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Um our next speaker is Mr David Holmes and his talk is dyslexia and me. So he is an ST six in trauma and orthopedics in the Mersey region. And he has had a diagnosis of dyslexia for the past 20 years and he is going to tell us about all the exciting things that he has been up to this one. Let's see if I remember to do this properly as well. So, no, ok. The awkward moment standing out front of you. Ok. So, um so I got asked by one of my colleagues to give this talk because this day sort of came upon. And so, you know, what, why, why not get involved? It's very difficult to do something like this. And as you'll see of all the other presenters stand in front of you and talk about weakness. It's quite tough, but we'll go through it and see how we go on. So, firstly, decorator interest, it's all about me. I mean, nothing very exciting. So, um there's no financial or commercial or anything unless somebody wants to invest in me, that's fine, but otherwise we'll just move on. Um So the aims of this is to talk a bit about a background of dyslexia because some people know what it is. Some people don't. Some people say, oh, it's this and that. So we'll talk a little bit but we will try to move on as fast as we can. And then we will talk about how Dyle has affected me and we will look at the negatives, the positives and how I have, I learned to cope with it because that's the biggest thing. And then again, has dyslexic limited you because you will go through training. When you get diagnosed with ADHD and your diversity, you will sit there again, I'm just going to miss out on stuff. I'm not going to be able to achieve. I'm just going to struggle and I think that's the biggest thing from what I say today, I want people to walk away with not feel sorry for me, but just to say, actually know what you are achieving and everyone can achieve and do something. So what is neuro diversity? Everybody's brain develops slight, slightly differently, even though we are meant to be the same neuro diverge means having a brain that works differently from the average neurotypical person. If we have what a normal person is, this may be different in social preferences, ways of learning ways of communication and or ways of um perceiving the environment they working. So examples of neuro diversity are just listed there. So I think the first thing is how many people are affected by dyslexia in the UK. So it's one in 10. Ok. And about 2% of doctors have dyslexia. And if you sit in your dean, now, how many of you are known to have it? And how many of your colleagues do you think sit in your training room actually have? I mean, there is 45 S in Mersey. I, I know publicly, I'm probably one of the only ones who speak about it, but there's six of us who I could put names to, who are dyslexic, who no one knows about. And I think that that's the biggest thing to take away from this. How dyslexia is diagnosed as anyone who is dyslexic. It's a great day out. You going to sit in a room and talk to somebody for about three hours doing spellings this, that and the other, which is great. But again, that sometimes puts people off and why do people hide dyslexia? I think what's been said already, we're surgeons. We don't want to be weak. We don't want to be the odd one out. We want to be the same, we want to be treated the same. And whereas if we say we are dyslexic, we've got ADHD or we've got another new diverse condition, we will think we got people start feeling sorry for you. You treat it differently, which you don't want to be half the time. And again, I think that's a stigma that's associated with it. But through, since being dyslexic, since age of 14, I think it's changed, the stigma is changing, but there is still a stigma associated with it. So we go for, um, what is dyslexia? Dyslexia is a learning difficulty that prime affects skills involved in accurate and fluent word reading and spelling. Characteristic feature of dyslexia difficult in phonological awareness, verbal memory and verbal processing speed. But dyslexia does have sort of positive traits and I think that's what we sort of don't remember. Ok. So common traits, let's not move and poorly organized written words and work that is less expensive, difficult planning and writing essays, letters or reports difficult for exams and we can just go on. But again, the advantageous traits of being neuro diverse is often advantageous traits such as attention to detail, creative, um team work is empathy, spatial awareness and practical skills. So when was I diagnosed with dyslexia? So I was diagnosed when I was 14. So I'm an identical twin. So my twin didn't get diagnosed for another 10 years. He's actually dyslexic. So again, I don't know how that is the case because we basically identical. But originally when I was 14, I thought I was weak, I thought I had an abnormality. I wasn't right. And I thought, alright, great. I mean, being competitive with great, he's going to beat me on everything else. And then I think it was just difficult and I think the reason I was diagnosed with dyslexia was because I thought it, my family thought it, one of our English teachers who was actually so in hindsight, it, giving me loads of positivity from it. But again, initially, I thought, why, why do I have to have dyslexia? How has it changed since you got older? I think it's, that's the difficult question, I think. How has it changed? I think you moved into a world which doesn't quite understand it in education. It's easy, easy to a point because there's loads of support being put in place, it's getting better and better and better. But as you moved into the post grad era work at the university a little bit more challenging. And then once you leave education completely and go into being a post grad, going into being a junior doctor core trainee. Now as a registrar, I think it gets, gets more difficult and I think it's harder for me to be open about it. And I, again, I mean, it might be me but I don't want to be vulnerable. And I think for me having this vulnerability was very, very difficult to admit to. And I think looking back, it has stopped me getting certain things out of what I wanted to and sort of made me not do something again, particularly sort of sign a room like this. But um also sort of you in a room in a meeting and people are chatting about something. You just don't want to divulge into it because you don't want to sort of highlight, you might have an issue how as I supported, I think, varying degrees of support, which I've touched on at school, you're sort of given loads of support and which is really good. You're putting in this special group of kids, you all looked after you given extra time, you given extra tuition, which I think makes you achieve more easily. And as you get older and older and out of that system, you sort of have to try and find the support yourself. I mean, I'll hold my hand up. I mean, I sat the MC Q for, for my MC five times because initially I didn't want to tell anybody I had I needed help. So I didn't put in for extra time. I didn't want to look different. Again. That's my fault. But I think for me, this is to highlight to people you can be different. So all the medical students are watching or anybody else who is a June to me, just admit it, no one is going to look different to you differently at you and you will save yourself a lot of um so how is dyslexia affect me? So lower self esteem. So as I didn't have a normal route for medical school, went through foundation school, then went to Leeds Medical School, which is a really good medical school, not a plug, but it's really good. I had a really good time there and good nights out and just enjoyed myself. But again, I thought, try to set myself up to fail with my Mr CS because I didn't want to tell anybody about it because I didn't want to be different. I had a low self esteem because I struggled a bit during medical school. So I thought it's going to be another multiple choice. It is going to be terrible. And I think it just knocked me massively psychologically. It still does today. The chance of people to try to help me revise with the FCS. So um lacking come in academic environment, you might think this is the same but to touch and boy, you don't want to sit in a room with some really academic people, they start having discussion and you can't follow it or you can't quite understand that they're progressing too fast. So you sat there going, you know what, I'm just trying to avoid these situations. Oh, I'll go and do something and you disappear out. So sometimes you just have a bitter lack of confidence, retesting, retesting. The biggest reason I put this up there is I don't, don't know why, but I've been tested since the age of 14, 5 times. I've done the same test five times, which is fine. I mean, it's a nice day out. You have a nice chat to people, but it's what you felt like. You just been trying to be sort of like caught out and I think that's the biggest thing. So, were you dyslexic? Oh, let's make sure, let's make sure. I think that, that, that, that doesn't help at all really, to be honest. And I think the big thing it's about, it hasn't moved on. Sorry. And being overly enthusiastic and outspoken and I think that's the big thing from being you diverse, you process things differently and you will explain answers differently to somebody else. And when people don't understand that you can sort of get yourself into lots of trouble which I have in the past. And I hold my hand up for that. And I think looking back at it, if I told someone I was just like, say at the time, would that change that? I don't know. But again, I don't want people to repeat the same mistakes. So again, this is something just to think about and it's just a useful thing to talk. So positives, ok, let's talk about some positive. Um, oh, that one, well, practical ability, my practical skills are all right. And to the consultant you are, they do say you are performing above where you should be. So, again, being dyslexic, my practical is ok, team working. So I've always been told I'm part work, well, part of the team, I've gone less than full time in August, which is probably the best thing I ever did. Going to 20% but I work with teams that way from the NHS. I work in sort of two for two professional sports clubs and stuff like that. And again, your team working in schools are good creative. I will think of ideas that someone else might not thought about. One of the, one of the consultants I've worked with recently said exactly that after coming out of this because I've done this in the Mersey train, train, the trainers day to all the consultants in the Mersey Deery. And I said, creativity spoke to after he said, now, looking back at that, I can see and you can look back at some of the comments that have been made and like you can see why and you were positive. Also, you have some in the negatives actually thinking you do think outside the box a little bit. But again, I think it is just it can get you into trouble, but again, it's useful. Um, so I think how, how have I managed it previously? What I mean by this before going to specialist training, I locked it away. I didn't tell anybody and I thought I didn't want to be abnormal, abnormal. Um I wanted to sort of be like everybody else. I do want everyone say, oh, Dave's struggling with this, Dave's doing this wrong or etcetera, but I think that's hit back massively. I missed goals during an F one F two join CT or I didn't get my exam until the end of CT two. So it was a staff grade for two years up in Manchester, which is really good. Had a really good time there. Um, but I just hid it away and I think that's just the wrong way to approach something like this. Try and avoid putting yourself in situations where dyslexia could be exposed. And what I mean by that I was struggling with the exam. So then what I did is how, what else dyslexia might be good. Oh, I'm not going to go and write reports. I'm not going to get involved in research. I'm not going to do that because again, I don't want to fail up. Something else will be shown. I'm struggling with something else. So again, I think from that point of view, I just took myself away from it, support network. It's important to have one no matter your, your new diverse condition because they are the ones who help you through it. I mean, my, why bless her, he's been put, put through lots of papers already, help me with my vision and sort of put up with my um peaks and troughs in my mood around exams. But I think it's just really important because they are the ones who are going to get help you get you through such things like this. So next one, how I manage post withdrawal. So increase my openness. This is the second time I spoke about this this is the second, oh, this is, I moved, oh, back, back, forwards, backwards, um, increase my openness. I think this is the second time I've done this. Um, and I've spoken to more and more and more people about it and it makes me feel better about myself because it shows that when you have this conversation, you will go into a room, someone can find you a bar or coffee up break and say I'm exactly like you, I haven't spoken to anybody. So what you're doing, you owing that individual to speak out and open up and go, you know what? I have a problem. And again, I had a message of a friend who's watching online who has just been diagnosed recently while doing her phd with this and she said it, this openness, there is no role models. So if no one is speaking about it, why is anybody going to sort of put yourself out of the honesty? You just got to be honest with yourself. You do, I do have issue with it. It hinders my ability in MC Qs hinder my I think. But I MC Q. So again, you just got to be honest with yourself because you open up avenues. People will help you. Me, he knew he really good. They've been really supportive since I've told the first EP and our current PD and they've always putting you in the right direction. So there is I out there but if you're not honest with yourself, they can't help you to do that easier. And I'm looking at, I look at just like different now as well. Um, I don't think it's a weak, I think it's a strength, I think at the day I'm a little bit different. But again, that doesn't mean you can't sort of succeed. You are not going to get anywhere. And I think that's the big thing to look at. And then sport network hasn't really changed except more people are involved in this now. And that's the thing I have grown it. So I feel better. I cope better. And I think that's the biggest thing. I think it's putting out there saying what you you are. So again, has dyslexia, dyslexia limited me. I have missed out on opportunities. I did slow my transition from CST to speciality training. Those two years probably made me who I am today. Opened up other opportunities which will appear in a sac financial cost. Yeah, I mean, I sat part a five times. That was a nice financial cost. But hey, ho move on. Um but it has also allowed me to do things like this. I mean, it's not just to talk about myself, but I got a lovely wife, got two Children. I'm Head of Medical Sharks, women, I'm a pool doc for the Sharks, men's team. I'm head of medical for women. Rugby league. I want the associate of Special for hand surgery for the R CS. Got Nhir Grant. I've got five publications and I have met some great people in work out of work and met some great trainers and colleagues you can achieve, no matter whether you are diversity, you just might need a little bit of extra help and that's fine and you can, and I think that's the one thing to sort of say, um, ongoing worries. Yeah, more exams joys and, and I think the only thing I reflect on exam, I spoke to other people and some of that was in the RC. Education is are the exams right for everybody. And that's the thing. We've got to ask ourselves as a part a the right way to assess everybody's ability to remember. Apologize to all the consultants in the room, but some really useless facts which you never get asked at the end. So again, when you are struggling to remember information and to do sort of MC Q interviews again. Yes, I worry about this because again, if I get fluted everything to get a complete mind blank um publications again, ongoing publications. Yes, I published. But again, I have had a lot of colleagues who helped me do that and I take my hat off to them and being a supervisor. I mean, I sit here going, how many people can hold up their hand. They know someone with dyslexia or adhd who is a supervisor in your Deaner. Not many, not many, there are them. But while we want role models, you still want to be somebody who can look up going. That person is achieved. And in me, there is another gentleman who has published, um who doesn't mind me saying Mr Hilly, who is one of the consultants in live. He has written something about dyslexia. He is the only person maybe in surgery is written and put himself out there where everybody can see him. And I think that's the biggest thing, biggest why you've got, um, continuing to learn so coping mechanism things you're always learning, always listening, learning from this presentation. I've learned more about dyslexia than I have in the last, the last, I don't know, 20 years and in the last six months and being thought about doing something like this, listening to the talks prior to this as well, I mean, fascinating. So make you think and so go ok, you can all achieve. And the biggest thing is to be open about being dyslexic. And I think the biggest reason I want to be open about this. So everybody else is my journey. I'm 20 years into it. It's not getting slightly, getting easier. But I think until more people talk about it's not, um, one I, I get to next. Ok. Ah, so quotes from the R CS education members survey, a good understanding from seniors will help the positive points which can be, can be brought to a team, not just the negative ones, neuro diversity assessment offered early on in surgical careers. So there's lots of things which have been, I'm not talking about, which we have been talking about for a while, which just needs to be, is being brought up to speed, but we are getting there. Um Again, the one thing I think from a trainer, trainees perspective is acknowledgement that someone is dyslexic, that it doesn't have a problem. And in me, I haven't come across anybody who has. So I'm not saying this is common place, but I think we need to acknowledge it as a community that people are dyslexic, people have newer diversity. Otherwise we are not going to get better. We are just going to be going more into our shells. Open discussions like this is great and I think it is the first step forward sign posting. So if someone is dyslexic, sign posts them to the right services, educate the supervisors in the region when I gave this talk at train the trainer day, if I asked the consultant who do you refer them to? They are not sure to make it easy, easy. I know which they are getting there. Hold my hand up to Mr and Miss Banks, they are pushing it in the right direction. I think this is something that I, I reflect it again on today is should we be having a committee where people can just come and talk to someone who has got it, have the same issue as them so that they can go. Right. You can succeed. Can you tailor this medical student who is struggling with exams with senior trainee or consultant? So you can get there might, might take a little bit longer but just sort of support. And um, yeah, the other thing to say, look out for trainees who might need help. So sign post them again. I'm not there trainees in your region or you know, friends who are struggling who want to talk to me, who is selected more than happy to chat to me. Because again, I think you just need to talk to individuals who are like talking about it and being open with one another and new surgical training built from your diversity and the common place it at. And I think that's the biggest thing to take home and go. How can we make it more? You are diverse and, and then I leave on a good picture from earlier this year. So thank you very much and thank you for listening. Some references is always important to include. Sure. Yep. Thank you very much for that talk. Do we have any questions since? Hi David, I'll keep it short and sweet. So it's very relatable. Uh I got my diagnosis last year and I just sat part one. So it's doable because I failed um MRC S3 times. So our first question would be it took most of us some of us um failing Mr CS or any professional exam at least 2 to 3 times before we get referred to PSW. So, because when we um screened our own registrars within our own deanery, uh the screening tool was about 20%. Then we said, can we send these 20% at se three of they said, no, no funding as usual. So it takes about. So where the question is, as you said, do we screen from the start? Is there funding within the Royal College of Surgeons? I think what I'm aware is when I got tested, I pulled out of my study budget. Me, let me pull it out so I could fund it for what I'm allocated and they were happy to do it that way again, I'm not going to speak for every other dean. So, so S A CS AC rep so very, very relevant. So that's really interesting that the 20% that were pulled up didn't get tested. So I was going to ask the same question. Um I think it's potentially there's a higher amount of neuro diverse people within surgery. I'm not sure if that's been actually checked, that might just be in my head. Um Do you feel it's fair that you had to pay for that out of your study budget when you already had a diagnosis? You know, should we be supporting our neuro diverse incoming trainees and colleagues in a, in a fair way? Why should you lose your study budget for that? I don't know. Is it tough one? I mean, why do I let them pay? Take it out of it? Just because I thought that was just normal to go with it to be not sure, 100% retested. I think it just said you will need to be tested and it will be up to date testing for when you apply for the F CS. So that's why I was retested. So I was tested when I was 14, when I was at college. Then when I went to one university, then I went to another university and then in training. So five times, which is great. I don't mind doing it, but it's progressively just a waste of three hours on one day and, and also money. But again, it's one of those things, I think it's, it's tough. And I think if we want to be inclusive back to your question, everybody should be tested. Who wants to be tested? Because how are you gonna know? And again, it's, we want to be inclusive so we can develop, we can grow and chat and listen to all the talks. We're surgeons, we find solutions to problems. And that's probably why all of the people who get diners late, you get through to where that point and then suddenly you get that you sort of start reaching your limit because you trying to balance about a million things for a solution to a million problems. And I think it's just tough and I think it's hard when to do it because it really should have been done at school. But then again, you miss the population who gets diagnosed as adults because there is evidence to the conversation. It's already hard that people will get diagnosed late. So you should have it open. But, and sometimes, I mean, is it fair to let someone fail exams three times? I mean, at the cost of whatever it costs nowadays to do it? I mean, I don't say my FRC that many times if I'm preferred. Um, so I think it's one of those things looking back at the financial cost to psychological cost, I mean, what? So I started trying to pass part A in F two and I passed it in CST two. So it took me three years to do it. Why did I miss out on those three years? Lots of things. But hey, that's what you do as a surgeon, isn't it? It's normal. You sacrifice, you sacrifice. But I think last, the last, the two years I had him in Manchester basically highlighted it. It was actually a good two years. I learned a lot, met some really good people and I think I grew as an individual from that, that I'm now better as an ST six than I would have been if I went straight in. So there's positives to everything and the biggest thing taken from your talk earlier. You got to look at the positive. Don't get ST in negative. I mean, it point this was of energy but I think it so just be more, need to be more accommodating somehow. And that's for the power to be let that thing from east of England and do me then because I forget to ask you later. Thanks very much, David. It's very good that you've been out there speaking. My name is Ian mcnabb. I'm, I'm actually treasurer of the BO A at the moment might be relevant later. Um No. Um, yeah, so, I mean, I don't know how to, I guess I got my diagnosis 49 years ago in the mid seventies when it wasn't really very easy either and kind of went through education when it didn't really exist. And although I knew that I was very dyslexic because under something I couldn't hide because it was pretty obvious to everyone. Um, and only sort of come back to it more recently when I, all the adaptions that I had made to live in a paper world were then taken away from them when we moved to on screens and computers and I am now struggling badly again. Um, but I think that within orthopedics, I've always had a strong suspicion that because the sort of special powers of dyslexia are 3d awareness, natural thinking, novel problem solving. If you made it through medical school there would probably be quite a high proportion of orth who are actually dyslexic and perhaps it is something more that, that vote and the bo a can do to help, sort of champion that and help those that are, that are, that don't know that they are as well and to make it much more open because I've never hidden it, but I've never got up and stood and talked about it like you have so hats off to you for that. And I'll perhaps be one of the people that comes and talks to you at a time.