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for this next episode off the F three Siris. We have the roads. F three we have to abroad after is it is a special doubleheader. Uh, today. So we have Harry and I spent ah time abroad. Um, in various locations. Not You're sort of traditional Australia or New Zealand. A zoo. A lot of three doctors do, um, branch out to, um you'll see later on the episode that they've actually, um, gone far and wide at, ah, various areas to practice medicine. So this should be a very exciting episode for those who are tuning it. Have just concerned about E post in the chat just to make sure I just say hi or something. Just so you know that you can all here, hear me out there. Perfect. Thank you. Thank you. Mom. Is, um so it looks like everything is working. Well, just given in there, we'll give a couple of minutes before we get started. Um, as you're probably aware currently, um, I'm not Christian, which is obviously not available today. So instead you have myself Ah, sergeant, who is one of the co founders of the portfolio clinic who run the AC three Siris. Um, I helped out. Well, I was one of two in charge of the first Siris of off the three series on Grischa has been doing a stunning job is unavailable today, So I'm a standard. Um, so, yeah. How you guys feeling? Yeah, I get this, um, that you suddenly busy Wednesday? Um, so I'm in between, Not ships personally, so Okay. Really? Oh, wow. So it's just straight onto the camera. Amazing. Uh, that's that's a hectic guys, but we've got a lot of people joining. That's good, right? We'll give it another minute, and then we'll take it from there. Um, that's right. I get these. That grind never stops. Indeed. No. Perfect. Okay, um, So should we get started? Yeah. Great. That's, like, the way. Yes. So, um, so do you have for me just a shame a screen and go ahead. Yes. Um uh, Hello, everyone. Use what we're watching back. Um, so yet night. Nice to be here. We were So my name's Larry. Um, s So we're just gonna take it through our experience of f three. I'm there for one night. Case and nonsedated 34 and five. Um, on. But We spent quite a bit of time abroad in various locations. Eso on. We'll show you, show you what we've been up to and then hopefully get many times over the Japanese conversation. And so any questions? So, uh, just by way of introduction. So I'm Alex. Nice to me. Everyone, Um I am now a gp training on December end of my foundation and then read on. I took three years out in the end. Always find I'm taking two. But I said just crept up on me on down F three main things have been those either birth plowman, topical medicine and hygiene at Liverpool And then when on and spent 4 to 5 months in Vanuatu, which is in the South Pacific. Anyone that doesn't know men and F four a did a a six month stint in New Zealand when I came back to the UK and converted my diploma into a masters in international Health. The London school last kind of covert hit as well on then also spent three months in Greece, voluntary in the refugee camps on Somoza's islands. And then we kind of headed into my five for I spent nine months in Sierra Leone. Um, with various. Well, so that's what I got to my three years. It was fairly back to back, but a few times here and there for travel and chilis. Well, it's just, um Andi. Yeah, I only made time for two years. Um, I'm Harry. I'm currently, um, in a CCS trainee in November. Um, Onda? Yes, sir. I started my three doing a bit of the local, um, in, uh, not in Scotland, which is not what this is about all to recommend it to go to their into the outer skirts of Scotland, some locum. It's a great great experience on Ben. Also did the DTM in eight. So that's the department. Proper medicine and hygiene limp You on Then I joined Alex for three months in Greece on nine months in Sierra Leone. So mostly we'll try and keep the presentation shore and leave it to spoke. Westchester's on the discussion, but we're just going to kind of briefly go through what it's like working abroad. Contract about the diploma for, um, a few experiences broad we had and what we get from them on, then we'll chat about how to find something similar yourself if it's something you're interested in, um, so pretty key for us was the moment documents in hygiene. So this is three months or full time intensive, a topical medicine medical course. It's well, hopefully back to being in person full time now with the opposite. People recently had to go in mind for a bit, but the main courses were in London limp all, or there's actually an East African course. It was running between tension here and Uganda. Alex and I both the diets and little book. But a lot, of course, is a very similar and actually brilliant. I think that's a distance there. Any options as well In Glasgow, MSF do a similar course. Um, if it's something that if working abroad into the results of them two settings or tropical step into something you're interested in, then this is pretty vital for most jobs in that kind of area, it's bringing course is really good fun. You meet lots of really interesting, diverse people on, but that's kind of a big part is where it's just a big melting pot of interesting people with lots of different ideas and opportunities on that's where a lot of how you get leaks into all these places. It looks pretty good on the application on, but if you actually do you go to do some stuff abroad. It's incredibly, really useful one. You won't get by without it. So lots of good things about that thing. The only significant com we can think off is it's pretty expensive. It's about it's about six grand or something for the three months or so. You need to save up to get it done, but definitely worth doing. This is something you're interested in. Absolutely. I have put it out there. That was probably the in essence, kind of a highlight from the of the three is Was those three months super and then just a brief, er, few kind of places I've seen. I won't touch on New Zealand as much, but just mentioned Vanuatu. Um, it's ah, hell ago of islands in the South Pacific. It's kind of longer in Fiji area, but a bit more remote and less visited, and I spent four months in a primary health care clinic that supported the hospital that was close. The picture on the bottom right hand side and our clinic was there orange building above on day stay where it was mostly deeply practice with an acute kind of care rumors. Well, for stabilization of patients to prior to the hospital transfer or hospital or transfer off the island. Um, lots of non communicable disease, some topical medicine, and then which was fine, I since, um, emergency medicine as well. And also something different was those visits many evacuation. So they do get tourists and they get islands divers on the islands to anybody, uh, fell sick, close, wise on localize, organizing many evacuations by an interesting cause of it. Um, I think medically wise as well. I had some some great pros. Things like home visits of the picture on my top right hand of the screen. I visited every day for a week to the liver, some palliative care to gentleman that's dying on the small island on that was me set me up to the boat kind of calm roots to my home visits. So it's been a different to Edinburgh West Lothian home visits, but it was pretty special, Um, in terms of that or are you just absolutely wonderful people that tend to vote of the happiest nation on the planet. So friendly, so warming, so welcoming know just absolutely yeah, really great people to work with and actually met a lot of people there and experience the whole another culture, which was great. And I have to say also start one of the world's best beaches. On the top left hand corner is a volcano that's constantly erupting that you could go sit by and visits. And that was kind of the non medical highlights. Um, complications that stick in my mind with things like You know, very well Children with pneumonias who are hired level oxygen family can't really afford to fly them to other parts of the island. And many evacuation might take 24 48 hours. So it was, you know, being up all night with someone and trying to do what you can and reach out for help the specialists on the other islands. And that was something actually really interesting about the job was using. Resource is from a far cause. We're supported, and I always had seniors with million seniors in the hospital, but kind of learning what resource is the best to use in what's already a resource polar environment was actually really good loan on. Yeah, I had a super time in Van. Are, too who? I'll tell you a little bit about Grease. We're both in groups on Thea Island of samples, which is home, too. Big refugee camps. Uh, coming into your we were with a organization called Medical Oddity Team. She's a French organization, but a big A big, um, big variety of people there from all over the place. It's really, really great. So it's mostly a primary health care clinic. So just so the top left picture there, I don't know if you can see my mouth. Maybe, but this is the This is the town of samples, which is a beautiful sort of Greektown lawsuits of boats on the front and stuff. And just in this corner here, this is the refugee camps of sprawling, uh, in the background. I think it is built 1st 600 it was housing about 8021st. Got there. I think that camp is largely been, uh, these have moved to Maine on now, which is good news, I guess. But, uh, still lots going on on the Greek islands at the moment, in terms of they stay stuff. So that top right picture is on the clinic on a very, very frequently quiet day. Which is why I checked the opportunity to state of photo. Normally, that entire payment so is falling with a long you of people waiting to be seen on this is in sort of go over time. So we're actually seeing people outside. Mostly, Just kind of, uh, funny is, uh, area where you have a date with Jack and seeing people on on the pavement essentially on taking them inside. Only if we needed Teo examine with things, um, would work six days a week, seven. Am to one PM before I got to Got to be out on the pavement. And then so the afternoon were off, which was, which is nice options. You explore the iron and stuff. Um, lots of lots of interesting things going on there. So, uh, you know, in terms of the medicine, it was largely sort of primary healthcare stuff. Lots of easy fix is sort of course codes, air infections, wounds that any cleaning up that kind of thing? Watch people who haven't got access to care for their long term medical conditions. Diabetes, hypertension, things who were born care for them. But then lots of, as you might expect, challenging, challenging things from, um, sort of that kind of population. So people have been victims of torture. People have been victims of of, of sexual violence and things as well. Lots of psychological problems which were which were pretty challenging to to manage them occasionally pretty harrowing. And unfortunately, you know, were many services available on the island. So, for the most part, what these people needed to be Teo need it was to be transferred to the mainland. Well, if you get some better care on So a lot of soups of working with urine HCR working with the Greek government in the hospital there and trying to serve advocate for these people on trying to get them, they can. They needed so lots of interesting things. Lots of changing things outside that that work. There was some good opportunity to teaching. So bottom left, there is Alexa, living some basic life support training into first eight courses and some of the year, like living in the camps on But, um on Yes, it was very interesting. This is a sort of a grassroots organization set up veritably recently and on. It develops over a course of a couple of years, and we're still kind of finding its feet and trying to work with on MSF and, um I r c who are on the island as well, working with you in a chair. You initially are working with the government seeing these interactions and things and try and get involved in seeing them. Those really fascinating that. All right, that, uh what is? Well, so, um uh, really enjoyed that. So some of the pros of in terms of if people are looking for opportunities to get abroad in F three, Typically, you know, there's lots of these organizer's organizations set up around grease, I'm sure. Now there's lots more developing on on borders of of Ukraine release in Europe as well on their pretty easy Teo access. Actually, I think Alex and I made it was probably about a month or something between applying and actually landing on the ground. So it's pretty pretty quick. Turn around. There's a constants of staff turn over. So actually turning up for a month or two is very, very doable and very acceptable on. Do you still feel like a contribution? Something that is quite a young, young, fun crowd? Lots of the threes and things there, but you normally very well supported. Um, Commons, I suppose. Just a year to be careful. What organizations you check. Make sure you do get enough support. Their what? Mark Junior Onda. A bit of the sort of the strange it takes is emotionally challenging occasion, and also, it's a bit of a strange, um, just position off. You know, you finish your your work at one PM and then you're on this beautiful regard and you can explore it. You can go to the beaches, you can hang out on the bars. But you're aware that this is sort of, uh, refugee crisis and this over sprawling refugee crime a refugee camp just, you know, 500 m behind you or something. And it's a bit of a stranger environments being so you know, people just be be, be bad. If you do, you go there for that kind of experience. Just say one other prone to me, and it's not mentioned his on the bottom right hand picture Harry to close friends. What was really nice is mostly NGOs primarily use refugees themselves in the camp has translated. They're all volunteers, and then some of the other NGOs manage to pay them like MSF's. Actually, you are day today. You're not just treating the refugee pet population, but you're also working with them and, you know, for drinks with them and bonds with then And that's, I think, quite a unique opportunity, which was a real pro for me, um, tell you about Crohn's? Well, so this was done. But I think a big highlight for us and I'm certainly for me of the the main experience of my three or four years is absolutely brilliant. We spent nine months in this District hospital in Sierra ago. Those every in West Africa, um, see, very or country it's been zero recently had a bowl of crisis, has had the Civil War, and it's pretty, you know, they're they're very rudimentary healthcare system. That's just the middle right Photos is a bitch of the main ward that we're working on so you can get a new impression of what kind of what setting it Waas um it sort of is a pretty classic, almost in my mind that this stereotypical kind of setting of what you imagine is a Zaruba Afghan hospital. It was really, really beautiful. A setting of a very lot of results limited. We were working on the acute medical ward, and we're so largely responsible for this ward and that sort of day to day running of it was about 20 bed Mission Ward. But we did have support. There is. Well, there's a team Dutch tropical doctors who were very useful. And we had sort of links into UK experts and things as well on Dutch experts who where we could ask your vice form. So it was fairly well, Thomas. But we did have that support as well on days. A really, really invigorating experience. Lots of really friendly staff on be working alongside them, the trainees there. So the top left picture is off the search will train needs to this a surgical training program run out of of Ms and a hospital on the top. Right there. There's a visiting surgeon giving extra, doing a war round and get into teaching things there. And we we got got high involved in a lot of teaching and quality improvement with a little research. Forget well, with that, really getting into things which is which is great fun on the medicine was just wild in terms of what we are compared to what we see Dates day in the in the UK, lots of lots of documents and lots of HIV. Lots of TB. Lots of very late present of presentations or infectious diseases or trauma of neglected trauma. The cultural challenges there is well, so still traditional religious first four to call so often people come in with legs that were broken nine months ago and they tried to have a field, but the other traditional dealers and on But you know now. So now they've got it. What's it like it? It's really challenged stuff, but fascinating. Yeah, and the rewards we're we're bringing Well, so I suppose if we're talking, uh, to give a few other little examples maybe so. Oh, reactively Leone. We have someone presents with DKA eso uh, actually a fairly late presentation. Diabetes. I think she was in a row twenties presentation in DKA managed get her out of decay. And six um, from that side of things. But then, you know, you left with these long term issues. You know, suddenly she eats. She's got this long term medical condition that she doesn't know, doesn't understand, hasn't really had any experience with before. She needs long term follow up, but that is gonna be difficult for her to achieve because she's got a travel every time to come to the hospital on healthcare isn't free. We don't. We have access to the insulin in hospital, and we have we have Fridge is there. But she lives in a rural village with the fridge in it. By how is she gonna keep her incident thing? So overcoming all these all these challenges was was was really interesting. Way had cases of, um, you know, we had a a gentleman with HIV being pricked. Scotland meningitis were then meningitis to eventually diagnosing. But problem enjoy. To sum it up on a rapid test. And so, you know, we had a diagnosis. We actually we need to work with them, except for a But down the road is to get the right medication. We've got that arranged room on. Been came back to hospital in families, family taking a way to get to the to the traditional Vida because they believe this is a spiritual, um, that's, you know, that's frustrating to a week now we're they're going down this we've got the opportunity to treat on. But still, the spectrum total challenge is getting in the way to really, really interesting things to take on. We'll see lots and lots of pros to this kind of experience. Open up your minds, all the medicine and they're different worlds. Events in out there remind Teo. Experience is all around the place. The cons, eso for this particular setting. We you know, you need to be probably a bit beyond that. Three really were also the end of hours of that in that four after that five. And that's what we're about his junior. They would have liked us. I think we're lucky to get up to do that at that level, you hear? They want me to commit for six months on this entire itself. Funded s so it's entirely voluntary roll finding. Be option. Issue Some people, there are other opportunities off similar of similar kind of opportunities. In them, friends go to of places in Africa which perhaps a little bit more set of, you know, surgery centers, often in the bigger cities in still in probably, um, or resource afternoon countries. But then then you can get up to me. She's in that three or four more easily away your So you've got a little support. Um, but yeah, that's that was fascinating experience, Uh, just briefly kind of some of the things that we learned and gained from weapons or kind of a broad in all of the different settings. It's definitely expanded kind of our medical knowledge, but also a medical world in terms of what is out there. And you know how I missed in this practice differently and how different treated. It's also, you know, really opened our rise up to gaining new skills and the importance of learning what's new skills. So we both didn't ultrasound course before we went out to see our own and start using ultrasound pretty much every day. Um, working with death, get lots of teaching opportunities, and we didn't really have a single them this anger and Sierra Leone, where we weren't teaching, which was really great, and it also kind of allows you think you I research projects and I mean, maybe you're different, but I think quite nice and projects that I really felt like I was making a big difference. Or hopefully you're really making changes rather than the force forms that sometimes we have to do or not trading, just take books. Exercise. Um, big thing, Just the future career stuff is it was nice insight into how other agencies work in cooperation with bends in Greece, we're often working and cooperating with MSF in Sierra Leone. Those lows of different agencies that were needing to work with you kind of understood all about a bit more about the policy and Sunday in and no memories of understanding and all sorts, bits and bobs. I've never really appreciated how NGOs work how, Yeah, kind of more management in the running of the hospitals. That was something that was really kind of important learning for us. Um, think we've learned a bit of resilience and confidence out there can be tell, fell out, go through some of the things I'm more difficult. But it is. You see things that perhaps you wouldn't expect to see. You know, certainly do. It's in UK. Andi has, I think, give us a bit of resilience, the future, which is nice. And also, you know, even though it's very different medicine or bringing home a lot of what I store and the way I practiced. Take your weapon and GP, you know we do, we get refugees and we get kind of people have more difficult on the hard access to health. And I think I use the learning from being a broad and put that into my practice now. And it may be that helps me understand the bit more how why in the UK you do certain things and save the benefit of that, I'm thinking, how can we kind of yeah shape potentially anywhere I do a parole it to try and bring them together and think how we can best use our resource is in essence. And the nice thing is, yeah, you get lifelong leaks into organizations also linked with other people that you hear lots about the other things that you could go and do, which you will be definitely helpful for the future. Um, a few other small bonuses you get to explore new places, countries opportunity to travel. You know, we have beautiful weekends. At times we're gonna work on the beach or exploring Cirio, um, things you never expected happens on the left. Um, this is actually a baby mongoose on a patient of mine who have been looking after quite a while, came back and visit me in the hospital. On brought the very mom use to me is the present, which I wasn't expecting. I didn't know what it waas on and perhaps is a bit risky to have a little road and live in your house for a little. And those things, like last fever about it was very few. And that was, you know, something that you don't get to see in the UK So it's little things like that big thing, I think lifelong relationships with people from all over the world with other NGOs, workers, people, you know, local workers and the hospitals has been a wonderful link with other people. It's something interesting still about in your application. You said only tested it a lot about it on the anesthetics interview. Don't get me my Yeah, And because of covert, I wasn't interview, but actually kind of It really gives you something to talk about when you back and working and in training. And people say I'm pretty interested in, um, you know, like I say, you just come across those things you never expect. This is wonderful. Yes, I suppose. Just, um, other things to consider. Um, yeah. As I mentioned financially, a lot of these most rolls your find, particularly nose. And it's an F three is relatively inexperienced that you're probably gonna be looking at, um, on three rolls on. So, you know, we're in a fortunate position in which we can get Really what a locum wrecks and things in the UK. So, you know, balancing those two is very doable, but yeah, don't don't expected to find a job that you can get a pool in this kind of setting. Um uh, so, yeah, I think about how long you're going somewhere. So I would say I think places like reach which you're quite set up have this high turnover and expect that controlling that very well of the bases, we'll expect you to stay longer on. It's certainly better for that environment and better for that organization. For the stay. Stay longer, you know, get to a point where you know the place, know people and you actually starting Teo makes, um, different things of the sort of metal doors and about it turning up and having a looking and having home. Um, personal health and safety so off course that these bases come with with higher risks if they're in places which don't have well with fully functioning healthcare systems or as well as a Z, any chest. So you know this, uh, you can see that we've got we've got a few quick recordings and since snakes that were about on so we saw around the base top, right, We're doing some teaching and some training on how to do on and off full P e or viral hemorrhagic fevers. So last, er, beaver on bola. Still, you know, cropping up around place in Syria on there are little outbreak. So, um, and you know, it's so it's not without its risks. Certainly, it's just to be considered, Um, you had be mindful of way juice ago and whether you eat and how that the climate there is going to affect you. It was hot in Sierra Leone. You can see me then hand over, drenched in sweat. And, um, it's it's pretty exhausting on that. Certainly plays plays into what you can achieve in the day and what county of mindsets and you date it stuff intend to revalidation. So I didn't have to. So I have to be validate or keep up with anything in particular I didn't find. That was a non school chance of me getting my job When I was in a round face in the UK and local thing I I I got a few. Um uh, sign off from things done. Just a key. Keep up a bit of her port bow, just in case anyone's after me. What? I was up to you, but actually that never came to anything on. Do you know, we We used our supervisor and see earlier and as a reference and stuff for for application. So that wasn't tickler issue the you off the three years that you need. So after three years, you less than three years, you don't eat three validates. I didn't have to use. I was on the three mark line, but any longer would have had to revalidated on again. I didn't read about a date. Actually, it's certainly worth thinking about it and kind of keeping perhaps a bit of a portfolio, getting things. Some things signed off, if you have the motivation to revalidated just looks quite professional. But also, if I had and this is a big learning point for me, if I had revalidated and got signed off on things and pass, kept more of a portfolio and might have been out to knock a week time off my training because a day can you can look up prior experience and not time off. So I may have enough to know to six months off if I had kind of revalidated. But because I was three years and no longer, it was no problem at all applying for jobs, and I didn't have to do any formal revalidation. I'm I'm just looking at the chart. We've got a question. The question is what this revalidation entail. Yeah, it's a really good question, and it it can kind of entail different things. A formal revalidation would be to find a supervisor, ideally kind of a full revalidated that will be a consultant or a train GP That and you can find the names on line people like offer to do it all through your own trust. You can email your trust and say Is that anyone that would be happy, in essence, to kind of be a revalidated on my supervisor and basically involves meeting, then saying this is what it does do They could give you a bit of guidance on phasing you to document on go through a formal online revalidation process with them. That other underscores the non formal way of doing it. Just kind of in terms of professionalism would be to create and keep a learning log in a portfolio and get yourself signed off on any procedures that you do and have a full in essence portfolios. So there's someone Look back at it. You could say this is what I've done. But to form a rebounded eight, you need to find like a supervisor. But the hospital boards who you're working or if this particular department or hospital that, you know, should we have to direct you to someone that be happy to do it. Yeah, I think I think what you've described there is an appraisal is a yearly appraisals. Yeah, exactly. Yeah, yeah, usually so Each each year. If you so it's good to have a formal appraisal with a clinical supervisor. Essentially, you should, um, keep a log of sort of many. Texas is case based discussions on and usually at the end of a a clinical year, and each Azaz Alex has mentioned hospital trusts have a certain system in place where you can have a formal appraisal, which is just basically a log similar to a foundation. Um, end of your appraisal. It's just a log off. Um, what you've done over that year on do, um, evidence that you've actually reflected upon it and that you've actually been working towards Ah, sort of your your GMC confidences. Revalidation usually occurs every five years, and that's a lot more of a formal process, usually assigned the revaluate ER, which which will usually occur that, after five years on that again, is just a reflection on the evidence of what you've gone off the over the previous five years. Um, so, yeah, yearly appraisals is an optional thing, but it's it's much better to have something formally down so that when you go for your revalidation after a five year period. Then you have evidence that you've actually done stuff over that period of time. Yeah. Sorry. Yeah, I think I used those interchangeably appraisal perfectly. Yeah, but after I had taken an F six medicines, then that would have been five years and started appointment. You have to start kind of reproving competencies to go and see. And your Diener e You can't just go straight. Kind of without reproving cult. Some of the competencies. Yeah, Perfect. I'll answer your question. And yes, I think there's a lot of things. Just say, uh, how to go about finding your own experience is a bit like what we've I should find. So the DT emanation again? That's the deployment. Topical medicine. Highly. That's out. That's the one we did a livable, But London and Peace after opens as well. This is ah, really, uh, great source. So very required for most things. And then whilst you there, they put on sort of NGO days or two opportunity days where you come and visit and then you can get in leaks there. Yeah, everyone else that has had previous experiences or or knows people or nose of links in or have ideas themselves. So that's a great idea that that's a great way of getting around getting into these things. Unfortunately, like the reality is that there is no serve warning on comes in Central Base way finally, opportunities. A lot of it comes through word of mouth and colleagues networking with people getting to conferences and things that that was a few websites that we mentioned there, which are useful Teo scout around on. But yeah, unfortunately, it's no, it's not quite as easy as just have them going on to the website and Googling favorite place or whatever. So is there is a bit It can be a bit complicated, but on then you know, if you got ideas of where where you want to go, then actually, what a lot of people do is just start emailing hospitals on there. That will give you an idea of whether they can. They can give you or no on diet normally does just take the better in this device that just to get, get, get into it. I think that's about what we've got so sure if we've banged on a bit there for a while, but I have got any other questions. Or if you want. Oh, yeah, that's that's think I did have a few questions. So, uh, so initially you mentioned that you donate a diploma first, and that was a three month course. Um, was that Was that just because you were interested in in tropical medicine, you're interested in that field? Always a sort of a requirement for going out abroad? Um, yeah, I would say crime. Married a number one on I don't think Before I did the diploma, I realized how much of a requirement or how beneficial it would be. But for me, it was an interest. And you don't want to work abroad travel before Just love being brought. I want to take time out. Was ready, you know, interested in it. Put sound really find I had just, like, such great reviews from it, um on. Then Once I was during the moment and certainly after the diploma, I then realized just how you spell it was a new rich. That how much I needed it. And I will be this stuff. That's it. Yeah, I see. It looks like I've got a question and as well. So did you guys know that you wanted to do, um, the training programs that you're on so gp and and a CC s before you start a draft three? Or was it something that as you progressed along in your your years traveling that you thought actually, this was already a preconceived for me? I think I think Yes. So I'm I'm on the other set. It's stem of a CC s. And I think I, um yeah, I think I had a clear idea. That's what we were you going on. But, um, you know, um, of maybe going with the idea of any messes and set, expect up opening there. That's where it's going. Um, I mean, I don't know if this is ah, so, um, behind the question. But, um, certainly I would say that these it's not sort of only people who are just in infectious diseases or things. That should be it. Be it's worth while doing these kind of experiences of doing the moment documented, like it's not a lot just about investing in a local medicine is about international help and developing out systems and things, and, you know, from. From my perspective, for example, you know how expensive a time in Sierra Leone they do a lot of surgery there and search that surgery is hugely escalating field in. And that kind of setting the time, basically, they did all operations, including the Rocks Museum on ketamine and diazepam. You know, So it's going to be is going to be a huge expansion India and in the field man, Except this I know. I'm already thinking, you know, multi. He involved in in global health on down. You get involved in training programs in developing lose this kind of skills in, in in resource into seventh is up on these kind of areas. So I think a bit of it, Yeah, I didn't a toll. I actually always thought I was going to do. I am tea and infectious disease. And actually, it may have changed, but certainly when I was looking at idea vacation, you needed the diploma. Um, probably pollen Reason I chose the diplomas well on, but actually, over the three years I debated a long time and pretty much just before I was handed time, I changed GP for me, dude, who will give me a lot more flexibility on what? Interested in I'm really interested in Bible health and international health. And I kind of see myself doing DP part time. We'll only here and there and then, you know, working in the field or working on more kind of policy and help management. So I took quite a dive from I d around two GPA and certainly my time out. Um, kind of held it version. Yeah, exactly. Um, the question is a copy and thick and fast. So we have another question. Do you have any advice is to or for for those who wish to pursue on anesthesia or intensive care medicine, Um, in relation to having that experience abroad or yeah, opening up opportunities with with regards to that experience of, um So, uh, certainly for me. It definitely helped me get my at work. I'm pretty sure it helped me get my anesthetics or I interviewed from Sierra Leone on, um Well, since my, uh, way in action would hold, but ah, ah ah. Since coming back, I met the concern that, uh, if you need and you know, she She remembered that interview. Remember that? You think So that's pretty to get good town ascetics then, is that? Yeah, Well, just a Z, I think anesthetics. Probably one of the specialties that do know one appreciates it. Yet a favor range of experiences. And, um, eso, I think is definitely know it's definitely wants in your favor rather than maybe some specialty which might think, you know what, let you get much experience of anesthetics when you were, um, abroad or or was it mainly sort of. It just depended on the day independent. So not not much. So I, um uh, you know, we when we, you know, simply Sierra Leone is probably only place I would have had recently exposed to that. Yeah, but we we took this job as Internal Med. It's basically that was our role there. There were anesthetic nurses in the back and sets of practitioner. I spent a day or two there, too, with damage. Seems seeing what they got up to have a bit of the chat slim. But that wasn't my primary role. I wasn't I'm not on any HSAs and therefore not in a position to do any teaching or draining. Oh, are running and on aesthetics so it would only a bit of that walk in a month. And I think, eh? So I did a little bit about that. Yeah, that's the hospitalist. I just like no in terms, I'm not sure provides, like opportunities, but for anesthesia and global health at him for someone which a few days go down the phone dropped medicine and he is part off and says worth looking at the website. Guess Sock g s S o C. On. But that is a global health kind and anesthetics partnership between the UK in a few different countries abroad. I'm not saying that they provided twosies that just something I was told about Stansel. I Yeah, I think that's that's, uh hopefully that that will be really helpful. It sounds promising. Um, we have another question. So, um, the question is, do you feel that, um, conducting F three or international unit ease um are not compatible with those people you want to pursue hospital based training or pathways? I think that the question is basically asking, Would it be seen as a disadvantage? Or is it Ah, does it restrict you in terms of if you want to pursue a hospital specialty. Um, doing the doing, the three or going abroad? I don't feel personally. No, I think it only benefited Teo our experiences, but maybe, I mean, I can't speak for all specialties, and I know some surgical specialties on. I think you when you were applying speaking people in that specialty those especially as you start to gauge but a picture of who likes what? You know, again, this is just, like, word mouth. But I hear some social specialties, and there may be others less keen on you having longer time away and, you know, quite like to get people spray out to one year of rules. And actually, the long spend away can be seen, um, to be detrimental. Certainly for GP on your six, we're we're flying. It was no from it'll. Actually, people really interested, I think the most violencia occasions, especially if you're going down the IV route. But I assure you want to see you. How If you if you can a spoke. I suppose the key the key is probably Teo demonstrate. Well, get it trying for a knockout unity, which is really actually useful. And, uh um you're getting lots of medicine and not security on your on. Demonstrate what you've learned from that. Yeah, You've been taking away, you know, avoid. Basically you've got is a delicate line tractor To make sure that you don't sound like you. You've been on holiday and having a number on, you know, occasionally you in a bit of a clinic, work with him and make make sure you you expect that you would you happen to be in this beautiful facial speeches? Sure. But you were that you use when I would like just in that. Yeah. Yeah. And you continue that. It's that it's from it. Uh, you will learn. Learn that. But yeah, you You presented in the right way. Yeah. The key really is just reflective practice. More than anything else, I think whatever opportunity that you have home or away abroad, if you're able to demonstrate how it's made you about a clinician and a more well rounded finish in, then it won't disadvantage you for most specialties. To be honest, I can't even even surgical specialties. If you were able to demonstrate how you become a bit better condition, um, you'd be struggling. Teo. Find reasons to penalize someone for that, so I wouldn't be too concerned about that. I would actually advised to make the most of opportunities abroad because it makes you more of a well rounded ah commission on give you a better sort of world. You on medical practice? Um, yeah. When you So, um, you guys really like traveling? Clearly, that's not something. Anything. This what? What was the What do you feel? Was the underlying motive for spending a chunk a large amount of time? Um, abroad in in areas where medical practice may not be, um, perceived as, um as advanced, a zit isn't in the UK What? What was really that? What was the key motive, Do you think? Well, for both of you, we're looking back on it plumbing And it sounds like it sounds cliche. VA is something I'm really interested in it. It's just like the disparity between our healthcare, another healthcare system, and it's a it's a synergistic relationship, something. I gain a lot from going out there, and I, you know, new culture. Lesser, much inflected, realized, like how much you burn, but also just understand that you know the health care system and then starting to try and improve and make change in a different setting to me, just like, yeah, I'm interested in that disparity. And that was something that really throws me to kind of want to workable. Nice. Yeah, I think I mean, exactly the same for me. And that's that. That's why it's been on my mind for a while. I'm getting too. So, um, getting to the end of, uh, of to Well, maybe maybe you should have a few months after the end of that, too, when I have done some milk. Um, working, but kind of For years I've been thinking goes first opportunity. I really want to get get into some work aboard. I'm going to do adventures. And on then you kind of it was almost in a dorm move was like, Oh, well, actually, I'm actually adequately for employees on D. I will. I'm right now. I'm just done four months of local, so wow, I don't really know what the Fine I've got the finances. Well, yeah. Oh, this's this is my shot. Yeah, this is this is so, um eso that That was what was a big, ulcerated perfect time to do it. Yeah, break it. We be foundation in training. Yeah, Road's come along on. Do you can fit it in with other times? Of course. You know, by that time that thing, things change all the time and you know, ages Life to get it a little bit later. You know, it also depends on it once it like seven senses walking. Well, yeah. When When did that science. But for us three last time on you have a huge motivation for me as well. Was knowing that for a long time I wanted to do something like that and just finding out is this just a, uh, a scratch? It means itching. Or is this something that I actually want to incorporate into my really on And actually, once go, you know, for for with And certainly I think I think it's the active for me. And now we wait. Should have, uh, there, um, definitely mentioned the the organization. We went to Sierra Leone with school assembly UK on. Now we've got on going to them, and we're now we're taking on the role of volunteer ordinators for their S o. If there are those listening who are a keen on opportunities. But we've had in in the sand it then, Um actually, we're we're the people to get in touch with ti. Try and see how you do You do get There you go. They have it, folks, you know, even a link alive Link that. Ah, sun necessarily. You mentioned obviously finances one thing as well. Um, so four months of low coming. So you finished f two. You've locum for a bit. You obviously doing the diploma. All of these things are happening at the same time. So four months of say, hey, Giller low coming. Is that enough to take you through, say, for the rest of the year for, like, eight months or or so? So my my um So if I, um my local thing was in, um, a basal week, which is a 20 minutes from John A gross it's about is yeah, yeah, that's funny. Little remote hospital on, but it was a pretty well paid local job. Full time on down is it was really exciting and interesting, but this is not a huge amount of stuff to spend money on in whipped. So it was it was pretty ideal for is a thing for me. And actually, so that's four months and looking there I after that, after the bone, I did another government months and then cover it. Well, before we went away to grease on, that's I think, saw me most of the way through stage three. And of course you know Okay. Wow. Look, um uh, living expenses and things of a brilliant pretty low. So it is. It is an expensive thing to do, I guess on go away for nine months and be the funded. But certainly it's less expensive, so? Well, actually, every year had to difference in savings and things, of course, but, uh but I think actually a good that locally saw me most the way through you. Yeah. Yeah. Zimmer safe as much as possible. And I phone left to you and then kind of local pre diploma. I think the Zealand was a big thing for me because I was there six months and you get paid really well and you can pick up, um, good funding there on Dalser local. Think over solidly. Two months. And at that time, that actually it's still be most of you. Yeah, well, just my husband says we don't live in London, so Oh, yeah. No. And ever hate on London there, but it is not a very valid point. There's a lot to do with this. So, uh, exactly Yeah, uh, in terms of actual clinical practice, did you find obviously, being abroad being in in fairly remote areas? Were there any sort of language marry is or any sort of cultural barrier is And we obviously you mentioned local healers when it came to Syria. Did you find that you were getting frustrated at all with the language barrier or or different barriers in terms of local practical, uh, absolutely like super regulative all I still the time. But that part of the fun and part of a challenge Have you have a comet? Yeah. So in Greece, less so because we use translators. We had kind of one of one friend's later, and a lot of the people were completely by an angle. We still at times got frustrated, but we really learned how to work. Translators have much in Edinburgh on, but I think but it's also a that is, that is true. But these these guys that were not suit of professional counseling if they happen to speak languages. So, you know, there are still times when you ask, You know, um, how long have you had your cough or whatever? Is this packing for in Arabic for about five minutes. I sit and then, you know, it's like you always going on on. Then they say the answer is no, you know, way. I don't know the answer I wanted. I think that that may be typically also good. Uh, really refining my questions. You kind of you kind of ask the question. And then the translation starts Already thinking that's not gonna change anything. I don't know why I asked. That was stupid. And I just wasted five minutes, basically, because it's touching a long, but I'm sure not speak. I don't get into using translators. Similar, but, uh, yeah, it was a similar in Sierra Leone, but kind of quite a It's a language barrier. A plus, a cultural differences Well, you know, we're using staff is translated is and it is very exhausting. Everything takes three times longer. Everything's exhausting. If it's not really answering all the haven, they get a little slap for a here, and you're You know, you know, that's not how I would be. But I understand that the cultural I need it Well, no cultures, but it's also trying to work here. This is How are you doing? I mean, truthfully, a lot of the way is coming away just laughing about it and being, like, how could we make this better? You get frustrated. Yeah. No way. Do you feel you're always well received over the times where you know they only like moments which really stick out where you were, like, I don't feel that this is going very positively coming. You know what? Uh, I think more so in in Greece than CEO makes, um there were, I think, most of times, most of the vast majority of time. Steve, go. I think, um, you know, unfortunately, um, the route is in in Syria along that the people were treating on really aware of what's standard they you she like what sounded his idea on what is essentially out there is a treatment options. And so any kind of interaction and treatment, then just, you know, is really were appreciated in Greece. it was occasionally bit more challenging in there. You know, a lot of these refugees in the camp were very, you know, of course, there's sort of welcoming. And on know I have high expectations. And yeah, well out there was available in this in the country. They left and on. Now they basically 100 in this in this place where they don't have access to that Onda, Uh, on that, that's that's very frustrating for them on. But they just, um you know, a lot of a lot of mental health problems about sort of. Well, do they work? The work? There was access into seeing psychiatrist and psychologist, but the waiting queue with a huge actually, you're skating a brick wall on here very good as well. And so yeah, occasionally that that that causes attention. Things, of course, for I think mostly that's just from frustration, brother, than any any. Well, yeah, I can imagine not being very difficult situation trying manage with that Valium. But, you know, it is something that you must you must learn to adapt. Um, with this Well, uh, you have 22 final questions. Um, the other one, The question I have is, um, personally in terms of you mentioned in terms of gaining the experiences themselves. It's it's really dependent on sort of word of mouth. And there's not really and you can't really like specifically, um, just search for a country and and hope Teo obtain work. How did you personally obtain the work that you did? Was it was it a Google search? Was it just directly emailing the hospitals? Was it luck? Um what? Why did you pick those countries as well? That's a great pressure. I mean, first of all, I even though I say you come across these kind of things, I have spent hours and hours, and I do still spend hours group being various opportunities and freeze. I'm interested in typing in, you know, country and your opportunity. You know, you do fine places and you can fire or emails, and you can learn about them. And that's definitely like a possibility. And I still find myself doing it. But I mean, the way I came across, I mean, was pretty much through the diploma wrestle on the diploma. You had a day? Well, two different NGOs come and talk to you and talk about her experiences. And actually, you come across a lot of other people that have worked in injuries as well. So a lot of work with math stuff and that's where I heard about Syrian was kind of on our NGO day little room. I that also your was it your stand for Sorry, don't government organization own government organization? So Yeah, lots of different charities. You come talk about it and then say, you know, would you be interested in coming out? So that's the way I found then, um, was all through the diploma. But you you absolutely can and there is possibilities of Google and you do fine places. But it's quite long, arduous. And there are a few websites like the fall from the things that Do you know, eventually medicus. You've heard of them before. They have a website. It tilts that different opportunities as well. There, I think. I think a lot of yeah, we did. We did get lucky. Roots was likely with the mouth. Think that you have this loop already. You see, already open. So you have them. So we didn't have the luck was a large part of it. But I suppose if you fire off another enough up changes new yet numbers gave. Yeah, you got you better play the field when it comes to the t. O. Um, my final question is, um what was your what was your most memorable or best experience that you had everything. All the incredible stuff that you've done? What do you feel is your most proudest or interesting experience put you on the spot. That's the best for this. So many things, I think. Probably mine. Waas actually the monkeys. And just because I had this chap had come in and he said, um, well and it was You just didn't really received much education about his disease, and I really kind of took a couple of hours out to spend time with him and saw Mcgillian gave him lots of education. And he was also diabetic and a fortune. Sara, in diabetes type one is really, really difficult to marry, said on. You know, I worked with him a lot, and then he'd never had that amount of care before. I had never had a health care professional built to provide him this. I was lucky that had the time to do it, and I think him coming back and seeing the rain regularly on bringing me a present, which is actually quite unusual there. You know, it doesn't happen regularly, and it's not like you got the line. Most doctors get credit for favorite 83 year old. You know, that's quite unusual thing, and I think that for meal, just, like always sit with me being given a baby monkeys by patient was a pretty Where is the longest? Now that's the That's a big I mean, we talked about people crawlies, but my plan was to we I wanted it to grow and then be let her how into the wild because it was too small. Pillows So Captain are covered. For a while. Last week, I got it to grow like it is nice uncovered, always and stuff that they want to get it to our friends. Zero. And we made them a lovely you make love Vick eight. But unfortunately for eating by giant aunts Oh, usually on the creepy crawlies we talked about, that wasn't a very happy ending. Really. Didn't you know it was a nice memory? Well, hopefully you Harry, you can you can end on a less, uh, on I probably for my for me, Um, a little Sinus area. And I think we do the lovely moment when we were working for a good while with the lab team, there were used, uh, whole blood for blood transfusions and things that I've often donated by a relative or something of a patient on eating it. But we're trying to work out a way of developing a blood bank so that, you know, in emergency cases, people were paying reluctant. So So it's a donation things. So we'll we'll go. We spent I spent a good sort of a couple of months working with it's now team until conducting surveys and also some ideas, it's trying. How can build this this'll blood bank and of Google These, um wh show ideas and things don't think also is a clever ideas. And then and then these guys are like, Well, why don't we just get the town cry it toe caught a meeting tomorrow and we'll see if anyone I didn't I didn't know that the town crier existed. I did. It was really simple On the town cried. It is rounded six billion was, um it was a whole village was gathered in the fall at six. AM Oh, these These local lab guys just gave a very it's all. And before then, you know, they have, like, 20 people lining up to get blood work. That was such a simple solution. Yeah, problem on. It's just really nice to see. Uh, we've been working for a good while and seeing these guys come up with the come up with the goods in the solution. And hopefully that's something that's gonna be sustainably happening as well. And they kind of taken on that role of those of blood. Been trying to do regular meetings and things regular donations. So So it just felt like a a good result from a lot of work actually didn't come from me. It's all 16 from all these. These guys just great learning like yeah, well, everything to do about it. Love bank drives and like, from them, they just needed that tiny little bit of us just direction. And you get inside inside, going to do exactly what to do. Okay, now, that's a nice story. That's it. That's a very, uh, happy story. The longer story is happy as well, but they're ready. Thank you so much. Guys. Honestly know where I've just seen that someone's posted asking for a month. So I just want to apply to that, uh, hoping, uh, I said if you if you could drop it in the challenge and verify my count first, I, uh I tell you what I'll do. Um, uh, if we if I I just Shannon screen again. Um, yeah, that's then, um, I just right in here. So sorry. This is a roundabout way of doing it. Um uh, I feel pretty to use this to, like, ask the questions rather than to do it necessarily cereal. And it's just that that would Yeah. So this is this is the mail that gets you to both of us. Yeah, exactly. Specifically about, um, sound good, But feel free to use it for other other, um, things as well. Thank you so much. Going on. It's did in in Ms Younger than going for you to hear from you. So, um yeah, Harry. Alex, thank you so much of this talk. It's been extremely interesting and very, very useful. Um, I would just also like to mention a shot. A medal for hosting us. Um, as always on the poor focusing, working closely with metal metal, um, provide opportunities that wide and access Teo medical talks on. Also, they have their own portfolio is Well, there have been a very informative service, so I would definitely check out metal on. Then I couldn't finish a talk without mentioning the portfolio clinic. Obviously, um, so myself and shipping, Christian and the rest of our committee have been working hard foot together the F three Siris. But we also have our own, um, portfolio analysis service is well, so we try to provide personalized, practical and goal orientated advice and support for those who are applying for specialty training on also those in foundation training as well tol the material. They RCP outcome. So, um, definitely check out the portfolio clinic as well. Um, I think that's everything then. Thank you, Harry. Thank you, Alex. Thank you for such a fantastic talk. Yes, it's been very good for a pleasure. Thanks very much. Is a take care