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It's just loading. Okay. I think we're live. Can the audience audience here us? All right. I'm sorry. Can the audience here us? All right, someone can respond in the chat. That'd be great. No, it might not be them. Yes. Wonderful success. Okay. Um Thank you so much to everyone for coming along to the east of England academic Surgery evening. Um, so I'll introduce myself first. I'm Alyssa, one of the fourth year medical students at the University of East Anglia and I'll let Ellen introduce herself. Um, so, hello everyone. I'm Ellen. I'm 1/5 year medical student at the University of Cambridge and nice to meet you all. Uh I want to also say sorry, I've got just a little bit more today and then I'll let you hand over to, um, doctor let or um, so today's event is obviously aiming to bring together people in this region who are interested in surgery and research and we're really lucky to have a variety of speakers lined up this evening. Um, so I'll hand over to Ellen to introduce Doctor Latorre who's going to be speaking first tonight. So our first speak, speak of tonight will be Mr Gilliam or, uh, so he's graduated from Brighton and Sussex Medical School and is currently an academic clinical fellow in vascular surgery at Cambridge University Hospital and a trust trust. And today he'll be talking to us about life as an academic surgical trainee. So, over to you. Right. Hello, everyone. Let me try and share the sides. Mhm. So, what I think would work best is, um, I mean, I can tell you all you want about what I've done, what, how I feel life is as a about academic surgical training. But I think the best thing if you guys drop some questions in the, in the chat and then we can go through all of them and I'll show you my presentation. So I am, I just said, I mean, I could have a click of fell in vascular surgery at Cambridge University Hospital. Now I ended up here by, um, by mistake. Pretty, pretty much I studied in Brighton. You see the slides changing, right? Yeah, we can. Yeah. Yeah. Okay. So I went to University brighten and I uh was very much average. Yeah. Then more some prizes here here and there. Nothing. Nothing great. Nothing much. I went to uh do my foundation years in Birmingham and West Middle and Central wanted to go into Queen Elizabeth Hospital. I did that during uh COVID 1st, 2nd and 3rd COVID pandemics. I was redeployed to I T U and uh during that time I didn't really know what I wanted to do. So I talked a bit of philosophy. My, what I didn't say is that I studied in Italy and everybody in Italy has to study philosophy. And then when I interrelated, I interrelated in philosophy of kings. And when I then went to Birmingham, I started teaching a little bit philosophy. And honestly, I found that a little bit more interesting than medicine. Then I got to know one of the nuclear medicine physicians who um, new, one of my supervisors previously in Brighton and we started doing some research together. And um during the time in uh ICU, there were some very large trials that were going on like the recovery trials and other stuff. COVID mostly and I was involved with some of them. And then I don't know if you guys remember how everybody was concerned about the COVID vaccines for um central venous clots. One of the hematologist in Birmingham had what published uh one of the first papers on the mechanism for this happening. So I kind of that was always in the background. Um But basically, I didn't really want to know what to do after F one, I thought maybe I'll do law, maybe I'll do nuclear medicine. Maybe I do G P remember this surgery I didn't want no. Um But one day I met one of the renal physicians kind of became quite close and he, he essentially said that he regretted or doing surgery because the changes that you can do in a patient's life are there and then you can, you can make a life or death this decision and you can make a difference instantaneously in someone's life on top of being able to look after them in the long run. Like most physicians do. And I think that's what India kind of clicked for me. Made, made it click for, um, to wanting to do surgery. No. Why? Uh, an academic training? I think it's a good idea to think about doing an academic training for a number of reasons. Um, first of all, you get extra time to do research, so I'll go through it in detail. But you get the opportunity, you get extra opportunities that you wouldn't normally get. Um, eventually though all of us, if you do surgical training, we'll have to do some, uh sort of research. Some people I met all sorts of people. So I met some people that absolutely love it and have quit surgery and medicine to do research full time. And I have known people that actually could not be bothered to do research and I, they just have to do it for completion of surgical training. I think that in the end there is something nice about research because the, although it might seem like what you're doing now, it's not relevant as you become more senior and you develop some of these projects, some of them can actually change an impact medical practice. And, and you know, as a surgeon that you can, you can say you can save, you can do a surgery today. Maybe you can do five in a, in a day. But if you make a change in, in how medicine is viewed, then you can save a lot more people. So ultimately, that's, that's, that's the overall aim. But you know, to get there, there's, there's a few things to do beforehand. Some of you might also know that to get a job, especially a surgical job with some of the more competitive specialties in the big hospital. Then research is something that they, that they want. So what I took is an extract from the curriculum, the general surgical curriculum of the things that you need to do. And one of them is this the main nine of the G P C framework, which basically means that everybody needs to be involved in research, everybody needs to have is to participate in clinical research and collaborative trials and share these outcomes in general clouds, literature reviews and then papers. But then down here, he also says uh some people choose to focus a significant part of their training time on academic medicine that need to complete all essential elements of their specialty curriculum satisfactorily. In order to achieve certification, I think that's, that's a key bit of information which means that you can be as good as you want as a, as a scientist and they encourage that however, you need to do the surgery, you need to be able to do the surgery. And I'll come onto that in a second. Now, it also says that arrangements for academic training differ in detail across the nation of the UK and the Republic of Northern Ireland. And I'll tell you right now that things vary incredibly amongst trainees and among training locations. So, um it varies widely. So once you completed medical school, you might have done a research degree during medical school, you might have been engaged in research in general. If you feel strongly about it, you can apply to academic foundation training. Um I have not done academic foundation training. So I don't know the specifics of that, but what I do know from people that have done it is that it's pretty much you get actually get allocated a project and a supervisor and you get to develop that in your, in your time after that, you can apply. So these are sequential, but you don't need to have done 12, then progress on to the next one. Unless you become a clinical scientist and for academic foundation, academic clinical Fellowships, you can apply whatever grade. So if you're a foundation doctor, you can apply for academic foundation training. If you haven't done academic foundation training, you still apply for academic fellowship, which is what I did. Um So the academic Clinical Fellowship is to cover the core training um side of things. So during core training, you're given extra time uh to do research, you get uh I had the freedom to choose my project and to choose my supervisor, some places allocate you a supervisor. But it is quite free. The idea of the A C F is to um basically get enough experience to have some pilot data so that you can then apply for A phd, which is the ultimate aim after the phd, you come back and the, the ph D is normally done as a full time thing. So you get three years out. Um After that, you can apply for what's called an academic lectureship, which is specialty training where you get 50% of your time for research and 50% of your time for clinical training. And then eventually, if you get a big grant that can support you, then you can become a clinical scientist. So a consultant who's also a scientist. So the arrangement for the S S E F uh in my experience varies greatly. Most places advertise it as a three month block. So you get, you get three years to complete core training instead of two for surgery and you get an extra nine months to complete research. You normally get three years, sorry. Uh And those three years you get three month block each year in research. Um I did a six month block and then I'm going to do a three month block in August. Some other people do 1.5 days per week for the whole three years. Some people enroll in the masters or an M feel while they're doing the A C F. Some people don't, I didn't. Um But the idea is that you do enough that you can get part of data supplied for phd. Yeah. Now what that the Domain nine said is that you need to do both the thinking and the cutting. So you need to be smart about how you arrange your, your time. Um If you're quick at learning the surgical skills, I think that really stand in good stead because you'll be able to progress quickly given that our surgical curriculum now is competency based rather than time based. So the moment that you have achieved the competencies for core training, you can be signed off core training. The moment you've achieved the competency for S T 45 saturate, then you get signed off for the next year and, but you have a maximum of three years to complete the A CF some people after the second year get signed off and complete the core training and either continue on to the specialty training or they continue to do research and then apply for extra funding and or some of them managed to get funding for A phd. Earlier on. Um The other question I wanted to, to answer is how do I get involved in academic surgery. Well, if you ask most people will be happy for you to get involved in whatever they're doing, uh, be worried that you will start with the basics. Um, most people, you know, need people to help them with data collection and this analysis. Um, but just ask, um, and to get involved, also, many people don't know about academic training. Um, so if you're here, you're probably the few people that actually actually know about it. Um be wary that the deadline is slightly earlier and the job adverts is a little bit earlier. If I remember it's around October time, they get published. Um for the actual, for the actual selection, you have a clinical and academic interview. I think this is standard across all of them. But the difference is that you apply to the specific training post rather than nationally. So if you know that you really feel strongly about Bristol, you want to go to Bristol, you can apply to an A C F in Bristol. You know, you're gonna be in Bristol for those three years at the very least. The other quite nice thing is that although they have scrapped, run through training posts, all academic, run through all academic training posts are run through. So although it doesn't say that it is a run through posts, you are guaranteed progression onto uh specialty training in that specialty. And that is for both uh surgery and medicine. So I think I'm blabbed enough. If you can write questions, ask me questions, I'll answer any anyone. Thank you very much. And it's definitely very helpful to know a bit more about um, what the academic clinical Fellowship is especially. There isn't much information around, I think. Um, just, uh, perhaps like in the meantime, while waiting for people to take their question, I have a question to ask. That's all right. I'm just wondering how important you think having uh being in the academic foundation training is in the application for academic Clinical Fellowship because they have uh because people talk about, talk a lot about the academic foundation training. I don't think it is. If you managed to get equal experience is not important. So I had um national presentations. I had some national prizes and audits that I've done in my own time. Uh I managed to get those done without the academic foundation. So if you, what I probably, what I'm assuming is that once you apply for an A C F, they're gonna have some blank questions and they're gonna ask you uh tell us about project that you did tell us about your leadership experience. So then you can start writing about your projects. You've done this, you let that you've done this. So if you have equal um experience, it doesn't matter. No one asked me if I had done academic foundation training. Yeah, that's very helpful. Thank you. I can't see any questions in the chat. So, do you want to move on to the next introduction? This speaker? Thank you so much. Uh All right. And if there's anyone, um, want to ask questions after the talk we'll send around if it's all right. If, if you, if we send around your email. Absolutely. Absolutely. No problem at all. Amazing. Thank you very much. No problem. So, um, so now, um, comes to our second speaker, um, Doctor Conner Galaxy. And so he is graduated from University of Liverpool and the past chair of Nancy Checked and Neurology and Neurosurgery special interest group. And he's currently a foundation year one doctor in uh in the Clinical Neuroscience S A P at Cambridge University Hospital NHS Trust. And today he'll be talking to us about the specialized foundation program. Let's because it's like, thanks Alan. Can you hear me? Okay? All right. Let me just see if I can. Uh Shabba. Uh Is it the shot uh screen? Um just trying to see which one is the best one to, to share. I'm guessing it's this one. Can you, can you see that, Elon? Okay. Yeah, we can see that. The presentation, right? Great. Uh Hello everybody. Uh My name is Connor. I'm one of the basic, I'm an SFP doctor. As I said, Cambridge basically just going to give you guys a whistle stop tour on what the SMP program is, how to apply. Uh and some top tips based on my experience. Uh So I'm guessing that most people are going to be med students in sort of the audience. So let's just, I'm just assuming that's of our baseline. SFP isn't very well promoted. Uh It used to be called the AFP. But exactly as the previous speakers, uh said, it is just all it is is just, it's the normal doctor Foundation program, but it just gives you a little bit of time to pursue an area that you're interested in. Usually this is research. So it used to be called academic foundation program just for those people for research, but it encompasses a lot of other areas as well. So it's not just research, it can be leadership, it can be education and teaching. Um sort of things like medical education in particular, you can have dedicate your programs for that. So it's not just for uh not just for research. Uh So going through a typical sort of SFP pathway job looks like compared to the standard. Uh I'll show you using the written bit here and then I've got like a table on the next slide. Basically, you have some dedicated time for this area of interest. So just assuming it's my one say for research, usually in most programs, your f one year looks pretty normal. It's the exact same as the standard, the standardized program that all doctors do. But then in your f two year, often you have one block or one rotation of four months, which is dedicated to uh your education, your research or your leadership. So for that, you don't have any clinical duties you're not expected to cover on calls. You don't have to go into work, you just have to, to complete your research project. So some programs have more depending on which area you're based in. Uh So for example, in Newcastle, they give you four months of F one and four months of F to, to, to do research. So it's a bit more uh but some have a, an integrated or mixed program. So for example, let's say if you're in, if you're on like a teaching program, then often your work Monday to Friday and you're normal like doctor job on the walls and then the next week. So every second Friday, you'd have the Friday off where you could just do some research or some teaching. Um So some integrated and some uh sort of stand alone. Uh some of them give you lots of nice hidden perks. So you might be able to do a uh they might, some programs will fund you to present work at conferences. They might give you some study budget of like 1 to 2000 lbs and some will even fund you to do like a postgraduate qualification. So if it's an education based one, they'll, they'll often pay for you to do a postgraduate certificate of education, which is very valuable and it costs about three or 4000 lbs. So you have a lot of options with SFP programs. So choose wisely, okay. This is an example, sort of wrote job rotations for an SFP uh doctor. This is actually my rotations. Uh So what you can see is basically you have, you have six rotations from F one to F two. You have three in F one and three and F two. Uh uh This is an SFP pathway as it's mine. So for the first year you start off on sort of generic rotation. So this is geriatrics, general surgery and trauma orthopedics. Um I'm currently based at list of hospital which is actually in Stevenage even though I'm a, you know, Cambridge SFP. So I'm about 45 minutes away currently and then you can start to see that on rotations 4 to 6 in the F two year, it starts to become a lot more neuroscience focused. Uh So that's sort of where the SFP element kind of comes in because a lot of the, your actual jobs will fit the theme or pathway of your SMP program. So all my rotations are a neuroscience based. So if you like neurology surgery or just research, it, it really fits for someone who likes neuroscience. And uh exactly the last speaker said this, basically, it sits about here where it's a, it's a, it gives you a nice introduction to higher academic clinical training. So usually your steps on the pathway are an academic foundation post gives you a taste of research and experience. If you want to progress the higher appointments, then you can do things like academic, you know, clinical fellowships, which are the same as normal training, but you have research time uh and then it progresses on to other things like, you know, things like lecture ships and, and progressing onto eventually becoming a professor of some sort or something like that. Now, here's the more honest bit. So just a quick disclaimer guys, this is all based on my personal experience. This is not the views of the colleges that represent Cambridge, the Cambridge SMP program or any other SFP program. Okay. Um So I'm just gonna give it to you as honestly as I can give it and what I would want to tell someone a few years behind me. Um The reasons why you should do the SFP and the good things about it is that it does give you protected time, whether that's the research or leadership or education, you want to design a teaching program. If you really liked teaching, you can do that if you want to go and just do some lab work, you could do that if you want to just do a big massive research study and you never got the chance to do as a med student. You could absolutely do that. Another good thing is it gives you links with universities and colleges that you would normally lose uh as just being a normal doctor. So they don't tell you, most of your union won't tell you this. But as soon as you graduate, they'll take away your university email, uh and then you'll lose it. So you won't be able to log into university computers. You won't be able to access articles, etcetera. So if you keep up an SFP, then you get a link to, to that university often and you can still keep that, that link. You do also get to feel a little bit special, but not much. Uh, as in when someone finds out your SFP, they just go, oh, you must be pretty good. Um, but that's pretty much it. Importantly, I think people don't think about this. It actually gives you an option to do things outside of medicine. So if you, let's say if you're mean, you have a four month block at the end of your F two, that is completely free for research. There's nothing from stopping me taking two months to just do the research project to do a small one. And then I could just take two months which a lot of people do if their supervisors happy with it just to go and travel somewhere. You know, if you got relatives in different countries, if you just want to go and travel across the UK, you absolutely could do that. Uh And as well if you apply for the SFP, you have to do an interview process. So it's good interview practice for hire, specialty training, you know, when you apply to do sort of, you know, G P or, uh, you know, or surgery jobs you always have to interview. So this, you'll interview for this and it'll be good practice. The convert are that just like the normal foundation program? A lot of SFP jobs suck. Uh, to be honest that, you know, if that's all depending on your preference, you know, um some pathways just aren't that good. You have less time to complete your core competencies than like a standard F one doctor uh to progress from F one to F two and F two to complete the program. But it is usually manageable and to be honest with you, exactly as he says, you know, the interviews don't look for this program, they don't treat it as a big thing. It doesn't really affect your, your higher progression, whether you do it or you don't, it's all about just what you've done. So you absolutely do not need this to progress. Um And to be honest as well, you're even if you're an academic doctor, you're not really treated the same as, as students. So even though I'm technically University of Cambridge, you know, SFP, I am not treated the same as a Cambridge uni student in terms of like what it does to my career. It is literally just I work there if that makes sense. And the harsh reality as well that I've learned in this year is that you are still a foundation doctor at the end of the day, you're still on the wards. It doesn't afford you any protection from that. And you're very much just like everybody else for the first year. At least of your training, which, which I've been so a little bit on how to apply for the program itself. So, it's done on Oriole, which is the standard foundation program website where you apply, you can pick up to two academic Dean Aries where you'd like to apply. It usually includes places like Oxford, Cambridge Northwest Northern, which is like Newcastle London, big groups like that. One thing to note is the application deadlines are very early. So they're in September compared to March for the normal Foundation program. Usually you'll have to write some white space questions. So these are short worded statements that are about 200 words, each questions such as you know, what's your favorite research achievement? Tell me about the time where you got involved with leadership or a committee or a society uh and so on and so forth. At that point, you rank weight, your choices, you have an interview. Uh And then after that job offers come out in January as far as how to work towards an SFP as a medical student, I personally would say it's a double edged sword because N S A P is designed to show people about research is not for people have just done those of research. So the more research you do and the more experienced you are actually the worst you're gonna be for your applications. I know it sounds very counterintuitive, but that's what I've found throughout memory. You know, dozens of students is the more experienced people are somehow seen as less appropriate for these jobs, which is a bit of a joke if you ask me to be honest. But that's, that's how it is my top tips for what you should do basically is you should approach a supervisor to discuss the potential projects, whether this is in research or whatever, you should be knowledgeable about the program that you're gonna do, you should ask around maybe find some people on linkedin or, or whatever who've done the program and can give you some advice. And I think focusing on not what you've done previously to contribute towards your SRP application, but what you want to do during your SFP will give you a good amount of success. And as well, I would get encourage you to have someone to read your whitespace questions, have someone to do practice interviews with you. Uh And think about joining sort of an SFP mentorship scheme. Uh Mind the bleep to a really good one every year. So I would uh keep an eye out for those ones when they come out. Uh I haven't got much time so I'll just be very quick, but for all sort of Cambridge in particular, SFP is the one I'm doing. Your F one year is pretty standard. You're not going to be doing anything good. You just stand the foundation and your miles away from Cambridge. But then your F two year is really good because you move into Cambridge and you just do Cambridge jobs. So that's great. Uh, Cambridge is an academic office. They don't give you much events for your SMP program, but of course, you're amazing research unit. So uh you're gonna, the opportunities for research are absolutely endless and it's amazing facility to be a part of. All right guys. So I'm happy to take any questions and there's my email, it's A C G 8 to 3 at com dot A C dot U K. If uh if you'd like to ask any questions, I'm happy to mental students. And uh yeah, just basically let me know if there's anything that I can answer. Thank you, Connor. Um There's a few questions in the chat, so I'm just going to read them out case anyone can't see it. So, um one of the question is, can international medical graduates who complete F one in the home country join the S F P N F two when they join the UK training system? I'm not sure you have any experience. A great question from what I understand you'd have to have uh if you wanted to do that So I, if you wanted to do that, you have to, you have to go back to F one basically. Um Because I know a lot of people who are on the program. So someone who's doing the Neuroscience one, uh he graduated in Malta, but instead he, instead of doing his F one in Malta, he elected to come here so he could do the SMP program. Um So if you've done your F one, then you probably have to go back to F one in order to do the SFP. Otherwise you'd have to just come in at F two level and do the normal foundation program. Um So it's up to you and it's depending on your circumstance. If you're, you haven't yet graduated, then I would try and join as F one to do your SFP if you want to. But if you haven't, then just try, you could, you could go back if you want. Um All right is the next one about, do we need to start taking point of research in med school? Um So, yeah, this is a bit of massive. I'm about to like, ruin a lot of people's day with this comment. Um But I'll be brutally honest with you all the research you've done in medical when it comes to the SMP program. If people, people done so much and some people have done nothing, it does not matter. So if you've done no research and medical, I'll be honest, it's probably a better thing for the SFP applications than it is if you have done any. Um The example is that I didn't get this job first time. It actually got offered to someone who I know one of my friends and she turned it down because she was going to London. Uh and she had zero research experience, zero projects, zero prizes, zero presentations. Her best achievement was organizing a ball at Oxford that actually got cancelled because of COVID. So she organized an event that never took place. Uh And you know, I came in with, you know, 25 decent papers, numerous prizes and she got it ahead of me. So it's proof that it, it doesn't matter when it comes to SFP and it's probably better to have done less work. Um So yeah, that person, you're absolutely perfect. You can, it doesn't matter whether you start in medical or after graduation. Um The email address. Yes. So it's C G 8 to 3 at uh com dot A C dot U K. I'll put it in the chat for you. Uh And then the last one. All right. So let's see how, what factors need to be looked at to decide. Okay. Um So look at the, look at the rotations within that program. So the Cambridge scenery has 21 SFP jobs, for example, I'd say about 18 of them are really good, but there's going to be about three of them where that the hospital you're working at in your F one is really far away and it's unsupportive and then your F two program, it's the research area might be something that you hate, for example. So I wouldn't take foundation jobs and I wrote an SFP that you hate into, like, if they give you one that's not your first choice. So if you're really keen on vascular surgery and they give you an option, Gynie Sfp, and you really hate Ob Gyn gave me, I wouldn't take jobs and I wouldn't take the SFP just because it's an SFP. At that point, you can get any foundation job with any rotation you want and you'll have a much better time. Um But yeah, that's, that's all what I suggest. Can I also ask the question, Connor? Sure. Um because in the talk, you mentioned that there's quite a bit of a variety between different S A P program, right? Is there like any resources online that kind of talk about the, I don't know, like a review page of H S F P program that we can have a bit more information about it instead of just the standard book, standard kind of cancer venue or available online. I mean, it's great that you mention it because that's actually a huge, huge gap. Um So that it does not exist. Um What you do have my best advice for that is to find people on as soon as you're usually, you'll be interested in about three or four uh sceneries or programs. And at that point, I just try to find people either from your med school who have done the job or like Med Twitter is really good or, you know, linkedin, whatever, who've done the program, just send them a message about. How much time did you have? The, all the knowledge that I've got is literally just passed on from word of mouth. So you're right that there is not a actual resource which has all of the programs and their exact academics. Um You should actually look at that actually, I think it'd be helpful to collect a resource for people to, that shows the different tracks will be um because Oxford is different to London, which is much different to Cambridge and Northern and Northwest are completely different. Um You don't know about study budget, so Cambridge don't have any study budget at all. Um But Northwest, if you go North West, you get 3000 year, which is mad because Cambridge gets 15 times know it gets 30 times the research as a university gets 30 times the income of Liverpool. Um Okay. Do we apply for the SFP in September of 50th? Yes. So in September of your, your 50th, that's when you would apply for it. The deadline is very early. So you really, you should start preparing your wide space questions um about July, the start of August time because it's usually early September as well. Uh, but yeah, it's, it's September. You finally? Yeah. Okay. Yeah. Um, thank you so much for your time. Um, so I'm also going, oh, no, you did pass on your email. So it's fine. Um, so, um, if there's any question that you kind of come up with after the trial, feel free to email Connor, I'm sure he'll more back, more than happy to answer and then thank you so much. And then I think I'm crossing to Lisa. Yeah, thanks. Um So I'll be doing the next talk, just going to try and share my slides. Can you all see that? Yes, wonderful. Um So I introduced myself at the start, but for those who have joined since then, um I'll introduce myself again. So I'm Alyssa Bag 1/4 year medical you ea currently and I'm going to be doing a short talk on how to get involved in surgery as a medical student. So, um as the other doctors have already iterated as well, it's a rewarding career, but it is also a very competitive career to get into. Typically, the competition ratios are about 123. Um So it's really advantageous to start thinking about building your CV early on if you can. Um, the other doctors again have already kind of gone into this what the training pathway looks like, but it's just another flow chart um to show what it roughly looks like but I'm sure you're probably familiar with this now um that it starts off with two years of foundation training, two years of course surgical training or an academic clinical fellowship. And then going on to you especially anti training, which takes a number of years. Usually it's around six I think. Um and then going on to being a consultant afterwards, in terms of the court surgical training application portfolio, there are a number of ways that you can start getting yourself ready for a career in surgery. So this can include putting work in for your portfolio. A portfolio is made up of a number of components that show your engagement and commitment to surgery and achievements can be from medical school onwards. So start building it now if you get the chance and if you don't take anything else from this presentation tonight, I'll reiterate it again at the end. But collecting evidence is a really, really important thing to do for everything that you do. Otherwise you may as well have not done it. Um So make sure that with everything you do, you do have some sort of evidence to back it up. This is the front page of the 2023 court cycle training, self self assessment score ing guidance for candidates. It's something that you can go away and Google and familiarize yourself with. Um But it basically shows you how many points different sections are worth. So for example, your presentation of your publications, which I'm sure that Ellen will go into a bit further in her next presentation. Um But disclaimer is that this uh application, the scoring guidance changes every year. Um and the requirements uh yeah, they change every year. So you don't need full marks and everything to get a court surgical training post. And it's actually important that we don't have everyone score ing top points in every single section because otherwise we'd end up all being the same. Um And for a career like medicine and surgery in particular, it's important that we do have a diverse workforce with a variety of skills. So don't make yourself unhappy chasing after points equally. Don't think something is not useful just because it's not worth any points. It's definitely worth looking into lots of different sectors which I'll talk more about um later in this presentation, even if it's not worth any points right now because it might be worth points by the time we get around to it. And it's good for just your overall personality, working as a surgeon as well. Um So we'll go through some of the specifics on how to build the surgery, a strong portfolio as a medical student. So the first section is commitment to specialty. This can include things like attendance at surgical conferences. They don't have to be the really expensive Royal College of Surgeon ones and they can be any sort of surgical conference. And I've seen that there are more and more of them being done online these days, which obviously saves the kind of traveling burden that comes with that. Um And are often a bit cheaper to attend as well. So there's lots of different options for those. Again, collect evidence of being, having attended conferences, etcetera to keep the your applications in the future. Another really good thing to do is to get some operative experience. So whether that's you're able to find a, a supervisor or a surgeon that you're on placement with or something, keeping their contact details and seen if you can attend extra surgeries in your own time and then possibly even assist is a really good thing to do. Um Some of you may or may not have heard of the log book. It's an online platform where you can log all of the surgeries that you've observed or assisted in and this becomes really important later on in your court surgical training applications because having assisted in surgeries counts towards points. So it's completely free to set up an account, you can go away and Google it after this. Um And yeah, start building that L log book. Um And finally surge collectives will have the opportunity to organize an elective as a medical student at some point during med school. So if you're able to get a surgical one that would be really positive just again to increase your exposure and learning and surgery, um There's also grants available um to help fund these as well and take the opportunity to go overseas if you can as well and experience a different healthcare system, quality improvement projects in clinical audits can be done at any stage. Um And for maximum points, they should be surgically themed. Um It's better to do a simple but effective project and branch out on the explanation of the standard and really kind of dig into that audit. So often believed to be really laborious when actually you can do them quite quickly and easily find issues within the department. A topic that you're personally interested in areas which have high volume of work and the results can then be presented back to the department in areas for change or intervention can be suggested re auditing the data following an intervention is known as closing the loop and this shows evidence of change and is key to the audit. So make sure you do close the loop. If you do decide to do an audit, once a loop is closed, results should be submitted for presentation at conferences and additional points can be gained from this presentations. This will be further built upon Ellen's presentation which she does next about getting involved in research. Um once but just as an overview. Once a research project or quality improvement project has been commit completed, submitted for presentation. These can be at surgical research meetings, conferences which are local, regional, national or international in terms of publications there, obviously in a number of different types of publications such as case reports, letters to the edit er original research, systematic reviews and meta analyses, submit your own research of publication. Um First authors do usually score them worst points. If you're unsure of where to submit, ask a supervisor for guidance and where is the most appropriate. And also particularly as a medical student, collaborative research counts towards court surgical training applications as well and can be a really good place to start. Um If you're unsure of where to start um teaching, engaging with teaching, when in medical school is really important, you can set up your own teaching sessions and even better teaching series for other medical students. This can be things like going through medical cases, knowledge based sessions and even surgical skills. If you get the opportunity, for example, something like suturing course, a great way for medical students to do. This is by being part of the surgical society as they get to run teaching sessions for their members, you might also get the opportunity to have formal training on how to teach, whether that's through master's or postgraduate qualification training programs run by educational institutions like universities or the Royal colleges. And one thing to note is that feedback is essential for any of the teaching that you do because it acts as evidence and obviously helps you to improve your teaching. The next time you have a go at it. So this is a bit more specific to the 2023 application because the various sections have been removed compared to 2022 from the self assessment score. And this includes things like the mrcs part, a surgical courses, postgraduate qualifications prizes and leadership and management. However, don't disregard these because these requirements may change by the time we get around to applying and while they still might not score any points, they are still important to aspiring surgeons based on the skills they bring in the next few slides. We'll go through some of the specifics on how to build these skills as a medical student. So degrees and qualifications, you may have previously done an undergraduate degree prior to medicine. If you didn't do that, um consider the opportunity to interc late. It's a great opportunity to learn more about research and also an opportunity to explore different interests within medicine as well. Prizes and awards. Medical school is a great time to get some prizes under your belt. These maybe national or local awards run by regional or national societies and prizes representing research are available. Achievements in medical school including honors and distinction grades and exams can also be noted um also consider applying for scholarships, bursaries and grants if you get the chance to do so, leadership and management um during your local university surgical Society as a member and understand what activities they organize and try to participate as much as possible apply to be on university society committees as this demonstrates leadership skills. And also if you get the chance, consider applying for national committees like the B M A star surge or asset, it doesn't necessarily have to be surgical but ideally health care based and show evidence of interest. Get to know the surgeons and surgical trainees and keep your contacts to help opportunities in both teaching and research in the future. Find a good mentor, apply for f pass rotation strategically with surgical rotations to help make contacts in a field of interest. And as I mentioned earlier, I'm going to keep banging on about it, the evidence is crucial. So everything that you do have evidence for it or it won't count, even if it's something like an email confirmation or a letter from a consultant, it will still help. So just keep you organized and keep lots of evidence for the future applications a little bit about my own experience. Um So this year I joined the knowledge undergraduate Surgical Society in their mentor mentee scheme, which meant that I was paired up actually with an aura maxillofacial surgeon. Um and basically got the opportunity to go and attend many more surgeries in my free time and even assist in some of them as well. And he's invited me to clinics and extra ward rounds and um some of the research that you've done previously, so if you're able to have a really good mentor like that and have the opportunity to do extra stuff outside of your normal med school timetable. Definitely do because it can open up a lot more opportunities. Um I obviously undertook the regional lead position for Norwich star surge this year. Um So the I think it's sort of like around July or August time when those positions will be up for grabs again. So if you're interested and you can talk to Eleanor I afterwards or um email, the star surge kind of the general email. Um I have also got an organized plastic surgery elective at the Queen Elizabeth Hospital in Birmingham for July and August this year, which I'm really looking forward to and in terms of conferences, I've actually only attended one surgical one so far, which was the asset conference in March earlier this year. Um But I'm looking forward to attending lots more in the future and final tips to send away um be strategic. Don't take on too much and we'll go help each other out as well and collaborate. It reduces the individual pieces of work. And also, as I mentioned earlier, keep all your evidence, organized organization will be the key to getting a number of projects going and also use the log book, which you'll be able to Google after this and set up an account for free. So if you've got any questions, free to put them in the chart. Thank you for listening. I'll hand over now to Ellen if you'll be doing the next presentation. Thank you. Uh, is there any question for Alyssa? Travels? Okay. Uh, does evidence Culleton during dental school count after graduating from medicine? The case of that's a little facial surgery. Do you have any experience with? Uh, I don't have any experience of presenting or any prizes yet. However, I do know that anything you get during medical school prizes presentations does count as points in your court surgical training. So anything from medical school on which does count, unfortunately, things like in your A levels don't. Um But yeah, anything you do in medicine does count and for the log book, how did you get them signed off? So if you're, if you're observing a surgery, you can, I don't actually know what the sign off process is for observing a surgery. But if you have assisted, which is the stuff that counts towards points in your course, surgical training application. Basically, what I do is I get the date and like the hospital number of the patient and what surgery they had and stuff and put the who the supervising consultant was and then it gets sent to their email or to their logbook profile or something and they're able to, um, say and verify it basically and send it back. So it's uh you have to actually be there obviously. Um, and it, you can do it via email or you can do it on the log book format itself, I believe. Um Are there any other questions at all? No. Should I hand over to you, Alan Thinki? I'm just gonna share my screen. It uh works. Can you see high scream? Yeah, we can. OK. Amazing. Also my network it's a bit unstable. So if you can't hear me just like, let me know. Um so hi, my name is Ellen. I'm 1/5 year medical student uh Professor Cambridge and I'm the star search regional lead for my uni this year. And today I'm just going to talk a bit more about how to get involved in research as a medical student. And at first, I'm just going to quickly run through what research is and why you might want to get involved. So research is a process of answering a proposed question or hypothesis and it can be seen getting done from basic sciences, um clinical sciences all the way to biotechnology or clinical application and prescribing as well. Um So there are different types of research. So it can be broadly divided into two categories which are lab based and clinical based and the lab based. One can be further divided into wet lab and dry lab. So the wet lab is research done in a setting, working with biological matter, for example, cell lining teacher culture small mammals and different chemicals as well. Attempt to be more time intensive considering all the time that you need per pitting, dissecting rats and culturing cells, etcetera. And it's most it's usually done during intercourse a year or as an ongoing project or uh collaboration with the lab throughout the year. And in dry lab research, it's tend to base on the data from registered database, for example, a genetic sequencing database or current literature on pub med or end base etcetera, which then leads to a systematic review project. So this tends to be a much more accessible in terms of getting started because you usually only require a computer and an internet connection compared to the whole lab equipment that you need for the wet lab project. And but you would need to use the all the statistical software, for example, RSB S S uh Python metal etcetera um or systematic review related software like regimen depending on what kind of project you are on. And for clinical research, it is supervised by a consultant in a clinical setting. So there, there's a, a broad priority of stuff that you can do. So you can either you can like do surveys with patient and outpatient clinics, you can help recruit patient um for a clinical trial or you can work on audit project um looking into the local clinical practice and there are different stages um which leads to a paper publications. So from conception of the idea to writing up, preparing for the study protocol to data collection analysis, writing it up and then finally, the dissemination of result which can be in the form of poster or oral presentation and conference or as a paper publication as well. And students can get involved with research at any stage in the process really. And I think we strongly encourage everyone um to get involved as many stage as possible just to get a gist of what uh what the process from an idea to paper is like. So now I'm just going to talk a bit more about why you might want to get involved in research as an undergraduate. So you might want to improve the understanding of diseases and clinical processes. You might find it fulfilling and stimulating and you might think, oh it's such a good escape way to escape from the clinical placement and and just simply revision and um you might find it very stimulating and fulfilling as well. And um it is also a very good opportunity to learn valuable new skills, for example, the basic data collection or how to analyze a a large set of data and how to write a manuscript and so on. Um from a more pragmatic point of view as Alyssa has just mentioned that um the further training application would require some sort of research. So when you look at the court surgical training or um the internal medicine training, all of the application scoring system would ask for some sort of presentation experience and paper, publication experience experience. So from that point of view, you probably might want to get involved in research as well. So there's a few questions that we think it's very important to ask before starting research is that? So the first one is what kind of subject and topic that you're interested in? Because sometimes research will involve like a lot of sitting in front of the computer quite a bit of dry data hauling and you might encounter quite a bit of rejection and also uh constructive criticism from different people. So um even though the whole entire process is very fruitful and and good for learning and all these challenges and barrier uh makes makes, makes the topic of the project very important because finding a topic that you're interested in will make the process much easier and much enjoyable. And then secondly, how much time would you be willing to spend? So, um a lot of research would require quite a bit of a time commitment there and there's no point of doing great research but not allowing time to study for your degree, right? So um the time management, skill and balance is really the key hit. And then thirdly why you want to do this. Um So it's quite important, especially when you're communicate with the supervisor. So say, for example, you're only aiming for like a poser or representation for city application. It would be good too, mention it to your supervisor straight ahead so that they can plan ahead for it. And then make sure give you a feasible and uh appropriate size um project and or you might just doing this because you want to know if a academic career in academic surgery is what you want. So there are different reason why you want to work on the project and it's, it's very important to be clear about it from the very beginning and then forcefully last but not least is to ask around. Um So, yeah, I did mention uh earlier that um quite a lot of this kind of application and research involves a lot of asking around and there isn't a very organized resource as to which civilization find or um what kind of project you should do. So um asking senior colleagues, for example, medical student from the upper year, junior doctors and also even register will be very, very helpful in terms of getting you in the door and prevent you making mistakes that they have made. So now I'm just going to talk a bit more about ways to get involved. So there will be two main ways that you can get involved. The first thing is the inter curricular research which is performed as a requirement of the medical school and extracurricular research, which is performed based on your interest. So um we won't focus too much on the inter curricular research because I think it varies from medical school to medical school. But essentially this is the most accessible because you are required to do research by your degree and by your medical school, right. So, but um there's a downside of it is that the this way tend to be limited by the time of the placement. So say, for example, for S S E, um it tends to be 4 to 6 week period. Um So, and it's quite difficult for my experience to do uh to complete everything within four weeks. So what my colleagues or myself uh tend to do is that we tend to like go beyond the current um placement period and then kind of um extend the research after the S S C placement and continue doing research with the team. Um And the second way of doing it is in circulation. So some medical school school will have a whole year of interrelation. Yeah, where you can take a break from the current medical degree. And then um and then uh do some research and then most of the people tend to do like wet lab or uh yeah, wet lab research with a, with a team, but they're, I don't think there's any limitation as to what you can do in, in the equation. You uh at least that's the case in Cambridge. Um And then the third way is um elective. So uh well, elective essentially is where you can go anywhere in the world and the wrong medicine. And um quite a lot of people would use this opportunity to do research in that uh experience as well. So um now I'm going to talk a bit more about extracurricular and how to get more opportunity in this regard. So it is less Haman I would say because it's not directly required by the medical school. So the students would need to utilize lots of the free time um to conduct this kind of research. So it tends to be more self directed and self initiated and it can be more difficult to get because you will need to find a supervisor, support you. Um But there are like different ways again, uh summer projects where you can explain your summer holiday, working with the lab on independent studies where you can approach individual supervisors consultant to do research with them. And thirdly, oh sorry, collaborative research where um there, there, there will, there, they're currently quite a bit of collaborative research that is organized by students where you can form groups to do systematic or uh do work on some multi center order project which I think um landside and also start search has organized um in the past and also this year as well. Um So perhaps one of the most important thing is to find a good researcher. So um you probably want to find a supervisor who's working on the topic that you are interested in uh with regular paper publication. And also previous experience with mentoring students, definitely definitely ask around to see if people around you have any recommendation and really from my experience of responsive and supportive supervisor is really everything. Um because especially when you're quite freshen you two doing research, you probably don't want to do it on your own in the dark. So, um yeah, definitely. Um finding a good supervisor is crucial and here comes the daunting, often, daunting and scary bit is too, is um how and who to find. So, um students often find contacting's supervise a very difficult task. Um As I mentioned, you might not know who to contact and how to contact. And now the full question that I've just that we've just discussed comes becomes very important, right? Cause if you know what you want to do, what kind of specialty you want to say in your surgery or a vascular surgery, then identifying a supervisor can be done through simply like just searching on the university database or the hospital data database because they tend to have include like supervisors profile and there like publication and also contact emails as well. And in the hospital, there will be like consultants, details, having a little um info page, talking about the research they do. And or another way would be you might come across the paper that they have written and which interested you and then they incidentally become um is the corresponding author for that paper. And then, and everything is just kind of uh going to places. And another way of contacting supervisor is through your um clinical supervisor of your placement and you can definitely like email them and ask for your the advisors to who which person would be best to contact for research project and they tend to be quite friendly with students. And um, so that is also another good way to contact the supervisor. Another challenge is that another challenge that student might find is that uh the situation where you've sent so many emails, but there's no one reply. Um, so please be assured that, um, it is very, very common and please do not be disheartened. If you do not get a reply, just keep sending, sending it. It's kind of like a job hunting, especially if it's your first experience, first time doing it. It would the first, the first is always the most difficult to get. So from my experience for my first research, um, experience in first year, um, I'd send more than 30 emails just to get one supervisor to get back to me. So it's, it's kind of, it's a normal process that you, that everyone went through at least for me. Um So another daunting part is that to create a template email with a C V to send out to your supervisor. So, um, I would reckon, I'm not sure if it's good, but I would recommend using chat G P G P T or any sort of artificial intelligence just to create the email. Um, so this is just like a very quick one that I have just generated like in two seconds or something. But essentially, there's a few poor elements that you want to include. Uh So first of all, definitely introduce yourself. Tell them who you are, what you're in and then mention why you want to do research with them and then tell them about like your current abilities and experience and researchers. It is okay to say no, But uh to, to, to mention that you have no research experience at all. But I think it's quite key that you show that you have a basic understanding of what they're doing and their area of interest. And uh from so what I tended to is I would like site some of read and write some of the recently published paper and say like, oh, I do find it quite interesting and I would like, definitely want to talk a bit more about that and to see if there are for a meeting as well, if you are very clear about what kind of project you want to do as in a specific question, do you want to answer uh that you want to do research on? Definitely, definitely feel free to mention it in the email and just to let them know that you have let them know what you're kind of level knowledge and your level of capability is, I guess. So that's that. And then another, if that, if neither of that works. Another way is to approach um clinicians or researcher after a talk or a lecture um at university or um in the conference. And um it's always good to start accomplish this conversation with a question as to uh the previous talk and, and then you can kind of just um ask for their contact and stuff and then um it's express your interest to work on the research with them. Um Right. I know I'm very behind but I'm just gonna quickly talk about my experience. Um So I did most of my research outside of my curriculum, a medical degree that is on top of my clinical placement. So in preclinical year, I'm I was quite interested in brain and neuroscience. So I did a some in tension in my first year in MRC Cambridge Stem. So institute looking to remyelination, as I've said before, I've sent more than 30 E mails just for one super faster to get back to me. And then in indicated year, I've done a dry lab project on addiction and Opto genetic brain networking. And then in clinical year, I've attended quite a few neurosurgery conferences and then through there and in some that meeting I met Connor, which then, which we kind of work I kind of work with him on this is a matter review on chronic subdural hematoma. And on top of that, I've joined the student led collaborative project organized by Start Search and Nancy. So I find, I think that is a very good start point to go. And then also the Royal Society of Medicine, uh they have been organizing systematic review, student collaborators where they will give a series of course as to how to conduct a systematic review and then they will group the students into groups and then you can work on the systematic review with the supervisor organized by them. So uh through that idea of paper on your neurodegenerative disease on and uh long term air pollution. And then in my fifth year, I was, I was very, I, I uh I've switched late and then I find vascular surgery and transplant surgery. Very, very interesting. So through the S S P uh student selected placement, I then approached Mayes vascular surgery supervisor and also my Hepatology supervisor saying like, oh, I do want to do some research and that's also calling there's a few like projects on uh have been done as well. So I think um if you're someone who enjoy doing something outside of clinical placement and you want to know the topic a bit more in depth, definitely, definitely, I would definitely recommend um doing some research outside of your place. Then as it, I do find it as a very fruitful experience to learn how to use different software, how to analyze data, how to formulate a protocol and how to write up a manuscript with a good narrative. So and there's a few tips that I want to share is that, um, it's, it's very important, uh, to know what you're interested in and also with supervisor, um, definitely show how keen you are and how organized you are because sometimes they can be quite busy. Uh, so you might need to send multiple emails to follow up and, and, um, you might need to, you know, pay a lot of effort to learn about the topic itself because they probably won't have the time to teach you uh um and communication with your supervisor. Definitely he and let your supervisor know what your goal is from the very, very beginning. It's okay to be ambitious, but make sure you deliver and make sure the project is feasible within the time commitment that you have decided. And for starter, I would fully recommend the collaborative project because um sometimes when you're very new to research and you and you're super keen, but you just don't know how to get started and joining the student that collaborative project will give you a general overview as to how research project should be done. And then you can like learn from antique reference from it and then carry it on forward. So um would recommend joining the collaborative doing projects as well. And then here are some resources that created by Stihl search that we would recommend. You have a look and there have a lot more information um than I should said. And that's all for me. Thank you. Sorry, I kind of ran over for a bit. I'm just gonna start. Sorry. Uh That was very, very informative. Thank you. Has anyone got any questions for Allen at all? There is one in the chat there. How do we find some conferences to attend? So, um it depends on what kind of specialties that you're interested in. So say, for example, if you're interested in vascular surgery, they have each specialty will have like annual meeting um organized almost every year. And then there's also some students organized conferences as well. Uh For example, the Imperial College will have a Neuro traumas conference every year. And then the different roles Society of Medicine, uh Royal Society, Medicine, Royal uh collage of surgeon will have different conferences organized throughout the year as well. So what I've done is that I have like signed myself up to be the affiliated member of like Royal Society of Medicine and Royal College of Surgery of Surgeon and a different kind of um surgical society that I've interested in. And then they will have like monthly, weekly bulletin where they talk about like different conferences as well. So that would be a good start. And another thing would be if you have a supervisor, you can definitely ask for the advice as well because um for vascular surgery, there's only like the British Vascular Society and also the European Fastco Society annual meeting that's going on. And then I think your surgeon to have a lot more like the S P N s and generally for surgery wise, there's the acid that Alyssa has just mentioned. So there's, there's quite a few um going on, I'd say as well that at least at U V A like are kind of general med sock page. Advertises conferences all the time, both medicine and surgical. So if you've got university society, social media pages, then keep an eye on them as well because they often advertise a lot of different opportunities, both research related, non research related conference, not conferences. There's loads of different stuff that comes up on there. So I recommend that as well. Are there any other questions at all for either of us? No, we're just waiting for our final speaker. Um I can't see him in the audience. Can you valid? No, I don't think so. He might be in the surgery but he's a transplant surgeon. Uh Yeah, I think it's like uh yeah, we'll give him a few minutes and then if not, that's the end of the academic surgery evening. So we'll just hang on for a couple minutes and see if he turns up extra second. Fine. Mhm. Uh Oh, okay. Uh When would you recommend attending events like conferences? Uh huh. That is a very good question like okay, I think different people have different approaches. So I think for me, I tend to attend conferences when I am presenting something cause like um as a medical student, I don't have a much money. So uh I tell you what I did is like, cause conference tend to be super expensive. So what I did is like, I try to present while I'm attending the conference is so I can take two boxes of um at one. But I also know that uh if you have extra funding and you want to like get to know the specialty bit more safer, something you want to do. Like you, you're quite interested about classic surgery and you kind of want to network through that event without anything, anything to present. Um, I think if you have that kind of mindset or a, mmm, going to a conference then would be a good way to get to know people and get to learn about the stuttering skills and extra, um, skills that a plastic surgeon would need so that you can get to know the especially bit more. So I wouldn't, I wouldn't specify like a specific timepoint in your training. Instead, I guess if you want to get to know the specialty a bit more, attending the conference, getting, you know, the people and show your faces would be a good way to start again. Like different people have different approaches. So, yeah, I was quite, yeah, my spin on it. Um, surgery wasn't really, I didn't really know what I wanted to do when I started medical school. So, surgery is a fairly newfound interest for me. I don't only kind of grew a little bit more interested in it when we had more exposure to surgery from third year last year. So I'm fairly new to it, which is why I haven't had the chance to kind of do presentations and stuff yet because I'm a lot further behind than some of the med students who've been doing it all since first year. And, um, like, that's why also the first conference I attended was only in fourth year. But even then I used it as an opportunity as Ellen said, just to network and to speak to the people who are around. It's a very highly attended conference. The asset one with lots of different specialties, their doctors at all levels, lots and lots of medical students, consultants, like pretty much the whole span. Um Really good opportunity to ask questions and gain insight into all the different specialties. So, um if you're unsure of where, uh uh I thought it was an echo. Um So if you're unsure of where to start, uh probably just sign up to one and go. Um and then see what it's like first if you're not brave enough to kind of go and present because I definitely will, I wanted to kind of go and find out what conferences are like first and then in the future, if I've got any, if I do get the chance to do research, which hopefully I will, I'll be able to present in the future when I know what to expect next time. So if you're new to it, it's, it's fine even in fourth year, even in fourth. Yeah. Are there any other questions at all? Were any other questions at all? All right. Um I think what we're going to do is um yeah, so um Mr someone might be in the operation. That's why um him, he's not turning up. But what we're going to do is we're gonna email him and that cause he has a presentation prepared. So what we're gonna do is we probably ask him to perhaps like record um his presentation and then we'll send it around um after the talk if that's alright. I'm really sorry uh for that. Um but yeah, if you have any questions regarding the content that were discussed or any um yeah, any if you want to like approach us or anything, just feel free to email us um for email, I think. Yeah, if you want our emails, I'm happy to put mine in the chat, Ellen. Do you want to pop yours in the chat as well? Just if anyone wants to be sure. Yeah. Thank you so much to everyone for attending this evening. I hope it was useful. Uh apologies again that our final speaker isn't here this evening, but he's a surgeon, so he's probably up to something else um important. So I hope you have a lovely rest of the weekend everyone. Thank you coming again. Oh, thanks. Yeah, just uh.