Portfolio building is one of those areas that I think most medical students are fairly dimly aware of - that is to say that most people have the understanding that portfolio is vaguely important and probably will become more important at some point in the future, but can probably be dealt with after medical school. And as someone with I think an extensive portfolio for my stage of training, I actually very much agree with this. For 95% of people, the goal of medical school should (I think) simply be to pass medical school and be a good and safe doctor for your patients. That should absolutely be where the priority is.

In this video however I’m going to address two things - why does portfolio building matter and for who specifically does it matter - and how to actually go about doing it. It’s often really difficult to know where to start, but we’ll get to that in a second and hopefully relieve some of those anxieties. It’s also quite likely that I’ll do a deeper dive video into each subtopic and flesh things out further, so if that’s something you’d like to see be sure to let me know in the comments.

So - why and when is portfolio building important? Your portfolio serves as a reflection of your skills, aptitudes, interests and competencies - as much as a portfolio can. Just like an artist, photographer or designer, when it comes to finding jobs, those employers will want to see evidence of a broad range of skills and experiences.

Now when we apply for our first jobs as doctors, the portfolio is not taken into consideration at all. Everything comes from your exam performance throughout med school and your performance on the Situational Judgment Test (SJT) at the end. There is no look at you as a person, no interview, no viva, no nothing - you are a number, not a person. And in fairness, there’s no good way to do this. You cannot feasibly interview 6,000 people or look through their portfolios. So for most people, the first time their portfolio will become relevant is likely Internal Medical Training or Core Surgical Training two years after they graduate, at the end of FY2.

This is why for most people I’d advise against investing huge amounts of time into the portfolio as a student - it does help you get a head start and reduce pressure later. However, in my view there are three major reasons why you may want to consider building your portfolio more aggressively as a medical student.

The first is if you aim to apply for an academic foundation programme post, now the Specialized Foundation Posts as a junior doctor, or indeed an academic clinical fellow job later down the line. These are posts that you take as part of your normal clinical training, and give you some protected time to work on projects you’re interested in, such as education or research.

The second is if you’re applying for a run-through specialty post straight after your foundation training. There are a small number of specialties such as paediatrics, neurosurgery and cardiothoracic surgery which recruit very early and are also very competitive - which also means your portfolio must be very competitive. There is not really going to be enough time to start working on these applications during FY1 because that’s not enough time to get things published, presented and so on.

Lastly, just because you want to! Lots of people are passionate about portfolio development and projects for no other reason than because they enjoy it - that’s great and should be rewarded too. And of course not everything has to be about portfolio.

Now let’s go through some of the common themes and things you can do to help build portfolio, using a combination of the different scoring matrixes for specialty training - mostly core medical and core surgical training. Each specialty is different - go and check out the relevant person specification for your specialty as they do vary in exactly what they want.

Extra Degrees

Exactly what it sounds like on the tin. Many programmes reward extra degrees, be they taken before medical school, intercalated into your medical school years or taken as a junior doctor. Now in my opinion extra degrees should never be done purely for the points, but especially intercalated degrees are a great way to learn more about a particular subject and develop a special interest, as well as giving you time to work on a project in that area. Typically the higher the class and level of a degree, the more points it is worth.

Academic Achievement

Medics are generally smart-arses but many specialties will reward being extra special brainy, or at least being very good at exams. This is usually demonstrated by graduating with honours, meaning you might have the degree title MBBS (Hons) or equivalent, and usually marks out the top 10% of the cohort by their academic performance. While obviously this is extremely difficult and is usually only worth a single point, it’s a nice thing to have if you can get it.

Audit & QI

These generally fall under the umbrella term of quality improvement projects. An audit is the most common project to pursue, and involves comparing the performance of your department to a known standard, say a clinical guideline. You might look at how long catheters are remaining in place on a urology ward, or how many patients are being given the correct dose of tinzaparin during their hospital stay. If you find a failing, you make some sort of intervention, re-assess the results a few months later and look for an improvement (or non-improvement) - this is an important part of being in a clinical team so showing evidence that you know how to close the loop on the audit process is a great thing.

Research & Publications

One of the more well-known facets of portfolio building is research, that is carrying out a project, generating some data, writing up that data and turning it into a paper, ideally which you can then get published in an academic journal. This definitely needs its own video, but you can consider surveys, focus groups, lab projects, teaching interventions, getting involved with larger projects such as clinical trials - there are many avenues into research and it’s one of the most ubiquitous ways of scoring points at specialty selection. Note that more papers isn’t necessarily better, and sometimes being able to demonstrate a range of academic skills across a variety of subjects might be better than 50 systematic reviews in your specialty.

Presentations

Once you’ve carried out your project be sure to present it, going to an academic conference and telling the community about your amazing work! This can be broadly divided into either poster or oral presentations, that’s presenting a poster about your work or speaking to an audience about it, and then national or international, with an international level conference usually considered the most prestigious. But especially at the student stage, any presentation is a huge achievement.

Prizes

Next prizes - these are one off awards that signify achievement in some domain. The most obvious ones are those for academic performance - say the highest performance on the written exams in your year, but there are loads of other ways to get prizes! There are countless essay prizes run for medical students in each specialty and usually not that many people actually enter. Scholarships awarded for research would also count, elective prizes, academic bursaries - there are so many ways to win prizes and I’ll leave some links down below.

Teaching Experience

The next one is teaching experience, which is a great thing to reward since all doctors are supposed to teach their juniors. This is split into two concepts usually, that being commitment to regular teaching over say a period of 6 months, and training in teaching, usually at least a minimum of a specified number of days. Don’t worry about these too much as they’re very easily addressable as a junior doctor, especially if you’re planning on working a year as a teaching fellow.

Leadership

Leadership can be demonstrated in a variety of ways - it might be being president or a committee member of a student society while at medical school, a course representative, representative of a national society, something like the BMA student team - basically anywhere where you have to make leadership decisions and can demonstrate a positive impact based on your work. Again, no rush to do this as a student, can easily be done as a junior doctor.

Commitment to Specialty

Lastly but not leastly, the other thing you can definitely build while a student is commitment to specialty, which most specialties are going to love. All of the above areas can be tailored to this, whether that is research in your subject of interest, attending conferences regularly, winning prizes related to the specialty, undertaking your electives in that specialty or belonging to the student society at university.