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continuing on this topic of academic surgery. I've got Mr Alexander Graham. Um, and he'll be speaking on the Korean academic surgery. He is a London plastic surgery. NIH are academic, clinical, fellow and assets academic representative. Thank you very much, Brian. And good morning, everybody. My name is Alexander Zonegran, and I'm an academic plastic surgery training at Royal Free and University College London. And today I'm speaking as part of my assets Academic representative role, um, to talk to you about a career in academic surgery. This talk is really a prelude to, um, more lengthy talk, which is going to take place on the 10th of November with five esteemed speakers from different parts of the academic training pathway in the United Kingdom. I I look forward to seeing many of you there. So what do I hope to cover in the 15 minutes I've got with you today? First of all, we'll start with some definitions about academics, surgery, research and surgery. Well, then talk a little bit about the integrated academic pathway I'll touch upon my own personal experience before, So I'm posting some opportunities and providing some tips based off my experiences. So let's talk about what surgical research actually is. I've included a couple of definitions to the left, which start with the earliest definition I could find and the most recent definition I could find from a Chilean group who did a recent review on this. Uh, really? I think what these to highlight is that the what is considered to be surgical research and the role of the academic surgeon has really evolved. You look at 1973 that definition is predominately based on coming up with therapeutic or drug related interventions for surgical pathology. Um, and now, in 2022 they're talking about how they're novel technological methods that can help supplement the traditional randomized control trial. And actually, what I would go and extend that towards saying is that in 3 to 5 years time, the role of the academic surgeon will be completely different to what I'm talking about today. It's a very exciting the field and one that, uh, well, I enjoy a great deal and would recommend anybody who has an interest to get involved with. But I've come up with my own definition, and I regard surgical research as a set of problem solving skills, which allows us to praise evidence, improved processes and innovate in our daily practice. And I believe it covers five domains when we look specifically at surgery, Um, and that would be clinical laboratory, teaching leadership and innovation. And actually, I want to come back to the fact that I believe that research and the academic surgeon possesses, um, a set of problem solving skills which are applicable too many different walks of life, both within medicine and beyond, in business in any other field. These are fundamental skills and very important to have. So let's move on to mid busting. Um, there are traditional perceptions that regard academia and surgery as a dichotomy. Um, that's mainly because surgery is a craft specialty, and it's very important as a surgical trainee to acquire skills. However, what I want to emphasize is that it is not a dichotomy. All surgeons have research skills. All surgeons perform research, particularly when and looking at what the best available therapy is for, um, for a particular pathology in treating their patients. Everybody looks at studies, so we all use the skills in our daily practice. Academia in surgery really exists upon a continuing more spectrum and a career in academic surgery is where the salience of academia and research is greater. You have protected time to dedicate towards your research endeavors. So, um, I touched upon it previously. The integrated academic training pathway. This is a picture courtesy of NIH are and it talks about the different stages of training. So I'm not 100% sure what the audience is today, but we'll start with medical school in medical school. It highlights different opportunities. So as part of the DBS program, you've got your students elected modules, the GMC sort of mandates as part of the curriculum that your medical school needs to equip you with skills to, um, to be proficient in performing research. There's also the integrated B S C, which about a quarter of medical school graduates undertake, um, and that has a dedicated research project, as well as the options for an MD PhD integrated degree at the point in which you graduate medical school. For those of us who are interested in academia, uh, there is an academic foundation program which I think has recently been returned the SFP, and this gives you a dedicated four month block where you can carry out research in a particular unit to give you an opportunity to get involved, require new skills, develop your skills and get, but also their research opportunities as part of your F one F two, where it's regarded as desirable. To be able to talk about to be able to perform research in particular fields audits, quality improvement these are all things that are very important for your ercp. Moving on to specialist training. The traditional non academic pathway runs from ST one through two S. T eight um, entry level. You can do such a thing called an academic clinical fellowship, which is essentially the equivalent of, um, the Academic Foundation program. But for people who are in specialty training, uh, this involves a three month placement rather than four month placement every year. But again, it's a discussion between you and your supervisor with regards to how you wish to take that time beyond the A CF. There's an academic, clinical lectureship, and for people who have C CT and completed their training, um, there's the opportunity for senior lectureship as well as research professorship, so I'll talk a little bit about my academic journey with the caveat that I'm currently in a CF so I'm not completed this pathway. I am sort of midway early to mid way through it. So I started, Um, my experience in research When I was in my second year of medical school, I just accepted and offered to go to do an integrated B, S C and management. And I wanted to get some experience of laboratory research before I did that. So I applied for a welcome trust student ship where I worked in a laboratory focusing on cardiovascular sciences. And my role was actually dissecting out rabbit mesenteric artery's, um, and working close closely with a PhD student doing some standing to try and identify different types of channel, um, implicated in the hypertensive therapeutic pathway. When I went to my B S C, I was equipped with probably more skills to, um carry out research. The first thing that I did was an economic analysis, um, as part of my health economics module. And this was in a team of of other students where we looked at early versus delayed laparoscopic cholecystectomy for patients with acute cholecystitis. Looked at what the most cost effective option was, um, we also were able to do projects looking at hospital efficiency and then for my thesis, Um, we looked at that development for patients on the bariatric surgery pathway. So here's where I was in my third year. At the time, Tech is slightly creeping into what was what was starting to do in academic surgical research. I then went back to medical school for my third to 50 years and did a clinical study in orthopedic surgery, looking at the relationship between vitamin D and orthopedic infection and here really impressed upon the the importance of, uh, developing relationships with supervisors to be able to follow up your work over a number of years. This is a project that I perceived for three years. I was able to do a systematic review and then a clinical trial case controlled study. Um, and really, the outputs are great when it's something that you're interested in. You have a supportive supervisor and you have the continuity of being in the same center. Um, also, the final thing that I want to touch upon which I did in medical school was looking at the impact of stimulation training on medical education. I think as medical students, your very well positioned to be able to sort of interact and perform research with other medical students. Um and obviously it's a It's an area that's not going to go out of fashion. Um, University is always looking for ways to improve the delivery of education to their students. So then moving on to the foundation program I did an AFP in medical education at Guys in Saint Thomas is, um during my f one year was 2019 2020 interrupted by the coated 19 pandemic first wave. Um but whilst everything was disrupted at that time, a number of grants were made available. So myself and one of my other F one colleagues applied for this particular grant in the US, um, to do a study called Proceeded Study, which we used sort of smart devices that monitor the heart rate, temperature, respiratory rate and basically the basic vital signs of health care workers. We try to correlate that with the presence of 19 positive infection. Um, it was a very interesting thing that we were able to do while we were F one. So not specifically in an academic area which really illustrates that you don't have to have, um, beyond the academic training pathway to be able to be involved in academia whilst you're sort of in your training, then as part of my PG, then as part of my, um, AFP in medical education, I did a PG certain clinical education, which is one of the options. There are different types. You can do one in leadership, you can do one basic clinical sciences, but mine was specifically in education. And then I took those skills forward to come up with a learning platform called Virtuoso, which uses augmented reality to help to stimulate the consultation, um, to develop your sort of stimulation skills. Um, moving on to the specialist training. When I finished my f two, I went into your surgical training. This is a non academic role, but still you have to remain active, uh, in terms of your audits, quality improvement projects, and really building upon what we just spoke about with collaborative research. My big project last year was the F F Bombs study, which, which is an orthopedic surgery sort of lower limb fragility fracture, postoperative mobilization study Uh, and we were able to achieve a sample size of about 20,000 people and really deliver something that's quite high impact research. So there are opportunities available, whether your academic or non academic, and now fast forward into my current role, where I'm in a CF in plastic surgery. In my research, interests focused on education, public health and longevity and plastic surgery. So what are the highlights and what are these benefits of being an academic surgical trainee? Well, I've put a few highlights. There are many, many more, but, um, started with publishing. I think when you're working with any units, a research active units, you're able to publish your work. And there's a It's a great feeling to be able to publish your work, but also to contribute to the body of evidence of something that you're passionate about and interested in. Um, as part of that, there is the presenting conferences. Every year there's the asset National uh, annual conference, which is always the highlights. But you're able to travel from local regional national to international conference is to share your work and learn more about what's being done in in different areas, which really helps to, uh, advance you, um, in terms of your thinking and finally grants. When you come up with an exciting new idea for your research, this needs to be funded, so you need to be able to pitch your idea. And it's always great when you have the support of your unit and a particular organization believes in you and fund your research. Uh, work. So what tips would I have for people who want to get involved? But starting with identifying opportunities, I think it's very important to get stuck in. Um, but that would come with the caveat. Um, you should know what to say, yes, but you should also know when to say no because say, you're starting out and asking somebody for a research project. It's essentially applying for a job without knowing the job description it needs to needs to suit you. You need to have the skills to do it, so that needs to be some diligence, and you need to be able to say, Okay, is the supervisor supportive? The other tools in place for me to be able to excel in this particular field that takes me on the team work. You should never go it alone, at least not in its entirety. You should have a stable and, uh, supportive team of individuals around you, which can help with delivering the different facets of research. Research project can be quite complex, um, and require many different moving parts, so it's important to have a good team behind you. Next. One is time management, and also, I would say organization, Um, as an academic surgical trainee, you have to acquire the competencies clinically in a shorter period of time, and you're essentially wearing two hats at the same time, you'll have your academic supervisor who will expect and outputs, and you also have. Your clinical supervisor would expect you to develop skills, since because of the integrated academic surgical training pathway, it's entirely achievable. But you need to You need to have the experience and the support to be able to prioritize and organize, um, to be able to deliver all of it. This takes me into communications, so it's always really helpful. As an academic, you will have people asking you many different questions about your research about deadlines, but also you'll be communicating with in a team and This is a This is a skill that can't be overemphasizing something that you need to develop as you're going through and be able to leverage fine. Finally, I would say Enjoy the journey. So it's a long and sometimes can be challenging but highly rewarding career, and it's important to enjoy the moment whether you're in medical school, foundation training, specialty training or beyond. It's a very exciting sort of thing to be able to contribute to the cutting edge work in your field, so make sure that you enjoy it. Finally, I've put a slide signs, posted some opportunities, Um, in terms of student ship scholarships. What I would emphasize is asset is very supportive. In terms of research, make sure that you submit your work to the annual conference, Um, and also the specialty societies. You might not know necessarily what specialty you wish to go to, but depending on what work you're doing, they all have outreach grants and scholarships which are achievable when you're sort of just before applying for academic surgical training. So I'd like to end on on the simplest thing to events one I've already touched on, which is the preparing for a career in academic surgery talk on the 10th of November, which I hope to see many of you at, um, and also for those interested in innovation, there is the Royal Free and Plaster Plastic Surgery hackathon with a 1000 lb price taking place on the ninth 20th of November. Which again, I hope to see many of you at. I've left my email there. If you have any questions or if you have anything in particular you wish to be covered. Um, in this year or next year, I'll be the academic representative, and I hope to be able to deliver events which can help you sort of in your journey through academia in research and surgery. Thank you very much. I think I have one question. How can I m g apply for academic surgery positions? Um, it's the same way that you would apply for normal clinical positions, but in terms of the academic training pathway, Um, as long as you're eligible for working in a normal clinical position, um, you can apply. There are specific things that they look for, so they look for publications presentations. Um, and I think that if you've got those, um, they rank you on a point system, which is available on the H e website, and, uh, they'll invite you to interview you. It would be roughly the same process. But if you're going through an academic surgical training pathway, you need a benchmark both surgically and academically, to be a point double. So it's sort of an additional thing to go through if you want to go into an academic surgery position. But again, I would highly recommend it. Any specific question you have feel free to reach out, and I'm happy to help you. Thank you very much, Alexander, for that really interesting talk. And I really like your top tips on, uh, balancing academia and clinical work, particularly with surgery, which can be quite challenging. Um, anyone. If you've got any questions, please feel free to post it in our chart box. And as Alexander said, they were really keen to have you all at preparing for Korean academic surgery event on the 10th of November. Alexander's worked really hard to get some really exciting speakers, and they'll they'll be speaking on different stages in your academic career, uh, from foundation training all the way up to consultancy and how we can integrate academic practice into our clinical Data Day work plans. Thank you very much, Alexander.