Transplant Rota Application Form
How to take part in the on-call student transplant rota:

1. Ensure you are eligible for the rota.

2. Fill in the online form below to indicate your availability. The included questionnaire is being used for research purposes to determine if the Student Transplant Rota affects attitudes towards surgery and surgical careers. Data will be anonymised before analysis. Your responses will be kept confidential. They have no bearing on your allocation or future allocations. By filling in this form you are agreeing that you consent to your responses being used in this way.

3. The deadline is Wednesday 29th June 2018 10pm.

4. The draft allocations email is sent out the day after the sign up deadline. You have 24 hours to make your objections before it is sent to the coordinators.

Surname *
Your answer
Forename *
Your answer
Mobile Phone Number *
Please write in the following format: e.g. 07123 123456 NB. The space is very important: if you do not include it, your number may appear incorrectly on the rota.
Your answer
Cambridge Email Address *
Your answer
Which Stage are you currently in? *
Year 4 students only, which of the following have you completed?
Is there a maximum number of days you are prepared to do? *
Which dates are you available for the rota? *
Yes
No
1
2
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5
6
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9
10
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12
13
14
15
16
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20
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28
29 (henceforth only if this date exists in this month)
30
31
Do you wish to be put on the standby rota? *
How many times have you been called up to the Transplant Rota and scrubbed for an implantation operation? *
How many times have you scrubbed for a retrieval? *
How many times have you been called up but no operation occurred? *
Views and Experiences of Surgery
We are hoping to establish the impact of the transplant rota on student views on and experiences of surgery, please state to what extent you agree or disagree with the following statements:
1. I enjoy surgery *
Strongly disagree
Strongly agree
2. I am likely to pursue a career in surgery *
Strongly disagree
Strongly agree
3. The operating theatre is a dynamic, exciting environment *
Strongly disagree
Strongly agree
4. I have experienced surgical decision making under pressure *
Strongly disagree
Strongly agree
5. I feel I would be well suited to surgical decision making under pressure *
Strongly disagree
Strongly agree
6. Working conditions in surgery can be challenging *
Strongly disagree
Strongly agree
7. I understand what the workload/job of surgical trainees and consultants entails *
Strongly disagree
Strongly agree
8. Points 4-8 increased my insight into surgery as a career *
Strongly disagree
Strongly agree
8. Surgeons are approachable *
Strongly disagree
Strongly agree
9. Surgeons are good role models *
Strongly disagree
Strongly agree
10. Surgeons are motivated to recruit me to their speciality *
Strongly disagree
Strongly agree
11. Surgery has a certain required "personality" *
Strongly disagree
Strongly agree
13. Points 9-12 influence the way I view surgery as a career choice *
Strongly disagree
Strongly agree
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