HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), Page 1 of 36 [Application form - Part 1] Personal information 1 Contact information SurnameyFamily name First name Midate name(s) Preferred name ‘Any other name(s) used, where different from the above Title Date of bith Country of birth Bo you have a National Insurance Number? National insurance Number ‘Address line 1 ‘Address line 2 citytown Post code Country Home telephone Mobile telephone Work telephone May we contact you at work? Please indicate your preferred telephone number Email address!” Wong Zhen Yu Dr uinznss7 Singapore Yes 710907338 Flat 26, Bolingbroke House Castle Road Boston PE21 999 Uni red Kingdom $407361542275, Mobile oscarzhenyuwong@gmail.com (please note: Most recruitment communications will be via Oriel message direct to your Oriel account. Any communications will also be your Ori int by em: Your contact details can be updated within the "My Profile" I account regularly for messages throughout the recr 50 you must provide an active email address. Please ensure you check ment process. section of your port ‘To update your profile, click on the pencil icon alongside the fields. 2 Right to work in the UK Your nationality - country pertaining to nationality ‘Are you a United Kingdom (UK)/Irish national? ‘Are you a European Union (EU) national, European Economic Area (EEA) national or Swiss national? Malaysia No Your current immigration status (personal status) ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 1 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21A10000170299/000271 Page 2 of 36 Your eligibility to be considered for this position will be determined by your immigration status on the closing date for applications for this post. You must inform the recruitment office If your Immigration status changes at any point in the recruitment process. If your immigration status changes after an offer of a training programme has been made, this could affect your right to work. Please select your current personal immigration status _Diseretlonary Leave to Remain from the following options, If you are a dependant of a main visa holder, please select the main visa category from the following options. You will then be asked whether ‘you are a dependant on this visa status. You may be asked {or more information once you have selected a status. If your visa status is not listed, you should contact the relevant recruitment offic. Is this your own visa or are you on a dependant visa? Yes) this is my own visa Visa start date 10/07/2022 20/08/2024 Visa expiry date Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 2 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {hewn24.25/3057/028)1.14/0000170299/00027] Page 3 of 36 [Application form - Part 1] Equality and diversity information 4 Equality and diversity information The Information you enter on this Equality and Diversity monitoring form will be used for monitoring purposes only and will not be Used in assessing andjor scoring your application or at interview stage. This information Is kept confidential and accessibility is strictly limited to individuals on a relevant basis, 5 Monitoring information Most public sector employers including healthcare organisations are required to collect data about an applicant. The information is used solely for monitoring purposes to ensure that recruitment policies and procedures are applied fairly and do not discriminate against individuals, We believe that it is good practice to employ a diverse workforce that reflects the communities we serve. ‘The information you share with us will be used to monitor and evaluate how well we are doing in eliminating discrimination and advancing equality. The NHS is committed to the principles of faieness, consistency, meritocracy and equality of opportunity. The Equality Act 2010 requires equal treatment in access to employment as well as private and public services, regardless of age, disability including long-term health conditions, gender re-assignment, marriage or civil partnership, maternity or pregnancy, race, religion or belief, sex and sexual orientation. Date of birth uinznss7 Gender Male (including trans man) | would descrive my ethnic origin as Other Ethnic Groups - Chinese Please select the option which best describes your Heterosexual or Straight sexuality Yes Do you live and work permanently in @ gender other than that assigned at birth? Please indicate your religion or belie: Atheist ‘Are your day to day activities limited because of a health NO problem or disability which has lasted, or is expected to last at least 12 months? (please include problems related to old age) Please indicate your marital status Single No ‘Are you pregnant, on maternity leave or returning from maternity leave? 6 FOR APPLICANTS APPLYING TO NORTHERN IRELAND POSTS ONLY To demonstrate our commitment to equality of opportunity in employment we need to monitor the community background of applicants and employees, as required by the Fair Employment and Treatment (Nl) Order 1998. We therefore ask you to indicate your community background by selecting the appropriate option below. Please note that itis an offence under the Fair Employment and Treatment (NI) Order 1998 to give false information to the Trust. ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 3 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), Page 4 of 36 Please select your community background Please indicate your marital status Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 4 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21A10000170299/000271 Page 5 of 36 [Application form - Part 1] Employment history 7 Full employment history (UK/Overseas) Ihave ne employment history If you completed clinical training equivalent * your employment history. Foundation Year 1, before graduation from medical school, you must include this in Remember to include any F1 / F2 posts here if applicable. It your posts are concurrent, please ensure you list each post separately stating the exact whole time equivalent for each, ensuring posts are listed in chronological order including exact start and finish dates. For consecutive posts, please ensure the end date of a post is not also the start date of the next. 2 Employment history - data entry sec! lease use this data entry section to ada/update your employment history and ensure you use the ‘Cancel " etc) to submit information against your record. Important information Please list all medical/dental employment from currentimost recent employment history detailing back to graduation from medical/dental school. For rotational posts in Core Training programmes, please list each component post separately. Please also list posts that you are due to undertake but have not yet started, that is, future posts, If you are currentiy in employment and do not have an "end date" please put the end date as being the day before the commencement date for the post for which you are applying (as per the Applicant Guide). if you leave your current post before this date you must send details to the relevant Deanery/NHS England recruitment olfice Important information regarding employment gaps ‘The system will autogenerate any gaps in employment of longer than four weeks within three years preceding the advertised post commencing from date, Please note the following would be considered an emplayment gap: + any expected or planned career gap between submission of the application form and the post commencing from date of the advertised post + any potential gaps between the end date of your last planned post and the advertised post commencing from date where you do not currently know what your employment status will be - you should provide information about your intentions for this period + any periods of short-term, ad hoc or locum work greater than four weeks; where this is the case, please summarise the nature and amount of full time equivalent experience gained across any posts undertaken during this period + any gaps where you have stepped out of programme with the expectation of returning such as to undertake research in a formal post or to take a career break + periods of leave such as maternity leave or career breaks + where you have less than 3 years employment history If you have less than 3 years employment history, you must note the dates and explanation of what you were doing before your first employment post as a gap (for example Undergraduate Education). Duration of Employer post (in name Post title Post type Please specify Start date End date months) Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 5 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028"1-R1A/0000170299/00027), Nottingham University Foundation Hospitals nas Programme FY Trust Nottingham University Foundation Hospitals nus Programme FY Trust Nottingham University Foundation Hospitals nus Y Programme FYI Trust Unites Lincolnshire Foundation Fe Hospitals NHS Programme FY2 Trust United Lincolnshie Foundation olnshite vy nda Hospitals NHS Programme FY2 Tust United Lincolnshire Foundation Hospitals nus "Y? Programme FY2 Trust 03/08/2022 72/2022 05/04/2023 02/08/2023, 06/12/2023, 03/04/2024 6/12/2022 04/04/2023 o1yoa/2023 05/12/2023 ozyoas2024 06/08/2024 4a 39 39 4a 39 4a Page 6 of 36 Some gaps have been detected in your employment history you have entered above. These are detailed below, please update the ‘reason’ column(s) as required for each gap. Gap from Gap to 08/08/2021 02/08/2022 9 Employment gaps Do you have any gaps in your employment of more than 4 Yes weeks duration? Please include career breaks for maternity leave, health ete The answer to this question has been auto-generated based on the employment history entered above. ‘Therefore this appears as a read-only field, you are not required to answer it If you think that this is Incorrect, please review the employment records entered previously. Do you have any gaps in your employment history, of ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Gap duration (days) 361 Reason Undertaking PLAB 1 and PLAB 2 while applying for UKFPO programme Page 6 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028"1-R1A/0000170299/00027), Page 7 of 36 more than 4 weeks duration, prior to three years before NO the advertised programme start date for this post? ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 7 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 8 of 36 [Application form - Part 2] Training history / Previous training details 1 Training history / Previous training details Level to which you are applying ‘Academic Clinical Fellowship CTSTL If multiple levels are available to select, please choose t highest to which you can demonstrate eligibility. This training post/programme is not normally available to any doctor who has previously relinquished or been released/removed from this training programme or the associated core training programme Have you previously relinquished or been released or NO removed from a training programme in the specialty or associated core training programme for which you are applying? Do you currently hold a National Training Number (NTN) or NO Deanery Reference Number (DRN) in the specialty to which you are applying and are you applying to continue your training in another area/region? ‘The information you enter on this part of the form will be passed girect to the recruiting department at the arearegion or national recruiting organisation. It will not be used in assessing and scoring your application. If you are successful the details entered in this part of the application form will then be passed to your prospective employer and/or HR department. Please note that incomplete application forms will not be considered. 2 Personal details Do you currently hold a National Training Number (NTN) or NO Deanery Reference Number (DRN)? All trainees in core (with the exception of dental core) higher, speciaity or locum appointment for training posts| will hold either an NTN or DRN. ‘Are you a member of the Protecting Vulnerable Groups N@ (PVG) Scheme? Please note, this will only apply to applicants who have previously worked in Scotland No Do you have a disability, learning difficulty or health condition, or are pregnant or breastfeeding and require any specific arrangements / adjustments to enable you to attend a computer based test, interview or assessment, or other selection pracess? Depending on the circumstance/request, you may be asked to provide medical evidence. It you have a disability, defined as a physical or mental Impairment which has a substantial and long term effect fn your ability to carry out normal day to day activities and you meet the minimum criteria as specified in the Person Specification, do you wish to be considered for an ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 8 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), interview under the Disability Canfident scheme, ‘Are you considering an application for less than full-time N@ training (LTFTY? Please note that selecting "Yes" does not result in an application for LTFT training. This must be submitted directly to the region/area appointed to 3. Professional registration Do you have FULL General Medical Council (GMC) Yes registration? Ityes, are you registered with a license to practice? Yes UK GMC reference no. 7900898 Date of full UK GMC registration 28/07/2023 ‘Are you on the specialist register for the specialty to which N@ you are applying? If applying to OMES, will you have registration with the General Dental Council (GDC) by the start date of the post to which you are applying? 4 Support for doctors new to the UK Yes ‘Are you a UK medical graduate or do you have more than six months experience in the NHS (including Foundation)? Language skills EVIDENCE OF ENGLISH LANGUAGE PROFICIENCY Page 9 of 36 [As a doctor you are required to demonstrate skills in written and spoken English which allow you to perform your clinical skills safely and to communicate effectively on medical andor health topics with patients, colleagues and the public. Was your undergraduate training taught in English? Yes 6 Special circumstances Do you have special circumstances that may require you Ne to remain in a geographical area for specific caring or health reasons? ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 9 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 10 of 36 7 Programme specific information Do you wish to apply for a deferred start date?? No 8 Academic clinical fellowship / Clinical specialty training Have you also applied for academic clinical fellowship Y@S (ACF) training in this specialty in the 2024 academic recruitment round? be considered for following Aeademic Clinical Fellowships and Clinical Specialty Training Programmes Which posts do you wis submission of this application? ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 10 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {hewn24.25/3057/028)1.14/0000170299/00027] Page 11 of 36 [Application form - Part 2] References 9 References information Reference reports are not used at eligibility checking or at assessment but will be requested and reviewed after offers have been accepted and prior to confirmation of appointment for successful applicants. The reference process is designed to check the accuracy of your previous employment and training history and to provide assurance of your suitability for employment. You must provide contact details, Including e-mail addresses, of three referees who have supervised your clinical training during the last two years of your employment or undergraduate training. One referee must be your current or most recent consultant or educational supervisor familiar with your clinical development. NHS pre employment checks require your NHS employer to take up references spanning the last three years of your work and education. You may be required to provide further referee details to your NHS employer, if appointed. If you are applying for an Academic Clinical Fellowship post, one of your referees must be able to provide the academic You should contact your clinical referees in advance to confirm that they are willing to provide a reference and are available and able to do so in the time period required for selection and appointment. Please ensure they provide you with thelr preferred email address. This will be the email address that will be used when requesting references. ‘Your future employer may need to request an employment reference from your medical/dental school if you graduated less than three years ago. This information will not be requested until after you have been made a conditional offer of employment. Employment or trai Referee 1 B ing post 1 This referee must be your present or most recent employer, Consultant or Educational Supervisor. Post specialty, ‘Ophthalmology Post grade F2 Start date 02/08/2023 End date 05/12/2023 Referee title Mr Referee forename Gareth Referee sumame Lewis Job tite of referee Consultant Consultant What was their role in relation to you (e.g. Consultant, manager)? Contact email address Gareth.Lewis@ULH.nhs.uk Please ensure you enter a valid email address as your referee may be asked to submit an online reference in support of your application. Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 12 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), Confirm referee email address GMC/GDC registration no. Contact phone number Employment or training post 2 Referee 2 a Post specialty Post grade Start date End date Referee title Referee forename Referee surname Job title of referee What was their role in relation to you (e.g. Consultant, manager)? Contact email address Please ensure you enter a valid email address as your referee may be asked to submit an online reference in support of your application. Confirm referee email address GMC/GDC registration no, Contact phone number Employment or training post 3 Academic referee 3 2 Gareth.Lewis@ULH.nhs.uk 4709736 Respiratory FL ornzpozz 04/04/2023 or Patience Ehilawa Consultant Consultant patience.ehilawa2@nuh.nhs.uk patience.ehilawa2@nuh.nhs.uk 7oasaaa ‘This referee must be able to provide you with an academic reference. Post specialty Post grade Start date End date Consultant or supervisor title Consultant or supervisor forename Consultant or supervisor surname What was their role in relation to you (e.g. Consultant)? Contact email address Please ensure you enter a valid email address as your referee may be asked to submit an online reference in support of your application, General Surgery FL 03/08/2022 ossiz/ozz Ms Rosemary Lamb Consultant Rosemary.Lamb@nub.nhs.uk Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 12 of 36 Page 12 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028"1-R1A/0000170299/00027), Page 13 of 36 Confirm referee email address Rosemary.Lamb@nuh.nhs.uk GMC registration no. 6129495 Contact phone number ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 13 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 14 of 36 [Application form - Part 2] Fitness to practise 13 Data Protection Act 2018 ‘The Data Protection Act 2018 requires us to provide you with certain information and to obtain your consent before processing sensitive data about you. Processing includes: obtaining, recording, holding, disclosing, destruction and retaining information, Sensitive personal data includes any ofthe following information: criminal offences, criminal convictions, criminal proceedings, disposal or sentence. ‘The information that you provide in this Declaration Farm will be processed in accordance with the Data Protection Act 2018. It will be used for the purpose of determining your application for this position. It wl also be used for purposes of enquiries in relation to the prevention and detection of fraud in the Interest of patient safety ‘This Declaration Form and any information provided relating to a positive declaration will be kept securely and in confidence, and access to it will be restricted to designated persons within the recruiting organisation and ather persons who need to see it as part of the selection process and who are authorised to do so. If successfully appointed to a training post, this information may be passed to designated persons in your first ar lead employing organisation and any organisations through which you rotate. 14 Fitness to practise It Is vitally important that you read, understand and answer the questions asked in this section by ticking ‘each box. Please read the notes below carefully before completing this part of the form. If you require further information, please contact the recruiting organisation that you are applying to. All enquiries will be treated in strict confidence. We aim to promote equality of opportunity and are committed to treating all applicants for positions fairly and on merit regardless of race, gender, marital status, religion, disability, sexual orientation or age. We undertake nat to discriminate Lnfairly against applicants on the basis of criminal conviction or other information declared, ‘The position you have applied for has been identified as a regulated activity within the terms of the Safeguarding Vulnerable Groups Act (2006), as amended by the Protection of Freedoms Act (2012) and is eligible for an enhanced ctiminal records check (Access NI in Northern Ireland, Protecting Vulnerable Groups Scheme (PVG) in Scotland) under the provisions of the Police Act 1997 (Criminal Records) Regulations (as amended). The enhanced criminal record check will, where appropriate to the role, also include any information which may be held against the barred lists for working with children and / or adults Before you can be considered for appointment in a position of trust as a trainee in this position we need to be satisfied about your character and sultabilty. ‘The position you have applied for is exempt from the Rehabilitation of Offenders Act 1974. This means that you must declare all criminal convictions, including those that would otherwise be considered ‘spent’, under this Act, unless they are considered protected, ‘Answering ‘yes’ to any of the questions below will not necessarily bar you from an appointment. This will depend on the nature of the position for which you are applying and the particular circumstances. Prior to making a final decision concerning your application, we shall discuss with you any information declared by you that we believe may have a bearing on your suitability for the position. if we do not raise this information with you, this is because we do not believe that it should be taken into account. You still remain free, should you wish to discuss the matter with the interviewing panel. As part of assessing your application, we will only take into account relevant criminal record and other information declared. ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 14 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 15 of 36 Please answer the following questions. If you answer "YES" to any of the questions, you will need to complete the FTP declaration form found on the national specialty training website. Please submit this form via e-mail to the lead recruiter's confidential fitness to practise e-mail address (details can be found on the recruitment leads page) Please mark the email "CONFIDENTIAL", Emails should be received by no later than the submission deadline for applications. If you would ike to discuss what effect any previous convictions, police investigations or fitness to practise proceedings taken or being taken either in the UK or by an overseas licensing or regulatory body might have on your application, please contact the lead recruiter (details can be found on the recruitment leads pagel, 1. Are you currently bound over, or do you have any No convictions or cautions (including warnings and reprimands) which are not deemed ‘protected’ under the amendment to the Exceptions Order 1975, issued by a Court or Court-Martial in the United Kingdom or in any other country? You do not need to tell us about parking offences, or fixed penalty notices but other driving offences must be declared, 2. Have you been charged with any offence in the United NO Kingdom or in any other country that has not yet been disposed of? Please not You are reminded that you have a continuing responsibility to declare any new criminal convictions, police Investigations or fitness to practise proceedings that arise after application submission. Where recruitment is ongoing, you should inform the recruitment office. After an offer has been made, you should notify the appointing region. Once in a training post or programme, you should inform your employer(s) and the Postgraduate Dean. ‘You do not need to tell us about parking offences, or, fixed penalty notices but other driving offences must be declared. 3. Are you aware of any current NHS Counter Fraud and NO Security Management Service (CFSMS) investigation following allegations made against you? 4, Have you been investigated by the Police, NHS CFSMS_N@ or any other Investigatory Body resulting in a current. conviction or dismissal from your employment or volunteering position? Investigatory bodies include: Local Authorities, Customs and Excise, Immigration, Passport Agency, Inland Revenue, Department of Business, Innovation and Skills, Department of Work and Pensions, Security Agencies, Financial Service Authority, or any successor bodies to the above. Note: This list is not exhaustive and you must declare any investigation conducted by an investigatory Body. 5. Have you ever been dismissed by reason of misconduct NO {rom any employment, volunteering, office or other position previously held by you? 6. Have you ever been disqualified from the practice ofa NO profession or required to practise subject to specified limitations / conditions / warnings following fitness to practise proceedings by a regulatory or licensing body in the United Kingdom or In any other country? No 7. Are you currently the subject of any investigation or fitness to practise proceeding by any licensing or regulatary body in the United Kingdom or any other country? ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 15 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 16 of 36 8, Are you subject to any other prohibition, limitation, or NO restriction that means we are unable to consider you for any position for which you are applying? No 9. Do you know of any other matters in your background which might cause your reliability or suitability for employment to be called into question? Ifyou answer "YES" to any of the questions, you will need to complete the FTP declaration form found in the resource bank. Please submit this form via e-mail to the lead recruiter's confidential fitness to practise e-mall address (details can be found on the recruitment leads page). Please mark the email "CONFIDENTIAL". Emails should be received by no later than the submission deadline for applications, Where you have a Fitness to Practise declaration as a result of a health issue, please contact the recruitment lead for a confidential discussion to determine the level of detail that you need to provide. ‘They can also be found on the Recruitment Allist of FTP email addresses is available in the applicant guidanc: Leads page on Oriel for each Recruitment Office. Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 16 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {hewn24.25/3057/028)1.14/0000170299/00027] Page 17 of 36 [Application form - Part 2] Competences / Eligibility Achievement of foundation competences: CT/ST1 & public health (medical) In order to submit an application for a specialty/academic training programme you need to demonstrate that you have attained UK foundation competences or equivalent. Please ensure that you have read the guidance regarding verification of achievement of foundation competence before you complete this section and answer each question honestly and accurately. Only one of the standard forms of evidence of achievement of foundation competences will be accepted, ‘Your answers to the following questions will be used to determine whether you meet this requirement. If you cannot provide one of these forms of evidence then you are not eligible to apply for a specialty/academic training programme ‘Are you currently in the second year of a UK Yes affiliated Foundation Programme which finishes before the start date for the post for which you are applying? = answer NO if you have already completed a UK affiliated Foundation Programme Which Foundation School? ‘Trent Foundation Schoo! ‘Will you be entering this post directly from a foundation or ‘Yes training programme post, ar with a gap of less than 3 months? Please give details of your primary medical qualification Qualiication Bachelor of Medicine, Bachelor of Surgery (BMBS) Entry date medical school/university 22/02/2036 Date of qualification 21/04/2021 Medical school / University Other: please specity IF Other, please enter medical school / university International Medical University Medical school / University address line 1 126, Jin Jal Perkasa 19, Bukit Jail ‘Address line 2 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia Address line 3 Postcode 57000 Country of primary medical education Malaysia Recommended contact for academic/educational Professor Dr Nazimah Idris reference! Telephone number Contact email address for academic/educational reference nazimah_idris@imu.edu.my Your future employer may need to request an academic/educational reference from your medical school if you graduated less than three years ago. This information will not be requested until after you have been made a conditional offer of employment. Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 17 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), 17 Entry qualification - applicants to Oral and Maxillo Facial Surgery only Please give details of your primary dental qualification Qualtication Date of qualification Dental schoolluniversty ‘Address line 1 Address line 2 ‘Address line 3 Post code Country of primary dental education 18 Accreditation of transferable capabilities If successful in your application to this specialty, would NO you be interested in accrediting transferable capabilities ? See specialty specific guidance for further information, Please note, accreditation of transferable capabilities reeds to applied for separately through the area/region where you accept a training programme, ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 18 of 36 Page 18 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 19 of 36 [Application form - Part 2] Declarations 19 Confirmation | have met or am expecting to meet the essential entry Yes criteria as set out in the person specification for the specialty and entry level to which lam applying, including where necessary, the acquisition of the relevant competences and college memberships | confirm that my data may be used anonymously for Yes research and evaluation purposes in particular for the continued development of national application processes and shared with the GMC and Royal Colleges for this Purpose | confirm that | understand the implications fide not Yes complete this application form correcty, | have read the guidance for this specialty/application and Yes understand the specialty entry requirements for the training programme | have chosen. See Applicant Guide. 20 Declarations Important: The Data Protection Act 2018 requires us to advise you that we will be processing your personal data. Processing includes: holding, obtaining, recording, using, sharing and deleting information. The Data Protection Act 2018 defines ‘sensitive personal data‘ as racial or ethnic origin, political opinions, religious or other beliefs, trade union membership, physical or mental health, sexual life, criminal offences, criminal inal proceedings, disposal or sentence. ‘The Information that you provide in this Application Form will be processed in accordance with the Data Protection Act 2018. It will be used for the purpose of determining your application for this position. It will also be used for purposes of enquiries in relation to the prevention and detection of fraud. Once a decision has been made concerning your appointment, the recruiting organisation will nt retain this declaration for any longer than is necessary [see further details in ‘Guidance Notes for Applicants'], This declaration will be kept securely and in confidence. Access to this information will be restricted to designated persons within the trust / employing organisation who are authorised to view it as a necessary part of their work, Declaration 1: | declare that the information | have given in support of my application, including information supplied on this form and any attached appendices, is, to the best of my knowledge and belief true and complete. | understand that if itis subsequently discovered that any statement Is false or misleading, or that | have withheld relevant information, particularly on criminal convictions andlor fitness to practise and/or have breached the Confidentiality: good practice in handling patient information (2017) stipulated by the General Medical CouncilGeneral Dental Council/any other licensing or regulatory body of which | am a member, ry application may be disqualified. If have already been appointed, | understand that | may be dismissed and I may be reported to the General Medical Council/General Dental Council or any other licensing/regulatory body of which | am a member. Declaration 2: | declare that my answers to the questions on this form, any attached appendices and any ather application forms required by Deaneries/NHS England recruitment offices are my own work and are not copied or reproduced from any other sources. | Understand that if any of my answers are discovered not to be original, my application may be disqualified. Declaration 3: Where applying for medical posts, | am aware that Good Medical Practice states that if | formally accept a post I ‘must not withdraw unless the employer has time to make other arrangements. | understand that failure to comply with this requirement may result in a complaint being made against me to the GMC. Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 19 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21A10000170299/000271 Page 20 of 36 Declaration 4: | understand that if | am allocated to a training opportunity, any subsequent contract of employment will be subject to satisfactory pre-employment checks and subject to a condition that the information provided on the application form or any related documents is correct. | also understand that pre-employment checks will be carried out to review and confirm the details of my application, Declaration 5: | understand that employment offered in this training programme is subject to satisfactory medical clearance which ‘may include @ medical examination and/or blood tests. Where applying for a medical post, | am aware of the GMC guidance on Gateways to the profession explaining how health and disability issues should be handled by education and training providers. Declaration 6: | understand that if recommended for training | wil be subject to a Disclosure and Barring Service (DBS) check (previously known as CRB), Access NI in Northern Ireland the Protecting Vulnerable Groups Scheme (PVG) in Scotland. | am aware that | must inform the National Recruitment Office/Deanery/NHS England recruitment office of any new criminal convictions, police investigations or fitness to practise proceedings that arise after the completion of this application form, Declaration 7: have read and understand the Privacy Notice and understand that my Personal and Sensitive Personal Data will be processed in the manner set out in this Notice, Declaration 8: I confirm that if there is a change in my training status once have submitted my application (ie. removal of training number, interdeanery transfer etc), which would significantly affect the content of my application form, ! will inform the Lead Recruiter for the training programme, Failure to disclose such changes could lead to the withdrawal of any training otter. Declaration 9: | have read in full and confirm the acceptance of the 2024 Medical recruitment applicant declaration, lagree to the above declarations Yes Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 20 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21A10000170299/000271 Page 21 of 36 [Supporting information] Evidence 1 Addit jonal Undergraduate Degrees and Quali Please list any additional completed undergraduate qualifications with dates. Include intercalated BSc/ ‘equivalent degree here, if you have one. Do not include details of your pre university schoo! education/ exam results ‘Qualification 1 Place of Study 1 Grade/Honours 2 Date Completed 1 Qualification 2: Place of Study 2: Grade/Honours 2: Date Completed 2 Qualification 3: Place of Study 3: Grade/Honours 3 Date Completed 3: Qualification 4 Place of Study 4: Grade/Honours 4 Date Completed 4 Qualification 5: Place of Study 5: Grade/Honours 5: Date Completed 5: 2 Postgraduate Degree and Qual Please give details of any completed postgraduate medical qualifications/ other degrees/ diplomas/ certificates (e.g, MD, MRCP etc,). Where a qualification is partly completed please state your exam status e.g. MRCP (Part 1) etc. For an MD please state whether this is linked to your primary medical qualification or the result of an independent research thesis, Please include here any relevant qualifications listed as desirable on the person specification. SubjectiQualification 1: MRCS Part A ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 22 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), Place of Study 1: Grade/Resul 1 Date Completed 1 SubjectiQualification 2: Place of Study 2: Grade/Resut 2; Date Completed 2 SubjectiQualification 3 Place of Study 3: GradeResuit 3 Date Completed 3 SubjectiQualification 4: Place of Study 4: Grade/Resuit 4: Date Completed 4 SubjectiQualification 5: Place of Study 5: GradeResuit 5 Date Completed 5 Page 22 of 36 Royal College of Surgeons of England Passed 12/09/2023, Additional Achievements - Prizes, Awards and Distinctions Prizes, awards and other distinctions (please include specialty and qu: ifying distinction). Please indicate whether these were awarded to you as an undergraduate or postgraduate. Prizes/Award)Distinction 2: ‘Awarding Body 1 Date Awarded 1 Prize/Award/Distinction 2: ‘Awarding Body 2 Date Awarded 2 ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Prize Winner: Paediatrics (Postgraduate) IVMC: Spring Conference 2022 - Humans in Heatthcare 23/04/2022 Champion: Platinum 10 Trauma Simulation Competition (Undergraduate) International Medical University Orthopaedics and ‘Trauma Society 18/04/2019 Page 22 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), PrizejAward/Distinction 3: ‘Awarding Body 3: Date Awarded 3 PrizejAward/Distinction 4: ‘Awarding Body 4: Date Awarded 4 Prize/Award/Distinction 5: ‘Awarding Body 5: Date Awarded 5 PrizejAward/Distinction 6: ‘Awarding Body 6: Date Awarded 6: 4 Training Courses Attended Page 23 of 36 Include in this section the most relevant training courses to this specialty that you have attended and details of courses that you are currently undertaking. Please Include any Advanced Life Support or similar courses mentioned in the Person Specification. Course Title 1 ‘raining Provider 1: Duration of Course 1 Date Completed 1 Course Title 2; ‘Training Provider 2 Duration of Course 2 Date Completed 2: Course Title 3 raining Provider 3 Duration of Course 3 Date Completed 3: Course Title 4 ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Microsurgical Skil Junior Doctors is Introductory Workshop For Cambridge Microsurgery Institute Unit Lday 09/11/2022 Charles Wolfson Centre Microsurgery Training Course Charles Wolfson Centre and Royal Free Hospital Plastic Surgery Department Lday 24/10/2023 PLASTA Plastic Surgery Workshop Practical skills 2022 Plastic Surgery Trainees Associ Lday 29/11/2022 Microsurgery Masterclass 2022 Page 23 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), Training Provider 4 Duration of Course 4 Date Completed 4 Course Title 5: Training Provider 5: Duration of Course 5: Date Completed 5 ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 24 of 36 British Association of Plastic, Reconstructive and Aesthetic Surgeons Lday 30/11/2022 Advanced Life Support Resuscitation Council UK 2 days 18/10/2023 Page 24 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), [Supporting information] Supporting 5 Achievements Outside of Medicine Please give details of outstanding achievements le the field of medicine 6 Presentation and Publications Page 25 of 36 Beyond medicine, my athletic endeavours showcase discipline and teamwork—2 years in cheerleading, 3 in ultimate frisbee during medical school. As a sport house captain, | honed leadership amid the challenge of balancing sports and medical school. This struggle refined my workclife balance, now seamlessly applied as a doctor juggling personal life and professional life. | am also managing a Youtube channel in my free time, My YouTube channel, focused on interviews, requires communicati skills, which is vital in academia. These varied experiences sculpt a holistic academic trainee— melding discipline, leadership, and effective communication, In this section please provide details of your most relevant publications in journals or presentations to local bodies, regional or national societies. Please state whether the presentation was oral or a poster. Please give full citation details of any published work (please provide PubMed link or alternative in your answer). Please give a statement about your personal contribution to the work (e.g. first author, lead investigator) Presentations at regional or national level ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) In the realm of regional and national presentations, Ihave had the privilege of delivering several oral presentations and posters. At the BAPRAS Celtic Meeting in 2023, | delved into the Disease and Economic Burden of Plastic and Reconstructive Surgery-Related Diseases in the United Kingdom, Presenting findings from the 2019 global burden of disease study. Additionally, | explored the outcomes of temporalis muscle-based facial reanimation surgery and discussed the epidemiological characteristics of burn injuries in the UK through systematic analyses. These presentations were all delivered orally. LivPlast 2023 Online Conference saw me presenting the Changes of Facial Features After Bariatric Surgery as an oral presentation, earning the second-place spot. This was complemented by an oral presentation at the ‘SHARE 2023 conference, where | discussed a quality improvement project focused on recycling theatre waste. The OSCEazy Medical Education Conference In 2023 provided a platform for my oral presentation on Competency Assessment from the ‘medical student perspective, a multinational study conducted across Asian-Australasian countries during the challenging times of the COVID-19 pandemic. The UCL OFMS 2023 Conference Page 25 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), witnessed a revisit of the Changes of Facial Features After Bariatric Surgery through an oral presentation. At the IVMC: Spring Conference 2022, my meta-analysis on donor-recipient sex profile in paediatric living donor liver transplantation earned the prestigious Prize Winner title in Pediatrics, presented orally. At the International Digestive Disease Forum 2022, | presented a poster highlighting the prevalence of hypertension in non- alcoholic fatty liver disease and its consequential impact on all-cause and cardiovascular mortality. SAGES 2022 Annual Meeting showcased my poster presentation on the innovative virtual international platform for Near-Peer Teaching during the COVID- 19 pandemic, organised by the IASSS, aimed at enhancing the surgical ward round experience. My involvement extended to the Exeter International Undergraduate Surgical Conference 2022, where | presented a poster featuring a systematic review and meta-analysis of donor-recipient sex distribution in paediatric deceased donor liver transplantation. The UKCAWS Annual Conference 2022 featured my poster on the geographic and economic correlation of paediatric living donor liver transplantation donor-recipient gender profile. Notably, the 10th Malaysian Conference on Healthy Ageing 2022 and the Edinburgh School of Surgery Undergraduate Research Symposium 2021 provided platforms for my poster presentations on Benign Positional Vertigo in Community-Dwelling Malaysians Aged 55 Years and Over and MRSA Infection in General Surgical Wards in a Malaysian Tertiary Hospital: A Retrospective Study, respectively. In 2019, at the UKM 11th Medical Undergraduates’ Annual Scientific Research Meeting (MUASRM), | showcased a poster on a Rare Case of Distal Humerus Epiphyseal Separation. Scheduled for the BAPRAS Congress 2023, I'll present two posters—'Protocol for Facial Features after Weight Loss (FACE-WL), A Multicentre Longitudinal Prospective Study’ and ‘Factors associated with outcomes in surgically treated burns: A World Health Organization (WHO) Global Burn Registry cohort study.’ At the 2023 BASO Conference, I'll present two posters on cutaneous melanoma and breast cancer's impact on mortality. Additionally, ‘two oral presentations will explore temporal trends in paediatric malignant melanoma and cause- specific mortality differences in skin cancer patients. Presentation at Local Level | presented findings from an 80-patient series at the Nottingham Renal and Kidney Transplant Unit monthly meeting, unveiling insights into poorer graft function In extended criteria for deceased donor transplants. Importantly, there was no increased risk of graft loss after one year. ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 26 of 36 Page 26 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), Publications in peer review Journals ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 27 of 36 First-author/co-first author; Lead Investigator, Conceptualization and Design, Acquisition of Data, Analysis and Interpretation of Data, Writing - original draft, Writing - review & editing Wong, Zhen Yu et al. “Changes of Facial Features After Bariatric Surgery: a Systematic Review." Obesity surgery vol. 33,2 (2023): 332-33 dol:10,1007/s11695-022-06363. hhttps://pubmed,ncbi.nim.nih,gov/36434358/ Quek, Jingxuan et al. “Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, in the overweight and obese population: a systematic review and meta-analysis.” The lancet. Gastroenterology & hepatology vol. 8,1 (2023): 20- 30, doi:10,1016/52468-1253(22)00317-X https://pubmed.ncbi.nlm.nih.gov/36400097/ Tan, Darren et al. “Global Epidemiology of Cirrhosis: Changing Etiological Basis and Comparable Burden of NASH between Males and Females.” Digestive diseases (Basel, Switzerland), 10.1159/000533946. 13 Sep. 2023, doi:10.1159/000533946 https://pubmed.ncbi.nlm.nih.gov/37703863/ Ng, Cheng Han et al. “Hypertension is prevalent in non- alcoholic fatty liver disease and increases all-cause and cardiovascular mortality.” Frontiers in cardiovascular medicine vol. 9 942753. 8 Aug. 2022, doi:10.3389/fevm,2022.942753 hhttps://pubmed.ncbi.nIm.nih.gov/36003916/ Wong, Zhen Yu et al. “Meta-analysis of donor-recipient gender profile in paediatric living donor liver transplantation.” Archives of disease in childhood, archdischild-2022-323892. 8 Jun. 2022, doi:10.1136/archdischild-2022-323892 https://pubmed.ncbi.nlm.nih.gov/35676083/ Wong, Zhen Yu et al. “Clinical practice guidelines for the management of hyperemesis gravidarum: A systematic review and quality appraisal with AGREE 1." Australian journal of general practice vol. 51,10 (2022): 758-765. dol:10.31128/AJGP-01-22-6288 . bhttps://pubmed.ncbi.nlm.nih.gov/36184858/ Wong, Zhen Yu et al. “Positivity towards virtual learning is associated with higher self-rated clinical competency.” Medical teacher vol. 45,7 (2023): 789. doi:10,1080/0142159x.2023.2169119 bhetps://pubmed.ncbi.nlm.nih.gov/36705016/ Co- author; Acquisition of Data, Analysis and Interpretation of Data, Writing - review & editing Chan, Kai En et al. “Longitudinal Outcomes Associated With Metabolic Dysfunction-Associated ‘Steatotic Liver Disease: A Meta-analysis of 129 Studies.” Clin Gastroenterol Hepatol., $1542- 3565(23)00754-1. 28 Sep. 2023, doi:10.1016/j.cgh.2023.09.018 ttpsi//pubmed.ncbi.nlm.nih.gov/37775028/ Danpanichkul, Pojsakorn et al. “The silent burden of non-alcoholic fatty liver disease in the elderly: A global burden of disease analysis.” Alimentary pharmacology & therapeutics vol. 58,10 (2023): Page 27 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028"1-R1A/0000170299/00027), 1062-1074, doi:10.1111/apt.17714 https://pubmed.ncbi.nIm.nih.gov/37694808/ Chan, kai En et al. “The Spectrum and Impact of Metabolic Dysfunction in MAFLD: A Longitudinal Cohort Analysis of 32,683 Overweight and Obese Individuals.” Clin Gastroenterol Hepatol. vol, 22,10 (2023): 2560-2569.615. ol:10.1016/).cgh.2022.09.028 https://pubmed.ncbi.nim.nih,gov/36202348/ de Jongh, Frank W et al. “Botulinum toxin treatment of the buccinator muscle facial synkinesis: A systematic review.” Journal of plastic, reconstructive & aesthetic surgery : JPRAS, vol. 86 88-93. 19 Aug. 2023, doi:10.1016/}.bjps.2023.08.006 https://pubmed.ncbi.nlm.nih,gov/37716254/ Lim, Wen Hui et al. “Donor Diabetes and Steatosis Affects Recipient Survival Following Liver ‘Transplantation Based on Etiology of Liver Cirrhosis.” Transplantation, 110.1097/TP.0000000000004718. 12 Jul. 2023, oi:10.1097/TP.0000000000004718 https://pubmed.ncbi.nIm.nih.gov/37439778/ Kong, Gwyneth et al. “A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States.” Obesity (Silver Spring, Md.) vol. 32,3 (2023): 832- 840. doi:10.1002/oby.23658 https://pubmed.ncbi.nlm.nih.gov/36748957/ Ng, Cheng Han et al. “Safety and tolerability of obeticholic acid in chronic liver disease: a pooled analysis of 1878 individuals.” Hepatology communications vol. 7,3 €0005. 9 Feb. 2023, dol:10.1097/HC9.0000000000000005 https://pubmed.ncbi.nlm.nih.gov/36757421/ Xiao, Jieling et al. “Hepatic, Extra-hepatic Outcomes and Causes of Mortality in NAFLD - An Umbrella Overview of Systematic Review of Meta-Analysis. Journal of clinical and experimental hepatology vol. 13,4 (2023): 656-665. oi:10.1016/}jceh.2022.11.006 https://pubmed.ncbi.nIm.nih.gov/37440949/ Several ongoing works are currently under peer review. Other Publications - Conference Extracts etc. ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 28 of 36 First-author; Lead Investigator, Conceptualization and Design, Acquisition of Data, Analysis and Interpretation of Data, Writing - original draft, Writing - review & editing Wong 2-Y, Goh S. P232 Better Surgical Ward Round: Replicating Near-Peer ‘Teaching (NPT) on a virtual international platform During the COVID-19 pandemic organized by the 1ASSS, 2022 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Denver, Colorado, 16-19 March 202: Posters. Surgical Endoscopy. 2022;36(1):70-218. dol: 10.1007/s00464-022-09220-y. httpsi//link.springer-com/article/10.1007/s00464- 022-09220-y#Sec570 Wong Z-Y, Ng C-H, Chan K-E, Ou K-Q, Noureddin M, Siddiqui MS, et al. IDDF2022- Page 28 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-21410000170299/000271 Page 29 of 36 ‘ABS-0134 Hypertension is prevalent in non-alcoholic fatty liver disease (nafld) and increases all cause and cardiovascular mortality. Gut. 2022;72(Suppl 2):A82-A3. doi: 10.1136 /gutjnl-2022-IDDF.103. hhttps://gut.bmj.com/content/71/Suppl_2/A82.2.abstract Co-author; Acquisition of Data, Analysis and Interpretation of Data, Writing - review & editing 00 ZP, Wong ZY, Ning Lee RX, Whisker L. A single- centre audit on outcomes of mastectomy and immediate implant-based breast reconstruction. European Journal of Surgical Oncology. 2023;49(5):e263, doi: 10,1016/j.¢js0.2023.03.176. https://www.e}so.com/article/S0748-7983(23)00347- 5/fulltext Abdul-Hamid S, Wong Z, Benaissa M, Lamb R, SP3,1 80 patient series from UK renal transplant centre shows extended criteria deceased donor transplants are associated with a poorer graft function but at no increased risk of graft joss after 1 year. British Journal of Surgery. 2023;110(Supplement 6). doi: 110.1093/bjs/znad241.033. https://academic.oup.com/bjs/article/110/Supplement_6/znad241.033/7245222 Ong CE-Y, Chan K-E, Ong EY-H, Chung CH, Koh 8, Tan DJ-H, et al. IDDF2023-ABS-0050 Longitudinal outcomes associated with non-alcoholic fatty liver disease. a meta-analysis of 129 studies. Gut. 2023;72(Suppl 1):A23-A. doi: 10,1136/gutjnl-2023- WwpF.22, https://gut.bmj.com/content/72/Suppl_1/A23-1 Wong T, Buddle E, Jaffer R, Adiamah A, Murugan V, Wong Z, et al. 0141 The patterns of metastatic disease and survival in patients with pancreatic neuroendocrine tumours: a retrospective observational study. British Journal of Surgery. 2023;110(Supplement_3). doi: 10.1093/bjs/znad101.141. https://academic.oup.com/bjs/article/110/Supplement_3/znad101.141/7159088 Buddle E, Jaffer R, Adiamah A, Wong T, Murugan V, Wong Z, et al. 0147 The incidence and impact of pattern of metastases on treatment strategy and outcomes for patients with pancreatic cancer. British Journal of Surgery. 2023;110(Supplement_3). doi: 10.1093/bjs/znad101.147. https://academic. oup.com/bjs/article/110/Supplement_3/znad101.147/7158995 Jaffer R, Buddle E, Wong T, Adiamah A, Murugan V, ‘Wong Z, et al. 0149 The utility of chest computed tomography in the staging of pancreatic cancer: a retrospective observational study. British Journal of Surgery. 2023;110(Supplement_3). doi: 110.1093/bjs/znad101.149. hhttps:/academic.oup.com/bjs/article/110/Supplement_3/znad101.149/7158993 Nah KYB, Wong ZY, Keh JH, Muthiah M, Koh B, Ong EYH, et al. P57 Proton pump inhibitors increases longitudinal risk of mortality, decompensation and Infection in cirrhosis: a meta analysis. Gut- 2023;72(Suppl 3):A49-ASO. dol: 10.1136/gutjnl- 2023-BASL.73. https://gut.bmj.com/content/72/Suppl_3/A49 Ou K-Q, ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 29 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), Ng C-H, Chan K-E, Wong Z-Y, Noureddin M, Siddiqui MS, et al. IDDF2022-ABS-0133 The spectrum and impact of metabolically healthy mafid. A longitudinal cohort analysis of 32,628 individuals. Gut. 2022;71(Suppl 2):A82-A. dol: 10.1136/gutjnl- 2022-1DDF.102. hhttps://gut.bmj.com/content/71/Suppl_2/A82.2. 7 Teaching and Audit Page 30 of 36 In this section please provide details of teaching and clinical audit experience. Please give full details Including a statement about your personal contribution to the audit work What experience do you have of delivering you undertaken a teaching skills course or a formal ualification in teaching? ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) aching? Have Embarking on my teaching Journey with the ‘Consultold! peer teaching program as a final year medical student, | dedicated alternate weekends to guide fourth-year medical students. | encouraged my junior peers to actively engage in patient care by taking on the responsibilities of clerking and presenting cases. The collaborative approach of collectively examining and discussing patient scenarios fostered a dynamic and Immersive learning environment. This peer-to-peer teaching dynamic, free from senior oversight, created a comfortable and well-received atmosphere among juniors. Post-graduation, my role as a peer tutor in the clinical skills unit, spanning six months, allowed me to teach clinical skills for pre-clinical medical students. In my role, | was responsible for delivering and coordinating clinical sessions to Impart fundamental procedural skills, guide the Intricacies of history taking, and instruct on the nuances of physical examinations. Formal training, both theoretical and practical, preceded my involvement. Valuable feedback from students and senior lecturers further refined my teaching prowess. Serving as the Asian chapter lead for International Association of Student Surgical Societies (IASSS), | spearheaded the design and delivery of an impactful online teaching series. Collaborating with specialist surgeons across diverse Asian countries during the challenging period of the Covid-19 pandemic, we successfully shared valuable insights. A notable accomplishment was the presentation of one of our sessions at the prestigious SAGES 2022 Annual Meeting, underscoring my dedication to advancing medical education and fostering innovation. Entering my role as a foundation doctor, | eagerly seize the chance to impart my experiences and knowledge to medical students during their placements. I've actively contributed to JAST placements at Nottingham University, enhancing the learning Page 30 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), environment for aspiring medical professionals, Recently completing the Train the Healthcare Trainer course sponsored by Health Education England underscores my commitment to continuous professional development, ensuring | stay abreast of the latest skills and knowledge in healthcare training. What experience of clinical audit do you have? Please state clearly where and when this was undertaken and state specifically your role in each of the projects. Suitability for Specialty Describe how you believe you meet the person specification for the programme you are applying for. Include the particular skills and attributes that make you suitable for a career in this specialty ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 31 of 36 During my F1 year, ! assumed a co-leadership role in four distinct audit projects, underscoring my commitment to continuous Improvement in healthcare practices. | spearheaded a quality Improvement initiative within the general surgery department, Our focus was on enhancing the proportion of recycled waste in the main theatres by increasing awareness among theatre staff through physical posters. The success of the second cycle audit revealed a notable increase in recycled waste, aligning with the Royal College of Surgery's vision of Sustainability in Surgery. Our findings were presented as an oral presentation at the SHARE conference in 2023, showcasing the impact of a local initiative with broader implications for sustainable practices in surgery. Subsequently, ! collaborated with the plastic surgery department, taking a leading role in an audit project that qualitatively assessed WHO Surgical Checklist compliance across distinct stages of surgery—brief, , time out, sign out, and debrief. The study revealed notable areas for improvement, Particularly in briefing, signing out, debriefing, and during emergency surgeries. The demanding theatre schedule, necessitating attention diversion to emergencies or preparing for upcoming patients, ‘emerged as a plausible explanation for these findings. | took a leadership role in two projects within the breast surgery unit. The first, a service evaluation of breast chaperone utilisation among both patients and staff, indicated a reluctance among patients despite awareness efforts. This was presented as a poster at the BAPRAS Celtic 2023, Meeting. In the second project, investigating the outcomes of mastectomy and immediate implant based breast reconstruction, we identified a higher complication rate than the National Quality Standards in our local unit. This noteworthy finding was presented as an oral presentation at the Association of Breast Surgery Conference 2023 by my colleague. My diverse exposure to various surgical specialties during F1 and F2 training such as general surgery, neurosurgery, and oculoplastic surgery positions me as a fitting candidate for the program. | possess a keen interest in plastic surgery and my commitment is underscored by a realistic insight into the demands of a plastic surgical career. I showcase a Page 31 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewmy24.25/3857/028/1-R1A/0000170299/00027), dedicated approach to personal and professional development, demonstrating a critical and enquiring mindset in knowledge acquisition. My capacity to apply sound clinical judgement, prioritise clinical needs, and exhibit technical competence aligns with the demands of plastic surgery. Effective communication skills, problem- solving abilities, and a collaborative approach in multidisciplinary teams further characterise my suitability. | have a track record of managing workload, understanding the importance of information systems, and demonstrating vigilance im rapidly changing situations. Coping with pressure and maintaining objectivity in emotive scenarios reflects my resilience, Values integral to the NHS, such as respect, compassion, and commitment to quality care, resonate with my professional ethos. Please provide evidence of activities and achievernents which demonstrate your commitment to a career in this specialty and/or have led to the development of skis relevant to career in this specialty Please provide evidence of activities and achievements which demonstrate your skills in the above, relevant to a career in this specialty ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 32 of 36 My journey towards a career in plastic surgery is driven by a genuine passion for constant improvement and a commitment to acquiring a diverse knowledge base applicable across specialties. The spark ignited during my elective in paediatric plastic surgery at the National Seoul University Hospital, providing invaluable insights Into the intricacies of the field. Building on this, 1 honed my surgical skills through hands-on experiences during my F1 and F2 surgical training, complemented by taster days in the local plastic surgery unit, Attending microsurgery workshops further enriched my technical competencies. ‘Throughout my foundation year training, | showcased unwavering dedication to refining essential skills like wound closure and operative techniques. These experiences reflect my proactive approach, continuous growth, and hands-on engagement, aligning seamlessly with the nuanced demands of plastic surgery. Evidence of my skills relevant to a career In plastic surgery includes my successful completion of MRCS Part A, showcasing proficiency in surgical skills and anatomy essential for this specialty. | have been an instructor for suturing | al school, coordinating multiple national suturing workshops and representing my university In a surgical skills, competition. During my neurosurgery F1 rotation, was tasked with the removal of ICP bolts and subdural drains, as well as the closure of wounds, demonstrating my hands-on surgical capabilities. In my F2 role, | actively assisted in the oculoplastic unit where mainly handles the facial skin cancer cases in a district general hospital, performing excision biopsies and utilising advanced closure techniques such as Z-plasty or skin grafts, and cauterization to control bleeding. Moreover, my engagement with allied surgical specialties has cultivated a nuanced understanding, equipping me to collaborate effectively with diverse medical disciplines as a plastic surgery train. Page 32 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), Please give brief details of all research projects, and/or relevant research experience that you have undertaken or are undertaking, including methods used. Indicate your level of involvement and your exact role in the research ‘team detailing when this took place, your time commitment, your contribution/invalvement and source of funding. Ifyou have been awarded a higher degree as a result of research, this must be detailed additionally in the appropriate section above. Detail your academic career plans, if applicable ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 33 of 36 Embarking on my research journey after graduation from medical school in Malaysia, | Initiated with a systematic review and meta-analysis, spearheading two projects: "Clinical Practice Guidelines for the ‘Management of Hyperemesis Gravidarum” and *Meta-analysis of Donor-Recipient Gender Profile in Paediatric Living Donor Liver Transplantation” in collaboration with local universities. Transitioning to international collaborations, | served as the Asian Chapter Lead for IASSS, resulting in publications such as a poster presentation on the Better Surgical Ward Round project at the SAGES 2022 Annual Meeting and a letter to the editor discussing the association between positivity towards vi learning and self-rated clinical competency during the COVID-19 pandemic. Further contributions, ‘emerged through partnerships with Upper Gastrointestinal Surgeons (TUGS), TUGS E-Health, Education, Surgical Publishing Research (TEESR) Group, focusing on facial and BNP changes post- bariatric surgery. These collaborations expanded to projects on facial reanimation, botulinum toxin for facial paralysis. During the summer preceding my enrollment in the FY program, I had the privilege of Participating in a Singapore-based research network focused on comprehensive research in metabolic syndrome and liver medicine. A notable achievement during this period was my co-first authorship in a publication featured in Lancet Gastroenterology and Hepatology titled "Global Prevalence of Non-Alcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in the Overweight and ‘Obese Population: A Systematic Review and Meta- Analysis. Entering FY1, | contributed to renal transplant, colorectal, breast surgery, and. hepatobiliary surgery projects. Recently, | completed a project in collaboration with the Nottingham Plastic Surgery Unit, focusing on the management of calvarium invasive scalp SCC cancer. | have collaborated with NDORMs Oxford unit and RSTN, leading investigations into patient- reported outcomes and the surgical site infection rate of facial soft tissue injuries. Additionally, | have contributed to an educational microsurgery study with the Cambridge Microsurgery Institute, participating in data analysis and writing. Moreover, Tam co-leading a qualitative and quantitative analysis of emotional intelligence among UK surgical trainees. My ongoing endeavours involve exploring the epidemiology of various plastic surgery-related diseases, with presentations slated for scientific conferences. These experiences underscore my commitment to advancing knowledge and making meaningful contributions to the field of surgery. | take pride in attaining a competitive standard as an ACF applicant in my current role at F2. | am enthusiastic about pushing my boundaries further and achieving even more in Page 33 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 ts ym/24.25/3657/028/1-81A/0000170299/00027), the future. Hailing from a low-middle-income background, my options for research opportunities were limited. Despite these challenges, | seized every available opportunity to nurture and expand my knowledge in research. My current emphasis is transitioning my focus towards plastic surgery projects. | aspire to secure a position in the ACF programme, where | can immerse myself in plastic surgery research within an academically active unit. ‘The prospect of mentorship and access to resources Is pivotal for me to delve deeper into unanswered questions. As a doctor-scientist, | take immense ride in straddling both clinical and research realms. While my ongoing research primarily centres on clinical aspects, my keen interest in translational research aligns seamlessly with the potential opportunities that the ACF programme offers, laying the foundation for future engagement Ina PhD programme. Please describe in more detail one of the research projects, above ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 34 of 36 In the research project titled "Global Prevalence of Non-Alcoholic Fatty Liver Disease and Non-Alcoholic ‘Steatohepatitis In the Overweight and Obese Population: A Systematic Review and Meta- Analysis," | embarked on a journey that unfolded the intricacies of a seemingly simple question, leaving a profound impact on my understanding of research. This study summarised the prevalence of NAFLD, NAFL, and NASH in overweight and obese individuals by use of imaging and histologically proven diagnostic methods, and found that an estimated 69.99% of overweight individuals had NAFLD and an estimated 33.50% had NASH, These findings could support further development of frameworks based on bodyweight categories as key factors for first-line screening of individuals with NAFLD. While this project may not be directly affiliated with plastic surgery, it stands as a testament to the profound impact that seemingly simple inquiries can yield. This project was more than a compilation of data; it was a venture into the unknown, revealing gaps in the literature that begged investigation. The process of identifying these gaps and recognizing the vast unknowns in our understanding of the subject matter was a transformative experience. The skills honed research project have laid a solid foundation, instilling in me the confidence and capability to tackle the complex queries that pervade the realm of plastic surgery. Statistical skills became paramount in unravelling the complexities inherent in the data. Through this project, | not only gained proficiency but significantly enhanced my skills in statistical software, particularly in Stata and R. This hands-on experience allowed me to navigate and analyse large datasets efficiently, equipping me with valuable tools for future research endeavours. | am eager to apply the lessons learned from this, Project to contribute meaningfully to the ongoing " Page 34 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 {Wewm24.25/3857/028/1-R1A/0000170299/00027), discourse and advancements in plastic surgery research. Please say why you want this particular Academic Clinical Fellowship, indicating your medium and long term career goals in relation to an academic career in this specialty Page 35 of 36 ‘The Academic Clinical Fellowship at Birmingham University, celebrated for its pioneering burns research, presents an unparalleled opportunity for me to immerse myself in a multidisciplinary program of research. | am particularly drawn to the team’s groundbreaking work regarding the role of Danger Associated Molecular Patterns (DAMPs) in Immunosuppression post-injury, and the potential therapeutic interventions, resonate strongly with my research interests. The team's exploration of existing therapies targeting DAMPs and their applicability to critically ill patients aligns perfectly with my long-term commitment to improving patient outcomes through innovative treatments. In the medium term, | am enthusiastic about the prospect of exploring this research domain to help generate Ideas for furthering my PhD. Leveraging the extensive support and resources offered by the ACF program, | aim to actively engage with the team to deepen my understanding and contribute valuable insights that can inform the direction of future research. Looking forward, my long-term career goals are intricately tied to advancing the understanding and treatment of burn-related ions. | aspire to actively contribute to the n of research findings into clinical practice, ultimately making a tangible impact on patient care. The renowned burns research conducted at Birmingham has solidified my belief that this ACF is the ideal platform to cultivate my skills, explore innovative ideas for my future PhD, and align myself with a team dedicated to unravelling the complexities of burn care. | am. excited about the prospect of contributing to Birmingham university's legacy in burns research and forging a path towards an impactful academic career in this specialty area. Coming from an LMCI background, I've actively learned about research, showcasing my commitment. With your unit's support, | alm to shine and contribute significantly to plastic surgery literature. Applications for training In some specialties can be linked to generic research or to one of the NIHR priority themed research areas on offer. For details of the research available within each scheme please see the relevant job description and advert. ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 35 of 36HEWM - Plastic Surgery - ACFST1, ACFST2, ACFST3 theww24-25/3857/026/1-R1A,0000170299/000271 Page 36 of 36 Application submission 1. Before you submit your application, please make sure that you have reviewed all of your responses to ensure that you have provided accurate information, Pressing the submit button at the bottom of this page will automatically submit your application, By pressing the submit button, you are confirming that you understand that you will NOT be able to add, amend or remove ANY information entered against the application once the submission has been completed. ‘once your application has been submitted, you will be able to view a read-only format of your submitted application from your application summary screen, You must have completed all the mandatory field within the application, and reviewed and confirmed the below declaration, in order to submit your application. | confirm that | have reviewed the content of my application and, to the best of my knowledge and belief the information | have given in support of my application, including information supplied on this forrn and in any attached documents, is true and complete Application was submitted on 31/10/2023 11:19:37 ‘Tue Oct 31 2023 11:24:07 GMT+0000 (Greenwich Mean Time) Page 36 of 36