Your First 30 days as an ST3 Registrar in NHS placement: How to prepare

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A friend recently asked me how to make the most of their first ST3 placement. It prompted me to reflect on my own journey and consider the advice I’d give myself if I was starting again. Those early weeks can set the tone for your entire training year, getting it right from the start can make a big difference.

Here are some to the steps I found most useful to prepare for a strong start:

1. Contact the Directorate Early

Reach out at least 4–6 weeks before your start date to request both the on-call and daily duty rotas. Familiarise yourself with the pattern of a typical month so you’re not caught off guard by expectations.


2. Plan Your Leave

Once you have the rota, sort out your study and annual leave early. Remember, you may need to swap on-calls—so the sooner you sort this, the smoother things will be.


3. Map Out Teaching, Courses & Conferences

List all deanery teaching sessions, courses, and conferences you plan to attend. Aim for:

  • 80% attendance at deanery teaching
  • 1 conference per year
  • 1 course per year (not a strict rule, but advisable)

Factor these into your leave planning.


4. Speak to Current Colleagues

Touch base with someone already in the department. Ask about day-to-day expectations, working styles of different consultants, and any tips to help you hit the ground running.


5. Understand the IT Systems

Make sure you can use all essential hospital software to the level of an FY1 doctor. Early familiarity will save you countless hours down the line.


6. Update Your ISCP Portfolio

Ensure your current placement is reflected on ISCP, and that your portfolio is ready to go within the first 2-weeks.


7. Check Your Global Objectives

These are usually provided by your Training Programme Director (TPD) and serve as a roadmap for the year. They typically include:

  • 50 Case Based Discussions (CBD)/ Clinical Evaluation Exercises (CEX) on critical topics in your specialty
  • 50 Procedure Based Assessments (PBA)
  • 5 Observations of Teaching (OOT)
  • 1 Multi Source Feedback (MSF)
  • 2 Assessments of Audit (AOA)
  • 1 Conference
  • 150 eLogbook cases

8. Secure Your Supervisors

Within the first two weeks, arrange both an educational and a clinical supervisor. Colleagues can guide you towards consultants who are engaged and supportive in these roles.


9. Set Up Your Supervisor Meetings

Meet each supervisor separately. Come out with clear, written objectives for your first half of the placement.


10. Set Work-Based Assessment (WBA) Targets

A practical target is around 3 WBAs per week, totalling ~120 per year. That’s based on:

  • 52 weeks – 4 weeks (annual leave) – 2 weeks (study leave) – ~6 weeks (buffer) = 40 weeks

11. Build in Daily Reading

Read around the cases and scenarios you encounter daily. This keeps your knowledge fresh and relevant.


12. Teach to Learn

If you’re unsure of a topic, offer to teach it. It’s a powerful way to consolidate knowledge—and you’ll need at least 4 OOTs signed off by a consultant each year.


13. Prepare for Elective Theatre Days

Maximise learning in theatre with a bit of prep:

  • Read up on the topic, steps, patient scans, and notes beforehand
  • Arrive 30 mins early to consent patients
  • Discuss with your consultant what parts of the procedure you can perform
  • Aim to log 1–2 PBAs or CBDs afterwards
  • Reflect and review areas where your knowledge felt thin

14. Prepare for Clinics

Approach clinics as learning opportunities:

  • Arrive early and review the clinic list and referral letters
  • Pre-plan likely management options
  • Discuss cases before and after seeing patients
  • Log CBDs and CEXs as appropriate

15. Join Research or Audit Projects

Start with one or two projects ie. quality over quantity. Finishing a single project is far more valuable than dabbling in several unfinished ones.


16. Lead a Project

If you identify a gap, design your own QIP, audit or research project. Get a supervisor on board as a mentor and recruit juniors to help.


17. Ask for Feedback Early

During months 1–2, proactively ask for feedback. You may not always agree with it, but it helps you identify blind spots. A solid MSF review later in the year starts with early awareness.


18. Reflect on Communication

Think about moments where interactions could have gone better e.g. perhaps a tricky handover, a tense conversation with relatives, or a referral conversation that didn’t land well.

Replay those scenarios in your head. How could you have handled them differently? What words might have worked better?


Starting your ST3 year can feel like a big leap, but planning ahead can give you a solid foundation to thrive. I hope this guide helps you prepare, and I wish you every success as you start your new post!

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