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Ok, we've got a few people coming in there. Hi everybody. Um, welcome to one of our first surgical events of this year. Um We are having a surgical welcome effectively. Um So this is one of the scrubs events. Um This is kind of kind of the idea is that we're gonna be introducing you to a little bit about tips and tricks of how to get through your surgical placements, how to get the most out of them, how to enjoy them. Um We've got two amazing speakers with us tonight. Uh So we've got Mister Doan, who's um one of our general surgeons and we've got here as well who is one of the fourth year medical students. Um And they're both gonna be having a chat to you about different perspectives about how to make the most of your surgical placements, um, different things you can be doing, you know, in the earlier stages, um, and sort of tips and tricks for, for getting through, maybe what's a slightly different way of learning. Um So I'm gonna hand over first of all to, to Mr Doran and, um, and if anybody has any questions, we'll be doing a little Q and A at the end as well. Hi, everyone. Thanks for the introduction. Ellie. I'm hoping my slides are still visible. Um, and we didn't change any of the settings. So, so they should be. So, as Eddie said, I'm a general surgeon, I'm a staff grade surgeon in the, in the Belfast Trust and I'm quite involved with um undergraduate education and with surgical education in Belfast. So, um that takes me to my first slide is, well, what would I know, why have I any? Um right to be here pestering you all on a, on a, a miserable winter uh Thursday evening. So, well, I'm a past Q UB student, I've been where you guys are admittedly, albeit a long time ago now. And uh I've been working in general surgery uh for about 13 years. So I've got the undergraduate and postgraduate perspective and in terms of um the medical education roles that II have. I'm currently the sub lead in Belfast for specialty focus week in surgery and for the er emergency surgery ward. E MSU, I supervise some students on L ICI facilitate um CBL and I do some other things across final year in terms, in terms of assistanceship. So I've got a little bit of um inside knowledge in terms of the discussions that go on behind the scene when putting these things together. Um So hopefully, um I can share some of those insights with you to try and extract the best from, from your, your time with us. So, um, I guess a good place to begin is thinking about what really are the purpose of, of surgical placements in year three? What, what to the university? I want you to get, get out of your, your time and surgery. What do you as a, as a learner, want to get out of your time in surgery? What do you need to get out of your time in surgery to become a safe and a competent doctor? And what do we as surgeons expect you to get out of your time? Um A and, and I guess um the, it's important to remember that the, the, the theory behind longitudinal clerkships, which seem to be the university's preferred uh placement model at the minute is to try and stay in one place for longer and to try and learn the skills of how to integrate into a ward team and to become a safe and a competent fy one doctor. And while not everybody will have ambitions to have a career in surgery, it is a good idea that at some point over F one and F two, you will actually work on a, a surgical ward and um gain some of the, some, some of those principles and some of that noise to take with you throughout the rest of your career. So the only way that you can really learn how to become a safe and competent team member is by actually spending time in the ward environment, time with patients, time with F one S and just getting stuck into the, into the job at hand. So, you know, there's no, there's no getting around it. It's very obvious, um, between the students who are very comfortable in that environment and, um, those who, um, have been a little bit more lax with the, with the, the attendance and so forth. Um, the next thing that I've said is a bit more of an academic point. So, you know, it's, it's the learning, it's the theory. So you need to know about the range of surgical conditions, the presentations, how to investigate things, how to manage things. And even although anatomy is not extensively examined, um, at the minute, in terms of progress tests or os and so forth, it doesn't really feature that heavily on the, the assessment side of things. It is, it's pretty important to have that basic science basis for and understanding. So, um, you can think about, you know, the, the, the principles of investigation and management of those diseases. And again, in terms of surgery, we don't need you to know every single type of operation under the sun. We certainly don't need you to know every single complicated step and 100 and 50 steps of the whipple or, you know, we don't need that level of detail, but you do need to, to have a a basic grasp of some of the common surgical procedures and some basic principles on how to, how to take things out. Because even if you end up as a GP, you'll be counseling people who will be having operations all the time. And while it's not necessarily your place to take them through the full consent process, you know, they'll still look to you as a physician or as a GP or, you know, if you do end up in surgery, obviously, you have a more in depth um knowledge of those kinds of things, but there's learning here that you will use in ways that you don't anticipate or don't expect throughout the rest of your rest of your career. Uh So do think about, you know, if, if we um I do a lot of cholecystectomy. So if we think about that for a second, you know, the basic principles of how you would do that, you know, explaining to a patient, the key hole or open uh approaches, thinking about the anatomy, you know, every organ will have a blood supply, everything will be connected to something else. So just the very, very basic basic principles will help you inform those discussions. The equally as important as knowing some er surgical details is, is knowing what can go wrong after. Um there's the Amazon prime at this time of the night. Sorry, if you, if you can hear that noise in the background. Um knowing what can go wrong after an operation, being able to have that conversation to balance the balance. Uh the seesaw of risk and benefit with, with your patients is important. And also when you become that F one or that F two or more senior surgical doctor, it will become your responsibility to pick up on, on those things. So the learning, the understanding the basic science that you gather now will inform the way that you work and the things that you look for in your, in your patients beyond graduation. And of course, the other purpose of of surgical placements that are different uh to medicine or ed or any anywhere else is that you get access to theater, you get to learn to come scrub up how to behave in a theater environment, get to see some hopefully pretty cool stuff. And um there's also some learning around patient safety, human factors and all of the all of the peripheral things. So there's lots of skills that you will need to get. Yes, to pass exams, yes, to answer things on progress test or to perform in acies. But there's learning that, that, that you will pick up and consolidate over year three and year five that you will take on for the rest of your careers. Hopefully. So that's kind of what we, we hope you to to, to take away from your surgical placements and to do that, obviously, um you need some, some resources and not all, er, surgical wards, not all trusts are equal. So, it's important to consider the context of, of where you are. Obviously everybody will have a peripheral semester and a semester in Belfast. And that means that we take all of your year group, uh, through the, the surgery in the Belfast Trust as well as about three quarters of year five and some University of Ulster students as well. So, surgery in Belfast is quite, is quite pressured surgery being a smaller specialty than medicine. For example, we find it difficult to make sure everybody gets a base ward placement. So in Belfast, our L I CS are shorter, they're three weeks instead of seven. And even with that, not everybody will manage to get a base ward experience. So to make up for that, uh we have a, a specialty focus week which I'll, I'll talk about in more detail over the next couple of slides. What we do have. Uh however, is a wider range of subspecialties in regional services and things that you might not get the chance or you will not get the chance to see outside of Belfast. So if you have a particular um interest in a particular surgical subspecialty or there's, you know, there are some things that you will only see some patient groups that you will, you will only see and encounter in Belfast. So think about um maybe um trying to do some of the more general things whenever you're in the peripheries and do some of the, the more niche and um less commonly seen things in, in Belfast peripheral trusts by contrast, will have better opportunities for you to attend clinics, endoscopy, to go to audit meetings and multidisciplinary team meetings. If you if you're interested in that, but obviously with a lesser range of subspecialties. So thinking about where you are and at what point in time can, can help um, just shift your focus and there's no point looking for something that's, that's not there. So if you know what's available to you at a particular point in time, uh, you can, you can sort of save time and concentrate on what you, what you will get at at that particular point in time. Um, surgery just in general as a, as a note can be less predictable, um, than some other specialties that can be more difficult to organize formal teaching. Um, and unfortunately, uh, some people do end up having to run off to theater and do things that, that wasn't always in the, uh, in the master plan for that particular day and sometimes sessions do not happen. Um, at, at short notice. Um, I organized the specialty focused timetable and this week three sessions back to back, uh, just disintegrated because of people on call and things that, that came up at short notice. So one of my, my tips would be, um, you know, be prepared to fill your time with something useful if some planned teaching falls through and I'll come on to some other other resources at, at the end that you can, you can use to, to fill that time. Hopefully, wherever your, your placements are wonderful and you get lots of, uh, lots of planned teaching, but, um, life is unpredictable and it doesn't always work out how we intend it for you to work out for you. So, um, yeah, just have something up your sleeve that you can work on or go and see some patients if, if, if you have some followed time. Um So a little mention just about the way things are set up in Belfast. As I've mentioned, we've got the specialty focus weeks and we've got shorter L IC placements. And I generally tell the patients the students beg your pardon, that I supervise that the specialty focused weeks are really good opportunities for seeing things particularly in Belfast. The weird and the wonderful uh things that you won't get, get to see in the peripheral trust. And from a surgical point of view, we've got some endocrine surgery, cardiothoracic vascular HPV transplant. We try and pack some of that teaching into the week. Um And you won't see those things outside of Belfast. So hopefully you have an opportunity to see something slightly different when you're with us. Um And you have a perioperative case to follow for that week as well. L IC placements by the country then are opportunities for doing things. There'll be lots of, lots of new patients. The turnover in surgery is generally quite quick compared to the turnover in medicine. Every new patient is um is um a resource for you to take histories to do examinations. Um you know, do cins write in the notes, write an epic, you sure you should be doing those things. The other thing that is resource rich in surgical wards are the number of practical skills that, that you have the opportunity to perform because most patients will have daily bloods, most will be having fluids. Again, a big percentage will be having antibiotics. Some will be receiving blood transfusions. So they all need cannulas, they all tissue, they all need replaced. Some patients come in with obstruction and need empty tubes, placed catheters and if they become unwell, uh sometimes they need um ABG S and you know, and worked up as a, as an unwell patient. So all of these things happen but not all of the time. So again, it comes back to spending time on the ward time with the F ones and for people to know your face and to come and find you, uh when there's a, you know, an opportunity to do some of these things. I know that none of us like to spend a lot of time in the hospital in the evenings, nighttime weekend, whatever, but particularly in Belfast because there are so many students around. Um, some people who come back at the end of a placement and say that things have worked out really well for them are people who have actually taken some initiative and have maybe come in a bit a bit later and stayed a bit later into the evening because in the evening time you get more emergency admissions, that's, you get more, sort of one on one on time with the staff whenever, um, less people are around and, um, people tend not to get sick whenever there's loads of people to help, they tend to get sick whenever everybody's going home and there's only a couple of people juggling things. So that sort of early evening twilight time is quite a good time to spend on a, on a surgical ward after everybody else has disappeared. So that would be another suggestion I would give to you, um, think about communication as well. Um, you know, the f one doctors you're with will be tasked with making referrals to other teams, negotiating with radiology for urgent requests, putting discharge summaries together, all of those things will soon become your responsibility in a couple of years time. So, while you're not necessarily tested or examined on those things, now again, be listening and learning all the time. Er, and the final point on this slide is ward rounds and these are a really good opportunity to get some, one on one or one on two teaching with whoever's leading the ward round and the best way to get noticed, the best way, um, to get some of that teaching is if you have something that's valuable to the person leading the ward round, if you have some information in the trusts that have not yet moved across to IC, that's pretty easy. You can pick up an observation chart, the card X, the blood book, the fluid balance charts, all of those things, the person leading the ward round will need to know all of that information. And by, you know, diligently at each bedside, reporting the observations or the bloods or any of those things and having something that shows that person that you're there, you're present, you're checked in and you're willing to participate, that will get you, um, that will, they will be grateful for your help and, and in return, they will spend a little bit of time, um, making sure that you understand what's going on and hopefully getting a little bit of a little bit of exchange of information, um, in return for the information that you're, you're helpfully giving them. It has become more difficult in Belfast since I and I guess in other trusts as well because all of that information is now contained in the one place and we don't really run around with five or six different different computers. So, um, if you've seen the patient, uh, on the ward round or the day before, if you've clerked them in. If you've been back to examine them, you should be offering to present that patient or to give your details. And again, that really impresses us if we're doing a ward round and you say, um, had I seen this patient yesterday, can I present the details? You, you're getting a lot of bonus points for that? Um, quickly moving on, then just a quick um point to some of the implications of C 25. There haven't been very many changes for surgery, but the changes that have come about have been around anesthetics and the poem placement, which used to be used to be a standalone placement in year four. And that's now mostly migrated into, into year five within the preparation for practice two module, which is surgery and human factors. Um But some of the, some of the learning outcomes have fallen back into year three. And I guess this is because um you would have potentially done your written finals at the end of fourth year without ever having covered any, any anesthetic. So they've been a bit sneaky and put some learning outcomes in, in year three surgery. Um So there are some peroperative learning outcomes. There's the patient journey and patient reflection that you, that you have to, you have to do. Uh So again, my, my advice is that you take a kind of wider angle view of, of the patient's perioperative journey and consider things as a perioperative case and not just a surgical case in the, in the past and I did it as well. Students came to the theater, we stood in the corner of the theater or were shown outside the door or out to the tea room for the first, you know, 30 45 minutes, whatever while the patient was going off to sleep. And that was a massive waste of time and a massive waste of resource because had you had the opportunity to spend 30 minutes with the anesthetist, one on one, putting a patient over to sleep, getting to understand the basic principles of general anesthesia, how to monitor the patient, what you're doing during the anesthetic to keep things nice and stable, the patient safe. And actually the planning uh that they do for postoperative pain management, nausea, um managing blood sugars and so forth, all of those principles. You can be, you can be learning now. You don't need to wait until until year five to, to do that. And the I think it's my next slide yet is, is um my progress. And um on the ace patient journey, you'll find that there's five or six things that you can sign off. Uh when, when you're in theater with anesthetist, putting somebody to sleep and in semesters and in the last couple of years gone by, I've had people come at the very end of the semester and saying, you know what I did this, I was in a theater, but I didn't realize that um we had to get this signed off or I didn't realize that this was a learning objective. So my advice in terms of my progress is to open every single page as early as you can in the year, know exactly what's on every page. What every box that requires a signature. Every box that requires a tick, know what you're supposed to see, know what you're supposed to do and sign it off as you go along because you will do lots of things throughout the year. And if you neglect my progress until the end of the semester, um you will inevitably um not record everything that you've done and potentially struggled to find signatures or email addresses or evidence for things that you did do and make life more difficult for yourself. There are also a couple of pages that are not mandatory to sign off on my progress, but they're actually quite useful revision aids and those are the recommended conditions and the recommended, uh, signed or recommended symptoms, it might be called and the, the surgical one is quite extensive. It's got a list of all the common presentations. It's got a list of all the common surgical diagnosis. And if you take off the ones that you've seen as you go along, it becomes very easy as time goes on that. Ok, I've actually seen three quarters of these and a couple of things that I've yet to see are somebody with cholangitis or somebody with uh you know, an upper gi bleed and you can single out the opportunities that you uh that, that you, that, that you need uh to, to, to satisfy that the other thing that I will say is that the portfolio is the minimum number of things that are required. And as I've said, it went during a surgical placement, you know, why stop After six bloods, you could literally do 60 you could do 100 during a seven week placement if you were there because all of those patients will need bloods most of the time. So don't get to six and stop do as many as you have the opportunity to do because again, this will become your responsibility in the blink, blink of an eye. So you want to be able to do the difficult ones as well as the easy ones. My uh last slide you'll be glad to hear uh is just uh uh some pointers to, to, to other other resources, the Q UB med portal. Um I was on it yesterday. Um Again, open every link, know what's there have a look at all the videos, the recordings from previous years, even if the, you know, there hasn't been too many Thursdays and Fridays this year yet. But you can access, I think the last couple of years and there's a good number of those er, previous recordings that are from surgery and from Perioperative medicine. So there's a good resources. There, there are some great apps and websites that are not affiliated with the university. Good information on the Royal college website. Um Medtronic or one of the companies that manufacture theater equipment, have a nice app called Touch Surgery. And they've got some little videos and graphics about some, some of the common surgeries. One of the things that I did when I was a student um was when I went to a clinic or um into the clinical environment, I rated all of the patient information leaflets. Now in the digital era, these have kind of disappeared and there are more patient information websites and QR Codes and various things. But I always felt that they were a good foundation in terms of, you know, they were sometimes explaining complex um conditions or complex operations in a, in a very easy to understand and um you know, layman's terms and they provided a good, a good foundation for you to then stack some anatomy physiology, pathophysiology on top of it and create an understanding around some basic language. And again, it helps with communication, you know, if you go to see a patient and they ask you about a particular bit of the operation or a risk or something, of course, you should always be deferring that back to somebody more senior. But if you've read or seen something in one of those leaflets, you might be able to share that with them and feel like you're actually being of some benefit on your placement. Who else can you tap into them? Well, um, there are likely to be more, uh senior students on the, on the ward or in theater that have done it, you know, in the year before you, the f ones have done it not all that long ago and much more recently than, than people like myself and others who are, who are teaching you. And the other group of people who are a great resource are the undergraduate staff figure out where they hang out in your hospital, they can help you with, you know, what passes to get around it. They can become a good link between the teaching staff and, and yourselves and, and can help organize um formal teaching and reorganize things if it falls through. So think of just cast your net more widely than, than, than you think both in terms of the skills and the attributes that you're trying to, trying to learn and also cast that net widely in terms of the resources that you tap into. And I apologize because I've, I put these slides together just immediately before this. And I thought, yeah, that's about 10 minutes worth of worth of stuff. And II can see that I've been going way over that. So II hope some people have managed to, to, to stay the course. Um And um yeah, I, I'll leave it there for, leave it there for now if that's ok. Yeah. Thank you so much. That's been so useful. And as I, I've so, I'm third year, I've just started on my surgical placement and it is a leap like it is definitely a change. Um, but it is so useful to hear it from like another side. Um What I'm going to get you to do then if, um if you could stop sharing your screen, Emma, thank you so much for that presentation. I'm going to get here to share her screen. Wonderful. Has that? Yeah. Yeah. Yeah, that's all good. Um And then we're now gonna hear it from the other side. We're gonna hear it from a student's perspective with some tips and tricks uh for helping you through your surgical placement from a student's point of view. Perfect. Thank you so much Ellie and Emmett. Um, so my name is he, I'm one of the fourth years and I'm currently placed in, uh, the Ulster and Lo Valley. Uh, but I did my surgical placement in the L IC in Craig Aven and Daisy Hill as well as in Belfast. Um, so these are just a few tips and tricks about things that I found helpful that I'd love to know before I started. So, uh, and it'll be a lot of repetition from Emmett, but I think those are the key highlighting points. Uh So what to expect whenever you enter surgery, whether in your L IC or in your specialties. Um The common things that stay are ward rounds, ward allocated times. So it will often be in your schedule. Go to Ward XYZ. Um You'll have theater time as well as pre op and POSTOP care, which you are more than welcome to access. Um And whether you're following a patient on their patient journey through the anesthetic pathway or just in general, you're always welcome to follow patients along to recovery and things like that as well as this, you'll have surgical outpatient clinics which are more common um and more allocated time in the L I CS, but they're present in Belfast as well as well as just else in the Belfast trust. So getting ready, the prep tips. So theater days, if you have a theater day allocated to your morning or afternoon, uh know what procedures are on the list, it, even if you're there five minutes early, just have a quick read. Otherwise, if you're already in the theater, um there's always gonna be a list stuck on a board somewhere. You can ask someone. Um It's, it'll be better for you if you know who the patients are if you've spoken to them beforehand, but of course, this isn't always mandatory and it's very understandable that sometimes patients are brought in super duper early and you don't have to be in for that time in terms of anatomy. It's not necessary to know all the anatomy, you don't have to know all the operative steps or ins and outs. But like, uh, Emmett said previously, it's important to have a general idea. It'll help you learn a lot more if you know what you're looking at or seeing effectively in the surgical field and you'll learn more as you observe. Um, and if you get asked, get asked questions, it's always helpful just to know even a vague idea of where you're supposed to go with your answer. Um Some quick resources that I think are really helpful where teach me anatomy, geeky metics, um essential surgical skills and then past med and quit for questions. Um If you're practicing them around exam time, they have a good coverage of surgical topics as well. Um in terms of being on the ward, a few top tips, but the most important one is being really proactive, not all wards are the same. So take five minutes, 10 minutes to familiarize yourself with the wards and the signs of course, in your L IC, it will be more familiar because you'll be spending a longer um duration of time there. However, even if you're on specialties and you're in a surgical ward, just take a minute to familiarize yourself with where everything is. Um Additionally, if you go in on one morning and there are many ward rounds happening, this is very common. Uh The hospital often has multiple rounds going on at the same time. Some of them from the same specialty and some from others. So it's important to stick to one team. You'll likely find an F one or a more senior doctor that you can introduce yourself to and go along with them as well as this. If you're signed for, um, award round, it's important to arrive a few minutes before it starts to familiarize yourself with the doctors. It's really important to introduce yourself to everyone and this is daunting at first imposter syndrome is really common. However, a simple introduction of hi, my name is and I'm a third year medical student. Is it ok? If I join your ward round today, something like that will get you a long way because people will know that they have to teach you otherwise they're gonna go on, um, doing the war drawn quite quickly and sometimes you might just miss out. Of course, this doesn't mean that every war draw is gonna be super interactive, but it's important that everyone knows that you're there and it makes the process a lot more easier for you as well. Um Additionally, it's really important to ask questions. Uh Of course, this is scary and sometimes you don't wanna do this in front of the patient. You can wait until everyone's walked off or come back and onto the sides to write notes and things like that and feel free to ask questions. People do want to teach you. Sometimes it slips their mind because they're really busy. Um So if you ask questions, it makes the process easier for you and in terms of your cases and getting stuff logged on, get your cases done early, you'll be surprised at how many people are running to the ward last minute in the last few weeks trying to get cases done. Um, from what I remember, you have to have three surgical cases done and two are done in your L IC. If you get one done per week, that's you sorted. Um And also just familiarizes yourself with the process of actually taking a full history and a full exam. Um And if you have time practice presenting, this is something that everyone will magically expect you to know how to do by the time you're in fourth year and fifth year and no one's perfect at it. But if you get practice in your third year, it'll help a bunch and you can get loads of feedback um on the structure and how to present appropriately. Uh Surgical wards are also really good for getting bloods, Cannulas catheters, blood cultures. If you ask for the tasks list, which are made by the F ones and F twos after the initial ward rounds done, they're really helpful in allocating tasks that are good for you. Sometimes they'll say here's a list of patients that are really easy to get blood done, for example, or here's a difficult Cannula. Do you wanna give a go or do you want me to come along and help with, um, like Emmett said, continue doing as many as you can. Um, it will really help, uh, familiarize yourself with the skill and when you're asked to do it, for example, on your baseboard, uh, it'll make your life a little bit easier and then some tips for the theater. I think theater is one of the most enjoyable places to be. If you enjoy the whole aspect of surgery, I think it's really important to recognize the, um, uh, the pertinence of teamwork. Introduce yourself to the theater nurses, the staff, the technicians and the doctors as well. Uh, if you're entering the surgery a little bit late, start talking to the nurses and, uh, they'll often introduce you even if they don't, uh, ask them for permission to stay first of all. And then you can chat to the doctor or, uh, anyone who's assisting the surgery and offer help where you're able to. Of course, if you're scrubbed up and if you're within your competence levels, so never cross that in terms of scrubbing up. Uh, it's one of the things we have to get ticked off, but once you learn how to do it and you've seen how to do it, you can always just say I've scrubbed up before. Is it ok? If I scrub up and join, um, or come closer to the table just so you can have a better view. Sometimes it's just easier to be closer to the table, learn the rules of maintaining a sterile field. This will be really important, not only in med school and in your placements in the future, but also, um, if you ever choose to do surgery and then I think one of the really important ones is sometimes we feel that we shouldn't leave theater if we're feeling unwell or shy away from it. So if you feel faint or unwell, um just sit down or go away from the surgical field, it's safer for you and safer for the patients as well. Uh In terms of learning, be proactive and be respectful, um ask questions but ask them at an appropriate times. So sometimes you might see a really high stress environment and have a, a question that you wanna ask, which is uh completely OK, if you just wait until everything sort of settle down and then you can ask and sometimes timetables don't work out. So always check if there are other theaters that you can go to. And most times people are really happy and accommodating, but just make sure you get everyone's consent and you and the OK, for my one in terms of organizing things and um like matching up with your colleagues and peers in terms of learning on the go I think uh the MLA content map as well as the conditions we're supposed to know for our exams, whether that's for your progress test or just for your MLA, it's really important to learn the surgical conditions. There are a few common one, one that you just can't miss, they will happen in every ward and you will definitely come across them. So it's really important to carry just a small notebook or even on your phone, jot down the conditions you see and go read up about them. That's the only way that you'll be able to consolidate information really well. Um, and if you're ever scheduled for meetings, bedside teachings, MDT S, things like that attend them as much as possible. I found that in surgery, bedside need, uh, bedside teachings are often one of the best ways to learn and they are a bit scary because you're getting asked all of your questions in front of the patients, but they're super helpful. You don't normally forget conditions after that. And uh being realistic and practical is really important. Use your time wisely if you have, uh, another way that you are gonna be more productive. For example, there's nothing to do on a ward. It is a little bit calmer, a little bit quieter. And, um, you've been sent away, sometimes it is nice to take a break. However, if you need other stuff ticked off, you can always go ahead and try a different ward and that's completely ok. Some pitfalls to avoid. First of all, always introduce yourself to everyone. This doesn't limit yourself to doctors or surgeons or top consultants to everyone is really important. Um because they all form part of the team. Um You need to always act and perform skills within your competence. If you're ever worried about a skill, you can ask someone to supervise you. Um If something's going wrong in the middle of a procedure, ask for help. Uh if you're doing a cannula, um blood goes everywhere or you've gone in the wrong place or things like that, just ask for help and stay within your competence and don't disappear during ward rounds and theater time, people will notice if uh halfway through a theater, you've just gone away or halfway through a ward round, there's just one less person. Um So just make sure that even if you have to leave for something, everyone understands and if you just let someone know they'll be really understanding and appreciative that you've actually informed them. And if you're unsure of anything at all, uh just ask someone because you're compromising someone else's safety as well as your own safety if you don't. And just in terms of the practical part, don't leave your cases, your skills uh to the last minute and really, really brush up on your abdominal exams. Queens loves asking this whether it's an OCA or just in bedside teaching and it's something that's done so commonly that this is your perfect opportunity to sort of practice it. So don't leave any of this to the last minute and get familiar with it as much as you can. Um, so that's me done. Thank you so much for watching and I think we're happy to take any questions if, uh, there are any here. Yeah. So if anybody has any questions and pop them in the chat, thank you so much here for that. Um, it's, you know, all these pieces of advice, like you pick up as you go along, like, I'm sure you agree here that you go into surgery, sort of not really knowing what to expect. Um, so if anybody does have any questions, pop them into the chat, there should be a little chat function that you can, um, put messages into. Yeah, I thought that was a fantastic presentation. Well done and very catchy slides as well. Um, your hints and tips were probably a little bit more practical based than, than mine. And I think that's, um, as said, we're coming at this from, from two different sides of the coin as a, a learner and as an educator and, um, II think it's nice actually, um, that the guys can hear, um, the perspective from both sides. I think everything you said was probably more important than, than what I said. Um, so well done. Fantastic. Thank you. Thank you. Yeah. Really good. And if I'm honest, I wish I'd had it before I started. I don't mind as well. Um, because it's, it is definitely a bit of a shock to the system. Thanks. I'm glad, I'm glad that was all. Um Right. I don't think you currently have any questions of anybody. I don't know. People are able to unmute on here and this is my first time using metal. So this is a, this is a learning experience for lots of us. But if you can't then pop it into the chat. Oh, here we go. Um, so someone's asked, are there any surgical anatomy or surgical books that are recommended? My personal favorite is grays. Um But yeah, Grace um has been on the go for a long time and there are lots of editions and it does seem to have a nice balance of um sort of the depth of content and you know, some nice explanation alongside the uh alongside the, the pictorial stuff. Um I find an atlas more useful than a, you know, than a, than a textbook. And I also um I find some, some videos on, on, on just youtube just searching things. Um very good around the time of coming up to exams and revision where you maybe didn't have a couple of hours to sit down and go through a few chapters. You could watch a few summary videos. There is a guy, excuse me for one second while I turn around and get the name off my book shelf. Um Professor Aland, um who's a professor of anatomy from Edinburgh or Aberdeen has a, a series of um, of talks which were available on originally video and then DVD in my time and I'm sure now you can, you can access them and stream, stream them online. Um, but Professor Alan was the, er, was the guy that we all followed in terms of um postgraduate surgical exams. So the details may be a wee bit more than you need for undergraduate. But if you're somebody who likes to listen and watch as opposed to read, I would recommend that you look up Professor Ackland or even as well. Um I've actually found for learning anatomy like an anatomy coloring book, which is, you know, it's very basic stuff that you learn, but it does give you a good understanding, especially of things like osteotomy and um you know, bony stuff and um you know, just general locations of things in relation to other things, that's quite a good way and a bit more of a more relaxed way to learn anatomy as well. Um And to kind of drip, feed yourself up. Uh So I use the Netters anatomy coloring book which is um which is quite nice to kind of supplement other things that you're doing as well. I think just in terms of surgical conditions, um clinically oriented anatomy is really good as well. Uh I think we were recommended in our lectures as well. So if you're ever looking for condition based, I think that's probably useful. Yeah, or any of the online resources, teach me surgery is really good, which is a or teach me anatomy is the anatomy aspect to it. And then there's a Teach me surgery, which is another website by the same company. Um, and they've got some really good resources on there that break things down really slowly. Any other questions at all? Fab? Ok. Well, I think we will, we will leave it there for the evening. Um Thank you so much, both of you for coming on and chatting to us today. Um I know here you left your email on that. So if anyone's, if anyone's got any questions at all, then, um, obviously you can either drop them to us at scrubs or drop them to anybody in any of the, you know, the scrubs committee. We're very happy to, to have a chat and answer any of your questions. Um Thank you so much everyone for coming tonight. Um Good luck for any surgical placements you have coming up. Good luck for any placements you have in general. Um, and we've got behind the scalpel coming up next week on Tuesday evening, which is gonna be an opportunity to meet lots of consultants, um, and registrars from different surgical specialties and to actually chat to them, that's gonna be an in person event. Um And the link is, has been sent out as well. So if you haven't had access to that, then just let us know and we can um we can send the link on to you. Um So hopefully we'll see lots of you there next week. Um But if not, we'll see you in the next couple of weeks coming up for scrubs. Thank you so much for joining. Thanks guys, all the best. Thank you. Before you leave, there is actually a QR code that I will send out. All this is to allow you to get a certificate. Let me just share my screen very quickly. This is my, so this should be a link if you are wanting to get a certificate for the event. If you scan this QR code, that will take you to somewhere where you can get a certificate to put into your portfolio. I'll just leave that for a little bit. Yeah. Ok. I'll take that down. Now if um if anybody hasn't got access to that then um or hasn't managed to scan that, then just let me know and I can um you can drop me a message or drop a message to the scrubs Instagram and we can send it over to you then. Um But that's everything from us tonight. Thank you so much for joining and thank you um to Mister Dorian and, and to here for joining us as well. All the best guys. Bye-bye. Thank you. Bye bye. Yeah. Thank you.