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Good afternoon, everyone. Uh, welcome you back to the, uh, d I training boto pre Congress course. Hope everyone's had a good lunch break with my shoe, grab a bite and have a quick coffee. I'll be moving on with our program, so I'll be introducing our next speaker. Who is Marissa Franklin? Our very own boto woman in surgery. Representative Morita is an S T seven registrar in the Mersey greenery, and she's nearly on the surgery and training committee as well. She couldn't sit on the boat committee as a woman in surgery, representative and forms forms part of our boat culture and diversity subgroup. Morita is also a member of the British Ship Society's Culture and Diversity Committee and also sits on the Royal College of Surgeons of England. Women in surgery for, um, and is a founding member of the women party on sexual misconduct in surgery. Should be giving a presentation today on women in surgery, So welcome her to the stage. Hello, And thank you for that. Karen, Um, more astute of you out there will notice that I'm using her camera. So we actually sat next to each other in real life here So I'm Aretha Franklin, and I'm the current voter women in surgery, representative. And I'm going to Mm. So that doesn't seem to leave their own. Thank you. Um, so I wanted to talk about why I think the role is is important. I have to admit, I was quite late to the women in surgery game in that I I first started working in 2007 and known I wanted to be a surgeon, um, for for years before that and an orthopedic surgeon from 2003. So I am. I never actually got involved with any of the women in surgery stuff because my my perception at that time was that I didn't need an extra leg up in order to to make it if you like. And what changed it for me was, um, in the year ahead of me applying to take this role. Uh, in the last 16 months, a medical student came to find me and asked me to speak at our local scouts Is surgical society. Um, surgical scouts is here in Liverpool, and and I kind of thought Why? Why do you want me to talk about what I've done, and I've not done anything particularly special. And and her feeling was that, actually, orthopedic women or insurgents, where women were really quite rare. I was pregnant at the time and and was working less than full time by then. Um, I was pregnant with my four third child, fourth child. At the time, I got four no more, and, uh and so I went along and talk to you about my experience. And what really struck me was on a Saturday morning at nine o'clock where most students would still be in bed. There were loads of medical students sat there, male and female asked me questions like, Oh, so you can do orthopedics and be small or who you can do orthopedics and and you can have a family still and and so I think visibility is really important. People need to see that there are all sorts of different types of orthopedic surgeons out there because we want to encourage the best people to come and join us in what I think is the best of all the specialties. So surely if we want to to bring the best people to us, we don't want to lose a cohort who are put off for what I would consider, Um, reasons that shouldn't be issues. So what is the actual voter women in surgery rep Parole entail? I'm a member of the culture and diversity subgroup and you've heard from from other members of, uh, of the subgroup already Karen leads it and does. It does a great job. We I also have a seat on the Royal College of Surgeons of England, women in surgery for, um, as part of my voter roll and also a seat on the British Ship Society Culture and Diversity Committee, which was ratified as a as a recognized committee by the BHS exact earlier this year. It was founded by Jonathan. How it is now headed up by Joanna Max and is a is really leading the way in terms of subspecialty d I groups for for Feed IX. So a little overview of the year. So far, we've brought about a lifestyle and support page on our website and and there's more on all of these areas to come. Um, we ran a successful campaign over the International Women's Day and the as part of the boat and culture and diversity subgroup. I've supported Karen in her excellent work in bringing about the C and D Champions program and was given the opportunity by the B 0 80 chair the diversity session at their Congress in September. Um, so really showing that the the movers and shakers of our specialty think these issues are important and recognize that they are as part of the the B, h, S, C and D committee We. I've been involved with the the inception in the early work that we're starting to do around a medical student engagement project that we're looking to run at the British Ship Society in March next year and again as part of the Winds Group for the Royal College of Surgeons. I put my hand up to be on the working party on sexual misconduct in surgery, and I'll talk to you about that shortly as well. Uh huh. So the lifestyle and support page, this for me was something I was really excited to to suggest. And it was it was well received by the committee, and I thank them for that. I think orthopedics really is a team sport, and we need to look out for each other, and we're better together. Um, it can be lonely if you're you. Think you're the only person out there that wants to train lesson full time or has been through a miscarriage or has issues with neuro diversity in the workplace and having this collective kind of resource, which is ongoing and evolving. So please do email the whiz account with any suggestions or contributions you'd like to make. I think it's just a way of people being able to to find some support or find that they're not on their own as they go through training, facing some of the issues that come up. I wanted to encourage people to to have that sense of togetherness and then the belonging that Nicole Lowry alluded to earlier on with her talk. Um, and also it was an opportunity to be able to celebrate achievements. Um, So, for example, there's a section there for the International Women's Day, Um, people that that I'll explain the process that we went through later on, but but they're celebrated on our page as well. Back in June, I was involved with this article that Tony Cason mentioned earlier, looking at talking about professionalism within two woman orthopedic surgery that's published in the J. T. O. And if you scan that QR code, it will take you to the ongoing survey would be great if you haven't already filled in, if if you could, because we want to contribute to the you to contribute to that conversation. And, as mentioned earlier, the the idea here was that if we better understand where different parties within our working environment are coming from, we'll be able to work better together. And this article looked particularly at the generational differences that we have with an orthopedic surgery now, which maybe weren't necessarily present 40 or 50 years ago. Um, so it's so worth checking out. If I do say so myself. The i W D campaign was run in order to to celebrate women who are people who identifies women who have contributed to the orthopedic landscape, if you like. So we put out a call for nominations through our newsletter website Social Media and anyone was able to nominate um, people that were nominated were then sent commendation letters and you know by way of recognition and were invited to take part in our social media and campaign. And again, it was all about visibility and letting people see that these faces are out there if you like. And that was that was run to to Well, it was well regarded and there was a good response to it. So we were pleased about, um, as part of the boat, a diversity subgroup. You've seen this photo? You might even see again later on. You've seen it a few times today already. We're very proud of the Champions Program and everything they've achieved. It's great to have so many of the champions. Uh, speaking here today, it's been lovely as the winds rep. To be able to support Karen is the boat to see and the rep to, uh to get everything over the line here. And and it's it makes me very happy to see it as part of the B, h S C and D committee. Um, there are multiple work streams that go on here in the hip surgeons from up and down the country and different backgrounds, different approaches to diversity and different protected characteristics involved, but with the key common goal of improving d I. And it was that their committee was born from them, attending BHS a few years ago and kind of looking around the room and seeing that it didn't represent our patient's or even our workforce as it was predominantly white male. Um, I took over from Cat Diana to who's the outgoing Windsor Rep ahead of me, and she was one of the founding members of this committee. So So I took over her seat and have have become involved with the with the engagement project to to encourage medical students and students from schools to, um to be exposed to orthopedics, an early stage, as I've mentioned with winds. And there was a really kind of, uh, feeling of change coming about within their organization in the last year. But all of the Kennedy report that we've heard about from Kate Accent Atkinson and so well earlier this morning, and there was a real call for change and that on the background of um, the movement around sexual assault in surgery, I'm sure many of you will have seen this article published earlier in the year by Fleming and Fisher. Um, how that started a wave, if you like of reporting so Philip Jackson then went on to to provide a named testimony. And then later in March, home. Arshad, who's a pelvic surgeon of Bart's, um, contributed to that conversation as well with her letter. Um, so from this within the Winds group of us, yes, there was a call for interested parties to become involved with setting up a working party. And that's how I found my way to being one of the founding members on the working party of sexual misconduct in surgery. And these are are are kind of vetted slides, if you like. I appreciate it's a potentially very triggering topic. And if you go to that, go to our website, which, uh which is on that slide? Um, you'll find support for anything that you feel you require support with, but the the idea behind this, um, so we wanted it to be a safe space, um, to work in, You know, you shouldn't come to work worried about sexual assault, and I think you know, it's ridiculous that we have to say that, but But unfortunately were in, uh, although these cases are few and far between, we definitely need a culture change with respect to this, we need to safe reporting systems so that victims can speak up without fear of personal detriment. And I think that again has been mentioned earlier on that. It's that ability to to speak up the ally ship, the facilitating reporting and all of which I think really comes back to patient safety as well. Because if perpetrators are behaving in in these manners to colleagues, what are they doing to their vulnerable patient's? And that's something we have to consider. Um, we really hope that you'll you'll get involved with the survey that I'm about to talk to you about, um and and contribute to that conversation. So as part of that group, was one of two people who helped design the survey, and this was built on preexisting attempts to do work like this by, um, some of our colleagues over in Max facts. And they were brought onto the, uh, the project. And what's really nice is we've got a lot of lot of women, and we've also got allies as well. The male, who often a big variety of surgical specialty backgrounds. Um, I think that's that's really important with an orthopedics that we're not isolationist and that we we reach out to to others for their experiences in areas like this. So we designed a survey with input from the psychology department at the University of Exeter, and it's it's ethically improved now. We went through that process because we wanted to make sure what we're doing was robust enough and and anonymous and reassuring enough to people that it would be anonymous in order to get a real feel for what the landscape is or has been our data and so far, you know, talks. Uh, we have data on people witnessing or experiencing sexual misconduct across the board from what we would what in the old days may be referred to as just banter and and jokes to, you know, the extremes of rape. And this isn't acceptable in our workplace. And obviously we all know that, uh, we need to speak out against it. So this has been a really useful project to be part of, um, the survey. We we've sought support from a range of organizations. Obviously, Botha being front and center to with that, and we push it be Oh, a And that's where the survey was launched in in September. Um, and in terms of of what the future will hold well, arguably the newer consultants, the new generations of trainees have different standards. And it may well be that the culture change we're talking about will happen anyway. But, you know, with evolution, if you like, of the the makeup of of orthopedic surgeons that we have. But irrespective of that, the the change has to be brought forward or encouraged and supported. I mean, what robust mechanisms in place so that people can report without fear of Reprisal and without fear of not being believed or being told? Oh, well, you know, we all know we can't send that trainer, female trainees or all the other frankly insane things that people are told, um, in these situations. So this really struck struck me. Actually, when? When it was it wasn't really came on this, But everyone is dismayed. Nobody will see here and go well, of course, that behavior is acceptable. Everyone's sorry that other people are going through this or that. They've been through this themselves and they're angry, but no one is really shocked. And I think that's very telling. Um, there's a link to the survey there. It's most of you will in the UK will have had it emailed to you, um, via particular channels. It's not something that we're pushing on social media, though it has been shared on social media. And that's all to do with the ethics around its, uh, its distribution. Because, as I'm sure you can imagine, it's quite extensive. Survey and uh is potentially very triggering for people I know this work was presented at Future Surgery Conference last week. Um, and and again it was triggering for people in that audience. Um, so how do I see the boat? A wins role and moving forward in the future? I'd really like to see the lifestyle and support area grow. I think it's something that all people, all trainees and consultants, orthopedics, should feel that they have the opportunity to contribute to. And I'd appreciate people getting involved and spreading the word with that. And for now, I think the Boat of Winds role needs to continue to be a trainee voice on the kinds of panels I've been fortunate enough to be involved with this year, but also others out there and and that's the beauty of rolls like this is that you can take them forward in the way that you want to visibility again. And I know I've already said it, and I won't apologize for bringing it up again. But I think it's really important. And then beyond that in the years and potentially decades to come, maybe we'll get to a place where we don't actually need a women in surgery representative and that that actually are seeing the role covers all of that. Because whilst a lot of people as, um, as Vicki Cherry said earlier, we'll consider we've ticked the box of including women. You know, diversity issues are sorted. There are far more issues around diversity out there rather than just a visible one of gender. Um, thank you very much if you are UK based and we've got a lot of colleagues from from around the world joining us on this, which is really lovely. Um, if the UK based and would like to take part in the surveys, the the QR codes are there, and we'd really welcome you contributing to the conversation. Thank you. Um, so just wanna say thank you to marry to for that really extensive presentation about the role and the work that we've done so far since you're here in person. And I would like to ask a few questions about about your experience about women working in orthopedics, and I know you work less than full time. And have you found the college and the bureau in terms of supporting less than full time training? I think there's been a really change in that culture, actually, even in the last decade. So my oldest child is 12. I remember going for ST three interviews with, you know, with two young Children, a newborn baby, Um, a toddler and remem we're talking to You really love being very supportive consultants at the time and say, Well, you know, it's a surgical specialty, so I can't can't train less than full time and being told Oh, no, absolutely. That's not really possible in a craft specialty, but you will be able to manage, and then you should not do the job. You want to do fast forward nearly 12 years, and we now have, um, certainly in my Dina, we we've got nearly 10% of the trainees in our less than full time back. When I went less than full time in 2017, I was the first person in mercy to do it. Um, it's It's such a rapid shift. We've got people going less than full time for without having to give an official reason. So I always used to feel I had to justify the fact that I have a large amount of Children as being my reasoning, whereas now it's great trainees that enjoy sport or want to have a bit more time off around the exam. And they just dropped 8% even 60% and then they maintain their well being And there were life balance. So so I I think that changes is definitely there. That's that's great. I think it's, um as you think the culture train is coming and I think it's also, as you say, that it's in full time Training for caring responsibilities doesn't rely for women in surgery. Um, it can also be for men or anybody who identifies with any other gender identity because it's not just, you know, the parenting role is beyond just for women. Um, and I know I think the work that you've done on with sexual misconduct is, you know, it's really, really important. And, you know, we have to really thank you for doing this because the fact that happens, you know, even if it's one case, it's really shouldn't be happening and it's not tolerable. Um, so it's one of you. Have you had any results from that survey that you can? So it's currently still ongoing, so we're not able to share results yet. We've got over 1000 participants and across the board, and, uh and so I'm really hopeful that it will be a genuine picture of what the state of play is. Uh, again, I know that it's not. I'm not suggesting that these things happen all the time, but as you've said, they shouldn't happen at all. And much like any hierarchical environment you know, you hear about, you know, me, too. Movements Hollywood. You hear about it. Within Westminster, there's there's a happens and there's an underbelly to these environments that people don't talk about. And so, um, when when the issue was raised, it felt like something important to get involved with. So there's some some fabulous, uh, women involved and and men involved with that group, that working party, and I'm just one of the supporting acts. But yeah, it's a It's a really worthy thing to do. So I'm proud of, you know, I really, really commend you for that. That work. Um and also, I know you mentioned in your role that you do some outreach work speaking with students, um, as women in surgery role and you can give about a bit about them. You know who you're speaking with, what has been the response to it. So that's very much a in its inception, and it's developing. So the idea is to work with schools and, you know, engage people from socioeconomic backgrounds that maybe aren't as readily invited to the table with surgery in medicine. So as you mentioned earlier that, you know, it's harder to get work experience, isn't it? If you haven't got the right connections and or to even think outside the box and then while I could go and do that job, so so that's where that's driving. As part of the women in surgery group RCs, England actually ran a project called 30 schools of 30 years. Just before I got involved with them. But I happened to take part in that, and that was a similar thing where they reached out to local nonselective schools and sent people in with somewhat pre prepared slides from the RCs. But also being able to add in your own story and taking part in that local schools where I live was actually really valuable and got some very interesting questions, and, uh, people who just didn't think that that was for them. Um, and I think that's that's key. So it's all about bringing the best people to the team. Mhm. And if you know, if any of our participants were interested in partaking in that you know what would be the best way to so the best thing to do would be to get in touch with the V h s C D committee, and we'll go from there would be great or email me the winds account. Sure, thank you. And I think it's a you know, widening participation in medicine is a it's a It's an agenda on a lot of surgical, not the surgical, you know, medical societies as well. And I think every way that we can do it, you know, going back to, like, primary school in, um, even second. You know, secondary school to start planting that seed. Because, you know, as you say, medicine, we're trying to be representative. The population. Yeah, we serve, um, and sometimes you have to really just start at the very beginning beyond medical school. Invite people who wouldn't usually even consider it. And actually, we said that primary schools really interesting, isn't it going back to what Nicole was saying about the kids who then had all the firemen and the doxy? Yes, women. And it is It's, you know, from a very young agriculturally. Sometimes were typecast. Yes, like, yeah, just breaking down those barriers. Yeah. Seeing that representation, it's important so that people can, You know, as Trish Campos said, you can't be what you can't see. Um, and I know that that's beyond the superficial layers Nicole mentioned, but I think that's a really good place to start. And it can, you know, create a lot of change for the future. That's great. Thank you so much. Thank you for joining