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got next, Mr Connor Boil, Who is the Dukes Asset representative? And he's a general surgeon registrar. And for those of you who don't know, Dukes is a colorectal surgery training organization. Thank you. Thanks, Ryan. Hi, everyone. My name is Connor. I am the Jokes Club rep for Asset. I'm delighted to be asked to speak here today. I'm currently a surgical reg in Edinburgh, where I also did my foundation and core training. And I'm just going to speak a bit about colorectal surgery and the reasons why I find it such an attractive specialty, keeping it quite basic. As I appreciate, a lot of stuff would have been covered already. In the juice comes a fantastic organization. And it's the key thing, if you're interested in colorectal that I would recommend looking into and potentially joining if if you want, I think it's fair to say and I know Nicola covered it that general surgery is such a broad and exciting specialty. When I was a medical student and foundation doctor, I thought I wanted to do plastics orthopedics, and it wasn't until I did a general surgery job that I realized how good it was and It's so varied compared to some things. And there's a whole list of which colorectal is one of many options you can choose. But it's one of the reasons I love it. For example, this year I'm on an upper GI I job, which is also very good, and the variety that it offers us a career is one of the main attractions for me. I think colorectal surgeons often have. It was viewed as very unglamorous special day. And and I think what people imagine what we do can be a big rim sometimes and other These X rays are seen during on calls. It's It's far from the main burden of work, and actually, there's so many things that are very satisfying and none more so, I would say, than seeing someone in clinic to 3, 10 years down the line from a colorectal cancer resection who they've got their life back. They've been healthy, they've got married, they've changed jobs. And even with what might seem initially, life changing, um, impact, such as getting the stoma can can really allow someone to to move on. And I think if you look at these figures colorectal cancer over 40,000 people a year, which is over 100 people every day in this country diagnosed with it. If it's diagnosed early, the survival is over 90% and I think that's one of the things that I find so appealing about doing the job. There is a small slide here from Cancer Research UK that shows boil cancer. Survival has has almost doubled in the last 40 years, and unfortunately, that's not the case for some of the other GI cancers, and it makes it quite a exciting specialty to be in. You see these improvements. You work in a big MG tea with of the gastroenterologists, the radiologists, particularly the oncologists, creating treatment plans for patients and in planning what surgery they're going to get. And I think, as I said, that it's not something with improvements and imaging and improvements in colonoscopy that's is going to go the other way. We're going to continue to see more and more, and it's a big area for research as well. So it's probably the primary burden of workload for a for a colorectal surgeon, and certainly and that's including both smaller district generals, bigger tertiary centers, everyone will be doing colorectal receptions, and it makes it quite an exciting time. When I was a court trainee on urology, my supervisor said this. He couldn't believe that I wasn't applying for urology and said, You're just going to be doing the same operation of different It's a bile and why that technically is true. I think the range of skills technique patients required in these operations mean that no one day is the same and one thing I do like and one thing that's good about the specialty is that you go from something like a right. Hemicolectomy, which may be a more junior trainee, can do up to a low anterior section or a P resection, which would be done at a much more senior level, and it allows a real development of skills that you can build on. The techniques for one of these operations will always be useful for the other and lovely anatomy and the outcomes are getting better and better. I think there's a slight area there, but I don't know if anyone has seen any pelvic exaggerations which colorectal surgeons lead on for both advanced rectal cancers or or guide me cancers and These are massive, massive operations that can last 12 14 hours. All the gynie organs removed the bladder, the prostate. I've seen someone sacrum removed, the leg removed as part of this and surgeries like this. Here's just a slave from Twitter that shoes, that's all one specimen. Surgeries like this are incredible to see. Incredible to be involved in cases that would have been a palette of diagnoses even 10 15 years ago. And and to see a colorectal surgeons at the forefront of that, improving with that is is, um, an honor to be a part of. I think it's only fair to say, and I've been asked to say some cons of the specialty, that the cancer work can be a con in the sense that you see we're seeing younger and younger patients with colorectal cancer. I'm 29 you see some patients that age coming in for cancer surgery and that that can be quite tough in in comparison to some specialties where maybe cancer is not such a key part of the workload. But it's that desire and drive to help people and to stop those young or to help those younger patients get diagnosed earlier and survive. That continues to inspire us. I think another big part of the workload be inflammatory bowel disease, often in quite young patients, actually, and that can be a bit of a challenge. Chromes is a very, very difficult disease to live with, and it really drives a kind of a mg T approach with with the gastroenterologists and these patients often of multiple surgery. It's technically very demanding surgery, but again, if you can intervene at the right time, if you can manage the disease to give someone a normal quality of life, that can also be very satisfying. And it's something I'm hoping to do more research in. And if any of you are interested in colorectal surgery, there's always a lot of studies in different hospitals going on, and that can be with the gastro team, which is a good, good option as well. If you are a medical student or foundation doctor, it's important to remember that you don't have to always do research with or in the particular special you want to do and research. If you're on a gas replacement and audit on IBD will be very relevant for any surgical implications I saw on the Crohn's and colitis UK website. This quote, which really stuck with me, um, a patient saying how much better their quality of life was with the Stoma. And I remember the medical student finding even examining someone's abdomen with the stomach quite intimidating. And it's one of the things that really had Really in impress is a need to improve your communication skills. You can speak to people. You can help them understand that other. It might seem like a big change. It could completely revolutionize their life. I mean, they're not going to the toilet 10 times a day, and that can allow someone who maybe wasn't at work, who was having a lot of difficulties with social interactions get back to what they had been like before and again. When you see those patients in clinic, it's, um it's a great, great thing to see emergency surgeries. The main reason I decided against plastics and orthopedics and and switch to general surgery his emergency surgery. You see very, very sick patients come in with a surgical problem that needs laparotomies, and a lot of the time that is a problem with the bile. They're not things that can be left the next day. They need to operate it on there and then. And if a lot of cases you can intervene in time, perform the surgery, someone who would otherwise not survive and they can leave hospital, which is, um, which is great. As I said, it's not glamorous. If someone's got a perforated by all, that's not him often the nicest thing to see or smell. But it is often something that can save the patients or or certainly stop it from being irreversibly damaged within colorectal. There's been a trend to sub specialist, so ideally, a colorectal surgeon would be involved in these cases. And I think, you know, there's been some studies done, including might not be able to see that that was. He's not a consultant in Cambridge, but when he was a Reg in Edinburgh presented a case where colorectal surgeons were involved in emergency diverticulitis, perforations and mortality have the rates of stones felt significantly as well, and it just shows the impact that can be hard if you do, um, training colorectal surgery and are present at these these cases again, it's only fair to say a con would be the burden of the virus Work. In general, surgery is a lot higher as a consultant than it would be in the other surgical specialist, and these are often extremely sick patients that the consultants are involved in overnight. But if that's what the patient needs to survive, then I think that's worth the worth. The interrupted sleep. And I'm sure every special has spoken about technology and the robot, but it's got huge benefits in colorectal surgery, particularly pelvis switch. For example. A man can be, and this will allow you patients who had surgery that maybe would have lasted hours and hours, having shorter operation times, quicker recovery and less morbidity out of hospital earlier. And all of these things allow us to do, I guess, more operations, more challenging operations. And as a trainee, it's very exciting to to see things like the robots come into your units. I think, um, it's been touched on already. But the collaborative research, I think, is a great thing to be involved in, as I said, and I think that it's important to stress your interest early, especially, for example, you do know you want to do a rectal. But one piece of advice I would says, if there's another general surgery project in something else that, um, it seems very good towards the General Collaborative. Yeah. Then I would definitely get involved a lot more productive if you're on peripheral placement and then trying to get involved in a two week period with a local. Also, those are definitely things that I would keep an eye out for on Twitter. I think the Jokes Club website has got lots of information will be running. Hopefully some collaborative studies over the course of the next year that people people can get involved in. And I'm also happy to to be emailed if people have any questions at all. Conaboy doctors dot org dot UK so that I think sorry. One minute over time, but I hope that gives a bit of an insight into the specialty and and and why? It is so great. Thanks. Thank you very much. Coroner, that was really interesting. And I think someone has asked if you can share your email and Twitter again in the chat box behalf so that they can get in touch with you, um, and perhaps get involved with the Dukes Club. Yeah, just put that there. Thanks. Thank you very much. So