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American Mr Wissam Al Baroni, come to the stage. Um He is a Urology registrar in Northern Ireland and he's going to talk to us about Javier Flatten in the I M G Valley. Thank you very much. Thank you very much for that kind of production. Um So today I want to talk to you about the platinum of the I M G um valley. And what do I mean by that? So do you have a mic that I can put it on door? That's the only one that's okay. So a question that I have is why do I MG doctors struggle a question that is very simple to ask yet. It's very difficult to answer. However, it is a personal question to me and it is the question that has shaped the person I am today. So my name is Wisam Al Baroni in, as you can tell by my accent and I'm I'm I MG doctor from Libya and currently a trainee in Northern Ireland. What I want to talk to you about today is flattening the I MG Valley um and want to share with you what we do in the Northern Ireland about that you may ask me, what do you mean by flattening the I MG Valley? Well, through this lecture, you'll discover two things is that is really suck at picking up title's. And at the same time, I'm not really good at coming up with acronyms, but bear with me. I hope it will make all sense throughout my years. As a trainee, I have engaged with a lot of I MG doctors um as being an ambassador for I MG doctors in my region. And at the same time as a mentor, uh and I've come to learn that a lot of the issues that we have, we share um a lot of us have worked with I M G doctors and a lot of us have friends as I MG doctors and usually you'll hear the description is that this is a good doctor or this is not as great doctor. But I want to share with you an example example of two MG doctors, doctor A and doctor B. So doctor is, is a struggling doctor. When they moved to the UK, they've had no experience of the NHS. They're struggling to settle in, they can't find accommodation, nobody there is to help them, they feel isolated within their team. Um they're not supported or they feel not supported. They don't understand the system. They've arrived either after the induction because of visa issues, they're struggling to progress. And even when they applied for training side comments. Have been made that the training joinery is lowering their standard to accept such a caliber of doctors. And unfortunately, it is true because even when they went to training for the first year as a core training, within three months, they've been referred to the T P D with two pages described them as doctors who are struggling to understand the system and they're not coping. There's a lot of external factors to the story. Also being away from family, being away from kids. Um They got the news that the dad have been kidnapped because their country is still at war and they've been kidnapped for six weeks. Unfortunately, none of these issues people who they work with would understand or be able to relate to doctor B though is someone who have achieved high scores back in their university back home, they scored highly in their national training in the top 10. They point for presentations in different conferences and publications in different places and they have managed to be in different leadership positions and excellent ercp outcomes every year. You know, you can tell immediately that doctor A, although both are I MG doctors, doctor A will be the doctor that will struggle, probably will even struggle to continue to work as a trainee in the future. The truth is that the same doctor and that doctor is myself and that is actually my story. But the question is how come a doctor that has struggled continue to reach their potential. And that is what I want to explain about the Eye Mg Valley. I know this is a picture of a mountain but bear with me just to try and explain what I mean. So a lot of I MGS doctors are really excellent doctors back home. It is the excellent doctors who are willing and wanting to pursue a further education outside the UK are outside the country. Apologies to be a better doctor and a competent doctor. And so you expect that the potential will continue to be the same. But unfortunately, the minute they arrive, a lot of us do struggle and a lot of us will go down that slope of the I M G valley. And so if you've met me there, you might describe me as someone who might struggle in the future, who would need extra support or extra help. But then with the presence of help or um support, they are able to reach their potential. So what I wanted to know is why do I MG doctor struggle or a better question is why do they have to struggle when they come to the UK? And I wanted to identify risk factors and protective factors? Now, I just want to share this story rather than bombard you with evidence and papers and quotes, etcetera. And you can hopefully understand and you can resonate with a lot of these stories. And if you're not an eye MG probably will give you a bit of an insight of the things that we have to go through. And so for that reason, during my leadership as a fellow, I wanted to come up with a project to try and address these issues. Because what I've learned as an ambassador and a mentor is that although we come from different backgrounds, different countries, we share one thing and that is we are I MGS and a lot of the issues are similar. And so I came up with a project, we call it New to Northern Ireland or Enter N I A short. And it deals in a holistic approach about all of the issues related to Northern Ireland for doctors who are new to the region. I MGS or those who are from outside Northern Ireland. And it's three phases, issues related to relocation, issues related to induction and support and issues related to progression and retention. Today, I'll be shared in some of the data in relation to relocation. As we're still collecting data. For the other two phases, the survey have dealt with a lot of issues and aspects and related to move into a new region. But for the sake of time, I can't share everything. So I'll try and make it a bit short. So in terms of education, of those who answered the survey, about 100 and 20 trainees, 33 of them were I MG graduates, 24 were from the U and the rest from UK Universities. When we've asked about accommodation, we have a major issue in northern Ireland in relation to accommodation. 90% of international doctors will struggle to find accommodation before starting training. It is the same for those from the UK, but only 40% of them would struggle. In fact, if you're an eye MG, you might spend 20% of them will have to still find an accommodation within the first month of their working. And that makes it difficult because there is new view in after five and there is no view in it during the weekend and you have no help for someone else to go and view the apartment on your behalf. So unless you're a night, sort of book leave or off, it is very difficult to find accommodation and an average and I MG will have to find 10 places before they can get accepted into one and 66% of them feel they are being discriminated or refused when they apply for an accommodation based on their step necessity or name. Only 6% of UK graduates felt the same. And you can tell there is that sense already when they come in and they're still looking for accommodation, that they're feeling a bit not welcomed. When we asked about bank accounts. 105, we'll need to open a bank account in Northern Island. But 70% of the would struggle to do that. This is because bank accounts will require a lot of pay slips bills, but they don't have an accommodation to provide that. And some trainees would have to wait for 3 to 4 months before they can open a bank account. And so they have no pay or money in and we're trying to find issues or solutions around this issue to try and overcome it when it comes to family. Um When it comes to UK, graduates, only 6% will have to move away from the family. When they come to Northern Ireland, 70% of trainees who are outside the UK will have to leave the family back home as they are building up the money for the visas. Cause some of them at that stage in the past, especially when I applied, it used to cost 2000 lbs for each visa for your wife and daughter and that takes time to make. However, for those who have the family with them, they still struggle to integrate their kids into schools. 75% of them find it difficult um to integrate the kids into school, to understand the system. And if they had kids who are not yet to school, 82% struggle to find a day care. So some of times, one of the parents will have to sacrifice and stay back to look after the kids is that assorted. So this is really just a small snapshot. But if you can imagine with me you being a doctor moved into a new country you've never worked with, can't find accommodation for the first month you've missed induction or the induction did not tailored to the needs that you needed to try and help you do your job. Have no access to the system. A little to no support from your people who are around you, feeling isolated. Don't have a bank account. Your family are away from your back home. They're counting on you to send them money to support themselves. You're dealing with issues such as war. You don't know if your parents are still there. Sometimes you can't get them over the phone and then you get the news that your dad has been kidnapped. Um And these issues are real issues and you can imagine if you've dealing with all of this and this is all before starting day one of your job, it's difficult to accept that the same support you give to someone else would be sufficient to such a doctor. So I think where do we go from here as an intern I project? So at the minute, what we've developed is a working group. We're working in the other two phases, but we're also developed a working group to solve the issues in relation to phase one. The working group will consist of senior leaderships at Nimda representative from the Department of Health. The DME is around the trust I MG ambassadors and also our leadership fellows and we're trying to work together also with hr and everybody around us to try and find solutions. So, in touch with few banks online are also local banks to try and establish a work work frame or a workflow is that whenever these doctors come in, at least in the bank account is open in their name and the Nimda will be their sponsor. We're talking to the accommodations and also the agents to try and ease the process for all of these issues. In the hope to make it a very easy and seamless transition to us. We're still also delivering a lot of courses and teaching to educators and supervisors and colleagues in terms of the issues and how you can support your colleagues who are not from the region. Apologies. And so I think the last thing I wanted to say is these are issues that we deal with the trust about. What can you do yourself? Just remember four things which is choke compassion, appreciation, support and be an ally or CASA is in short is what I usually teach. So be the person that breaks the barrier, be the person that bridge the gap. Because at the end of the day when it comes to working in the NHS, we all stand on the same line. Thank you.