VIC Internship explanation

Discussion in 'Internship' started by pi, Dec 1, 2017.

  1. pi

    pi Junior Doctor Moderator

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    Junior doctor
    In following from the brilliant thread Mana created for NSW, I thought I would share my experiences and try and decode the Victorian internship application process for everyone. I went through the process in 2017 (for 2018 Internships) and although at the time of writing this information is current, they are of course subject to change and the responsibility lies with you to get the most up-to-date information available.


    How does Victoria select its interns?
    Victoria is one of the few states in Australia that employ a merit system for intern allocation. This means that each candidate is scored by each health service they apply to, and the best candidates get the job. There are a range of factors that hospitals use in order to determine who is "best", and I shall detail that in my post here. It is worth noting that this is a vastly different system to other states such as NSW, which essentially have a ballot system instead.

    What priority group am I in Victoria?
    The priority groups in Victoria are as follows:
    • Priority Group 1: Australian permanent residents or citizens and New Zealand citizens graduating from a Victorian medical schools including CSP and domestic full fee paying students (i.e. graduates of University of Melbourne, Monash University, Deakin University and University of Notre Dame: Melbourne & Ballarat Clinical Schools)
    • Priority Group 2: Australian temporary resident graduates (i.e. international students) of Victorian medical schools.
    • Priority Group 3:
      • Australian permanent resident graduates of interstate or New Zealand universities (including previous residents of Victoria);
      • Australian temporary resident graduates of interstate universities;
      • New Zealand temporary resident graduates of New Zealand universities; and
      • Graduates from an overseas campus of an Australian/New Zealand University accredited by the Australian Medical Council (e.g. Monash University – Sunway Campus, Malaysia)
    Those in priority group 1 are given the top priority for internship allocations, and so forth. In 2017, I believe everyone in priority group 2 who applied in Victoria secured a position (4 people missed out the year previously). The situation is grim for priority group 3 applicants.

    What types of internships are available?
    All internships are accredited via the appropriate governing bodies, however internships come in two types:
    1. Full-time internships, which account for the vast majority; and
    2. Part-time, which are offered by select health services and which means the internship is completed over a two-year period
    Furthermore, in the application process, you can choose to nominate someone for a 'paired internship'. This means that you and that other person (who has to also nominate you on their application) will be considered as a joint application. This means that any health service that opts to take you will need to have two openings for each of you. These are inherently risky if the two candidates are miles apart in application quality, but are given as an option for couples who wish to stay together for the year.

    Who is involved in the internship process?
    There are three main stakeholders in the internship process:
    1. The Postgraduate Medical Council of Victoria (PMCV);
    2. The health services you apply to, all possible health services have their own application; and
    3. Yourself, the applicant
    I'll touch base with each of these sequentially in this post.

    What are the health services and how competitive are they to get into?
    Victoria has many many health services, more than you would probably expect. Here is a comprehensive list (source: PMCV):

    As you can probably guess, the competitive networks are generally the large tertiary services in the city and to a lesser extent, in the suburbs. These are competitive because they offer a wide range of training programs, are reputable, and generally have high pass rates in post-graduate exams. To get an offer at these sites, namely Alfred Health, Melbourne Health, St Vincent's Health, Austin Health, and Monash Health, which are probably the most sought-after sites, your application needs to be reasonably strong. However, given all internships at all sites are accredited, they are all decent at the end of the day. Indeed, working at smaller sites has many advantages over larger sites, you need to weigh this all up for yourself.

    For your interest, here is a breakdown of how many interns each had in 2017, these change slightly ever year (source: PMCV):
    And for more interest, here are the number of potential applicants in Victoria in recent years, giving you an idea of how your odds stack-up (source: PMCV):


    How does PMCV play a role?

    PMCV is essentially a preferencing system. Similar to the -TAC sites you used in Year 12 to preference your university degrees, PMCV allows you to preference different health services in what is known as a 'Candidate Priority List (CPL)'. Furthermore, and unlike those -TAC sites, PMCV is also a mediator for information that is 'common' to all health service applications, such as being a site to upload CVs, nominate referees, and provide InternZ scores. The PMCV also provides the option of nominating an applicant for a paired internship as well.

    The PMCV system opens for business around early May and closes in early June, leaving only a month to get everything sorted. This is a time that coincides with semester dates, so this is a busy time of the year if you want to achieve everything in this one month. I'd argue that it's simply too stressful and not possible to do everything in this month as well as do well in your clinical placements. Thus, I'd suggest starting everything early, at least a month or so beforehand.

    Communication between PMCV and the student applicant body is generally done via another group, the Medical Student Council of Victoria (MSCV). This group will usually run a Facebook group with all the applicants, which provides a medium for discussion about the process. Fair warning, I'd turn off notifications for that group because there are some absurdly moronic questions posted on a daily basis.

    The Candidate Preference List (CPL)
    This is straightforward enough. It's simply a list of health services that you preference from 1 until 15, with 1 being the one you desire most, 2 being the second-most, and so forth. There are no tricks here (unlike NSW), the hospitals you really want to be at should be at the very top.

    Although there are 15 spots in the CPL, you do not have to fill them all in. The cautious candidate will often fill them all in, especially if they don't feel they have a strong application, but the vast majority of people did not fill in all 15 spots. For the sake of full disclosure, I only filled in 12 of those spots. Most people filled in 8-10 anecdotally.

    The Curriculum Vitae (CV)

    PMCV provides a template for all candidates to use, known as the 'standardised CV'. This template isn't a suggestion, it's a mandatory requirement to follow and use. In all honesty, it's not the most visually-appealing CV template in the world, being filled with various tables and a reasonably ugly colour scheme, but it does the job and ensures easy reading for all the health services.

    There are a few things to note about the standardised CV. It's not a short template, it's actually quite extensive and covers everything from a photo, personal details, driving qualifications, awards, publications, clinical placements, schooling, and so forth. Each of these (plus more!) has their own sections, and some of the sections are so vague that you'll be left a bit puzzled as to where some of your achievements actually go. My advice on this front is to subdivide sections up. For example under the "Leadership roles and extracurricular achievements" section that exists in the template, which I felt to be extremely broad, I divided that into the four sections of 'Leadership', 'Professional development', 'Professional memberships', and 'Extra-curricular', which I felt helped made for easier input for me and easier reading for the assessors. Importantly, if you subdivide, all sections must remain in the same one table. You cannot delete any table, even if you have nothing to say in it. You cannot also change the fonts or the colour schemes or the page dimensions, and so forth. Just fiddle around with the tables, and that's it.

    Filling in each of the sections is reasonably logical, but it is time-intensive. This is the one part of the application I suggest can be started now. I probably started my standardised CV before final year even began using a template from a mate in the previous year. I would strongly recommend doing something like this, especially if you don't have an existing CV lying around to copy and paste from. This leaves you with heaps of time to refine the document as the year progresses. Furthermore, as I touched upon above, this CV also requires a photo. God knows why a photo is required, but it is, so try and get a professional shot instead of an obvious selfie or cropping a photo of your head from somewhere else. This photo is not for a passport, so you're encouraged to smile.

    The referees
    PMCV requires you to nominate up to two referees. These referees, once nominated, fill out a questionnaire about your performance in various areas in the form of boxes to check and a space to write comments. Once filled out, you are notified via email but do not get to see the actual feedback the referee provided. The form looks something like this (source: PMCV):

    A few tips and lines of tact here, because I noticed that people found this to be incredibly stress-inducing. Although PMCV states that up to two referees can be uploaded (if any), I strongly recommend you have two. This is because nearly all health services I applied to needed two referees. You will be ineligible if you have any less than two. Furthermore, PMCV states that the referees can be Fellows or Consultants. I strongly recommend you only choose Consultants (including GPs) for these referees, because again, most health services will not look at anyone who is further down the food chain.

    These two referees should have supervised you clinically (ie. not from a research stint) within 18 months of the application. So essentially, you have all of your final year and the year before to find two people to be you referees. Again, I'd strongly suggest at least one of those be from this current year. I know at Monash, this means at least one referee should be from the three rotations you have before intern applications are due. If this sounds stressful, it's because it is, but there are ways to approach prospective referees that might make your job easier.

    Personally, I found that your supervising Consultant on your rotation is in the best position to provide a referee for you. However, you need to ensure you get to spend time with them - and that means going to their ward rounds, going to the clinics, going to their theatre lists, and so forth. Show particular interest, keenness and initiative when around your Consultant. However, you can't just suck up to the boss, you need to maintain that level of natural enthusiasm for the whole rotation around all medical, nursing, and allied health staff, because invariably the Consultant will ask for their opinions before forming a final opinion on you. So aim to be a good medical student all the time, but try and secure as much time with that prospective referee as possible.

    Once you feel you've developed a good rapport and have performed well in front of that Consultant, approach them towards the end of the rotation and ask them if they'd be willing to be your referee for upcoming intern applications (they invariably say 'yes' if you did well on the rotation), and ask for their contact details and ask if they don't mind you sending them a reminder email closer to when applications are due (again, they say 'yes'). You've now planted the seed, this is important as medical students come and go and you might not be as memorable in the Consultant's eyes as you think.

    I'd then email them a couple of weeks after the rotation is over to thank them profusely for agreeing to be your referee and to also attach the mock-PMCV referee template (the one above!). In your email, briefly explain the process to them (without being patronising!), and encourage them to write some comments if they have the time. Health services love the comments, absolutely love them. Sending them this information early allows them to know what to expect, indeed some keen beans actually printed out the mock template and asked prospective supervisors to fill it out in front of them to see how well they'd give them. Personally, that latter approach is too far, but the email is a nice courtesy.

    Following this, email them again just before you officially nominate them in the PMCV system, telling them that they'll receive an email from PMCV shortly with a link to a similar form to the one you earlier attached, and if they could fill it out AND fill in the comments. Add the due date in your email, and stress that you'd prefer it filled out earlier rather than later, but at their convenience as well. It's a fine balance between your natural anxiousness and being polite, so go through a few email drafts. Once they've completed the official form from the PMCV link, you will be notified via email. The onus is on you to make sure your referee fills this in, PMCV will not chase them for it. As mentioned, you do not get to see what scores or comments they gave you, and that's probably for the best. Importantly, you cannot un-nominate a referee without going through a lot of paperwork with PMCV, so choose wisely!

    You need to do all of the above for two such referees.

    The InternZ score
    The InternZ score can be seen as the "ATAR of medicine". It's your place on a normal distribution curve that has a median of 3.5 and a standard deviation of 1. Ideally, you'd like to be above 3.5, which puts you in the top 50% of the cohort. The score is given to all Victorian students, usually around April-May, and is calculated differently in each of the unis such that a median student at Monash is theoretically academically equivalent to a median student at UniMelb or Deakin. I think it's universally recognised that it's got some issues, and that some say that perhaps it's easier to get a higher InternZ score at Deakin given their cohort is generally inherently academically 'weaker' (based on GAMSAT and GPA) than UniMelb, but that's all very controversial and the fact remains that we use it in Victoria so get used to it and stop complaining.

    The InternZ score is given to one decimal place, and there is no appealing the score once you get it. The breakdowns for the different Victorian unis are as follows:
    • Deakin University: score is determined solely on your penultimate year results (100% clinical)
    • Monash University: score is weighted approximately 2:1 clinical : preclinical
    • The University of Notre Dame Sydney: score is weighted approximately 30:30:40 for 1st:2nd:3rd years
    • The University of Melbourne: score is weighted approximately 1/3 preclinical to 2/3 clinical
    In the PMCV application you'll be given the chance to 'opt-out' of health services seeing your InternZ score. I would strongly recommend you NOT do this. Every health service I applied to needed the InternZ score, and many people included it on their standardised CV as well just to make sure they were getting it. Like ATARs, having a 'low' InternZ score isn't the end of the world, your CV, referees and interviews can make up for a few lost points on the InternZ score. Granted, higher the better.

    Notably, interstate or NZ applicants do not get an InternZ score, and I'm not entirely sure how their academic grades are processed by health services.

    Health services

    How do the health services play a role?

    Not only do you have to apply to PMCV, but also to each individual health service that you have preferenced in your CPL. Is this annoying? Yes it is, very much so in fact. Each health service has a slightly different application process, and there are a lot of health services (see picture above), but they all tend to open at the same time around May.

    Is there anything I should do before applications open?
    A bit of a leading question, but obviously: yes! The most important thing to do during this time is to get to know the health services you want to apply to. You've probably only spent clinical time at only a handful of the health services out there, so getting to know the other ones you might want to go to is really important.

    You can go about doing this in two main ways. The first is to attend the Medical Careers Expo at the Melbourne Exhibition Centre, which occurs just before applications open, usually in late April. This Expo has many of the health services present (as well as Colleges etc), and is a really good chance for you to ask their senior and junior staff questions, learn about their training programs and intern program, and get valuable tips regarding what they look for in intern applications. The second thing to attend are the individual information sessions many of the health services run at their mothership hospital. These are not widely advertised, so keep an eye out for them on their individual websites. Note that some require bookings in advance and do fill up, so be organised. Some will post up their slides from the day afterwards, but most do not.

    The applications themselves
    You need to apply to each health service on your CPL, otherwise you might as well not have it on the list. Each health service has their own peculiarities in their application, which is as annoying as it is stressful. Here are some of the various components you might encounter:
    • Cover letters. Several health services require cover letters. My tip about these is to start early, ideally in the month before applications open once you know a bit about each health service. Your cover letter, which should be 1 A4 page in length (as a maximum!), should introduce you to the health service and show them why you would be a great fit for their program. It can be generic to a degree, but each cover letter should be individualised to focus on that health services' strengths, values, and programs. Ensure you address the cover letter to the correct person, and this person is often mentioned in the application.
    • Questions. Many health services also employ questions, which can be as simple as "why do you want to work here" to specific scenario-based questions. Some of these take time to answer, so it's worth jotting down your thoughts on a Word document and refining your responses over the application time period. In general, unless otherwise specified, keep your responses to 200-250 words for each question.
    • Non-clinical referee. Some select health services (such as Eastern Health) also require a non-clinical referee. This is broad, and can be someone from work, someone who you have volunteered with, someone from research, someone from sport, etc. This person is required to write you a letter of recommendation that needs to be uploaded. Generally, they form a very small component of the application, but every extra point counts at the end of the day. Best to not leave this until the last moment, and best to choose someone who will say something that complements your application and the values of the health service.
    The applications do take a long time to complete, and it is a stressful process. Start early, and you'll be better for it. Worth noting that once applications are submitted, you can go back to them to change things. So don't feel stressed if you accidentally submit one before it was perfect, you have until the last minute to make edits. Once you are done though, go back and double-check you have attached everything that needs to be attached, filled in everything that needs to be filled, and then triple-check all of that again. Once you have submitted it, you will receive an email confirming that, which is some good peace of mind.

    Do health services have a bias towards their own clinical students?
    Officially, the answer is 'no'. Unofficially, and what the real answer is, who knows. There are a plethora of rumours regarding this, the most well-known is that St Vincent's is incredibly nepotistic in their selection, and perhaps Melbourne Health, Alfred Health, Austin Health, and Monash Health also are to a lesser degree. I personally don't believe such rumours, and I think people who did their clinical training in a hospital are more likely to preference it higher than hospitals that they're not familiar with. Therefore, I think it's best to cast those rumours aside and just focus on producing the best and most genuine application you can.

    Do health services have cut-offs for InternZ scores?
    Unknown. Many rumours about this, not many facts. In the end, if you've got an InternZ score above 4.2, which was apparently the safe cut-off (they did offer other interview spots based on other criteria) for Austin Health in 2017 based on their information session which I attended, you're probably safe. A lot of people will come up with ridiculous rumours about this during the course of the year, take them all with a grain of salt unless you also hear it from the health service themselves. Thus, the importance of meeting the health services so you're getting the most accurate information!

    Some health services, generally the large tertiary services which are quite competitive to get into, run interviews. These offers are released soon after applications close, so early June, and each health service tends to do things a little differently. Some examples include:
    • Alfred Health: panel interview with HR rep and consultant doctor, followed by SJT
    • Austin Health: MMI-style interview with two one-on-one stations, one with a consultant doctor and one with HR rep
    • Melbourne Health: group interview
    • Monash Health: video interview using webcam to record your responses, 1 min per question with 2 mins reading
    • St Vincent's Health: panel interview with HR and consultant doctor
    With each of the interviews, you may get to allocate an interview time slot or it may be auto-allocated. Personally, my approach was to allocate the ones I was least keen on first (as practice) and the ones I was most keen on towards the end of the interview season when I had the most confidence. This turned out to be a good decision for me.

    For the interviews, a few tips:
    • Dress code. Should be formal, and I found most people (especially the grad-entry applicants) were very formal and certainly more formal than interviews for med school in any case. For guys, this means suit and tie, for ladies, this means... Not sure on women's dress codes, but you get the idea!
    • Know the health service. This sounds super obvious, but it's really important. Know what the health service offers (clinical and non-clinical), know the values it has (you should be able to literally spit these out), know why you want to work there.
    • Know yourself. Re-read your cover letters and CV to ensure you can talk about anything you have written, and have an armamentarium of personal anecdotes that you can slide into interview answers (eg. about leadership, teamwork, working with difficult staff/patients, etc.).
    • Practice. Interviews can and should be practiced, and practice questions are easily available via a quick Google for any generic medical residency-type interview. You may also get clinical scenarios to deal with, so being familiar with basic ones from a book such as "Marshall & Ruedy's On Call: Principles & Protocols" is very valuable. Ideally you should practice with someone so you can get feedback, but I probably did most of my practice speaking into a webcam recording myself, and I think that worked a treat.


    How are internship offers decided?
    The application process closes in early June and interview season is over by late June. After all the applications and interviews are done and dusted, the hospitals then rank all their applicants. Each hospital ranks differently depending on what they value. For example, in 2017 Eastern Health weighted the InternZ score as 70%, the clinical referees 18%, the non-clinical referee 4%, the cover letter 4%, and the CV 4%. Most health services are not so public with what they look for so the general advice is to take each component of the application process as seriously as you can.

    Once these rankings are done, PMCV comes into play to sort out who gets what allocation offer depending on the CPL. This is reasonably straightforward to understand.

    When do offers come out?
    You are notified regarding the outcome of your application in early July (later if you're not priority group 1) via the PMCV website. Some health services will also send out congratulatory emails and even phone-calls. This is a tense wait, but once you get your offer you'll be able to look back on that period with fond-ish memories!

    Can I get multiple offers?
    No. You only get one offer, and thus if you want to work in Victoria you must accept the first and only offer given to you. If you decline your offer, you will not get another offer in Victoria in that year.

    Can I swap offers?
    No, no swapping is permitted in Victoria because it is a merit-based system.

    Best of luck in obtaining your internship where you want it to be and please feel free to post questions in this thread about anything! :)
    Perplex, Mana and karenh like this.

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