Computer generated transcript

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

Uh So finally we've arrived at our discussion forum session. Uh So I'd now, uh, so I'd now like to invite MS Aisha, a who's a consultant, pediatric orthopedic surgeon at the Royal London Hospital. And Mr Mohammed Al Ashkar, who is an SD, a orthopedic registrar at the Leeds Teaching Hospital for us uh to host this forum discussion. Thank you. I, so, um I think uh the way that we can do this discussion is, er, if you guys want to either pop your questions in the, er, chat function or if you want to speak, then we can invite you on to the stage. Uh, but please do, er, drop a message so that we can invite you onto the stage. Um, but I think to start with, um, I think our amazing speakers will just talk a little bit about uh the training pathway and work club balance and some other uh issues. Hi, everyone. My name is Mohammed Lashkar. Um I've been invited to uh come speak here as a trainee. So, um I'm an ST eight registrar in Sheffield Children's Hospital and I believe the first question was, what is the training pathway to become a pediatric orthopedic surgeon. Um So it's actually pretty straightforward in this country. Like most other training pathways you need to get through your medical school, make sure you pass and uh show that you're competent enough to be a doctor and then pass your foundation training. So that's two years of foundation, you get a broad mix of uh skills and different specialties. Um And after foundation training, um you have to decide whether you want to be more of a physician, a psychiatrist or a surgeon. And uh if you see the lights, you'll become a surgeon. So you'll do core surgical training for two years. Um And then after that, you need to pass your mrcs exams preferably early on in your core surgical training. So this is one of the biggest uh things that delays people uh in their training uh and may add extra years if you don't pass it uh early on. So have a plan from early on as soon as you finish medical school of how you're going to prepare for your mrcs exams, which are the membership exams of the Royal College of Surgeons, try to get them done as early as possible out of the way. So they don't cause you delays. And then uh after core surgical training, you have to decide what kind of surgeon you'll want to be. So that could either be a general surgeon or a ent surgeon, maybe a plastic surgeon, cardiothoracic surgeon or you could see the lights and become a trauma and orthopedic surgeon. So you apply for ST three trauma and orthopedics. You get in that. Um We're a very welcoming bunch and then you've got ST three to ST eight, which is six years of uh higher specialty training. So altogether, that's 10 years of uh training after medical school. If you go through smoothly, many people take longer and that's absolutely fine. Um And then during your trauma orthopedic years, if you already know early on that, you want to be a pediatric orthopedic surgeon, then you could uh start showing interest and uh being proactive uh finding a mentor, maybe during that time, getting involved with research, um learning the ropes early on and uh preparing for your CCT passing your FCS exam and then getting fellowships. So technically, it's minimum of 10 years of training uh followed by fellowships in pediatric orthopedics and then hopefully becoming consultant easy as that is that come on down. But you got to see the light many times throughout lots of life to see. So my um career, let's say has been a bit different. Um I did my training in Italy, so I'm International Medical Graduate. Um And then I went for a fellowship uh in the States. I knew I want to be orthopedic since I was seven because one of my classmates was run over by a car and I don't think a fracture, it was about Christmas time. So we went to visit my friend in the hospital. He had a frame and I was horrified. And in my, in my mind of a seven year old, that guy was dumb. And by summer time I was playing football. So I thought, well, that's really cool. That's what I want to do. That's why I went to the medical school, these orthopedics, uh and especially pediatric orthopedics. When I came to England to do further training. I, I always went to a fellowship in Mon Street in London and in Sheffield and here we are. So after you see all the lights that Mohammed said, you need to see the light into the fellowship because the thing that as you've seen today, uh it's a specialty orthopedics, but it's really, really diversified. And so you need to uh to get proper training so you can deal with everything. Um I did basically exactly what Mohammed said. I was trained here in London. Uh I did F one and F two then CT trading ct one ct two. Then I didn't get a number because I didn't prepare well enough as he's saying that happened some uh and then I did get a number the next time, did all of my training here in London, got a consulting job after my fellowship. So sometimes it's straightforward, sometimes it's not straightforward. But the point is that it doesn't matter how many, you know, hiatuses you take some people want to do research. Some people have got an MD, some people have got a phd, some people do educational research, some people go abroad. Some people come mount Everest and become Olympians and all sorts of amazing things. There's lots of different ways to get here. But the thing that I think Laura is correct about is that P is extremely diverse when you compare it to other subspecialties within orthopedics. And I think that is worth mentioning and celebrating in pe orthopedics. Thank you guys. Um So we've got some other questions which some of the uh um audience have put in before. Uh So I think if we just uh potentially work our way through them and you guys can take turns in answering that. Uh And uh in the meantime, if anyone does have any questions, feel free to post them in the chat. Um So next, uh uh we, we had questions about work life balance. So if we could go around potentially and just talk about what work-life balance means to you and how uh being in pediatric orthopedics uh helps with that or potentially, doesn't, we'll find out. Ok. Um I'll start off um I'm married and I have kids. So work life balance is very important for me. Um And as you could see, I'm actually at work right now, not at home with my family. Um But as uh Ausa was saying earlier, s people have different paths. So for example, for myself, I actually had four years out of training, uh, between core training and higher specialty training and that was mainly for family. Um, so I do feel a bit a bit older, maybe a bit more pressure. Uh, but I am catching up and it is doable. Uh, you still have time, I think in this country, keeping in con, in contact, in contact. Sorry, you still have a reasonably good work life, uh, balance compared to train programs in, uh, overseas. I do see my kids most weekends I am home most evenings. Yes, we do on calls. We do 24 hours on call. I'm, I am off site. Uh, it is a bit of a sacrifice. Uh, on the family's part, you know, my partner has to, uh, be alone with the kids often. Uh, but I think it's all worth it. I tell her, think of the Children cause I'm also dealing with Children at work, not just at, uh, home. So, so she forgives me often. Um, and, uh, sometimes my own kids break their bones and come to hospital so they spend time with me. So that's happened to both of my oldest sons and I have a third one now. So I'm just, uh, look, uh, hopefully not looking forward to that. Um, it is doable, especially if you have a supportive family. Um, and I am at home most evenings and most weekends, uh, with my family as well. I, I think that this question. So this is a very interesting question to me. I think you need to, you, we're all very positive about work life balance. But I think you need to be realistic about what you want your life to be like when you're thinking about what job you want, whether you want to be a GP, whether you want to do medicine, whether you want to do surgery, if you have a supportive partner or plan to have a supportive partner, I don't know how you do that. But if you have a supportive partner, if you, if you accept that, you will sometimes have to concentrate on your career and sometimes have to prioritize your career over family because I don't think you can do two things at once. Either at any one moment, you need to be prioritizing one thing. When you're at work, you need to prioritize work. When you're with your family, you need to prioritize your family. And I think that's actually the reality of being a surgeon in any country, but in this country as well and it might be worse in other countries. But that is the reality of it. And if you are happy to make certain sacrifices and to sometimes prioritize your career over your family, then do surgery. And if you are not happy to do that, you will actually find it very, very, very difficult fraught path to becoming a surgical consultant. And maybe you should consider doing something else, which isn't a problem. There's lots of other things within medicine that you can do without sacrificing time with your family. But if you're going to embark on a surgical specialty, you need to think very carefully about how much you are willing to sacrifice because there definitely are sacrifices there. So it's the same thing as the question that was asked in the chat about private practice. That is not something that you should be worried about asking. That is a question that everyone should be asking themselves. And I think more and more medical students and junior doctors are asking those really difficult questions about career pathways rather than just saying, oh, I love Children or oh, I love diabetic feet. And therefore, I want to be a foot surgeon. I want to be a pediatric surgeon. You have to ask those really difficult questions in order to make the correct choices for your life. So that's a bit of a bummer answer compared to my answer. But that's my answer. So I think that work life balance applies to every uh job you take. So whether you go into medicine or into law or into whatever it you have to think about your own work life balance. And what works for me, for example, may not work for Mohammed Rano or Janet or, or Mike. Um My family is important to me. My friends are important to me. Um my job is also important to me. And like I said, you can focus on one thing at a time but with a supportive network, which is just my husband because our families are not here, we can actually just manage, manage just fine. Um And obviously when I'm working, there are things in place so that my son is in school and look up, looked after and when I'm with my son, I just see my son. So there is not work, not, not work at all. I also have some hobbies. I like seeing friends. I like cooking. I like running and with some organization, I can do that. Uh, it's not always easy, but I think that motivation is a, is a, is a very important aspect of, um, of my life is I, I love my job. I go to work and I'm smiling even in the darkest days I'm happy because my patients and my trainees, um, give me, um, reasons to be happy and to feel lucky. Um, and so in the darkest moments, I think about them and I have my family pull me up. I respectfully disagree with a little bit of what you said. I think that surgery is tough and I think there are times particularly when you're doing your, your post graduate exams where, you know, you need to set and you need to prioritize that time. Um, and you have to accept that there are certain things you're going to miss, but I'm not sure that it should. I would go as far as kind of saying, you know, it's maybe not for you if you're not willing to make all these sacrifices. I think the training landscape has changed even since I started in 2009, think training programs and train program directors a lot more understanding about people. My wife's an OB consultant. Now we both work on call ROTA and to be totally honest, the way we manage it is we're super organized and it was Jack Flynn in the States kind of, I remember gave a talk once you're talking about that concept, I'm sure other people have talked about that. Your, your life is like the, the glass jar and you need to fill up with the rocks, the important things. So my kids' school sent a newsletter yesterday. All the key dates for the next term and beyond are in there. So all of the Christmas plays in there, all of the um the Saturday where there's going to be the um school fair. All of that stuff is in there and then we swap as much as we can to work around and we'd be organized and we make sure you're, you're there for the big things, especially when you've got a young family accepting that it's not always going to be possible, but you know, say, say yes to the important life events first and then work, work fits around it. Thank you very much guys. Um, uh, I think that was very useful and it was good that you guys really told us the truth. Yeah. Um, about what it means for you and how you have achieved, er, work life balance for yourself. Um, I think we've had another question in the chat, er, about how, how much, or how little, uh, years have you been, have been geared towards pediatric orthopedics and what impact has that had on your general trauma and orthopedics exposure? Um, from myself, I think most of my experience before ST six with the pediatric orthopedics was just with general trauma that you do in district general hospitals. It's not really a subspecialty I ever considered. Um, I was kind of bouncing around ideas of different specialties. I really didn't know what I wanted to do until I did my pediatric orthopedic rotation as an ST six. so later on in my training and so for me, it was a bit more late that I made that decision. Uh, but my time during that, uh, converted me and, uh, I kind of been playing catch up ever since. Um, I'm very lucky that I was able to get another rotation of ST eight in pediatrics and it probably means I'll need a couple of fellowships rather than just one just to give myself that confidence and that experience. Um, but, um, what you'll find is all your time in general orthopedics has been good general training for the generic skills that you could then apply in a more cerebral way to pediatric orthopedics. So, whereas um I found, you know, doing hip arthroplasty and the arthroplasty, you're doing the same course, set of skills over and over day and day out and becoming an expert at that. Um In pediatrics, you're drawing on everything that you've learned from everywhere and applying it to a much more kind of varied uh caseload. And so even though it could be, it could feel daunting, getting into pediatrics, actually, uh you're becoming much more of a pure orthopedic surgeon by applying all the tricks as opposed to just becoming a one trick pony. Um So yeah, I think that my pediatric uh rotations have uh really made me a better general orthopedic surgeon. Thank you. Um uh I think we've got a few more questions uh that were submitted before. Uh but due to time, maybe we just answer another one, maybe. Uh And then we'll move on. Uh So the next question I think uh we could potentially go around is what's what's been the most rewarding aspect of being a pediatric orthopedic surgeon. Um For me, it's um sorry, I, I've been told to speak first so I don't wanna take time from other people, but I'll make it brief. Um I think it's the variety of the work and the fact that you could do so many different things in one day. So you could be working on your casting and manipulation skills racing, working in a team doing surgeries. Um and also just working with the families, it's just such a joy. So for me, it's um both the actual work and the people you work with and work for that makes it very rewarding. So two things for me. So first of all, it's a very diverse specialty. So you cannot get bored when I was doing my arthroplasty placement. It was all the same, the same pathologist sitting in clinic, the same procedure, the same everything and I was just bored to death, impeded. Your brain cannot go to sleep. You are in clinic. Every child comes for a different reason. Every procedure is different in the same list. You can have a hip, a foot and knee. Uh So he's never in not a pilot. So that's one thing. Um the, the second and most important thing is the relationship that you have with the families and the patient. I find it privilege and a great joy to look after them. And when they come to see you, you are part of the family. So as time goes along, then about you, then about, for example, some patients who I was pregnant. Oh, the baby is cool. They OK. And the same for me. I know about their grandma. I know about the, the the other siblings. And so it's a very close relationship. One you are part of the family and Children are the best. They say what they think, they think, what they say sometimes it hurts. But you should always be honest. And that's the case. I, I'd agree with a lot of, of, of what you just said and I think, um, when I applied to medical school I, this idea in my head that I was going to, you know, have con continue to care for my patients. And that's something that pediatric orthopedics gives me that I think is not the case in a lot of other orthopedics, you know, um, I still do a little bit of adult orthopedics and you, you know, you do a procedure, you send them on their way and you know, all goes well, you don't see them again. We get the privilege of being part of these kids lives as they, as they grow. Um, makes you feel old every year that they come back and they're taller and you're greater, but it's, it's great. Um, yeah, I, I would second all of that. The privilege is, um, the patients and they get better, quicker and they are much more lively in every way. And some of these parents, we're talking about these parents of Children with real challenges in their life. The parents really take your breath away with the challenges that they have and how they handle them. So, um, yeah, it's, it's every day. Thank you. Um, Mr, I would you like to add anything or I think that covered everything, the kids, the Children, II, I will add one thing. So, surgeons have egos and the thing that one of the things that I love about, er, pediatrics is when you have a patient that has a problem that no one really sometimes no one understood because I do think that pathology in pediatrics is a little bit more complex than quite a lot of other things that we see generally. But also Children quite often have been not mismanaged, but not parents have not had things explained very well to them. Quite often. If you can be the person that explain something in a way that the parents understand and they are suddenly comfortable when, when they came to you, they had no idea what was going on. They'd been told this, they've been told that what's going on, this going on. They don't understand remodeling, blah, blah, blah. If when that those parents and the child leave you, they understand that is a massive ego boost and I really enjoy that. So from a selfish point of view, not for the Children, for me. I do like that. Amazing. Thank you guys so much. Uh I just want to say thank you to all of the speakers on behalf of the audience. I'm sure that if we were in person, everyone would be applauding right now. Um But just thank you guys so much for making today possible. Um So we're reaching the end and I promise I just need five more minutes. Uh, I'm just going to show a quick 23 minute video, uh, that Bisco have produced and then we're just going to put up the QR Codes to join the whatsapp Chat and, uh, to give us some feedback and get your certificates. So I hope that's ok. I am a pediatric, who's, I am a pediatric orthopedic surgeon. I am a pediatric orthopedic surgeon. I am a pediatric orthopedic surgeon. I didn't always want to do pediatric orthopedic surgery. Early on as a foundation doctor, I realized that I wanted to do orthopedics and later on in core training and then in my uh registrar training, I really fell in love with pediatric orthopedic surgery. So the main attraction for me, uh was that ability to see, um, see kids from a young age and follow them through their treatment as they grow and, and help them to, to do whatever they want to do. Pediatric orthopedics is the one specialty where you can go from, you know, surgery, treating the hip, whether it's open inductions or ostectomy to do your knee, arthroscopies to foot and ankle reconstructive surgeries. It is probably the best specialty in orthopedics. It's the most. What do I like about him? Well, I like the patience. I love the people that I get to deal with. I love the variety of pathology and I love the operations. There's a really broad spectrum of things we get to do, establishing relationships with families and Children. I've been in post now for almost three years. And the kids that I started looking after with hip dysplasia, for example, when they were babies and they running about as toddlers are giving high fives. And it, it's amazing. I have to say, I do also love that moment when you've draped and the lights are on and you're ready to sit down and start something and you're everything else can go out your head and it's just the beginning of a procedure. That's also nice. What I love is the practicality of making people better by using my hands and by operating, I think about what changes have occurred since I started surgery. I think one of the big things is short of working hours today than when we first started. I think we've seen a change also in training. You know, we, we basically lived in the hospitals as juniors and that's not the case. Now, we had to evolve to try and train our next generation. I've definitely seen a shift to more diversity in orthopedics in particularly in pediatric orthopedic surgery. And hopefully more to come, my operation has to be, I love the new disability work, I think because you can be multivision with it. You can be around the hip, the knee, the foot and ankle, the upper limb. I think it's a toss up between a complex hip reconstruction for the for late presentation D DH or a tibialis anterior tendon transfer. I know one was fashion, was satisfaction he in the operation on to Children. Good old super. So really, it's an endless variety of simulating and challenging conditions. So every operation is different and that's what I love about it. I love taking something planning on an x-ray, working out what's wrong and working out how I'm gonna improve it. I think the working with people who have a passion for subject guides. You, what, what you really like. I think if you're the kind of person who likes a very lifestyle and wants to have that spice of life of having variety, then pediatric orthopedist is definitely the specialty of your choice. Perfect. Thank you guys so much for staying with us till now. I hope you guys have been thoroughly convinced to choose pediatric orthopedics. Um So I've put up the QR codes. The one on the right is for feedback and certificates and the one on the left is to join the uh whatsapp group chat. Um I'd also like to take this opportunity to thank all the speakers once again and to everyone who's helped on this event, er namely uh Aon Gan uh and the bumps are members who have helped so, Kelly and Sophia Wakefield, er, as well as the rest of the IOE com. Thank you very much.