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amazing. Thanks, Ryan. I'm already looking at the questions on the chat, and I love that. There's a question about technology and robotics, which is what we're going to. And if that question isn't answered in the chat, I can give an attempt at the end. Um, so I was asked to talk about innovation and surgery. Um, and it's really, really broad topic. So what I thought I would focus on is one why we as surgeons all need to have essentially basic skills and understanding of innovation as a whole and technology and its use and surgery. Um, what it looks like in our surgical career. So how can we actually integrate innovation and technology into our training? Um, and hopefully leave you with some really practical advice as to how you might get more involved in this space. So as we know, there's no clearly defined career path that actually integrates innovation. So it will be less about sort of recruitment and all of that stuff and more sort of food for thought about how you can get involved, because it is. It is a very hot topic at the moment. So if you got any questions just put them in the chat. I will try my best to answer them at the end. Um, and I will try and stick the time because I know we're running slightly late. So just to start innovation, you you might not notice it, or it's not, at least for me. And when I'm working in the hospital, it's not really obvious that we're using technology, and it's not obvious that there is innovation that's happening, especially with the computer's being really, really slow, uh, and the systems being, uh, all over the place and not very integrated, so you might not actually realize this. But innovation is absolutely everywhere when it comes to the hospitals, when it comes to what we use in our day to day practice, and especially in surgery. And it doesn't have to be the creation of a whole new device, it doesn't have to be, um, you know, starting a startup company. But it can be things like translating over something that you've learned previously into what you do in your day today. Uh, so it can be an innovation of a new protocol or a policy or a system so it doesn't have to be a device. Um, but new technologies are constantly being introduced into our practice into our training into what we use, and especially in surgery, it's becoming more prevalent, and especially in surgical training as well. So just a couple of examples just earlier this week, I was using, uh, this, uh, laproscopic skills simulating it. Um, and this one is is give you what is provided by inverse. Um, and they actually use augmented reality to enhance the opportunity for training and your skill set when it comes to doing the bladder scopic skills. Um, so I myself was using technology using augmented reality just in the last week to enhance my training. Um, And then another example is this was an article that was in the evening standard yesterday. I'm not sure whether anyone else had seen it, but I was really surprised to see this because actually, I work in the marina and guys into the promise is sometimes the zoster was right next to me, and I didn't even know that this was going on. Um, so what, you can see there is actually the urology surgeons used technology both the technology platform proximity as well as using robots to actually try and address the issue of NHS backlogs. So they break this record of the number the most number of, uh, prostate operations. That happened in a day. So I think they did 10, um, to try and address this issue of the backlog and they were using technology to really try and enhance it. So there's there's two things there, one of them being that actually, they were using new technology. So innovations that that came up in the last coming last few years. So approximately one of the platforms that really blew up over Coated, um, and they were trying to implement a whole new system to address the problem and that, and of itself, is innovation. Um, and I just really want to stress that actually, innovation is everywhere, and it is happening in hospitals whether you're working at it, whether you're literally, you know, for my case across the bridge to be seeing it, um, and it can most definitely be used to enhance our careers surgeons, whether it be on the left to to improve surgical training or, um, in that article to improve patient outcomes in the practice that we do. So these three reports that the table review the future of surgery reports and future surgery technology enhanced surgical training report, which is a is a mouthful. Um, but these are three landmark papers. Um, And if you're interested in innovation at all, if you want to get involved with innovation, I really recommend that you do read them. You don't have to read them cover to cover, but at least know what What they're basis is what it's about. Um, and what they do is they really outline how innovation in technology will actually be advancing patient care over the next 20 years. So they focus on on the next 20 years and what we need to do as a workforce to address and be ready for these inevitable changes. And what they did was they really highlighted four key areas of technology that were identified as the ky technological advances that will impact healthcare over the next 20 years. So they have digital medicine, genomics a I, and robotics and all three reports talk about all of them and how it's going to be changing what we do so with digital medicine. I've already spoken about this as an example of augmented reality, which, which is a type of a massive reality. But you've got virtual reality is a part of that as well. Um, and and they can be used to improve our surgical training. We've got telemedicine that really increases the accessibility of health care for patients, especially with virtual clinics or virtual war grounds, for example. Um, smart phone applications are there are so many coming out now, and so many that we use that are patient sees and wearable technologies that are now being used to sort of enhance, um, ensure faster discharges because we can monitor people remotely at home. Um, so digital medicine is actually quite important in terms of data collection, monitoring, and or, you know, that accessibility that I talked about advances in genomics and a I can help with diagnostics. Um, they can help with predictive medicine with personalized medicine, and I've given an example of how robots can be used to help improve what we do. But actually they are advancing alongside our training, So they're becoming actually more versatile to use in theater. Uh, the old robots, um, really quite big and quite bulky. whereas now, if you look at the versus, it's just it's just one arm and you can roll it between theater cases, so they're becoming more versatile and easily easier to use. So what does this actually mean for us? As, um, uh, future surgeons? Well, that there are two key principles that were highlighted in the reports, the first one being that actually, technology will be playing and increasingly larger role in healthcare in the next 20 years. Um, and that's really important to bear in mind because we're not going to go any more years going forward without technology being a fundamental part of how we practice medicine, how we practice surgery and the second one being that our roles as doctors as a result of the first point is that we will have to become more digitally and technologically capable. So what? What does that you know, the digital and technological behavioral is really broad, really vague. When you read the report that the only thing like me, you'll get a bit frustrated by how vague it can be. Um, what I've done is I've tried to condense it into four key points. I think everyone should be aware of, um, as they go forward and progress through their careers. Um, the first two of these points being the fundamentals of what I think all sergeants should have and be aware of. And the last two points are probably only applicable to a handful of us, but a relevant and important number of us that are going to change what the future surgical career is going to look like. So the first one, At the very least, we really need to be able to have a basic understanding of these technologies so that we can explain them to our patients. So you know how many of you are actually confident in being able to explain how artificial intelligence works or how it's used in our practice because it is being used right now? And we are using it, um, in in diagnostics, in radiology. Um, and our patients might have questions about that. We need to feel confident to be able to actually explain that, and likewise specifically in surgery. You know how many of us actually feel confident in being able to explain why using robotic surgery is better than us doing hands on surgical? Um, open surgery or laparoscopic surgery itself? Um, a lot of patients, and I can imagine that this happens in clinics now, um, if not in the next you know, year coming years as it becomes more as the media becomes more aware of it. And we see it, um, blowing up in the media as it becomes more prevalent, I imagine patients coming to clinic and they're really worried about the use of technology in our practice, especially when they don't understand it. So they might not trust these robots, for example. I can imagine that they might come along and they might think that we as surgeons are taking a backseat, and we're using, you know, artificially intelligent robots to do their surgeries. We no longer have a role in theater. Um, and that's not what they might think. Um, and we need to be able to understand what it is. I understand technology and explain why we're using it so that one we can make sure that we're getting informed consent from these patients festival and secondly, to make sure that we can actually provide them with answers that will reassure them, because ultimately these technologies exist for us to provide better care than what we can offer at the moment. So if we really want to give them the best care for them and make them feel comfortable in being able to do that, we need to understand these technologies enough to be able to explain to them. And then the second point, as I mentioned before we're using, we're going to be using new technologies all the time. Um, when, uh when, uh, laparoscopic surgery first came out, everyone was doing open surgery. Before that, they had to learn how to use a lump escape, and they had to learn what minimally invasive surgery was and how to how to do it. Uh, likewise, with the advancement in robotics training, surely we should also know how to use robots, especially as it's going to become more and more relevant into our practice. And that's just one example of the technology that you know we need to be aware of. But with all technologies that exists and are at our disposal to use, we really need to be able to be skilled enough to use it. And I mentioned that these last two points probably only apply to a handful of us, but I think everyone should keep it in the back of our minds. So as we progress through our surgical careers and we become and we take on more of a leadership role with the responsibilities that come as you become a registrar as you become a consultant, it becomes increasingly more important that we actually need to be aware of, um, the technologies that we have our our disposal and decide which ones are actually needed and which ones will better enhance our practice and better and provide better patient care than what we already have. So developing skills and being able to appraise these different technologies and learning how to actually adopt them into practice into the department is really important to be able to, you know, leave the department in a state that was better than when you entered. And then the last point I would say probably is even smaller handful of us. Um, we are frontline workers. Um, we we we are the ones that you know are providing the surgical care, and therefore we are best place to be able to identify, keep problems that we face on a day to day basis. Um, and some of us would want to take that, and and some of us would want to create solutions to it. So developing skills and innovation, and also learning to work with people from different industries is really, really important to help us develop solutions that will be robust. Um, and we'll be able to change surgery for the better. So I hope I've convinced you so far that actually innovation is in surgery is really important. It's it's prevalent, and it's something that everyone should have a fundamental knowledge of. But actually, what hasn't been talked about previously, or at least, you know it was never discussed with me. And when I when I talked to other people about it, I always get the same questions I always ask me How how do I actually get involved with this? And how do I make How do I pursue a surgical career that also acknowledges technology and or innovative skills? Um, so I thought I talked about this, You know what does Actually what does it mean to have a surgical career that actually integrates technology and one of the things that comes up time and time again, which I think is a is a big myth is that you're either a fulltime surgeon. So you're either in full time training or you've completed your surgical career and you're a full time surgeon or you leave the N. H. S. And you're working full time in industry. Um, but there's actually loads and loads of things in between that you can do. You can do both, uh, and you can do neither. Um, but it's It's the both that I really want to talk about and talk about with you guys just to tell you that. Actually, you you can do both and it's possible. And, you know, I know loads of people that do do that. So I've outlined a couple of the roles here, and apologies. That's a little bit of a busier slide, uh, than the others. But let's just go into them in a bit more detail. So as a full time surgeon, um, this is pretty much what we've talked about so far. So you're on the front line you're using the technology's in your practice. You're you're doing the research on innovative devices or techniques or you're trying out new things in practice. Um, and all you've seen a technology that has come up in the newspapers or you've seen it happen at a conference or at another hospital, and you want to translate and adopted into your practice, Um, and as a full time sargen, you can most definitely do that if you, you know, have the time alongside, uh, everything else that we have to complete to be able to pass our ERCPs. But that's completely possible as a full time surgeon. But some of us and myself included, won't just be satisfied with that. And, you know, as as that basic fulltime surgeon, you don't have to have that contact with the med tech. Companies like you don't have to talk to you nervous to be able to use their lap skills kit. Um, and you don't have to have a contribution to the technology that they develop. But if you like me and you, you want to and you want to get involved with both sectors, then you can. And one way to do that is that you can be a full time surgeon, But you can also do some ad hoc consulting for med tech companies on the side. And what that means is that what consulting means is that you can give advice, your clinical advice or whatever advice that you wish to give to med tech companies to either make their product better. So you're helping with product development or you can help from the strategic side. So whether that be to do with adoption or whether you help them with research or do interviews for them, and you can be paid for that and there are a number of people that I know who do this but to give you something to work towards or to paint a picture of what it might look like as a surgical career, I know. Um uh is one example. There's a fulltime consultant general surgeon who doesn't have to do any private work because what he does is fulltime NHS work, and he consults med tech companies in his free time, and as a result, his salary is essentially equivalent to if he were to do private work anyway, um, so if you wanted to do a bit of both, you can and it can be quite fruitful. So, um, these roles in the middle here. I don't I don't think you can actually see my mouth. But these roles in the middle. So the innovation fellow rolls, the technology fellowships and the internships and or short posts. I put them in the middle because they are innovation roles, but they are not necessarily part of training programs. But that doesn't mean that you can't pursue them, right? So a number of innovation fellow roles have popped up over the last couple of years and broadly and very, uh, per location, um, or job description. But they tend to be standalone yearlong posts. Um, that might involve things like reviewing technologies that are available to these trust, um, and implementing them at a hospital wide or trust wide levels. So that's developing your appraisal adoption skills. But it also might include elements of education. If you're interested in medicine, whether you're developing innovation skills courses, um or, you know, you're you're educating yourself as part of it, or it might involve research, so you might you might be involved with specific project. So one of my friends up in Liverpool was doing one specifically to do a virtual reality. For example, um, you can have technology specific fellowship. So where I'm working at guys in Saint Thomas is trust. We have artificial intelligence fellows who focused specifically on artificial intelligence, and they will do research projects on that. If I have any questions about artificial intelligence, I can approach them. I had any ideas or things that I wanted to do with it again. I could approach them, and so could everyone else in my hospitals. Um, and, uh, to build on that there are a number of trust that I know that also hosts technology specific ones, for example, uh, robotics fellowships to help train the surgeon in robotics skills. And I'm sure that there are many other technology fellowships out there. Uh, these are the ones that I can remember off the top of my head. Uh, and some people might decide to have a break in their training, whether that be a natural breaks. So, um, most of us after course surgical training will have a two month gap before they go into registrar training. If they managed to get a number or otherwise, You know, if you unfortunately on, um, if you if you don't manage to get a number this year. Then you will have a natural break, and you have to decide what you want to do in the following year. Um, but or if you're in, if you're in surgical training at the moment and you still want to pursue something to do with industry and you wanted to develop those skills, you can ask for our program experience to do that. And I know a number of people who have done that. So one of my friends, who is a plastic surgery registrar and she took time out program So a new PPI to pursue an MBA, for example? Um, a couple more examples. I I did it myself. So I had a two month gap between finishing my foundation year and starting called surgical training. And I did a full transition into, uh, to work with the med tech startup, where I developed these skills a bit further and actually got to contribute to the product development, etcetera. There's also other ways you don't have to work for a company. You don't have to. You know, you don't have to do a master's or a PhD or anything like that. Um, I know there's a current. There's another consultant plastic surgeon who, whilst he was a registrar, took six months out of program so that he could work with BCG, which is one of the big, um, consulting companies in London. So it's not based in London, but the office was in London. Uh, so there are a lot of different opportunities that you can do, and you can take time out a program to do it and and come back into training afterwards to finish your surgical training and then as an alternative to that which is similar. So these these fellow rolls, these fellowships, these internships are chunks of time. So in my case, two months or, you know it can be six months or year long posts, Um, where you're not doing surgical training at all, but the alternative to that where you still want to pursue surgical training. But you want to, um, you want to keep up your surgical skills whilst doing med tech at the time? The other alternative is to do less than full time training. And again, I know a few people, Um, who who do that? So, you know, 11 of my friends is doing 50% clinical and 50% industry. So he works a couple of days, um, training and then a couple of days with a med tech company. Um, other people do 75% clinical and 25% industry. Some others do 80% and 20%. It really depends what you personally want to achieve and get out of each each part. So how much? How much you do you feel like you need to pursue surgical training to keep up with your skills and make sure that you're meeting your requirement versus how much do you wanna invest into learning these other types of skills, whether it be business management? Um, innovation, etcetera. Obviously, it's important to be aware that if you do go less than full time, it does mean that you're lengthening your time to see CT. Um, yeah, so that's important to bear in mind. Um, and there's lots of other things that you need to bear in mind anyway. But that's, uh, you know that to talk for a different day. Um, and then finally, we've got the surgeons who fully transitioned out a surgical practice to work in industry, and that doesn't mean that they're not contributing towards surgery. A lot of these surgeons actually utilize their skills to pursue and create companies and or create companies that are enhancing surgical practice for us as surgical trainee is working in the system. So, um, if you are an employee because you can be, um there are I usually say there are three routes where you can contribute. You're either going to be in sales or you're going to be in research, or you're going to be in product management or, yeah, project management. Um, but sometimes, if you're an expert in your field and this tends to be more consultant, you can be a CMO chief medical officer of the company. So an example. Mark Slack was a consultant gynecologist, and he's the CMO of Cambridge medical Robotics, who are one of the key robotics players in the industry. Um, as as a non consultant example, David wrote, uh is soon to be chief medical officer of a nervous, which is what we talked about at the beginning. But he was previously a trauma orthopedic registrar here in London. Um, so you know, you don't have to be a consultant to be able to contribute in these in these ways. And then finally, some of us will be really, really brave. And you'll come up with all of these solutions. The problems, Uh, and one of them will just be gold and you'll you'll know it. And you just want to pursue it. And you just think that, you know, surgery would be so much better if I just pursue this and I just created this is a start up. And some people do do that. Um, and a good example is staff who is the CEO and founder of Concentric Health. And he was actually I think he was a course surgical trainee before he decided that the, uh, consenting process was ridiculous. And then So he built the paperless consenting system, which is now used widely across different NHS trusts. So what I really wanted to demonstrate here was that, you know, there are many different ways that you can integrate innovation to your careers. But most importantly, you don't have to be a consultant to contribute to the med tech space. Uh, there's another point that I didn't put in that that that is, you don't need to leave the NHS to contribute and to, uh, feel fulfilled in terms of being able to pursue innovation while you're doing your training. Um, and lastly, you don't need to be that person that found the startup to be able to contribute. I think everyone, every one of us has a voice that's valuable for all these med tech companies if you want to pursue it. Um, so I promised some really practical advice on how you can actually get started because, you know, it's all well and good that I tell you, you can get involved with all these things, but I think the elephant in the room is you need to you need to start somewhere. So in terms of practical advice, I like to think of it as four key areas for development that you should focus on. So, firstly, education, I already mentioned that you need to have a basic understanding of technology. So you need to educate yourself in these technologies and in these innovations. Um, and that might be doing your own reading. But actually, if you if you like me and you don't like to do a lot of your own research, then you know attending conferences is a great way to understand actually what's out there and speaking to the industry representative to find out more about it and or there are skills courses that you can attend to so it can be innovation of entrepreneurship skills courses. Uh, it could be technology specific skills courses, whether that be, you know, a lap skills course or a robotic skills course or an AI course etcetera. Um, the second is you need to be aware of the new and existing technologies that are that are out there. So, um, the way to do that is, you know, sign up to newsletters and mailing this. Read the news because it sometimes comes up there as evidence, you know, earlier in this talk, or even better, just follow the key people on social media people who are active in the healthcare space. It tends to be Twitter and Lincoln, so make sure that you are following the right people, and then you'll suddenly find yourself in this big med tech health tech world where everyone talks about each other and to each other, which is really nice to see. So definitely do that. You can also get involved with research either at your hospital or with different companies and or attend events that different companies might be holding. If you are wanting to have a bigger contribution to sort of the future surgery, you want to make those changes, and you want to be that that small handful of people that I talk about the beginning that would require the bottom two points that I was talking about. Then I would recommend that you actually do take time out program just to get some experience in industry or you take an innovation fellow role if you haven't already developed these skills in the first place. And then, lastly, I can't stress enough the importance of actually building your network. So not only learning how to speak to other industries because it is a completely different language that we speak but also to be able to build the relationships with the people and the companies who are most likely to actually give you the opportunities in the future. And then, finally, I just wanted to leave you with some events that are coming up. So for those of you that are actually interested in innovation, so the acid innovation some. It is going to be hard on the future of surgery show this year. It's on the 15th and 16th of November, and I can promise you because I spoke to, uh, the speakers and arrange the agenda, that the agenda is going to be really, really exciting and really fruitful, especially if you want to get involved in innovation. And there are going to be some technical skills courses as part of it as well. Um, so you know, these speakers are worth hearing from if you're interested, please you come. Um, if you wanted to specifically develop your own innovation skills and you wanted a chance to actually apply it in practice and try and come up in a protected space, um, your own solutions to real problems that currently exist in surgery, then the, uh, innovation skills course that we've done with the which we organized with the Royal College Insurgents of England. There's a really good skills course to be a part of, and there is a massive discount available for asset members. So it is for what? For what we have organized. And what you'll get out of it is honestly a steel. Um, so I would recommend that you try and sign up to that. It's on the college website, and I think it's on our website as well. Um, and lastly, I'm going to be working soon with the other asset council members to hopefully organize some more local events because the top two events are in London. Um uh, So more local events around you to help you gain more exposure in the space if you wanted to, um, so that was essentially my last slide. If you've got any ideas for things that you actually wanted me to organize or wanted me to have a look at or look into, then just drop me an email. Otherwise, if you follow me on LinkedIn and Twitter, then I'm often posting about different opportunities for doctors to get involved with innovation. Um, so, yeah, just let me know and happy for questions. Thank you very much, Angela. That was a really interesting talk, and it's really exciting to see the work you're doing around innovation and surgery. If I can ask people just to direct their questions to the chatter box at the moment, and we'll just invite our last speaker for the day