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so I'd like to now invite our next speaker. Um, Vicky Cherry, who's on the court as well? Should be doing, um, a talk on ally ship. Hello, Vicky. So Vicki is currently working as a senior clinical fellow enhance surgery in Aberdeen, having completed her training in east of England as far east of Scotland and see DT in June 2002 should be taking up as a post in as a consultant in general and upper limb trauma and as well as elective hand and wrist surgery in N. H s five from August 2023. She is currently the B O and go to Scottish culture and diversity champion and is one of the lead investigator of the Ghost Project. Looking at the effect of gender on operative autonomy in orthopedic trainees, she has spoken locally and nationally about diversity in orthopedics, and it's particularly interested in reducing challenges faced by trainees who wish to take on a more atypical path Through training, Vicky Kerney divides her time between her fellowship and Aberdeen and living with her husband and two daughters in Dundee. I'd like to give a warm welcome to Vicky, who will be delivering her talk on Ally ship today. Thank you, Vicki. Thanks, Karen. So how's your work? Uh, thank you, Karen. And the boat. A team for inviting me to come and speak about Ally ship. So the first thing I want to ask everybody is Are you just normal? Imagine being asked right now to describe an aspect of yourself. For example, your race or your sexuality, your physical ability culture. Would you struggle answering this thinking even just for a moment? Fleetingly, You can't define it that you're you're not unusual. You're just normal. Eat every characteristic that's normal represents a societally structure, lack of otherness. And that is privilege. It may be so ingrained that we're not even aware of the societal domain in which we inhabit and that lack of awareness in itself is privilege, because those who don't have that are frequently made explicitly aware of their otherness. So if we consider each characteristic of ourselves as a coin, the top of that coin represents that societally favored outcome in our society. Generally, that's that's whiteness, male wellness wealth. And these are the normal. And at the bottom of each coin, this represents the societally opposed outcome, and that's the abnormality or the other. We all inhabit the side of each coin and for some will be on the top and and on others will be on the bottom. And for each, where we're on the top, we receive benefit for those on the bottom. Do not which we have not earned, nor we control. We have it simply because of who we happen to be, and this is privilege. And as you can see, we all have privilege. Just as we all have disadvantage. It's not something we can control. What we can control is how we respond to witnessing discrimination, harassment and oppression by the people who inhabit the bottom. So in that respect, want to discuss what what is an ally? So an ally is a person of one social identity group who stands in support of members of another group, typically a member of a societally favored group standing beside members of a group being discriminated against or treated unjustly. We can all be allies, as we've seen. We all benefit from some privilege in certain aspects of our identity. We also must remember that ally ship is a lifelong process so building relationships based on trust and accountability with marginalized individuals and groups. It gives us a chance to reflect on our own views and perhaps see things from a different viewpoint. And importantly, it involves giving those from minority groups a voice which they might not usually have due to lack of privilege. So that's what Ally ship is. But it's also important to understand what ally ship isn't. It's not a badge of honor. It's not a line on your C V or a pin on your lapel. It's not an excuse to save people to save marginalized colleagues or be a white knight. You shouldn't be doing it to receive praise, but rather because you want to make a meaningful change. And you shouldn't be an ally only when it suits you or is convenient. Sometimes the hardest part is challenging discrimination. When you are the only dissenting voice in the room, it doesn't give you a pass to speak on behalf of marginalized groups unless explicitly asked to. But rather, you should be using your privilege to, uh, as a roll of alli to amplify the voices of those who are often overlooked. And finally, it's not a favor you're doing for somebody. It is a lifestyle you might be asking. Why? Why do we need allies? Surely marginalized groups should be big enough and strong enough to fight their own battles. Well, sometimes lack of privilege results in a lack of voice and influence that makes these battles very difficult to fight without some help, particularly in the hierarchical structure that is orthopedic training. There is a significantly disproportionate representation of marginalized groups as we go up the power structure. Cool the S A C published this last year on gender balance, which it? Although it's just gender, it probably applies to most marginalized groups. And it shows the gender balance at varying career stage and the trend towards male predominance. As you become more senior and therefore more influential, it's quite stark. This trend is echoed pretty much across the board nor marginalized groups. Stan echoed representation in the council and the society boards, and particularly in a R C P panels. These are the people who make decisions about trainee's career progression, and ultimately, if they are not actively looking out for marginalized groups, there is a risk that they will be unfairly disadvantaged. We also know that in such a small pool of marginalized individuals to draw from when it comes to filling these positions, there is a risk of overburdening those individuals or running into tokenism. I'm sure we all know that one female consultant who seems to be asked to be on every panel to try and up the diversity active ally ship from non marginalized individuals can help alleviate this burden. We also know that there are some individuals who are unlikely to ever change their views. As Tony said, the dinosaurs. It's often difficult to deal with these issues surrounding this, so it may be more realistic to try and outnumber them with positive and active ally ship instead. So I know I'm speaking to trainees, and you might be thinking, Well, I'm not a panel or board, so why bother now? Ultimately, you are likely to finish training, and statistically speaking, you're likely to end up in one of these roles. The makeup of the consultant body is changing granted, but at a glacial pace. And so, in all likelihood, many of you will still be on panels where there is a mismatch of trainer trainee demographics and good allies Ship will benefit the most marginalized. Also, remember, Ally Ship doesn't need to just be the big things. Sometimes the smallest actions can be most meaningful. So you might be asking, How can I be a good ally? First of all, I'd like to thank Ivanko kill for providing the following infographic that I'm going to go through on the 88 of Ally Ship. Ms. Cockle currently serves on the NHS Equality and Diversity Council and is the vice president's the Royal College of Nursing. She's a fantastic anti racism campaigner, and I thoroughly recommend that you follow on Twitter and the handle will be on the following slides. Presumably, Twitter hasn't imploded by the time I finished today. Her work is mainly on anti racism. However, the principles can be carried over to any marginalized or oppressed group, so firstly, you have to have an appetite for change. It can be uncomfortable, especially when faced with difficult and complex issues such as racism, unconscious bias and, indeed, our own privilege. No one likes to think they've got something for nothing, and that in itself can be difficult to come to terms with to be a good ally. You have to really want to make things better. Then you have to ask, Read watched head talks. There are some interesting links I've got at the end of this, uh, the end of the talk. Speak to people. But be careful. It can be exhausting for your very identity to be a political debate or a position that you have to justify over and over. Instead, look for official sources and invited speakers such as events like this. Those who have volunteered their time and experience to educate people who want to learn once you ask the questions and dive deep enough into the lives of marginalized groups should be easy to accept that there really is a problem. In addition to the S, a C data presented earlier. Another example is that be a M E. Doctors are significantly more likely to be, um, investigated by the G. M. C. That's a problem. Yeah, so believe your colleagues when they say that there are issues, don't hand wave away. And just because it's never happened to you and acknowledge it, that small act of acknowledging your colleagues can really help validate their experience and that in turn can empower them to try and push for change. No, this is a bit of a tricky one. Apologize. I don't mean personally. Don't stand up and say I'm sorry that this person was whatever but expressed sympathy to your colleagues who have experienced discrimination or harassment. Stand by their side, validate them and empower them. That's what good ally ship is. It's also important never to assume that you understand the precise issues that your colleagues are facing. A personal example of mine would be when I was struggling, having just come back from maternity leave. My youngest child, I was finding the adjustment really difficult, and in part it was because I was coming back relatively senior compared to my first maternity leave, with all the expectations that the more senior role entails, and in part because I was working and very busy, and they're, I say, a chaotic team. But whenever I tried to tell people that I was struggling, I was met with sort of sage nods and ah yes, we understand. It must be very difficult juggling childcare. I even got asked. You try getting a nanny. It was exceptionally frustrating as my Children were not the issue at all. Uh, they loved nursery. They slept really well. They were great. The issue was really the lack of the robust transition period. There was no easing in. There was no return to work program. In fact, any understanding at all of what it was like to come back from a significant time off work. Hilariously, These are the same people who really struggled to get back to things after, um, covid restrictions and and lack of operative of elective operating. By assuming that they knew what the problem was, there was no way of actually finding out what the issue was and therefore enacting change. Most importantly, we have to be prepared to take Axion. It's all well and good, sympathizing and listening and not assuming, but without demonstrable Axion. It can be It doesn't mean anything. It can be really difficult knowing what to do. And it's inevitable that we will sometimes make mistakes. And that's why we have to be accountable. And it can be very difficult. So I've found some suggestions. This is from Brighton University of some small actions which can improve the lives of your marginalized colleagues, create a safer environment and improve the environment for all. So, first of all, create a safe environment for people, colleagues, students whatever to feel secure when speaking up, listen to them and believe them. Don't let your own experience color your perception of what may have happened. Challenge microaggressions in the workplace It may seem trivial to you, but understand that to your marginalized colleagues. This is a slow and drip drip drip of small slights, thoughtless behavior, and it's exhausting and the burden of feeling constant need to correct them. We'll have a talk later about Microaggressions, but be aware of them and actually take on the role to challenge them yourself, understand an individual culture and be flexible and considerate towards their needs. For example, do you always meet in the pub for after work drinks or journal club? Consider how this affects those who don't drink alcohol for personal or religious reasons and consider exploring more varied options. A word of warning, though orthopod seem to be particularly competitive when it comes to go karting. So maybe find out who's on for trauma before you book. It seems silly, but take time to learn someone's name. Ask about the pronunciation and actually practice it until you get it right. It's small, but it can be really meaningful, particularly if somebody has a culturally significant name. And they are constantly referred to by Anglicized nicknames or other things that they're not them. Finally, signpost colleagues to role models and useful resources be away in Botha are at the frontline of diversity. Equality and inclusion in orthopedics has shown both by this Training day and also the roles such as the Boat Woman's Rep, Cultural Diversity Rep and the Cultural Diversity Champion program, of which I am one of the champions. Everyone involved in these initiatives is passionate about equality and diversity, and anyone would be happy to help those who may be struggling. Hopefully, after today, you will all appreciate and value the benefits diversity can bring to our culture and continue to work both within your own role but also through the role as an ally to improve orthopedics for the future. And in the true spirit of ally ship, I'm amplifying some extra excellent resources and references for the topic of ally ship, including the source of the coin theory and privilege, which is the talk by um, doctor Stephanie Nixon linked there as well as some interesting work on Intersectionality by Kimberly Crenshaw. Uh, and women in Orthopedics by Laura Hamilton at all. So I appreciate probably a relatively quick run through a ally ship. It's a huge topic, but it's quite difficult to summarize and thank you to Karen and to the group for inviting me to speak any questions. Thank you, Vikki. Um, that was a really fantastic presentation. And I really think the infographic that you showed at the end was a really good way to try to summarize, um, different steps we can take. And, you know, as surgeons, we like to, uh I think in structure. And I think this is a really good way to put instructor and I picked up that, you know, you were talking about the 8 to 78 is you also use something, another A, which is accountable. And I think that is a really, really good point because, you know, we're now coming to learn a time where we're it's not okay to just stand by and allow discriminatory behavior to happen. And I think by not speaking up sometimes you almost just as accountable for allowing it to happen. I think we are being part of this change to ensuring that ally ship is is is active and proactive. And I think one of the other things that we need to be accountable for is our unconscious bias, as as Tony was saying and becoming more aware of it. And that's certainly something that I have tried to address as an ally is turning that unconscious bias into conscious so that you can then work on getting over it. Um, and that's really important aspect of it as well. And that is part of the accountability. Uh, and because I know you know yourself, sit at some intersections, be like, if you're not orthopedic. Um, Consultant, uh, surgeon, how do you, um uh can you think of it? It can give us an example. When you demonstrated Ally ship at the right time because of the you yourself. Uh, we'll ask to actually from others, but sometimes you can also provide that ally ship. Um and how do you know when is the right time to to step into that role? I think that we have to understand that although we all have I think, as you mentioned intersectionality, which is not something I've gone into in detail. But basically it means that for every coin that you're on the bottom, they are all additive. And so, uh, female orthopedic surgeon is not going to have the same experience as a black female orthopedic surgeon because they suffer both from their femaleness but also their blackness. And these are separate issues which we have to appreciate. And I think one of the best ways of of being an ally as a white woman is to be aware of that as an intersectional issue and not think that because women are getting better representation than we fixed it, we've solved the problem. You know, we've done diversity, but actually understand that there there is an intersectionality which is still not addressed and to to actively try and promote, um, the the Allies or that the voices and and and give them, uh, amplify them because they are not being addressed by sort of central feminism, if you like. So I suppose the a good example would be the recent, um, black surgeons event that went on this year. Uh, just just this month, Um and that sort of being aware that there are unique issues which still need to be addressed? Absolutely. And I think, you know, sometimes I have had, you know, people come up to me and said, Oh, how can I be an ally? Um and I think it's a very There's no direct answer to say decided to be an ally. Um, you have to really assess the situation is also nuanced. Um, but I think it's also about, you know, looking after yourself as an ally as well. There's only, for example, of the advocacy work in the Alice you work that we do. Um, it can take a toll. As you mentioned in your talk, that can be, like, mentally exhausting. Um, but I think you know, you highlight Good point. That activism, uh, also requires a bit of rest as well. Yeah, and I think it's Yeah, I think it's something that we need to start talking about a little bit more because, um, we can't be fighting this alone. And I think part of Ally Ship is recognizing that sometimes somebody needs to take a rest and you need to take up to take on that role? Absolutely. It's kind of what I was saying about the the Ercp panels, and you will find the, um certainly speaking as somebody who has just see CT. Suddenly, I'm getting asked to do all these things because they want they I think it's in good intentions. People really do want to improve diversity and improve inclusion and improve representation. But the problem is the pool is so small that as soon as they as soon as you add a person to that pool, they'll constantly be asked to do everything because, oh, well, you you you should do all of this because we need diversity and that is true. But it is exhausting. And so I think we do need to spread the load a little bit and make sure that the other people in the room are also actively trying to improve the situation. Not just we've got a woman or we've got, um, somebody of ethnic minority. We've ticked that box. We don't have to think about it. It has to be a joint effort, and it has to be, uh, an entire group. The other thing I mentioned was about, um, there are people who are never going to change their views. And I think we've probably all met those people, and they're the ones that don't think there's a problem and are unlikely to ever change. And my personal sort of approach to this is to not even try, because you're just going to exhaust yourself and you're not. And you're gonna frustrate yourself and you're gonna be angry. What we have to do is is bring it to the attention of the people who have the potential to change and make sure they understand the microaggressions and the macro aggressions that they understand the difficult situation that you're being put in and they can become active allies. And it almost doesn't matter so much what the people actively opposing you are are actually doing mhm. Have you had any instances where you actively seek out for ally ship? Um or, you know, when you've been in a movie situations where you felt that you know, you're in a position where you didn't feel comfortable, you didn't feel safe? Um, have you had those instances and whether they've been, uh, effective. So yes and no. There have been situations where I felt that and I felt uncomfortable because of the way I've been treated by, um, senior colleagues. And I've spoken to trusted colleagues who I felt would be potentially good allies and what I found why I stressed so much of my talk about Axion is that they were very good at acknowledging my problems and apologizing and asking me what the problem was. But they didn't take any Axion, and it kind of is a bit meaningless. It's nice to have somebody sort of say yes, we know with it It was a bit rubbish, and that's not great. But if they don't take Axion and try to improve the situation for you and use use their clout and their power and their privilege to try and improve the situation, it kind of doesn't mean anything. And so if you want to be a good ally, you have to complete the cycle. You can't stop at sort of of acknowledging and the actions the most difficult. It is the most difficult thing to do in partially cause you're worried you might be worried that you're going to get it wrong, but also it's when you stick your head above the parapet and As I said, being an ally can often be hardest when you're the only dissenting voice in the room and you do have to have you have you have a little bravery. Ultimately is the right thing to do, and it will make things better. Thank you. It's Yeah, I think it's a It's difficult. Um, and so I think it's very challenging, I think as as you say, um, taking action. The right kind of Axion, um, can be different can be hard. And sometimes you get it wrong, and then you feel like, Oh, I'm not gonna do it again. But actually, we're all here to learn together, and it's not No one ever fault you for trying to speak up for others and to try to, um, you know, advocate for others. Um, but thank you for sharing that, uh, everybody else anymore on talking can be an ally for positive groups of communities. What was that? Sorry. Yeah. Anyone on this, uh, on this participant group can can be an ally for lots of movies. I think we all have our privileges and as to acknowledge them, um and as you say, put them into Axion. being an ally. Yeah. Thank you. Thanks. Thank you much. Vicky, Um, that was really great talk. And thank you for sharing your slides and for sharing all that those resources nunik slide. Um uh, with all the QR codes, Uh, if you can show that, I'll just give Oh, yeah, of course. I'll put that back up. And people have some opportunity to, uh, just go to have a look and maybe take into those QR codes. Um, that'd be great. I'll just keep it there for a few seconds.