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Hi, everyone and welcome to our second er session in the lecture series, a career neurosurgery. Er, we're joined by a neurosurgeon, Mr Ron Wet. Um So thank you very much for doing this today. Uh We're basically gonna be uh going, going over a career neurosurgery, some of the positives, some of the negatives and uh yeah, I'll just, I'll just let you get on with the room. Thank you very much. Thanks Morgan. Um So as Morgan says, I'm right, I'm more of the neurosurgery registers in the heath. And um Morgan's asked me to speak to you a little bit about um how to get into neurosurgery and what, what the, what kind of the job is like and some of the good bits and the not so good bits. So if you go on to the next live piece, Morgan, um so this is um er s which kind of just to highlight for you the number of jobs that are available and how long it kind of takes to do neurosurgery. So you particularly look at the things that are circled. So if you look at the main surgical specialities, there are a few 1000 jobs and things like trauma orthopedics and general surgery. Um, but the jobs for neurosurgery, or at least the number of surgeons doing neurosurgery is much lower. So it's about five, just over 500 or 600 or so. And, um, that reflects the fact it's a tertiary speciality which does not, um, er, get, um, um, done in a lot of smaller hospitals. You have to go to a big hospital to, er, work in neurosurgery and there aren't as many of those. And so there aren't as many jobs which means that the ratios to get in are more difficult than some other specialities. Um It also takes a lot of time. So if you look at the, um, the little hill on the right that's circled, you can see that there's, you may have to zoom in a little bit and I'm sure MG will make your slides available for you to look at, er, later on. Um There are different time frames to get to the level of a consultant for different people or different specialities. You can see that the people in the middle of the mountain are people doing things like GP um where they at your consultant level and therefore, consultants salary a lot sooner than people at the top of the mountain who take a bit longer but to reach a consultant salary and a consultant level um to become a surgeon in, er, things like neurosurgery. So it's a longer haul than other specialities where you have to be a registrar for a lot longer compared to some of your colleagues. Um, but there are other benefits to, to that as well. You go to the next I PSS Morgan. So this next, um, er, picture again, it just roughly outlines the path you'll take after medical school. If you go into something like neurosurgery, it's kind of a similar for other specialities and surgery as well. Um, so if you look at the, the, um, we'll ignore the academic pathway for now at the top cos that's quite different, we'll stick with the clinical pathway, which is the second lot of, um, of, of lines. And you'll notice after F one and F two, basically everyone has to do F one F two. if you want to move forward, er, and then you can either go down the route of doing court surgical training years one and two after which you apply for an ST three job, which is a, a registrar from um, ST three to level ST eight, after which you will either become a consultant or you could do a fellowship, er, which means basically doing another couple of years as a specialist registrar, doing a specific type of neurosurgery. I know it says cardiothoracic surgery here, but it's basically the same pathway. And whilst I say that they are really clamping down on that pathway. Now, what they really want you to do is the lowest er line on this, which is where you do F one F two and then you apply to become an ST one in neurosurgery. You don't do basically core training anymore. What they want you to do is to do, run through neurosurgery training where you apply for neurosurgery at the end of F two. Um and then you work as a registrar from ST one to ST eight in neurosurgery after which you do your fellowship here or two. And then you apply to be a consultant in um er in neurosurgery in a different hospital. So that's kind of the pathway to go for the academic stuff at the top is slightly different and it's very flexible. And so those, those um those blocks can be moved around a lot and it doesn't really um flow in the same way that the bottom pathway to and the vast majority of people follow the clinical pathway at the bottom. So that's what I wanted to, to elaborate on for you next eye, please, Morgan. So yeah, so this is again, just to highlight that before you again, that that's a pathway of doing F one F two. And then applying for neurosurgery is what really they're pushing for now. Um And just to highlight for you the how challenging it can be applying for core surgical training. The ratio is once you get to interview a roughly 2 to 1. So there's two people applying per job but for neurosurgery, um it's a 10 people per job. So the competition ratio is, is quite high. So you've gotta bear that in mind when you're preparing for this next slide is Morgan. And again, this just highlights that for you. Again that um, the number of applicants per post in neurosurgery is about 10 per every post and other things like radiology. A CCS is basically anesthetics. Er, and, and guy is down at the other end there where there are, er, fewer number of people you're competing for registrar or ST one jobs for, you can see public health is quite popular. That's not because lots of people do it. It's cos there's only one job in the country at any one time so that even if, um, there are 11 or 12 people applying for it, it'll become 11 or 12 to 1. Um, so that's also quite popular. Um, but, uh, neurosurgery is one of the more popular ones. So you have to bear that in mind when you're preparing to apply for it. If that's what you want to do. Next slide is Morgan. And so saying all that and I'm telling you it's quite difficult to get in you. You're probably asking what can I do to help, get into this. Um, er, and I think that is a very important question but it's also worth thinking about, um, whether you want to do it or not and knowing what the pathway and what the training is like is very important for that. Um, some of the good things about the training in neurosurgery and other, indeed, any surgical specialty in this country is that you get kind of an organized regimented and kind of a usually secure job for a few years as a registrar. As long as you, er, don't misbehave, you've got at least eight years or so where your job is secure and you've got, er, a, a recognized pathway or a few steps in front of you that as long as you hit your targets, you will progress through for about 10 years or so, which a lot of other jobs outside of medicine or even inside medicine you don't necessarily have. So you have a period of time when you're training, when you're, you have quite good job security and good job and good career progression in front of you. Um, having said that it takes a lot, lot longer to become a consultant in things like neurosurgery, cardiothoracic and other types of surgery compared to things like GP and anesthetics, um, radiology. Um, so it takes longer. Some would argue it's more intense now that I think is person dependent on what you define as intense workloads. But on the whole, people tend to say surgical training is more, er, strenuous than some others. And the other thing to bear in mind, which often isn't told to people replying straightaway is that once you finish as a registrar and you reach ST eight and you're doing your fellowship here as a registrar, doing subspeciality operating. Um, there's still no guarantee you'll get a consultant job at the end of it. So you still have to compete with the rough, the almost worse numbers of um, applicants per post for consultant jobs at the end of neurosurgery. And that's, that's not so much a problem in general surgery in trauma orthopedics and that's a neurosurgery specific problem. And there are not many consultant jobs even when you finish as a registrar. And if you put on next line, Morgan, I talk a bit more about how you get into this um pathway going forward. Yep. So I am I next wanna get Morgan cos I've kind of talked about that already. Um So there's a few things you can do to help cos I've talked about how difficult it can be to get in cos of the, the, the competition ratios. There are a few websites here. I know one of them is about neurology but um you can go to these things where they give you ideas about different courses you can attend and different audits and stuff you can get involved with that are happening on a national scale, er, that can help your CD look better, um which you can all do as medical students. You don't need to be uh qualified doctors to do these things and a lot of it is collaborative work. So you, you're only doing a part of the work, which means it's quite doable whilst you're studying. And next slide P Morgan and you're already doing the right things by, you know, coming to things like this and being involved in these societies is all good things to help you identify, er, different things you can do for your CV, like audits research and even putting this, attending things like this on your CV. Um, shows dedication to neuroscience training that um, er, and what they want to do is see that from an early stage in your career. So they want to see people who are attending things like this um as medical students. So this is a good thing that you're all doing right now. Next slide, he's Morgan. Um, so, like I said, you want to demonstrate early commitment to the specialty for things like courses, um D applying for different SSC S which I think I believe Cardiff offer you to do and it doesn't have to be neurosurgery specific. But in Neurosciences it is, is, is good enough and then using those websites I showed you, you can look for things like different competitions that are open to medical students that you could at least take part in and you can organize taster placements, maybe not even in Cardiff, but outside of Wales, even, um, for a couple of weeks during your summers or if your electives and then once you qualify, if you're considering an F three year, you can spend a bit of time, not, not necessarily the whole year because you want to do other things in your f three year as well while you can. But, um, when you're not traveling or doing other fun things you want to try and maybe do a few weeks to a couple of months doing some neurosurgery somewhere. So you can, um, put that on your CV and actually experience the operating as a more, uh, a more senior doctor or not a foundation doctor at least. And one thing I would a would encourage you to do is when you're doing all these things, it can be difficult to, er, know exactly which ones are the best things to do because there's so many options for you. And I think the thing that you should be looking out for is whether whatever you're doing, whether it's a course or an SSE or applying for a competition or doing a placement is to try and get something tangible, a tangible output from it and by tangible output, um, what I mean are, are things like a publication, a presentation or a prize? So if, what if you're doing an SSE, try and structure it so that you might get a presentation or publication out of it when you go to that website? I just, that I showed you, um, see if there are any and I know there are some competitions you can enter, which might have a prize at the end of it because it's all well and good doing an SSC somewhere. But if you don't get a presentation or prize out of it, it doesn't quite look as effective on your CV, as it might. And even if you do a lot of work, go to a lot of, er, operating list, do a lot of work on the ward. Unfortunately, that's not enough, We need to get something tangible out of it. So, um, uh, so Morgan, for example, has done some work with me where most of his work was on the ward, helping us, you know, look after patients. But also we made sure we got him a presentation out of it, which is what we want. So this is what you guys need to be thinking about doing when you're doing your SSE S and electives. Um, and if you're doing other things, 11 of the boxes they do when you apply for a registrar job is asking you to talk about your transferrable skills and this is quite a broad subject. So, just have a think about your hobbies or whatever your, um, other pastimes are, whether it's sports or music and think, um, not necessarily too hard, but start thinking about how you, whatever you're doing could be seen as transferrable skills for a neurosurgeon. So, if you are playing music, it's quite straightforward hand eye coordination, um, is, is important thing you can talk about and you could say the same about sport as well. Um And so there are lots of things even learning a language can also be helpful. Um But I do know that box in the application form is often um sparsely populated by people applying. So think about things you can do if you don't do anything at the minute that have transferrable skills to neurosurgery or any surgeon. And next slide is Morgan. Um, so this is a little bit um, out of date now, but it's basically the same. So when you're applying to neurosurgery, what they give you is some information about the essential and desirable criteria. Um, so the essential criteria are basically things that without, you just won't get an interview and even if you, um, are lucky and sneak into an interview, you basically won't get, um, er, offered a registrar or an ST one job without these things. So you can go through those and see they're all about basic stuff, you know, um, being able to look after patients being safe. Um One thing that they talk about is this logbook which is circled there. Logbook is something you can Google, you Google, the words E log book and you'll find um, a page you can register for. And basically whenever you go on placement and you do a procedure or watch a procedure or go to theater and watch or do anything, you should log that procedure in this log book because when you go for your interview, you'll have to take a logbook with you or submit it online. Nowadays cos it's all virtual er and they will look at the number of operations you've observed or helped with and that will give you a score or add to your score when you're applying. Um On the other side, you can see that there's some desirable criteria where they talk about having an integrated degree. It which I believe now may be out of date, I think integrated degrees are now taken out of this. So just bear that in mind. Um But there's lots of other things like hand eye coordination. You can see there doing things that optimize your man manual dexterity, attending different courses. You can see there's a TL S and crisp there. These are post grad courses but you need to try and get them done when you're F one and F two. Um because whilst they say these are desirable criteria because the competition ratio is so high. What they essentially mean is these are essential criteria. So you basically have to do these if you want to be competitive. So essentially you wanna fill all these boxes unfortunately, but that's just the nature of of wanting to do a competitive speciality. Um Go to the next side please, Morgan er good. So that's talking about what you can do to help you get into the speciality. Next slide again, please Morgan. Um, but I even want to talk, finish off by talking about whether you should apply for this cos um, you know, when you're a medical student, you don't always get a full view of what specialities are like. Um, and in something like this where this training is long and it's difficult to get in, you have to put a lot of work in to get in and once you're in, you have to carry on working hard, which is the same for a lot of specialties. It's just a shame when I see some of my colleagues who do all that work and then end up not enjoying it and having to change careers at a later stage in life. And um I think it's, it would be helpful if you can make that decision a bit earlier. Um which is difficult because you don't really get much time in, in medical school to go experience different specialities, which is, er, unfortunate, but it's the nature of having to learn so much next slide, please. Morgan. Um So I guess I just wanted to give you an idea of some of the pros of, er, of doing neurosurgery. So you get to do lots of integration of practical skills um with clinical neuroscience. So you all the theory you use, you get to integrate with p doing lots of practical stuff like procedures on the ward and lots of operating, which is very satisfying. You also get to do procedures and operations which can save lives or which can maximize the quality of life, which is a very satisfying thing to do. And I'm on nights this week and I've done a couple of operations where the patients have done very well and it just feels great, you know, to go home from nights and think I made a difference today, you know, or we made a difference today and it's really satisfying and I don't think you necessarily get that from a lot of other specialities. So that's really nice. The run through training. What that means is, you don't have to apply multiple times as a registrar to get jobs, which is nice. So, like I said, for a period of about 8 to 10 years, you have good job security as a registrar and because you work in a small unit with a number of registrars that numbers around six or seven. I think we have nine in Cardiff actually. So there's a few more compared to say, general surgery where there are about, I think 50 odd registrars in South Wales, maybe a, a little bit less than that or in the entirety of Wales, maybe 50 odd. You don't get to know everyone, whereas all of the neurosurgery registrars all know each other, we all get along. We're all good mates. Um, and even the patients, um, are often, er, frequent flyers and you get to know them very well. And you get to have a bit of fun with everybody. Uh, same for the nurses. The nurses are very highly specialized that you get to know them on a first name basis, which you don't necessarily need, get to do on doing general surgery or general medicine. Cos there are just so many, um, different wards, different hospitals you have to work in. So the relationship you build up working in a hype in a tertiary center can be a lot stronger than, than some others. And next slide, please, Morgan. Unfortunately, it's not all, um it's not all positive. Um We have very busy on calls. Um Lots of, I would say lots of specialties are very busy on calls. General medicine is probably busier than ours. Um What I would say is our on calls are even though when they're not busy, they can be very intense in that lots of our patients all pretty much all of our patients are. And I the phrase we often use is salvageable. So we don't often get patients who are at end of life where decision making can be quite straightforward because they're a bit older, you know, they're not for intensive care and you know that the best thing for this patient just is to keep them comfortable. We don't really do that in neurosurgery. Most of our patients are young and when they get sick, you have to act and do something because the patient could be saved and that can be quite intense and doing that regularly, um, can take its toll sometimes. So the on calls are not easy. Um There's also lots of patients who die and patients who are left disabled now. Um, there are patients who do very well and that's very satisfying. But with any specialty where you're looking after sick people, whether that's neurosurgery accidents and emergency anesthetics, cardiothoracic, you're gonna have to be able to deal with patients dying or patients not doing well and not everyone can do that. Um, so you have to be aware that whilst it's nice to do that patients do well, some of our patients who are young, some of them are, Children don't survive and some of them are left very disabled and you have to be aware and be able to cope with that. Um, the patient loads and time pressures are probably, like I mentioned, I alluded to, I think before can be very intense compared to some other specialties. Now in, er, general medicine or rheumatology, dermatology that you often have time to make decisions. You've got time to go back and review patients multiple times before you decide exactly what you're going to do. We don't really have that in neurosurgery, you have to make decisions quickly and, um, it's life or death stuff sometimes. Um, and after a while it gets easier because you get experienced. But again that, um, er, that decision fatigue that can happen from doing that over and over again for the entire on call shift can also take its toll. And I guess this is a kind of a smaller thing. But if you want to live in the countryside, it's not a good option because you have to be in a big city to do neurosurgery in this country and in most countries, to be honest, um because it's all centralized. So realistically, you're gonna be living in the center of a, of a big city like Birmingham, Cardiff, Bristol London, that kind of place if you want to live in. Um I don't know, Cornwall or um East Anglia, you're gonna struggle to do neurosurgery. And next slide is Morgan. Um And II think it's all good. Well, listening to me talk about these positives and negatives, but II think the only way you get a view of whether you're gonna enjoy working in a, in a hyper specialized field like this is by trying it. So you can see a few people for of your colleagues here have spent some time with us. And I would say that all four of these people in these pictures have not done neurosurgery. They've all done other things, but they all learned a lot with us and they all were thinking about neurosurgery and they came to us now while some of them have, have gone to do neurosurgery. I don't think that's a bad thing cos a couple of them gone through surgery of other types. Um, which is still great. Um, but the point I'm making is that they all came and did at least one or two weeks with us and they got a good flavor of what it's like being a neurosurgical registrar or a consultant. And it gave them a good idea of what they, what they want to do, um, going forward. All right. Um, so that's the, the best advice I think I can give you, um, is to with your se with your electives or a bit of time in the summer is to try a bit of neurosurgery and then try some other specialities as well. Try spine, spinal surgery and orthopedics, try some general surgery, try some non surgical things. Anesthetics is often a good option to try cos they're very welcoming to students and they can, um, often expose you to different types of surgery whilst you're there so that you can, um, hit multiple birds with a single stone as it were next. IP Morgan. Um, so, yeah, like I said, you've got multiple opportunities at Cardiff to do SSC S throughout your time. And if you, I wouldn't say you should do them all in neurosurgery, you should do maybe one in neurosurgery and use your others to do other specialties to see if you're going to enjoy them, um, and see what's gonna be best for you. Um, before you start, you know, applying for things that are going to take up 10 to 15 years of your life, um, going forward and there's also the option of cos, there are only a couple of seats I know is during your summer blocks. I'm not saying spend your whole summer in hospital. That's not good either. But maybe one or two weeks of your summers where you get, you know, the, er, couple of months or two off, maybe one or two weeks in a speciality and you don't have to spend the whole week there, maybe a few days even it's better than, um, going in completely blind, applying for things, which is what some people end up having to do and then they end up regretting their decision later on. Um, next slide piece of Morgan that might be everything actually. Yeah. So that's kind of everything I wanted to say for, for your, um, for this talk today. So I guess there's a bit of time now um, to try and answer any questions you have. All right. Thank you very much, Ron. Uh That was really helpful. Um uh just before anyone else, uh kind of ask questions. II have questions myself as well. Uh So, uh some basic ones like how, how have you found training so far? Uh Just give a summary of that basically. So I, whilst I focused on the clinical stuff, I'm actually an academic trainee. So I'm in the, the very flexible group at the top that I didn't really talk about where I've done F one F two and I applied for neurosurgery and I managed to get it and then I've taken time out to do a phd. So I'm now doing part time phd, part time neurosurgery registrar. So my training's a bit longer than the eight years that you normally get, um, which has its good things and it's bad things. I guess the good things about it are that you get a phd at the end of it, which is nice. It does also make it challenging to balance doing research with doing surgery at the same time. But what the nice thing about what IW when you apply for an academic role is they give you a bit more time to do that. So that makes it a bit easier. Um, I would say that the first few years, so from SST 1 to 3 were quite challenging because you're new to the specialty and that I think will apply to any specialty you do and you're expected to not expected you are supported. But the, the level of responsibility goes up quite dramatically. And I think when I got to ST four is when I started feeling more comfortable with the on call stuff, making these big decisions and doing the operating on your own. So it does take, it does take a bit of time to get used to. And for the first few years, I was, I was still quite nervous doing stu doing stuff on my own, particularly, especially when you're operating. But after a couple of years, I think that a lot of my colleagues and other specialties will say the same thing about ST four onwards, things start to become a lot easier, kind of leading on from that. And is, do you reckon, do you reckon a phd in your, in your training, helps with um future job prospects or fellowships or anything like that? That's, um, that's a very specialty specific question. It's a very good question. And I think in most specialties, the answer is no, you probably don't need a phd in neurosurgery. The answer is probably maybe cos it depends on what kind of job you apply for at the end. So if you're applying for a job, for example, doing purely surgery of the skull base, which is a specialty neurosurgery, which is very intense operatively where you do lots of, um, long cases of, of benign tumors, but very thick tumors at the base of the brain. Um, doing a phd in a lab probably isn't that helpful for that kind of job. Whereas if you're applying for an academic neurosurgery job as a professor of neurosurgery, then you need a phd or we just won't get a job without it. So it, and I think that's, and I think, and looking back that decision is something you need to make when you're a registrar bef well, because you need the experience doing a bit of neurosurgery first. So from, I think, from a student point of view, it's, you know, pass med school first before you start thinking about whether you're going to do a phd or not. Yeah, that makes sense. Um So we have a, a question. Uh what's the M sra score required for neurosurgery? Do you know that? I do know the answer. The answer is as high as you can possibly get because I don't think there's a cut off and unfortunately for you, for you, for you guys, um, they're putting more and more weight on that exam as time goes on. Um So there is a, I believe there is a pass mark. I don't know what the pass mark is, but in all honesty, you should forget it because the pass mark is really for the GPS in neurosurgery, they use it as a, a cut off tool for application in it and the pass mark then really depends on what everyone else applying for neurosurgery gets. So if everybody gets 90% your pass, the pass mark really will be 95%. If everyone gets 50% the pass mark will be 51%. Does that make sense? So, every year for neurosurgery, specifically, the pass mark will be quite different, depend, it just depends how everyone does on the exam who's applying for neurosurgery. Er, so in, it's, it's not ideal. Um but basically do as well as you can is the answer to that question. Thank you, Ron. So it looks like there's no other questions. If anyone has any more questions, just email Cardiff our, our society and we'll get through to Ron and, and get those questions answered. I'm gonna send the feedback form to the chat now, so it would be great if you could answer that as well. So thank you very much, Ron. Any closing marks or anything like that or? Yeah, I guess um Morgan can give out my email if anyone wants to ask anything. Um in terms of doing placements and stuff. Um I have a few people already. I do have some space, I think in the next year or two for others, but some of my colleagues um don't have any students at the minute so I can always forward you on to them if you email via Morgan to myself. Um If you want to try and organize placements, the the problem is Cardiff is a relatively small unit. So if we get full up, um you may have to think about in your summers. You know, if you go back home to wherever your families live, it's looking at hospitals there to do a week or so in these places, it's more challenging because it's not your university and all that, but it's not impossible to do. Um But also remember you can do placements in other specialities as well. Orthopedics, general surgery. Cos you'll still get some transferrable experience going to theater doing operations, that kind of stuff to see if surgery is what you, you know, really want to do. That's great. Thank you very much and I'll definitely share that. So, anyone who wants, um, Ron's email or wants to get in touch with some neurosurgeons and w just, um, just get in touch with the society via the home page and email us. Ok. So thank you very much. Well, we know you talk about the E book there. Um I would, I don't know if there's a way you can, um, send them all the link to it or something because that's, it's often forgotten to be like the med school. Just don't tell you about it and I don't know why, but they should really do it because the earlier you do it, the better you look. I mean, I've told you this, Morgan haven't I, you know about this but um, it, it is useful to get it cos it's free, you'd have to pay for it and you can log things from around the world. So if you go away, if you're elective, you can log anything you do and you're elective on this thing as well. And it looks really good. If you turn up to your interview as an F two with, uh you know, a logbook dating back to when you were in medical school. Cos then they, it shows that you are aware of what surgeons need to do, which is keep track of their operations and it does make a big difference because a lot of people don't do it. Yeah, that's a really good point. I'll, I'll put that in the chat actually. So everyone can, um, can access that. Yeah, it's so straightforward, isn't it? Morgan? You just click on it. You say you're a med student? Yes, it works around the world to answer that question. You put any operation in from anywhere in the world. Yeah. So with, with you on, I've put some, I've put some surgeries in already and I'm sure that will look quite good. Um From, from I guess the 3rd, 3rd year of medical school onwards. So it makes such a difference. Honestly, you go to, you get F two and F four, F one and F twos going through the interview with a log book from nothing um with nothing in it. Um Whereas, you know, if you start it, even though you won't have that, you won't have big operations in there. Will you, you have little things, but that's not what they're looking for. What they're looking for is someone who knows or is aware that surgeons need to keep track of their operations. That's someone who's like done a little bit of research and knows that OK, surgeons need to have this and knowing that early shows a commitment to the speciality, which is what they're looking for. Um, so there's a question here. Um, competitive nature. Does Luck play a big part in this, or just assessments and CST Bits and Bobs? Um, yes, luck does play a role. It always does. Um, what do you mean by CST bits do you call surgical training? Um, so I, I'm not, maybe I'm getting the que, I'm getting a bit confused and I'm not understanding what your, your question is. So you, you're not supposed to do CST anymore. So you do F one and F two and then what you're supposed to do, what they want you to do now is apply for neurosurgery straight away after F two. So you go for your, er, an interview and you go for, well, you first you send your CV off, then you will get an interview um for neurosurgery ST one. So you skip CST completely. Um And the, the interview itself has kind of some similar vibes to the CST interview in that you'll have some VRS about um clinical scenarios. You'll have a CV station where they read your CV and they ask you questions about it, but the bar is a bit higher in that they want neurosurgery specific stuff in your CV. And the questions will be neurosurgery specific and that is the biggest role is doing well in that interview. Um And, but like, as you say, um luck does play a role because you might be in a bad year. Where you get a, a station that doesn't suit you or there's a station where everyone else seems to be really amazing at it, even though you do pretty well. You're not as amazing as everyone else. And, and now if it, if it helps you, Hannah. Um, I took three go to get in. So II applied after F two and didn't get it. So then I had to do AFA couple of, um, like F three years, basically F three years and eventually I got in. Um so I think I was, I was er in need of a bit of luck myself to get in. So Nitty says for ct one, ST one in neurosurgery, if I work in neurosurgery for two, more than 18 months, II over qualified. So the way it works. So that's a really good point and I didn't really talk about it is that um they now put time limits on the amount of neurosurgery you're allowed to do before you can apply. But what they say is, um if you do more than 18 months of neurosurgery, you, you're not eligible to apply for neurosurgery in this country anymore, but that 18 months does not include F one and F two. So what they mean is 18 months after F two. So if you do neurosurgery and F one, F two, it doesn't count. So if you finish F two and you don't get in, you then have, are allowed to have about 18 months of neurosurgery work before you're no longer allowed to apply for neurosurgery in the United Kingdom. So, what you would have to do is then make sure that you do about 18 months of neurosurgery, but then you stop and do other jobs that are not neurosurgery. Um If you haven't got in by then. Ok, thank you very much. Um Yeah, if there's any other questions, just po post them out. Um uh Otherwise II think that's it. Um Make sure to follow uh Cardiff uh clinical Neurosciences on here and you can just contact us whenever you want and uh we'll be sure to give out Ron's er, email as well, right? Um Yeah, but yeah, so Bud and me said it might be 12 months that may have changed. I might be out of date. Um but II would say it, it won't include F one F two. It'll be post F two and there are ways around it, which is to do work in non neurosurgery jobs for a bit basically is what is the way around it? Great. Thank you very much. Uh Anything else at all? No. Ok. Just hoping that that answers the questions. I'm, yeah, so I think some of you might seem to be more up to date than me with the application process, which is good stuff to see because it means that you're engaging with it, which is a good start. So well done. Great. Well, thank you very much for doing that. That was really, really helpful. I learned quite a bit there as well. Um So thank you very much. Uh Any other questions, like I said, just email us? Uh But otherwise I'll, I'll end the session now. Great. Thank you. Thank you very much. Thanks, everybody. Have a good evening.