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BMIA - Surgical Specialty Series - Plastic Surgery



This on-demand session hosting Mr. Yash Bama, a plastic surgery registrar from Adam Brooks Hospital in Cambridge, encapsulates his journey into medicine, exploring numerous specialities before settling on plastic surgery. Mr. Bama shares his unique insights into the field, emphasizing the versatility, creativity and collaborative nature that attracted him to the area. While he remains uncertain about subspecialising in a specific area, he is currently invested in microsurgery, detailing the process of operating under a microscope with fascinating variations, including stitching tiny blood vessels together. He reflects on the experience of traversing different stages of his career and offers encouraging words for medical students torn between multiple interests. Towards the end, Mr. Bama speaks about the responsibilities and challenges that come with being a medical registrar. Participants will gain first-hand experiences, demystifying the life and choices of a plastic surgeon.
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We are excited to introduce our next speaker, Mr Yash Verma, a speciality registrar in Plastic Surgery working at Addenbrooke’s Hospital, Cambridge. Mr Verma graduated from Imperial College London in 2015 and returned there to complete a master’s degree in Surgical Innovation. Currently, he is a clinical fellow in Artificial Intelligence at the AI Centre for Value Based Healthcare, which is funded by the Department of Health and Social Care and UK Research and Innovation. Additionally, he is a clinical supervisor for final-year medical students at the University of Cambridge.

Join this interactive session if you are interested in pursuing plastic surgery or if you are curious to explore other projects alongside clinical medicine such as in surgical innovation or AI.

Learning objectives

1. By the end of the session, participants should be able to articulate the driving factors behind Mr. Bama’s decision to pursue a career in plastic surgery and his personal journey through the medical field. 2. Attendees should demonstrate a clear understanding of the varied nature of plastic surgery, including its interplay with multiple other medical specialties, the age range of patients, and the different body areas it involves. 3. Participants should be able to describe what microsurgery is, the procedures it involves, and the role it plays in plastic surgery. 4. Expect learners to gain insight into the various sub-disciplines within the field of plastic surgery and the factors that might influence one's decision to specialize. 5. Attendees should be able to depict the daily life of a medical registrar, understanding their responsibilities, challenges, and satisfaction derived from their role.
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Computer generated transcript

The following transcript was generated automatically from the content and has not been checked or corrected manually.

Hey, hello, thank you for joining. No worries. How are you? Um I'm ok, thank you. How are you? Yeah, not bad. Bit on the later side out here, but doing well. Um So we have eight people who have joined, we're expecting around 17 to 18. Um So it's up to you if you want to wait a few more minutes. So, yeah, let's, let's let's let's wait for as many people as you'd like. I am happy to be guided by you in terms of when you'd like to kick off. So you can determine when to require it and can kick off them. Ok, maybe just a minute more that we can get started. That's fine. Um I think we should get started. Someone messaged me saying that they're getting some feedback. Is that true for everyone? So it sounds like we're same things twice. Ok. That's fine. Um ok, so thank you everyone for joining. Um As you know, this is our surgical specialty series where we get to talk to different surgeons in different specialties and kind of get a flavor of the specialty and what their life looks like. Um So today we're very lucky to have Mr Yash Bama who's a plastic surgery registrar at Adam Brooks Hospital in Cambridge. Um Mr Bama, thank you so much for joining us. It's an absolute pleasure. Thanks for having me on. Um, so I think we'll just start off the conversation by asking what made you pursue plastic surgery. That's an interesting question. Um I think it goes back to why I joined medicine in the first place. I kind of knew on to surgery. I had a frame of mind where I liked fixing problems in the short term. And that's what predisposed me to surgery. One I knew within that, that I wanted to do surgery. I think I explored many options. I first started off looking at cardiothoracic went into theaters, very long operations. Super cool as a medical student staring at a pumping heart life doesn't get any better. Um But equally, I had to look back or in the future and decide is that the life I wanted the hour standing doing certain operations. What was happening within the surgical field? Were there other specialties encroaching on this one? Like cardiology, for example. Um And then so I kind of tried to rule out other surgical specialties. The one that kept coming back to me was plastics because um in terms of the patients, you operate on neonates all the way to seriously elderly patients. And so your day is so varied, it can go onto the neonatal ward, nicu and you in the Jerry's ward at the end of the day, equally, you're operating from head to toe any part of the body. And the way I saw it was, it didn't really seem like a surgical specialty, but it seemed more like a technique. And I loved how within plastic surgery, you ended up working with all the other different specialties and collaborating and you as a result ended up witnessing and being part of a number of different surgeries. So it you need to be meticulous, you needed to be creative, you needed um to really work hard on honing that skill and you needed to work well on the team and all those things really attracted me to the specialty. The final clincher was one of the professors from who is also a reserve uh medic in the army and he came and gave us a chat about his time at Camp Bastion in Afghanistan and all the trauma um pictures kind of xi EDS um result in injuries, the reconstructive options and all of that. And I think that for me was a clincher to say this is well as well as all the points that I mentioned, if you get to do half of what this guy is doing, that seems really cool. You're making a huge difference, but equally, there's 10 roads leading to the same end result. And so you get to put your individual touch in each surgery and that really kind of resonated with my personality. That sounds really cool. So, I it sounds like it was the variety and a bit about like the flexibility of technique that quite attracted you to plastics. Um um I think you're ST five I like. Right. So, um you have maybe like three or four years until you're a consultant. So, have you thought about what you like to subspecialise in? Sure sense. That's one of the most asked questions about all my bosses start. Do you know what they want to specialize in? I think it's, it's a difficult one because I like all of plastic surgery. Uh and you as a trainee and I'm sure as a lot of you in earlier stages of your careers, you get infatuated and you love a lot of things that you do and one day you wanna do one specialty, another day, you wanna do another specialty and it's just, it results in who's someone really nice who explains this to you in a nice way, treats you well and you get to do one cool thing and suddenly you want to do that or you think you want to do that for the rest of your life. Unfortunately, that never changes, I think. And as you're a registrar, going through different parts of your own specialty, one day you'll do hand surgery and one of the bosses are going to be very inspiring and you get to do most of the surgery and it works. And you're like, yes, I want to be a hand surgeon the other day. You'll be doing head and neck surgery and you'll be staring at big pipes in the neck, cleaning them out. And you're like, wow, that's cool. I want to do this every day. So I think I've really struggled with enjoying lots and lots of parts of it. What I've narrowed down and I'm giving you a long winded answer because I think knowing the process is equally important and I feel that's always helpful, talking to people about how they arrive at an answer. Um I started by excluding some things and I knew instantly I did not want to do bands. Uh I'm not someone that does well with operating at 40 degree temperatures and I found it a little intense and repetitive. So for me, burns was excluded almost immediately. I loved Cleft, but it's so specialized and the number of hospitals in the country doing Cleft are far and few between them. And so career wise, I think I would, I would really be narrowing it down too early. So that's why I left Cleft. Um I've narrowed it down to wanting to do microsurgery. I really enjoy microsurgery operating under the microscope. So for those not aware, microsurgery is pretty much operating at a smaller level. So that can sometimes include digital nerves and nerves in your fingers, which are quite small. So you'd need at least a three or 4.5 times magnification, if not eight times magnification under the microscope, the other things is attaching blood vessels together under the microscope that are pretty small. So you're looking at 2, 2.5 millimeter blood vessels and that's the free flaps that you do. I really, really enjoy that part. And so I know that's going to be part of what I want to do. Um So that opens up doors doing lower limb trauma, breast surgery or head and neck surgery. Um, so I'm not entirely deciding as to which way it's gonna go down. But if you want to do plastics, you can keep it relatively open quite far down. And you, even after you've qualified, you can do a microsurgery fellowship and then decide after that where in plastic surgery you want to apply it. Ok? It sounds quite reassuring that even at your stage, you still, you know, you're uncertain of what you, what you want to do because you like everything cos I feel like a lot of us medical students are on the same boat where we know we want to do surgery and medicine, but we like so many things. It's hard to decide what we want to do. Um So as a reg how does your day to day life look like? That's a very important point to mention actually as a registrar, life is way better than before. Ok. And I feel that surgery is, it's so difficult to inspire young people to do surgery unless you want to do surgery in medical school. And I presume you guys are in a surgical specialty series. So I presume most of you are considering surgery and at least thought about it once or twice the point is in medical school, all you can do is go in and watch an operation. If someone's super nice to you, you'll scrub in and touch the patient, get your gloves dirty. And if you're very lucky, you put a stitch or two in. But that's about it. If I was to sit and watch surgeries, I'm, I'd still be bored today. I am so far down my training and if I don't get to do anything all day and I watch something, I come back home wondering why I'm doing this job. So it's so difficult to get inspired watching. And when you graduate as an F one and you're doing a surgical job, life's not very different to a medical student. You're sitting on the ward, your primary aim is to make sure that patients in the ward postoperatively preoperatively are adequately resuscitated. All their needs are met. You're following instructions from the op note and you feel like like a ward monkey, you're just doing ward jobs, you and if you finish your ward job, your, your reward is, yeah, sure. Come watch us in theater and again what you do you're watching. And so it's pretty boring. So, and enough two the same thing, maybe with a bit more theater time, but equally, you're not really progressing or in your mind, you're just watching surgeries, which is really boring and it's very difficult to decide. I want to do surgery based on these experiences because the difference is in medicine, you do a ward round, you see some patients, you go to a clinic that doesn't change. You do that as an F one, you do it as a medical student. You do that as a registrar, as a consultant. That's your whole life. You're still problem solving, seeing patients prescribing medications. And so you get to see what your life is like from a quite an early stage. But surgery, it is difficult to have that because obviously we can't have medical students cutting people up right from the beginning. You, you need to acquire a base amount of skill and you need to build on that. Unfortunately, it's only when you start core surgery that you really start feeling a bit like a surgeon. And I remember when I first was act one, when someone handed me a scalpel and said, you know, make the first cut. That's when suddenly you're like, oh wow. I feel like I'm on Grey's anatomy or something. Finally, I feel like a surgeon like someone's handed me something unless you make that first cut, unless you do something independently, even if it's bursting open an abscess and washing it out where your boss is. Like, you've got this, you can't mess this up. That's more like it. And they'd leave unless you have that independence, you don't quite feel like you're a surgeon and that's where I feel like when you're registrar life is great. I do little to no more jobs. Not saying that. That's, I mean, I put in my time we've done that. It's a very important part of it. Uh because unless you can take care of patients in the ward, they never make it to the theater. And unless you take care of them after the operation, they'll never recover fully. So it's a really important part. But obviously, a lot of my time now is spent either seeing patients in clinic or operating on them. And of course, while you're on call, you're clocking them in, you're diagnosing them with issues. And also even when I'm on call, I'm doing some emergency surgeries. So life is a registrar is very good. You finally start to see the pieces come together. You feel like a surgeon, you have independent lists, you get to choose your own music and theater, which again, you know, it, it seems like a small thing but you, it's a huge step in your mind mentally to say I'm making progress into being and becoming a surgeon and then you start mentoring the younger doctors. So I have medical students and I'm teaching them how to stitch because I know how boring it is just watching and I know that medical student is going to absolutely love life. At the end of that day, if they managed to put a couple of stitches in rather than holding stuff, you have sh Os our F twos and core surgery trainees as well. They're also working towards getting certain sign offs. And at the end of the day, the aim of core surgery is to learn how to cut and stitch. So when you're doing that, you can see yourself moving towards the bigger aim, which is being an independently operating consultant. So yeah, long winded answer again, but it gets a lot better. And there are still some downsides. You're not making all your own decisions. You're following orders from your bosses. Each boss has different preferences and you have to remember that and don't do one thing that the boss loves with another boss that hates it because suddenly they'll be like who taught you that. And it's really difficult to try and please everyone. But with all of this comes a lot of responsibility. So as a registrar, the buck stops with you. If you're trading a junior and something messes up, it's on me. If the patient is in the hospital and I've operated on them or my boss is operated them, they're my responsibility, whether it's a Saturday, Sunday or a Monday. So if I've operated some on Friday, I'm probably gonna come into the hospital on Saturday morning and make sure they're ok. Or if I'm away, then I'll make sure I've spoken to a colleague and asked for a personal failure rather than expecting that someone on the team will see them. So, yes, life gets a lot better. But you also take on a lot of responsibility and it's nice because you feel like you are responsible for the patient's care. And with that comes the, the work ethic that then holds true for the rest of your career. I see. That's quite interesting. Um from my experience, it's like, you know, everyone wants to be a consultant, but I think consultants spend less time in theater and as a surgical, I think that's like the one time in your career where you get to be in theater all the time. So to me, it sounds like the most fun that you're going to have. I agree. Um you have a lot of the fun with very few responsibilities in terms of eventually the patient is still under the consultant. You don't have a lot of the meetings you have to sit in and all the boring stuff. And you know, if you can't do something, you call for help. As a consultant, you can't really call many people for help. So I know everyone wants to be a consultant, but honestly, there is no rush to get there at the end, spend as long as you can training, doing other things. Within training. Uh There's no rush to get to the end and no one gets to the end to a consultant level. Wishing they had two less years of training. Surgery is a psychomotor skill at the end of it, the more you put in, the more you get out, it's as simple as that. Mm. Um And you mentioned that you like to, you know, train your um kind of younger colleagues. Um which is great. But do you feel like across the country? Plastics is a kind of specialty where you're able to be more hands on and independent earlier into your kind of pa surgical pathway? I think. Yes and no plastics as a whole in the United Kingdom is very consultant led mainly because a lot of plastic surgery is quite complicated and especially the inter working with other specialties is quite complex. So people are calling you when they can't do something themselves. So it's not as basic as come and close this up for us. It's because they can't close something up. You've got to figure something out something fancy in terms of flaps, et cetera. Um Overall it's on the lead. That means everyone's gonna be under consultant supervision at some stage or another. Uh having said that there's so many parts of plastic surgery that there's enough things that you can actually get hands on an independent and early stage. So you have simple things like skin cancers. We have so many skin cancers. Our wait list is so long and simple cotton stitches. I see that as an sho operation. So, if I have a list of skin cancers and I have my AIA with me, I won't do a single one of them. I'll sit there with them and guide them to do that. Because at the end of the day you're cutting something out and you're stitching something. You're learning how to cut, you're learning how to stitch two different ways. Um Equally, you have hand trauma, hand trauma is something you can do independently quite early on nerves tendons, uh things like that in the, in the fingers, they're quite forgiving, um especially nerves tendons less so. But equally, these are things that you will have consultants sitting down and doing with you. So you, you can do them from quite an early stage. It's anything with a lot of volume you usually get to do at an early stage. Things that are far and few between and quite complicated and the super cool operations, they're always going to have more senior people doing them. So I think, yeah, in short, the answer is yes and no. Overall compared to some of the other specialties, there's more consultant Overwatch, but there's so many little things to do that there's always something that someone can be doing and keeping busy with early on in their career. Ok. Um I'm moving on to more like the application side of plastic surgery. Um, I've heard that it takes people a couple of years to actually get into the training program. Um, do you have any advice on how to make the, your, like, your application more competitive? Yeah, I think it's a very competitive specialty by no means. Is it the most competitive? I'd say a, a lot of surgical fields are now competitive if you compare them to certain medical fields and that's just the way it is. That's because there's a lot fewer jobs out there with plastics. Not every hospital has a plastic surgery department. So there's fewer jobs. You have an on average about 30 jobs if you're lovely each year. And that includes Scotland. Um Whereas if you compare a specialty like orthopedics, you'd have maybe 100 and 50 jobs, didn't you? So you can see the difference. Um So yes, competitive, but cardiothoracic maybe have six jobs. So, not insanely competitive. Um As soon as you mention, you want to do plastic surgery, a lot of people will say, oh, wow, that's really competitive. And it might put a lot of people off. Just remember if you like it. It's the rest of your life. All it's not worth settling. If you like it, you should try and pursue it. Everything is competitive to a degree or another. And like I said, as long as you're making use of the years that you don't get it and still getting trust grade registrar jobs, working as a registrar, you're getting trained. So, even if you have to take a few years out, as long as you're using them, well, it's actually gonna help your training overall and it's totally worth taking time out to make sure you get a job, um, in terms of tips and tricks to get a job, make sure you the earlier, you know, you want to do plastic surgery the better because unlike other specialties, when you do come to apply for a registrar position, you have to have done quite a few different types of operations. For example, if I compare it with orthopedics, orthopedics, all you need to do is a certain number of dynamic hip screws. And that is it, that is your basic operative requirement for orthopedics for plastics. It's broken down into hands in terms of fractures, nerves, uh tendons and skin lesions and burns. So you have to do a certain number of tendons. You need to do a certain number of fractures, you need to do a certain number of nerves, you need to do a certain number of skin cancers. You can do a certain number of skin grafts, flaps and certain number of burns, resuscitation and grafts. So as you can imagine, that's a lot. So what do you need to do? Try and figure out early enough? Um If you figure out in medical school, make sure you do an elective and plastic surgery. That's the first step I did my elective in UCLA in Los Angeles. Amazing, really hard. But you get exposed to so many different types of people in surgeries that are gonna be pretty useful later on in life. Once you have an elective and plastic surgery, I'm hoping that you would have applied for foundation jobs with plastic surgery as part of them. Not many people have F ones and F twos doing plastics, but there's enough hospitals around that do get yourself exposed to a plastic surgery at an F one F two route equally. If you can't, it's ok. It's not the end of the world. Just make sure you have some surgical jobs in part as part of your foundation here to me, I had three out of my six jobs in F one and F two as surgical jobs. So as an F one, I started off in Jerry's, I then had trauma and orthopedics and psychiatry. And as an after two, I had plastic surgery, urology and then oncology. So one year out of the two were surgical jobs and I had four months of plastic surgery as part of it. The reason that is because we've gotta break it down to small chunks for medical school. You're aiming to get surgical jobs and foundation jobs in foundation jobs. Your aim is to get a core surgical job. And the only way you're gonna get a core surgical job is by having surgical jobs in your foundation training, meeting all the criteria working hard, doing certain exams. If you need to courses, look at the criteria for co surgical training early on and foundation training and work towards that. Forget about plastic surgery at the moment. As long as you, if you can do it, do it. If you wanna do some papers, posters go work in some plastic surgery departments, have a taste a week in plastics do that. But your main aim at that stage is to get a core surgical job. And if you wanna do plastics, it's really important. You get a plastics themed core surgical job. That means that the two years are gonna be based around plastics. Yes, you're gonna have certain other jobs. But overall it's gonna give you at least 12 months of plastics in the two years. Ok. Realistically, to be able to apply for a class of surgery number and get it, you probably need at least 12 months. If you really twist my arm and you want me to tell you the truth, you probably need slightly more than 12 months because you need BS hands and general plastics altogether and get certain numbers. Um, so it's really important to try and get a plastic, the draw if you don't, it's not the end of your plastic surgery career. Ok. Do your core surgery. But you'll have to take a year after CT one CT two and try do a trust grade job as a sho initially if you've never had experience in plastic surgery. Or if you've had six months experience in plastic surgery, maybe you can get a job as a trust free registrar and do another 12 months of plastic surgery. Get all your numbers and apply. So that's kind of the basics. So make sure you have an interest in plastic surgery. So you've got a CV that you're slowly tailoring towards plastic surgery, whether that's posters, presentations, audits and have a taste a week in plastic surgery. Start getting those numbers have an E log book from medical school onwards. It collect all your operations that you do log them down. So you always have a record. That's something you'll be using for the rest of your life. And then once you have all of that, it's a matter of looking at the criteria for application and preparing for the interviews. The interviews are actually quite straightforward in the way that it's predictable. It's like an examination, you study for certain stations. Those are the stations that come up and you perform based on how much you revised onwards. So it's, it's a very straightforward pathway and don't ever let anyone tell you that. It's not possible. It is. You don't have to eat, breathe, sleep and live plastic surgery to get a job. You can have a balanced life. Ok? I played loads of sports throughout university. I continued to play sports through foundation training, core training. I've had an active social life Um And I didn't live in the hospital and yet here I am a plastic surgeon training. Ok. So a balanced life usually is helpful. Ok, thank you. That was really helpful. Um II think most people when they talk about surgical applications, they focus on research and audits, but it's really good to know that there are certain kind of procedures that you have to do um as well. Um in terms of, you know, research and audit, um I've heard that it's not just about the volume, but also the impact of your paper. Um, and like what journals you submit to? Is that true? Uh Yes and no, I think at the lower stages when you're applying to co surgical training or so called surgical training, when you're applying at any paper, anywhere, doesn't matter when you're applying for plastic surgery. Uh If you're publishing papers and present doing presentations within plastic surgery, you get more points than if it's not plastic surgery related. So that's the first thing. The impact factor does not matter. Not at this early stage, the impact factor may make a difference if you're applying for an academic job. So as long as you're publishing something and not paying for it to be published, it's valid, you need to publish in a peer reviewed journal. And um a lot of the peer reviewed journals that most of us publishing are not that difficult to get into. As long as you have a piece that's worth something. It can be a letter to the editor. OK. That's still worth something at some point. Also gets you in the frame of mind to start your academic journey. Um, it could be an opinion piece or it could be a scientific article. It's really important that you work, especially for this. There's so many hoops, tick boxes and things to jump through. Unfortunately, you have to play the game. You look at the criteria. One of the criteria is you need an audit for every year are out of medical school. Ok? And 50% of those need to be closely reported, you have to play the game. There's no chance that you shouldn't all max out that point. It's very simple. They've told you how many audits they need. They've told you how many complete loop audits there should be max it out, get the most points and this is where it's I learned this slightly later on in life. You need to work smart, not hard. Yes, work hard when you need to, but working hard without working smart will get you nowhere. So let me explain what I mean by that. You need a, you need six audits, three of them completely. You are getting to a stage where you're struggling because of course, as diligent medical students, you are, you're like, I want my audit to make a difference. You end up picking this audit that someone else has said to you and explained to you like, wow. Yeah, that, that's great without realizing how much work you're putting in without realizing that audit's going on for a year and a half and it's probably not gonna be finished in time of application. Learn to say no, learn to ask what is it for me? What does it look like the any picture? What is the output for me? It's OK to ask that you have to start thinking about yourself. You're not just sitting there saying yes, politely to everyone. So what did I do? What is an audit? You are assessing practice and comparing it to a gold standard? Any gold standard? So I looked at the guidelines. I was working on this Birds Ward and one of the guidelines said that consult the patients must know their consultants names, right? I walked around my burns unit of 15 beds, asked my patients, do you know your consultant's name? I think 40% of them said yes, 67. 0, so that was my first audit. I audited against a gold standard which was all patients should know their consultants names. What did I do? I put patient, put consultants names and photographs on the booklet. Made it in a week, distributed it to patients who came in on the ward. Two weeks later, I went and asked them again, do you know your name? Consultant? And can you recognize them? Obviously they had a booklet in front of them. They're like, yeah, that's him. He sees me every day or she sees me every day and then it was like, 90% or 95% of them could have it. So, within the space of four weeks or less, I've done a complete loop audit. Done, sorted. And you're like, well, does it make a difference? Hm. It makes a difference to your application. Of course, it's a complete loop audit. You've still learned about audits. You've dealt with certain departments in the hospital in terms of how you published literature, all of that, you've spoken to patients, you're presenting, you're gaining presentation skills and really if you wanna play it smart, there is the Hello, my name is campaign. So actually you can go and link it to how important it is for patients to know the concerned names. So as small a project as it is, you can sell it to be a big thing. And I kid you not when I did pres present this, a lot of people took it very seriously cos I obviously brought in the Hello, my name is part of it and took that emotional element to it and sold it like that and it was no longer a tick box exercise. Of course, some of our bosses knew it was a tick box exercise, but everyone's on board. They're all trying to help you get there as well. So weren't smart. What? After that? You can also write up that audit submitted to BR which is this plastic surgery conference and present it as a poster. You've got an audit, you put it in there and now you've got a poster out of it, write a case report, every case report you write, publish it and then convert those case reports into posters, present them at three different conferences, not the same one, the three different ones, you can't present the same work again. So these are the ways you work smart and maximize what you're doing. If you've done something and you, it's worth writing it down and you published something or written an essay, think about it. If there's an essay that you've written as part of medical school as part of a masters, as part of a Bachelor's, it's probably publishable somewhere. So don't let your hardware go to waste, kind of squeeze every last point you can out of each and every bit of work that you do. I think that's really good advice. I think especially, you know, now that we're thinking about foundation jobs and surgical training, it feels quite overwhelming how much we have to do for our application. Um But yeah, I agree with the work smart um point that you made. Um I wanna move on to talking about your other interest, um Surgical innovation. A I So if you could tell us how you got into that and kind of what you're working on at the moment, so I have a pretty inquisitive mind from the beginning and I think most surgeons or most medics who have an aptitude for surgery are going in because they wanna make a difference, they wanna make a change and they want their field to progress. Plastic surgeons generally going back in history of being fairly innovative people, it's a relatively new field and because there's so many different ways of doing something, there's always people inventing new ways of doing it. So it's an innovative field and it attracts a lot of innovative people. So with that, I was always inquisitive in terms of pushing the field of surgery ahead, whether that's to do with medical equipment, medical tech or um operative expertise. Um So as part of kind of, I was working as a trust for Registrar in Oxford. It was during COVID time, I think, and I just thought there was a little bit of a lull in work and I've done my exams and all of that. So I was pretty confident I was going to get a plastic surgery number coming up in terms of my CV was all fine at that stage. I said, ok, so I'm satisfied my kick boxing need and try to kind of um hold my career here. Let's now do something for myself because you have to try and satisfy all your intellectual needs to be happy and to be working at your top potential all the time. I think if you spend a lot of time doing one thing and keep kind of putting your other needs aside. It will catch up to you eventually. And so I decided to do a master's in Search for Innovation. Um The topic, the title is, is fascinating. It's, it's Surgical Innovation. So it really grabs you right there. Um, and it was my med school that I went to, that was offering it. So again, that was another factor that appealed to me going back to those lecture theaters and all of that. And it was, uh, it was a two year course, supposed to be part time. I'm not sure if you have any, er, students on here, but I guess you'd understand that Imperial doesn't understand the meaning of part time. So it ended up being a very, very, very intense first year where I had lectures five days a week, 9 to 6 every six weeks, once a week. And then you had, um, 20% of your grade for a presentation at the end of that week and then 80% with an essay due in, within a few weeks of that. So, it was intense. But it was amazing going back to, I know you're still in university and you can't imagine studying more, but you'd realize that this isn't great. So, right now, your whole responsibility is to learn and pass exams. When you start part of trying to do exams or working, you really wanna go back to learning and that being your full time job. So it was, it was fun going back. Uh And cos you're choosing to do a masters, no one's forcing you to do it. It's completely out of choice. And so you put a lot more effort into it than you might do in your first degree. Um So there's some very interesting lectures. I had lectures on artificial intelligence robotics, um The future of surgery simulations, all of that. And then we had some projects that we had to make up like a dragon's den, part of it to present in front of everyone and then decide what the winner was. Um And then we had lessons on medical education, the advances in medical education where it's going, how we can influence that audit, audit cycles again, how they can improve surgery and how all innovations should be audited regularly, things like that. So I think overall it was quite a nice two years and the first series taught lectures and the second year is research based. You're doing a library dissertation and then your final big dissertation. So my library dissertation ended up being on the impact of deep learning on surgical simulations, which is quite a big heavy topic, difficult to explore out here. But it was interesting. And then my final thesis was on a novel way of rehabilitation of flex attendant repairs. Um So again, I chose both of my topics you get given topics or you can choose your topics and I thought I might as well do something I'm very interested in because it helps you work hard if you are actually interested in what you do. So, on my first stage, that was the little baby step towards surgical innovation. You have your foundations there and they tell you and they teach you and they connect you with different people and you get inspired by seeing people 1015 years ahead of you and seeing what they've done with their lives equally. It's a nice forum to discuss innovation with your colleagues who at the same level as you. And then you have a little foundation on if you were to innovate, how do you go from an idea to full scale implementation and all the steps in, in the middle? So that was a good two years. And then, uh since then, I have been part of the, I was head of innovation for plaster, which is the trainees of for plastic surgeries, the Training association there uh helping bring in innovation into our curriculum and plastic surgery as a whole. I've also, I'm on the kind of one of these groups for robotic surgery for trainees as well. And then finally, I'm now currently on a fellowship for called Fellows of Clinical A I, it's a health Education England or it used to be called Education England Funded Fellowship where two days a week, I am paid to not work in my hospital and go and do some research in artificial intelligence and help bring it to the NHS as a whole along with a few other people. That sounds really cool. All of it sounds quite cool. Um I just want to remind people that if they have any questions, they're more than uh welcome to put it on the chart. Um And I think just my last question was um in the previous conference that you went to. I think there was this running theme of um having projects on the side. So like you have a I, people have health tech, there are opportunities in leadership education management. Why do you think it's so important to have that alongside clinical medicine? It's a very good question. I think it's really important to have something alongside that for a number of reasons that's fast forward to when you're a consultant. I think the way the NHS is evolving, we're quite uncertain as to what it's going to be like when all you people are going to be consultants. I'm not sure what it's going to look like in five years time. Um Also the way the world is evolving around it, it's probably not enough for someone to land up as ap pure clinician. I don't think there's a space for pure clinicians anymore if you want to apply for a consultant job. And you're like, yeah, I'm uh internal medical doctor. I am a radiologist and that is it. That's probably you can go to work, come back, there'll be certain hospitals far away that might employ you. But equally with the competition around for consultant jobs, with a number of jobs around, with the way the world is going also, especially if there's privatization, there is no role for someone who's just a basic clinician. You ought to have other things you can offer. And that's the same in medical school. If you go back, what's really important in medical school is not just your grades, they saw you as an entire individual. What are your extracurriculars? What can you offer the student union? What can you offer the university? What can you offer your colleagues as a medic being book smart? Won't get you the whole way. You need to have a way of communicating with patients. You need to have that empathy and a lot of that and also trying to put in that knowledge that you're learning into use. So you need analytical skills. So again, our whole career is already gearing towards more than one thing. It's about building a wholesome person with various other skills that eventually all kind of lead into helping you become a clinician. That's one of the reasons. The other reason is I don't think anyone that I've ever met has said my whole life is medicine. I like nothing else. So I think we all inherently have other interests. It can be completely unrelated to medicine. Right. You could be amazing at sport. You might love art, you might love music. Uh, you might love dramas. It's, it's ok and I think it's really important to keep satisfying that part of you because that's eventually what's gonna keep you happy enough and motivated enough to keep going in the medical part of it cos medicine can get very difficult. Sometimes it can get very difficult. It can get very lonely. You're moving away from home, away from family, away from your significant others, traveling to cold, awful parts of the country where the people look very different to you. You might have nothing in common with anyone around you. Uh And on a cold rainy day, you'll be sitting a stoke on Trent like I was in one of my placements as act one. It can get very depressing very quickly. So you have to have fallbacks and parts of your life that help you cope through that and a lot of things around there, all these extracurricular things that you enjoy can be those coping mechanisms. Um That's broadly speaking. Um why? And for plastic surgery, again, there is a serious shortage of consultant jobs. So you want to come in and you want, ideally, the aim of everyone here is I want a consultant job and I want a consultant job where I want it and in the field that I wanted it rather than saying this is the only job in this middle of nowhere and you have to do this kind of surgery. You can't do microsurgery like you wanted. So you're kind of again just building your CV, throughout padding it. So you can go and create and demand the job that you want because you're such a hot commodity. So I think that that's my whole reasoning of building your CV. Never stops. But if you can link, building your CV to things that you're actually interested in, the journey becomes a lot more of a journey rather than turn more of the hallway and like serious hard work all the way through. OK. So it sounds like it's not just about being more competitive but also kind of fulfilling yourself. Um And finding things that interest you. Um DEA has put a really nice question on the chart um with regards to other interests such as A I or Health Tech, how does one go about exploring these different avenues through F one F two and CST? Do you think it's was time to talk? Um How do you go about doing that? Um The first thing is simply put open your eyes, these things are all around. You have conversations about it. If you're interested in it, have conversations about it with your bosses, have conversations about it with your colleagues. You never know your boss. There might have a project and just a simple conversation can lead to something else. An example is um I was sitting and operating with one of my bosses in Oxford. We were working on a flex attendant and I just said, she said, what, what got into, into medicine. And I was like, honestly, come from India and I really want to give back to society in a way that, you know, at some point, I'd love to go back and operate for free in my time and teach people how to operate and kind of make themselves sufficient rather than go there, operate and leave. And she's like, do you know that I am the president of a society or? Sorry, a charity for plastic surgeons that goes and operates in different countries and sets them off, tell you what. And so she was the president for B first and which is a plastic surgery charity that goes to different hospitals and different countries and sets up the plastic surgery units there so they can continue operating after rather than going there leaving and then being reliant on us. And it just stemmed from a simple conversation. She's like we are looking for someone to join the training committee. Why don't you put in an application and I will back it. And she did and I ended up working for that charity for maybe four years and I've just taken a step back and that this charity is gonna be part of what I'm gonna be gonna be doing for the rest of my life. So these things have conversations. A lot of your bosses, everyone around there are already doing a lot of things. Secondly, look through your emails, you have your deanery. We'll be emailing you with different fellowships all the time. The A I fellowship was a simple email that I ended up reading and it said for east of England, there's one spot or two spots for an applier fellowship in Clinical A I. These are the requirements if you want to apply for it, send an email and fill in this form. It was as simple as that I did that. Got an interview ended up doing OK in the interview and then got the fellowship. So look at the emails that your deaneries send, you, look at the landing pages and web pages of your deaneries. And sometimes uh there are some overall websites that publish fellowships and projects going through. And then obviously, as I mentioned, speak to your colleagues, speak to your consultants in the meantime, keep working on it. If you like it, read up about it, read up about everything that's happening around there. So for example A II had an interest in A I. So I ended up doing some basic courses of coding early on while I was waiting reading more about it following the news and that I joined the Alan Turing Special interest group for clinical A I. They send you newsletters, they have meetings once a month, things like that. There's always loads of things you can be doing. There's medical school societies, there's surgical societies. There, there's gonna be a lead for innovation in your hospital that you're working in. Go talk to them. So there's a lot of things that you can do. Answering your second question. It, sorry. Is that answered your first question via, I mean, you take that as a yes. So second question is, do you think it's worth taking time out of your training pathway to find these interests? I cannot stress enough how much of a resounding? Yes, that is OK. Take as much time out to follow these other interests, some of them will lead somewhere, others will lead nowhere and it does not matter. OK? Like I said, it's not about getting to the end of training and becoming a consultant. It's about the entire journey that's got you there because it's, it's gonna mold you as a person, all your experiences, everything you do and you never know just taking a risk of it here, taking some time out might end up finding a completely alternative career stream that you're far more passionate interested in or maybe combine it with what you want to do anyway. And for example, once you have a training number, there's, there's obviously there's good times to take a break and there's bad times to take a break or, and by a break, I mean, to pursue these things, not for personal reasons, it's never a bad time to take a break for personal reasons. So a good time to take a break, get a national training number. Like I have apply for a fellowship and you can do it together so you can go less than full time. And I do 43 days a week of clinical work, two days a week of nonclinical work makes zero difference and they end up adding three months to my CCD date at the end. So be it, it's not really affecting me. If anything, I look forward to going to work more now than I did before because, well, whatever you have at me, I can deal with it for three days. Also, after doing other stuff for the other time, you actually look forward to operating. So I'm making a lot more use of my three days a week now than I was before. Equally. If you wanna take a year out, you can take up to two years out of training and they'll hold a number for you and you just come back into it. So you lose nothing. You just have a year, you try that and come back and there's different fields you can be passionate about A I health tech innovation is one of them. Teaching is another one of them. Research is one of them and obviously management is another one of them. So whatever you have an interest in and I suggest it should be at least one of those four you need another avenue going in research, teaching innovation or um leadership and management. Take as much time as you want to explore them. Apply for these fellowships. Take a year out. Even if you're interested in leadership or management, there used to be an R CS and mckinsey fellowship. They used to offer go work in a consultancy firm for a year. Get a number, secure your clinical life and then take as many risks as you want. It's ok. Worst case scenario you go and come back and be like, mm, that wasn't for me. I'll stick with this or let me try something else. Try everything because you don't wanna get to the end with any. What ifs? I hope that answers your second question. I think it did. I think that was really helpful. Um It's eight o'clock. So I don't know if there are any more questions that people want to ask, but I found that really, really great. Thank you so much for giving up your evening um to talk to us. Um I think we've got so much insight into plastic surgery, um the application process and then also doing things outside of medicine just so helpful. No, you're absolutely, you're welcome. And if anyone is interested in plastic surgery or A I or innovation in general, I am happy for Venetia to give you my details in terms of the email and get in touch. And if any of you in Cambridge or east of England and want to work on some projects or anything. So I've not got any, I can always put you in touch with other people. So it's very important from the very beginning. If you don't ask, you don't get, ask, ask to ask until someone says shut up. Ok, you don't lose anything. All of us have only got to where we are because of other people who have helped us along the way. So there's no, there's no harm in asking and most of us are actually pretty helpful and if anything, if we can't help you, we'll direct you to someone else who can or just have an interesting conversation. Thank you. Um I don't think there are any more messages on the chat, so I think we can end the session here, but thank you again for talking to us. Oh, you're welcome. Thank you for having me on and I think enjoy the rest of your evening. Thank you, everyone for joining us guys. Take care. Bye.