was a fracture. It’s not just about being able to differentiate between normal and abnormal though; they may give you an awful peg view and ask how you’d improve it. Angle up? Angle down? Open the mouth more? That sort of thing. Try not to react too much to the images though; in one interview I was shown a frankly dreadful lateral ankle and I couldn’t help but raise my eyebrows when I saw it. Instead of commenting on how crap the image is (it might be one of theirs!), explain how you would improve it, and throw in something about patient cooperation, and how you’d only repeat if you think you could achieve a diagnostic quality image. If the image is rubbish but you can still see a particularly bad fracture, it’s worth mentioning that the patient might not have had analgesics (it happens), and this could be why the image is so naff. Patient care is hugely important, don’t waffle on about how you’d reposition the patient if they haven’t had any painkillers yet.

Personally, I think that technique is more important than interpretation. You’re interviewing to be a band 5 radiographer, not a radiologist. Being able to spot and describe a coin lesion is great, but you need to be able to take a decent mobile chest image first.

At some point in the interview, normally towards the end, you’ll be able to ask questions- don’t think for a second that this is of lesser importance than the rest of the interview. This is where you not only get to find out about the post (shift patterns, preceptorship, facilities, equipment etc) but you can also demonstrate your knowledge further. Asking insightful questions is an important part of the interview, and if you’re creative you can really use it to your advantage. Maybe ask what C-arms they use in theatre, and when they answer you can tell them that you’ve used that model on placement, or made a presentation on its features in your first year. Just don’t force an anecdote into a question as it’ll be obvious and really really awkward.

One piece of advice which I cannot stress enough, is the need to appear human. You might be able to cite IR(ME)R word for word and have the image interpretation skills of a trauma consultant, but you’re being assessed on more than that. Bear in mind that they know you’re a new grad, and therefore you’re going to have gaps in your knowledge; that will change with experience. Your personality probably won’t. They’re going to be judging how well you’d fit in their team, and if it’s a small department then this is hugely important. There’s not much you can do about this, just be yourself (or a slightly censored version of yourself) and hope they like you. If they don’t think you’ll fit in, then unfortunately that’s their call.

After the interrogation most places will offer you a tour of the department (this entirely depends on how busy they are, and whether they have anyone available to show you round). This is usually very informal, but remember that the person showing you round is a potential future colleague, so don’t relax too much; assume that they’re going to report everything back to the interview panel, that way you can’t go wrong. You can find out quite a lot about whether you’d want to work there from the tour: ask them how long they’ve worked there, what they enjoy about it, what theatres are like, ask about equipment and practicalities (room 4’s a nightmare, but there’s loads of space for mobiles in resus), whatever comes to mind. Don’t ask which band 7 is the biggest bitch, or who the nicest radiologist is. That would be something of a faux pas at this stage.

 

After the Interview

You should have been told when you’re likely to hear back from them, if not, don’t leave the room without asking! You’ll end up worrying unnecessarily, thinking you’ve been unsuccessful when in reality they’re not going to make a decision for another week. If judgement day comes and goes with still no word, it can’t hurt to contact them; it shows you’re interested at least, just don’t hassle them. If they said they’d ring by Friday and it’s now Tuesday, it wouldn’t be unreasonable to call. If it’s only Friday afternoon, lay off and chill out.

If you’re offered the job after your first ever interview, then well done! Whether you did it by skill, luck or a combination of both, it doesn’t matter, you did it.

If not, chalk it up as experience and move on, try not to take it too personally. The interview might have been excellent, you could have been the perfect candidate, unfortunately, there could have been 5 other perfect candidates and only two posts. It can be completely galling to come away feeling super positive, only to receive a standard “Dear Candidate” rejection email, and personally I think that’s a pretty crappy way to be turned down, but sometimes that’s how it goes. Any decent employer will give you feedback, and this can be vital; if they’re the kind of employer who won’t give feedback, would you want to work for them anyway? Remember that this is a two way street; they should be trying to impress you as well, after all, you’re going to be spending the majority of your waking hours there.

If, like me, you’ve gone for the “carpet bombing” approach, you’ll hopefully have another interview lined up, so you can use the feedback from this one to adapt your technique. If not, make some notes to remind you when the next one comes up.

Most important of all, try not to get disheartened. This can be really difficult, especially as the rejections pile up and the money runs out. I applied for over 40 posts and attended 7 interviews at a cumulative cost of over £75, but eventually the final three interviews all ended in offers. If I can do it, so can you.

Good luck.

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RadTips: Job Hunting and Applications

I haven’t seen much current advice for newly qualified (or near-qualifying) radiographers looking for work, so I thought I’d contribute, hopefully this will give a slightly different perspective to articles written by interviewers or academics.

The economy isn’t in a great state at the moment, and predictably, employment rates suffer. In particular, the current government made a nominal increase to the NHS budget this year, but along with “efficiency savings” and other reductions being made within Trusts, quite frankly, the NHS is facing a financial crisis. This means that the good old days seem to be over for now. You’ve probably heard the stories about radiographers basically being able to dictate where they work, and having job offers before even finishing the course. This doesn’t generally seem to be the case anymore, although the situation is marginally better for therapeutic radiographers. Here is my advice, based solely on my own experience and that of some of my friends. Please bear in mind I won’t be commenting on employment in the private sector; unless you’ve paid your own tuition fees I personally think it would be somewhat unethical not to “give something back” (yes, even if that means waiting longer for a job to appear).

Job hunting can be a full time job in itself; use every tool available to you to make this process easier and more efficient.

 

The Hunt

Sign up to the NHS Jobs website and create some searches based on where you’re willing to work. If geography isn’t a limiting factor you’ll obviously have more posts to choose from. These searches can be emailed to you, but they tend to get sent at the end of the day, and when I was applying, jobs were opening and closing within hours. In fact, one post I interviewed for was put up at 10am and closed by 2pm because of the number of applications they received. If you have a smartphone I recommend the following:

  • Create some searches based on both locations, key words, and salary (this excludes getting constant emails about band 7 posts etc)
  • Subscribe to these searches as RSS feeds rather than standard emails. This means that instead of getting an email at the end of the day (by which time it might have already closed) you get them as soon as they are posted. I used Blogtrottr to receive instant emails as soon as a job goes live.
  • Apply ASAP! Seriously, don’t wait. Unless you’re not that fussed about getting a job, in which case, why are you reading this?

 

The Application

Have a generic application form filled in offline somewhere; this means that when you make your first application you can just make some post-specific amendments and then copy and paste it onto the application. This form is then saved for future applications- make sure you change it every time you apply for a different post. You’ve probably heard it a million times before, but it really is important that you make a bespoke personal statement for each post you apply for. Personally for my applications I would change the first paragraph to be specific about the post, and the rest was generic. I researched the local hospitals and wrote introductory paragraphs for each and saved them on my phone; this meant that when I got a Blogtrottr email, I was able to apply for it immediately on my iphone.

The job offer I ended up accepting came about from an application made whilst out riding; we had to canter to the top of a hill in search of a 3G signal so I could press send.

If you’re re-applying for a post, you can go back to your previous application and copy/paste your statement, making the whole process much easier.

If your university offered non-standard extra courses on top of your degree, it’s really important that you mention them in both your statement and in the “training courses” section of the application form, under Qualifications. My uni ran optional courses in FAST and venous access; if you’ve done something similar, show it off! I’ve heard that some particularly competitive employers filter applications by these fields, so if they’re blank you’ll be automatically rejected.

Some Trusts (for whatever reason) advertise posts on NHS Jobs but make you register and apply on their own recruitment websites. This can be a massive pain in the arse as it means re-entering all of your info, but again, if you want the job…

 

Automated Rejections

Don’t be disheartened if you (sometimes almost instantly) receive an automated rejection. Unfortunately it does seem to be partly a numbers game, so if you apply beyond a certain time, but before they officially close, you might get rejected without anyone even reading your form. Hell, for all I know some of them were rejecting every odd-numbered application.

 

Invitations to Interview

Woo hoo! Finally you’ve got an interview. Some employers will tell you the date and time, others just give you a date range and make you log on and get allocated a time slot. I accepted every interview almost immediately, meaning that for every one where I had to register for a slot I ended up with an early morning one. Bear this in mind if you’re travelling any distance.

 

Interview tips are in a separate blog post as I think I’ve droned on enough in this one!

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