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Mhm. Hello. Hello everyone. Thank you for joining. Um We're obviously just one minute past seven o'clock. So we'll just wait a little bit longer for, for people to keep joining. Um, we have posted a few polls in the chat, so it'd be really nice if you could kind of go through those and select kind of the answers that you think most apply to you. Um Just to get people talking before, before we kick off. Um We'll probably aim to start at about five past when a few more people have joined. Um, but if you've got any questions in the meantime about the rest of the scheme or anything like that, please feel free to pop them in the chat and get the conversation going. We've got a few different members of the In Sync committee um joining us this evening. So everyone between us, we should be able to answer all of your questions committee and George is just hoping to join, but she said when she's trying to join through the um the link, it's just putting her in as the audience. Has anyone got any ideas how to help with that? She has to use the same email that you registered her with? Ok. So she might have to make a new round. I have also invited her to stage. So I don't know if that would make a difference. Yeah. Oh, it's just loading, you said thank you. Yeah. Um We've also just had an email from someone saying that when they tried to click on the joining link, it asks for the university. I don't know guys who've um already joined. Is that something that's happened? So I think there's a few more details in the email about this, but this event is open to everyone. So don't worry about verifying your email basically, just click the link as normal and just um put in any email address that we should just let you join anyway. Um Yeah, so a few people saying that they just put whatever uni that they fancy going to. I know that's great. OK. I'm sure people will start to join in Dribs and Drabs. So maybe we'll start with a few, a few admin bits. It looks like George's loading. So I'll just keep an eye on on that. Perfect. OK. So welcome everyone. Um Thank you so much for joining this evening and for giving up your evening to be to be a part of this. Um This is the In Sync Insight lecture series. So it's a bit of a mouthful to say, but in sync actually stands for inspiring students in cardio thoracic and the insight scheme, I guess is to help students like yourselves get a little bit more insight into the specialty of cardiothoracic surgery. And hopefully through out this week, we can teach you something a little bit different that you might not have learnt about at school before and get you interested in kind of careers in health care and particularly within cardiothoracic, but not that we're biased. But we think this is a really interesting specialty and it's always, um you know, sparked people interest hearing about, you know, operations that stop the heart and cracking open the chest and all of those things. So it's all a bit dramatic, but hopefully, we can teach you something new this week. Um So I'm, I'm Kirsty. I'm the one that's been sending you all the emails. Um I'm a foundation year two doctor and I initially started this scheme when I was part of the committee as a final year medical student. So I'm joined by my colleagues this evening who have actually taken on for me in the committee and have been helping push this scheme forward. Um So we've got some new lectures this week. Some, some people might have joined already last year. So this year it's gonna be a little bit different. Um And hopefully, yeah, hopefully we can answer some questions and this week's gonna be really helpful for you. So, um just a few housekeeping things before we start. I mean, it's great that everyone's posting in the chat. So as much as you can try and ask, ask questions in the chat, get the questions going. Um And we'll try as much as possible to, to get to the questions when we can. We'll either reply to you kind of independently in the chat or we'll have a little bit of a pause at the end of each talk and then we can try and answer some questions that will help um help everyone and we could all kind of put the discussion to the panel to, to chat about things, a couple of other housekeeping things. Um So at the end of each talk, um medal will automatically send you an, an email to give us some feedback. That's really, really helpful for us. I know it's a little bit boring for you to always fill out these, these forms. But this, this lecture series has changed actually quite a lot since last year based on the feedback that you've given us. So, you know, the transplant talk that we're doing tomorrow didn't happen last year. And that was one of the things that was most highly um sought after last year. So we've been able to change this based on things that you've said. So it's really helpful for us. If you can, you can give us that feedback in return. We'll also be, be able to give you a, a personalized certificate. So once you've done that feedback you'll get sent that automatically. Sometimes it goes to your junk mail. So if you haven't found that automatically at the end of this talk, then have a look in your junk mail and see if you find it there. Um Again, just questions that I've asked. So any questions we'll try and answer them at the end of each talk and come to them if we can. Uh And then finally, the other thing is a lot of people ask whether these sessions are recorded. So, so long as all of our speakers, which they have this evening, kind of consent to us recording and then we'll be happy to upload these back onto med all at the end of the session. So if you are able to, aren't able to join other talks later in the week or you have to leave early for whatever reason, then these should be accessible on med all for, for future reference, if you want to come back and watch any of them. Um Finally, if you've got any questions throughout the week, we'll pop the email on a bit later on. But please feel free to get in touch with us uh at that email on the poster. If you've got any other questions or want to ask for any advice or anything like that, we're happy to help. Um So I guess with that if anyone's, if no one's got any questions for the time being, we'll, we'll kick off with our talk from, from our medical students. Hello, hello. Um So uh I'll just do a quick introduction then um of who we are. Um So my name is Hema. I am the current in Sync Gleet and I'm also joined here with Alana and Mary who are also part of in this year. We're all medical students uh from different parts of the UK. And uh yeah, as Christie said, our main aim is to sort of inspire the next generation of cardio surgeons. And uh yeah, we're really happy to have you here today. Thank you so much for coming along. So, the first talk of the day then is uh the medical student talk. So uh this is uh hopefully um what you guys are gonna be going into very soon. Um So we'll just start with uh myself just talking a bit about the uh preclinical aspect. So I think just a disclaimer, um different universe will have different course structures. So at Edinburgh, it's a six year compulsory course because you have the intercalated year as well. I'll briefly speak a bit bit about intercalation, but um uh I'll just go through uh the main preclinical stuff first. So uh preclinical is really quite lecture based and especially when I started in 2020. Uh it was all in my bedroom, which was very sad. Um But uh hopefully, uh for you guys, it will be in a lecture theater. You'll get to know uh, who's in your year group and, uh, you'll have a better connection with your professors as well than I definitely did. Um, as part of preclinical, you'll sort of do your basic physiology, uh, going through different specialties. And, uh, the good thing is, and II think it's like this for most universities, um, you know, the, uh, the universities, they sort of understand that you are all from different schools and different backgrounds. So the good thing is that they try to catch you up to a level where everybody understands what's going on. So that's the good thing about having this uh preclinical part to the course. Along with that, you will study anatomy. Again, anatomy is taught differently at different medical schools. But at Edinburgh, it's through prosection. So that means that cadaveric specimens have already been dissected for us and we go through different stations and uh sort of complete worksheets and we're able to handle the specimens and learn that way other universities have it through dissection where you are able to use actual dissecting tools to work with cadavers. Um Also at uh Edinburgh, we do a module called research and Evidence based medicine. So remember that medicine is a lot more than just what you learn off the textbook. Uh There is a vast research network, lots of opportunities to get involved in. Um So this is becoming increasingly uh more relevant and uh you will use evidence based practice uh in in your own uh life as a doctor, uh there's also the uh social and ethical aspects of medicine. So, um you know, obviously, uh you have the biopsychosocial models and um lots of other factors that influence people's health and it's really important to understand those um uh things as well before you go into placement and uh see these patients um touching on the intercalated year. So at a lot of universities across the UK, this is a optional year. You don't have to do it at some universities such as Edinburgh, it's a compulsory thing. So this is a year where you are not studying medicine, but instead something else. So for me, I intercalated in surgical science, which is actually quite uh related to medicine, but there's lots of other options like zoology or uh sociology and things that you could uh take a year out to study as well. So at the end of my six years, I will graduate with my M BC HB and A B anti honors, which is actually quite nice. Uh I think it's a good deal. Um But yeah, so I'm gonna hand you over now to uh Alana who's gonna take us through the clinical years. Perfect. Thank you so much Hane. Um So yes, carrying on from um ha in the preclinical. So I'm Alana. I am a final year medical student at Queens University, Belfast in Northern Ireland. Um And so I have actually just taken my finals, um which is, which is pretty nice. Um But obviously very stressful at the time. Um So now I have, I essentially finished my clinical years. Um and I hope to be that then if I have been successful, I will be start working in August um as a junior doctor. Um And so in years one and two, and like he said, every medical school is extremely different. Um in years one and two, I learned the basics of clinical practice. So you were doing things like pharmacology, physiology, anatomy. Um We did ca uh cic dissection um but essentially no day will look the same and even more. So when you reach your clinical years, um as you will be routing through very vast um degrees of specialties. Um And again, every medical school will do this very differently. Um So this was a very rough guide of essentially what um the past three years kind of involved for me. Um And uh like I said, it is, it can, it can vary quite greatly. So, um II think I based this pretty much off my Olson Gyne rotation as it had the most structure. And so at seven AMI would aim to wake up, it didn't always happen and tended to hit the snooze button. Um But then at eight ami would be driving to placement, um It would take me about 30 minutes um to get there from where I lived. Um This is quite handy and I realize that that's not always quite handy for everyone. Um And then you would start ward round at about 8:30 a.m. You would see all the patients along with the consultants. Um This might involve getting questions from them, um being able to give your input, um, they might ask your opinion. Um And so you kind of always have to do um to be on the ball um in order to answer that and really to um gain their confidence in you. Um And so that they'll trust you um to go about the ward and really um see the patients and uh get to take part in a lot more of what's going on. Um And so then if you're lucky, we're trying to finish around 11 a.m. and that would usually be my time to get a coffee um absolutely needed at that point. And then from kind of midmorning on you would maybe go back to the ward. Um see if there's any bloods and things that need to be taken, um really get involved and being able to um get like be um there for all members of the multidisciplinary team. So really learning from um from the doctors, the nurses, the pharmacists, um they can all really teach you something different. Um And so I'd really recommend, you know, even if you only have like one or two placements in first year um of medicine, um I'd really recommend that you do get stuck in and really, um, try to make yourself known that you want to learn, um, around one then would usually be lunch time. Um, and again, that could take varying forms and then the afternoon usually was quite variable. I usually had teaching in medical education. Um, something that I didn't know is that a lot of hospitals have a medical education site. Um, and that there is teaching rooms for junior doctors, medical students right the way up until a consultant. And I suppose I didn't realize this before starting medicine, that there actually would be teaching um in a dedicated area of the hospital. Um And so that's really nice on somewhere where you can go um and meet your friends and you kind of always know that someone's going to be there in the evening then. Um there is a lot of studying and uh usually in your clinical years, your lectures and things like that will be online. And so there isn't really a structure um like in school. And I think that's what I find. Um probably one of the most difficult parts, but you will be taking care of your own schedule and really having to be dedicated in reviewing lectures, reviewing material in your own time and trying to start you about, but don't stress, it really does all come with time. And after five years, I don't know if I ever got it perfect, but we got there. Um, finally then, um there is a varying degree of rotation. So my third year pretty much was general medicine and general surgery. Nothing was too specialized. Um And really just to get you to grips of what goes on in the hospital environment. We and then in fourth year, sorry, we then did um uh more specialist um uh uh specialties such as S and gyne pediatrics, psychiatry, um emergency medicine anesthetics. Um And you rotated through those um usually every six weeks. So that was a great um way to in order to see what you liked, um what you didn't like and really to give you a good idea of what you would want to do in the future. And then uh how you're kept, the university keeps tabs on you is uh especially in Queens University is through logbooks. So you have to have a certain number of procedures completed before the end of that rotation. And things like Als and Gynae and Pes is very specific. Um you know, observing a number of C sections, um pediatrics, you know, you'd have to attend a number of clinics. Um And so again, that would be something that would be quite individual. And then I've already mentioned the lectures online. And the last part, um I kind of wanted to mention which I know is not on these slides but is the opportunity to do medical electives. Um Usually, um every university I think in the UK offers one and Queens then that is between or was between our 4th and 5th year. Um And so this gives you um the opportunity to go into any specialty anywhere in the world. Um And really um gain an insight into what you're interested in. Um And you do not need to think about that at this stage, but it is something to be quite excited about um because it allows you to explore something that you really love. And so again, that is the clinical years. Um and I will pass that over to ma who's going to share some top tips. Um Right. So my name is Moti, I'm a final year as well um in Cambridge. So in terms of top tips, I suppose, uh it depends on who you speak with, but you'll hear all sorts of different things. And I'm sure um for all those who um have applied to medicine this year, but also those who are um looking forward to applying next year, it can be quite a stressful time and um to remember that everyone in the application pool feels the same way. Um and to really make use of, of the connections in your friends who are also applying and um going through the same thing together. Um I've often been asked, you know, ii feel like I and students say, oh, I feel like I haven't had any unique experiences. Um I haven't had or seen anything, you know, super interesting yet. And I think the general thing that I usually say is um to use your unique experiences in the interview and on your personal statements, um no matter how small they are, they're unique experiences to you because you're the only one who's seen and felt those things. And so to really think um on what you saw, how it made you feel and any learning points that you took away from that. Um And so that's really the power of reflection, no matter how small the experiences are in terms of choosing a medical school. Um So various medical schools will have different requirements in terms of your grades and your extracurricular activities and really apply to your strengths. You will find um great medical schools all across the country and they will all prepare you to be an excellent doctor at the at the end. Um when you're thinking about medical schools, um some things to think about could be um the course structure. So um some schools are more traditional in their approach uh using more of a lecture based um style of teaching, whereas some other schools will lean more towards a problem based learning and you can look sort of the definitions up online but broadly speaking, traditional schools um as I said, use uh focus on lecture based um teaching. So the first few years you'll focus uh uh mainly on lectures on um the main topics of physiology, anatomy, pathophysiology, histology, et cetera. Um whereas problem based learning, you may have um access to a clinical environment and case uh based discussions sooner. Um also thinking about intercalation options. So um he spoke about her intercalation in surgical sciences. Um and every university will differ in terms of whether intercalation is mandatory or an optional um addition to your course. Um and thinking a little bit further on as well in terms of whether you're interested in research and interested in research career. So, um you know, if you would like to have a BSC or ABA at the end of uh in the middle of your, of your, of your medical school with the intercalation, that degree can lead you on towards master's degrees, phd uh projects, et cetera. That's not to say you can't, can't do a master's in phd afterwards if, if you wanted to without in intercalation. But um some people find that they want to experience research early on with the intercalation and thinking about, you know, hospital contacts and university contacts in the schools that you choose as well. Um Medical school applications are very competitive unfortunately. And um you know, not everyone will receive an offer the first time they apply. Um But if medicine is really something that you want to do, don't give up the first time if you're not successful, use a year. If you, if you want to um take a gap year, use that year to build on your experiences, do work experiences um locally um and look out for additional opportunities like what you're doing now. So joining these lectures and various other enrichment opportunities um to build up your, your portfolio and your CV. And remembering that medicine is a lot of fun. I've enjoyed my S six years, but it is also um an intense course where you have um a lot of lectures early on, It's a five day per week, um commitment and you will have to study and, and make sacrifices on the weekends and your free time as well. That's not to say you won't have a life and it's really important to balance what you're doing in medicine. Um uh uh without forgetting your hobbies. So, lots of medics are able to, you know, keep, um, keep playing instruments, keep um playing on sports teams. And so, um stay connected to what you're passionate about and at the very end to tie things off, um medicine is a lifelong uh learning and, and it's a career that um you will consistently be learning from. Um I think I used to think that once medical school was over, things were, would be done and dusted. But uh that's not the case. Um It's really only the beginning after graduating from medical school. Um There is foundation years and specialty training after medical school. Um And that's learning on the job, which is um something that Kirsty will be speaking about as well. Um, and that can be, you know, at least five years up to 10 plus years if you, um, choose a certain specialties and also if you, um, undertake any other research degrees along the way. But, yeah, that's all I had to say. Um, I think we're taking a few questions. Is that right? Yeah, that would be great. Um, there was one, so, actually it's been a little while since I applied now, but maybe someone else will be able to help about deferred entry for applying to medicine and, and impacting your chances of, of getting in. I was typing a response, but actually I think it would be good to, to see what you all thought from what I've heard. And again, I'm not on any admissions panel or anything like that. So I don't know how exactly it works, but it is a potential option that some people have taken, um, a deferred entry after they've received their offers. But, um, I think it will differ between universities and best to email the admissions um, office of the university or yeah, and I think like kind of adding on to that, I suppose it doesn't totally answer the question. But, you know, if you weren't successful or you felt like you needed a gap year, you know, doing something that is, um, like supports a career in medicine. You know, whether it be working, you know, within a care home or, um, doing a bit of traveling and, you know, volunteering, um, abroad, you know, that really does, you know, you can really talk about that in interviews and things. So I suppose it doesn't directly answer that question, but I suppose if you felt you needed a gap year or you wanted to, um, or you, you, you weren't successful the first time that could be, um, a way to really fill that year with something useful. Um is kind of what I would add to that. I think also when it comes to timing, you would be submitting your application at the very beginning of your gap year. Anyway, so um some people I've spoken to say to sort of mention what you're planning to do on your gap year in the personal statement. Um I know it's changing to a, a more structured sort of segmented personal statement now rather than the free text that we had. But um some people say to mention, you know, your plans for your gap year and what you plan to do to build up or continue your academic side. But um I don't it, I I've not heard of it impacting chances of getting in, but I think again, best to email your um academic office to, I think the other thing to bear in mind, II didn't take a gap year for example, but intercalation is a really good opportunity to do something different. So I intercalated in Neuroscience which was um you know, still fairly academic, but actually gave me a lot more freedom where I wasn't, my time wasn't quite so prescribed. And I didn't have to be in the hospital in lectures nine till five. And actually I had a lot more self directed study. So it's important to think about that in that intercalation might offer us a different opportunity to do something, not necessarily that you would have done in a gap year, but do something a bit different to medicine. And the other thing is, um, is lots of people increasingly nowadays take what's called an F three or an F four or take time out after they finish their foundation years. So if going on a gap year is something that's really important to, you don't feel like just because you haven't done it before, you've gone to uni diversity, but you couldn't do it eventually. And, and actually, quite often you can do a gap year, so to speak. But, but whilst working or going to another country or traveling and doing a short term shifts and locums and that kind of thing. So that's another thing a little bit further down the line. But to just be aware of, um, the other question that we have is kind of er, comparing traditional courses and lecture based courses with people that have slightly more hospital experience earlier on, which is difficult because we all have only gone to medical school once and only have one experience. Um, has anyone done, I guess a slightly more must, I'm not sure what it's like at Cambridge, whether it's, I imagine slightly more traditional there from your experience. What, how do you feel that that structure was for you? I suppose. I had a bit of a strange experience in that. I did my preclinical years at Saint Andrews and then transferred down so Saint Andrew's in normal days. so part of my degree was impacted by COVID. So in, in normal days, it should have been that we have um once a week clinical placements starting from the second half of first year. And so that would c clinical placements would continue on. Um And then in Cambridge, it's completely the preclinical students don't have any access to hospitals until fourth year. So they don't spend any time in the hospital at all. And while I because of COVID, I had a little bit of the clinical placements, but then those stopped when, when COVID came. Um in terms of speaking to Cambridge medics who've spent their entire time in Cambridge, I think certainly having that little bit of clinical exposure did help in those initial months or weeks of starting clinical placements for the first time and fourth year. But I think everyone catches up really, really quickly and that apprehension of speaking with patients or working their way through a hospital really didn't, really didn't last for, for very long. So II think there is that it always going to, I think there's always going to be that initial apprehension of going into hospital placements for the first time. But in terms of um lasting impacts, I think everyone sort of found their way. Not, not long after. Oh, he sorry. Um II wonder if we just can't quite hear you saying there's a connection issue. Um Sorry, we're not able to hear you. Maybe you could post in the chat. Um, would that be all right? So, um, a conscious time is, is plodding on. So I'm, I'll share my slides and we'll, we can obviously keep answering questions as, as we go. Um, so for the people that have joined a, a little bit later, I'm, I'm Kirsty. I'm one of the foundation year two doctors and I'm currently working in Bristol. Um, and the instinct insight scheme is something I set up last year. And so this is the second year we're running the lecture series. Um, I'm gonna have my perspective on what it's like to be a junior doctor, which I've now been doing for, I can't believe 18 months. Um, so I guess just to get people talking a little bit, what kind of things do you think is a junior doctor's job? Can you post in the chat? What things you think I might do or what we might be my responsibility or what is the word that comes to mind when you think Junior doctor, um, really interested to see what people say. Um, has anyone got any kind of one word things? What do you think when you think junior Doctor there's maybe been some stuff in the media recently as well. Has anyone got any thoughts? If not, we can just keep coming back to it? Yeah. Stressful strikes. Another s bye. Hard working. I'd like to think so. Um, yeah, exactly. So, all of these things. Um, so let's talk a little bit more about it now. So this is me, this is me as I think, a four year old. Um, you can see there that I actually got a Barbie, er, doctor. I've, one of those stereotypes that I've always wanted to be a doctor as, as, as early as I could talk and then I got my first stethoscope, I think, probably a year later, not convinced that I heard anything on it. But, um, er, yeah, so I, this is something that I've always wanted to do and this picture here of me in a, in a scrub cap and wearing some scrubs is actually taken in South Korea. And I took that selfie after I had done a 24 hour shift, observing II finished the shift. And then we got the news to say that there had been a, um, a donor of a, of a heart and there was a patient that was on the transplant list and they were, they were waiting to receive their heart. And I was quite tired, but wanted to make a really good impression and also knew that this was not something that I probably would ever see in my career ever again, unless I went on to do cardiac surgery. And I thought I'm exhausted, but I need to document this moment because I will remember this forever. And I think that was one of the things that I will always remember is seeing a heart being taken out of someone else's chest and still beating when it was not in there anymore. And then watching as another heart was donated from, from someone else and put into someone else's chest and it started beating again. And for me, that was one of the most amazing things I've ever seen in my career and think I probably ever will. Um So that's kind of been my, my drive to, to learn more about cardiothoracic and surgical training and all of those kind of things. So that was in my second year of university. So I hadn't even started going to the hospital yet. So I'd really just been in lectures for two years and then I had this opportunity to go to a, to this hospital. Um And then finally, you know, four years later after that, we've done five years at medical school and then an extra year in intercalation, II finally graduated from the University of Bristol. Um So I guess following on from all that was it worth it and is being a junior doctor living up to the expectation that, you know, four year old me had when I got my first Barbie doctor, I don't know if anyone has seen or read Adam Kay's book or, um, seen that the series. This is going to hurt. That's something that came out just before I started, um, started work as a doctor and II couldn't watch it because I thought I don't really need to know what it's actually gonna be like. And as much as you go through medical school and you think you're prepared, uh I think you're prepared. There's, there's nothing really that will truly prepare you for, for starting work than for starting work. So a little bit more of the kind of logistics of what happens when you um finish medical school and a, a apply to work as a doctor. It's a really unique thing in the fact that you don't actually have to interview for it like you would with any other job. So long as you pass your finals and you sit a couple of exams in your, in your final year, um, you essentially get put in this random allocation process and everyone across the country gets allocated a job and in my, in my years, although it's changed, um, in the last couple of years, you would essentially just rank these areas in the country and say, ok, I vaguely want to live in Bristol or I vaguely want to live in Newcastle, which is where I'm from originally. And you rank these areas from one to I think 30 you hope that you get placed in one of the areas that you want to work in. So you can see this map down here on the left hand side and all of the different colored colored areas. So those are the places that you could end up working in. And then finally you go through a random selection process and then they allocate you an area in the country and you, you've got to hope that it's an area that you want to live. And then after that, you then go through this painstaking process of ranking I think in, in Bristol, it was um 200 jobs, it was 200 combinations of six jobs that I would do in my F one and my F two. And you have a little bit of say over that. But actually all of the jobs are kind of pre stuck together. And so you couldn't say, oh, I want to do this and then this and then that it was kind of, you picked a combination of six. Um I think I got my I II think I got in the top 30 of my jobs, which was, was great for me. Um And I got to stay in Bristol, which was lovely, but it is a very weird feeling applying for things and not knowing where you're gonna be in the country, what jobs you're gonna be doing and not really having any, any say over that kind of handing that responsibility over for someone else to decide where you're gonna work for two years. But anyway, um, I've ended up staying in Bristol and these were the, the six jobs that I got allocated for F one and F two. So it was, so there are 34 month rotations in, in, in those two years. Um So I thought I would go through the jobs that I've done so far and I picked out one word that I think, summarized that specialty that I did. So I started on hematology which um I'm sure my, my colleagues on the chat II didn't learn a lot of hematology at medical school. It was something that we touched upon a little bit, but I never really got that much involved on the boards and that kind of thing. And I don't think I had a really good understanding of the kind of things that went on in a hematology department. It's a fairly specialist area to work in. Um So I was a bit daunted about, about starting on that specialty because it was something that wasn't kind of my bread and butter if that makes sense. And that was actually quite a sad ward to, to work on. So, the center that I was working in is a kind of um specialist center for blood cancers. And, and quite often that meant that it was young patients that were similar ages to me, all patients that were, were young in the sense that they weren't in their eighties or nineties, but they were probably similar ages to my, to my parents and, and they would often be admitted for long periods of time, say weeks and weeks for, for, for chemotherapy. And I think for me, all the jobs are hard to start on. But, but this was a job I found really hard to start on because often the patients were some of the sickest patients in the hospital and because they were there for such long periods of time, you saw them every day. Um And so it became quite hard to see them when they became unwell. And then unfortunately, when, when some of the patients passed away, you felt like you, you know, you'd met their family every day, you'd seen that patient every day and, and you'd watch them become more unwell. And, and I found that really, really difficult, especially with patients that I saw um similarities to either in myself or in or in family members. But I think the one thing that, that job taught me um in the sense that it was very specialist, and I don't think I was necessarily gonna contribute too much in terms of the, the medical side of things, but it really taught me the compassion that is needed to, to look after patients when they're kind of either reaching the end of their life or they're going through horrible treatments such as chemotherapy and how important it is just to be kind to patients and to recognize vulnerability and, and just, you know, the simple things that can make their day a little bit better. So, yeah, I think that that job was a really difficult place to start. But I think if you can start with the simple things like being kind and, and compassionate, then you're always, you're always gonna be, take, be able to take those on to the future specialties. Now, gastroenterology, I then moved on to, and this was a much busier job and I also had some what, what's called on calls. So, on top of my 9 to 5 working day, I'd also work some nights. Um, I do some weekends and I'd do some long, 12 or 13 hour shifts, but I'm not gonna dwell too much on, on the gastro side of things. But I think the one thing that this job taught me was what a privilege it is to be a doctor. And the fact that people will tell you bits about their lives that no one else has ever heard or no one else has ever seen. And there's one story that sticks out to me from my gastroenterology placement in that I actually got invited to a wedding on the ward. And I was, II had to act as one of the witnesses for a patient that unfortunately it was kind of reaching the, the end of their life, but really, really wanted to get married before they passed away. But they didn't want a big ceremony. They didn't want lots of people. They didn't want lots of fuss and they just want it to be this private ceremony between, um, themselves and their, their future wife. So I remember the day I, it had been a really busy day and it was already 10 past five. And I was thinking, oh, it's been a really long day and I just want to get home and these men turned up on the wards in, in a suit and they said, is anyone able to be a witness to a wedding? And I thought, well, I'm gonna be able to talk about this story in a little while time and what a privilege it would be to be a part of, of, you know, the most special day of that patient's life. Um, and I don't think it's something that will ever happen to me again. So that was the story that stuck out to me from, from gastro. Now, I next move on to general surgery. Now, as I slightly touched upon earlier, I'm really interested in, in doing surgical training in, in the future. And so I was really looking forward to this specialty as something that I thought, oh, you know, that that's what I want to do. Um And this was the first specialty, I guess. Um Other than obviously my, my colleagues that I've met on cardio thoracic that have been really supportive outside of medicine, but that I met colleagues at work that really took me under their wing and took me to theater and taught me how to do new procedures and got me involved with projects and all of that kind of thing. And people that I now really look up to in terms of how they are as doctors and as surgeons, but also in how they tackle all the challenges that it takes to kind of apply for surgical training. And I just really appreciate them, appreciated them taking me under their wing and, and teaching me all these new things. And I thought, oh, that's what I really want to do. So that's what I learned from, from that specialty. So that's me completed F one and I think, oh, gosh, that's time has absolutely flown over. And then I thought, oh, no, ok. Now I have to step up and I have a bit more responsibility and the stabilizers are off and I actually will now have F ones underneath me who will want to ask me questions and I have a bit more responsibility on the ward in terms of taking referrals and that kind of thing. So I did my trauma and orthopedics job in a smaller hospital. And that was really, really busy. It was quite stressful and I saw lots of, you know, little old ladies and little old men that had, had falls and broken their hips and were really unwell and frail and a bit older and all of those kind of things. And I think this job taught me how important it is to work amongst your colleagues and have really good teamwork to be able to get through a really busy day. Um So yeah, I think that that job was the kind of pushed the limits of how much you can do within a day. But really you relied on your colleagues for that moral support and, and the teamwork to get you through. And then I guess this moves me on to general practice, which is the rotation that I'm on just now, which is nice in the sense that actually I've got a slightly more, I've got a slightly more routine, I'm working AAA normal day, so to speak, which is 10 till six. And, but actually, this has also been a really big step up in terms of responsibility. So in GPI actually run my own clinics and I will see patients completely on my own. And yes, I'll have other supervisor, um supervisors keeping an eye on me and then they're always there for me to ask them if I've got any questions. But this is the first time that I've really had to make decisions on my own. And um yeah, make plans for patients. So I think that's been a really big step up. And the other thing is by nature of general practice is you see so much variety from, you know, newborn babies to people in, you know, 100 and one year olds and the style of communication that you need to be able to communicate with the baby and then someone that's maybe a bit hard of hearing or have dementia and all of that kind of thing really tests your ability to explain things clearly and communicate with patients and also give them clear advice so that if things are getting worse, they'll come back and see you or they'll know how to get help. So I think that's what I'm learning on general practice, although I'm not finished yet. So I'll let you know by the end and then finally I finish on, on stroke medicine and I'm not really sure what that's gonna involve or what that's gonna teach me. But I feel a little bit, if I'm honest, I feel a little bit stressed at the moment with a few other projects that I've been taking on. And I hope that maybe by the end of my f two, having had two years as a doctor that I might learn a little bit more in terms of work life balance and, and balancing the things of kind of coping with stress and um and yeah, and work life balance, I guess. So, moving on from that, these are a few things. So everyone I think had already mentioned them already. These are the few things that I might expect to be doing um as a junior doctor. So things like independent ward rounds, but also consultant led ward rounds where they might come round and supervise me assessing a patient in GPI run my own clinics. Um I also do things like clinical skills so on orthopedics, for example, I would kind of stick needles into joints and pull fluid out and help put plaster casts on people or take blood or put Cannulas in all of those kind of things on GPA. I actually go on home visits as well and I'll go and assess patients who aren't able to make it into the surgery. I also um form part of the cardiac arrest team depending on which team I've been working with. So if patients become more sick in the hospital and they need kind of urgent extra support, then they'll put out what's called a crash call. And sometimes I've been a part of that team to go and assess an unwell patient amongst, amongst um a team of other doctors. I've also done things like assisting in theater, which most of the time usually means just holding a retractor to keep someone's tummy open or handing, handing the surgeon a piece of equipment. But um that's always really fun and really interesting and then I guess the other side of the thing, um, the other side of the coin is those are all the things that I'm expected to do on my, in my day job. But outside of that, there's also this big role for kind of teaching and developing myself as a doctor. So as part of the foundation program, I'm not sure if people knew this already. But um, like marine was saying earlier, it's this lifelong learning. And as part of the foundation program, you should have weekly teaching either by your department or also by the kind of whole deanery um to help you kind of expand on your current knowledge. Uh I'm also at the moment attending conferences to talk about work that I've been doing, which is great and it's also a good opportunity to kind of hear about um research within the field and learn new things that you haven't necessarily learnt at medical school, which is always great. I'm also expected to, to teach medical students. So sometimes I'll have medical students on the ward that might come along with me and I'll teach them what I'm talking about on the ward round or I'll observe them. Um I'll observe them assessing patients and give them feedback. I also do other projects. So things like this, things like teaching um sixth formers and developing schemes like this um alongside and then finally, again, this lifelong learning. Um I'm also currently revising for, for an exam at the end of the year, which will help me if I want to do surgical training in the future, which is a bit of a challenge trying to fit in revising outside of a full time job. But is also something that's really good to, to be able to get my teeth into again and do a bit more of the academic side of things, which funnily enough, you slightly miss once you left medical school and you're doing all the practical things. So this was just a, a vague idea of some of the other things that I've been able to do since I've started work um as a doctor. So as you can see on the, the top left here, that's actually me presenting my ins insight lecture series that I did last year at a conference and, and talking about some of the results that we'd seen on the feedback that we've got. Um there's a few familiar faces in the, the picture at the bottom as well. So that was the cardiothoracic conference that I was able to attend through, through this committee. Um The one in the middle with the person, I don't know if you can actually see the face that's wrapped up in all of the, the sleeping bags and that kind of thing. But um I was actually invited to attend a, a wilderness and Expedition medicine course in Exmoor where we learnt about managing hypothermia and patients that had had falls or um, heat stroke and all of that kind of thing. So that was really good. And the amazing thing about that is that, that's actually part of my job. So I got paid to go and do that course. And then finally we also get invited to skills workshop. So I'm not, if you can see, I'm not sure if you can see that one at the top, but that was me attempting to put a new valve in a, in a, in a heart. Um which I hope ge is not looking too closely at because I don't think it's probably my best, my best suturing work. But um all of those kind of things are the opportunities that you might get when you start work as a junior doctor and then finally just coming back to the work life balance, I've actually been learning how to make sourdough bread since I've started work because I find kneading very relaxing and it's important to have good hobbies outside of work. Um But no one be Paul Hollywood and tell me that that's not a good loaf cos that was the one I was most proud of. Um And then I guess this one I entitled the good, the bad and the honesty. So I think often the things that make starting work as a junior doctor really, really good and so rewarding are often the things that also make it really challenging and quite difficult. So, one thing you'll notice when you start work after finishing medical school is that you get a really big step up in responsibility and in a way that's quite nice because it's something that you've worked towards and you finally feel like you're able to make decisions on your own. But on the other side of the coin that, that can be quite scary. And I remember the first moment that the reality hit that I would actually have to make decisions about patients. And then again, this idea of teamwork in that as a medical student, you often sometimes feel a little bit like a spare part because you're walking around on the ward waiting for someone to take pity on you and teach you something. So it's really great that when you start work, you really, really feel part of the team. But the other side of the coin is sometimes it's hard working in a team all of the time and sometimes you might have colleagues that don't quite pull their weight or who are having a bad day or you maybe don't quite agree on something. And that's another one of the things that can be challenging about the job. Um And then finally, it's this idea of lifelong learning. Um So it is really challenging, revising for a, er, revising for an exam outside of um, outside of work. But it's also really rewarding to be able to get my teeth into something and be constantly learning something new. And then finally, so I guess the good, the bad and the honesty, it, it would be remiss of me to not talk about the thing that's covering all of the media at the moment in the, in the junior doctor strikes. Um, that's actually me in the middle with the, the yellow jacket from a placard that I've made on some old cardboards. And it, it's very easy for being a junior doctor to be painted quite negatively in the media at the moment. It's maybe a little bit of a bleak time for the NHS. And I'm sure some of you have read articles already and probably have your own thoughts on the junior doctor strike action and that kind of thing. And it's really, really difficult and it's a big ethical dilemma. Um But actually, I just wanted to kind of note these were some of the quotes that my, I asked my flatmates when I said that I was doing this talk, what they would say about starting work as um junior doctors. So they're all F two s like me and these were the, some of the things that they said. So I never go home and feel like I've not achieved something. This is a career I can see myself doing for a really long time. It was challenging, varied and even on the worst days, I couldn't imagine doing anything else. And this job really is a privilege. And now that I'm in it, I couldn't see myself doing anything else. So I think what you see in the media at the moment, there's lots of different opinions out there and people will have different opinions on, on what it's like to be a junior doctor at the moment. It is a challenging time and it is very stressful and people are overworked and feeling tired and it means you're a little bit rattier with your colleagues and people are just stressed and patients are stressed because they're waiting longer for their, their appointments and all of those kind of things. But hopefully this talk this evening and some of the talks throughout the rest of the week will try to put your mind at rest a little bit. And hopefully those, those quotes will reassure you. Um Finally, I just wanted to finish and say that actually the the biggest privilege about this job is, is being able to teach other people and inspire other students because that's something that when I was much younger, I still remember the doctors that kind of took me under their wing and encouraged me to apply. I'll carve out this by saying that is not my son, that is my nephew, um Angus. But I as the proud auntie decided that I wanted to buy him a doctor's kit for his first birthday. So that is a wooden stethoscope and a wooden thermometer, which I'm not sure he entirely knows how they work yet, but that is for when he's too. Um, I'm aiming for when, by the time he's three, he should be able to get a proper one round his neck. Um, but yeah, that I'll, I'll stop rambling on now, but I hope, I hope that was helpful and I'm, I'm very happy to answer, answer any questions if anyone's got any in the chat. Um And also I've, I've left my email on, on the slide. If anyone wants to get in touch with me directly with any specific questions, I will do my best to help. Um Thank you for that, Kirsty. That was amazing. Um We have a question for you actually. Uh what made you apply to Bristol University? Would you be able to answer that? Yeah. Um So the honest answer is that I was quite tactical about where I chose to apply to university. So I'd done a bit of research and II, I sussed out the universities that I thought I would either get an interview at or um would have a slightly better chance of being seen. So Bristol in theory was my third choice. Um I'd also applied for Edinburgh and Newcastle um because I'm, I'm from the northeast. So um I didn't get an interview at Newcastle and I Edinburgh at the time, didn't interview. So they, they rejected me and Bristol, I thought I had a slightly better chance at getting in out based on the applications um at the time, but I also had visited the city and thought, oh, this is, this is really nice. And um I also like the teaching style. So that's one of the things that I think it's a good thing to, to have a bit of an awareness about is the style of teaching that the university will offer. Bristol was doing kind of case based discussions. So it was very clinically focused and also they had a focus on trying to get you um contact with patients as early as possible, which I thought was something that appealed to me. Um So that's, I guess in short, what made me apply to Bristol a bit of, I don't know where I'm gonna get in and a little bit also of um the teaching style I felt suited me. Um, um I have a question that I really like to ask all the junior doctors and that's um knowing what, you know, now, so all that you've experienced, especially working as a junior doctor. Uh Would you have still made the decision to apply to medicine and study medicine? I think the, the short answer I get is, is yes. Um There's definitely been some days where I've thought, why, why am I doing this to myself? And, and I've also thought that this job is not supposed to be this hard, you know, it's not supposed to take that much out of you. And, you know, there's always good days and bad days. But I think the, the overriding feeling is that again, I couldn't see myself doing anything else and I find it really hard but I find it hard because II care, I guess and I want to do a good job and I think if you lose that feeling then it's unlikely that medicines to be for you. But if you can still find good in all of the bad things and all of the difficult things, um, then I guess that's how, you know, it, it, it's right for you. If that makes sense, it's definitely not a job for the faint hearted and it's, it's not a job that you should go into because your parents want you to or because you think you should, you definitely need to know that it's the decision. That's right for you. But if that's the case, then, then I don't think people should be put off by, by how hard it, it can be because with every single job that you do, there will be good days and bad days. Um, but yeah, that was a bit of a wishy washy answer, but the short answer is, I think so. Yes right now. Yeah. Thank you. We don't have any more questions so we can move to the next speaker. That's ok and George is just messaging me, I think. Um, she might need to, she's just had to join another meeting. Um, so she might be able to join a little bit later or postpone her talk till later in, in the week. Um So I wonder if, if Mr Zars here and he's happy to move on where we, we could move on to him just now. Oh, he, you're just on mute. So, while we're waiting, there's a question about F one F two placements. Um Did you do them at different parts of the country or did you just, she said she's got five minutes free if, if it's all right, if we just squeeze her in, is that ok? Sorry. And we can come back to the questions in the chat. Hi, Veron. Can you hear me? Yeah, we can hear you. Yeah, sorry. II penciled this in for an earlier thought. So I'm just a little bit double booked now. But um let me just try and share very quickly. I'm just going to do a very quick word through of a day in the life and then um, oh no, this is not what we want. Um And then maybe if you guys have any questions, I can always answer them at another time if I have to leave. Um So hopefully you can squeeze see my screen. Yeah, we can see your screen. Yeah. Can you see my slides? Perfect. So my name is George. I'm a registrar on cardiothoracic surgery. So that basically means that I am a doctor who's in training. I'm in a training pathway to eventually become a consultant surgeon. So, registrar is a kind of middle grade level that you will enter after about five years of training. After medical school, you can enter in various different ways through training or non training. Um But ultimately, if you want to gain experience and progress to becoming a consultant, you will have to be a registrar no matter what specialty you end up entering or choosing to enter. Ultimately, the overall job of registrar is to lead the daily care of all patients. Um in the hospital, each specialty will be slightly different. There'll be nuances in terms of how much input you have from and how responsible you are and how independent you are and often that is really dependent on the special you're in the grade and your experience. So as you become more senior, your independence increases exponentially until ultimately, before you become a consultant, you will be practicing for some time, pretty much at the level of a new consultant with very, very peripheral supervision only. So our responsibilities are really varied and it depends on specialty, but ultimately for surgical specialties and obviously cardiac surgery, which is what I'm training in. We are responsible for our patients before surgery. We're responsible for our patients having surgery and making sure that safety, that surgery is safe and smooth. And we're responsible for our patients after surgery both in hospital and then once they've gone home and they're going through the ongoing recovery, which is often a couple of months and the specific responsibilities of your role are going to be dependent on hospital, how your teams are set up. But for patients before surgery, that will often entail meeting them in a clinic. So they just attend for an appointment, then you will talk to them about the problem that they have, which was often the reason they have been referred to you for an opinion. You will talk to them about the options for treatment, which will include talking to them about the non surgical options. And then you will talk to them about the risks and the expected recovery and what's important to them in their recovery and their treatment to help them come to a decision about whether or not they want to accept the risks of having surgery during the surgery. Of course, we are um again by seniority dependent for various parts of the procedure which ultimately progresses to you performing full procedures completely independently without a consultant present in theater, but perhaps in the hospital. Um and the speeds that kind of that you undertake that will vary by procedure by specialty, by individual, by, you know, how comfortable your consultant is to let you lead an operation. But ultimately, you generally follow a trajectory of gradual progression, gradually increasing how much you're doing, how much supervision you have or don't have and then uh seeing your patients regularly after surgery. So for myself, So for cardiac surgery patients that will involve seeing them maybe four or five times a day af after the initial surgery. So, um, immediately after an hour later, a couple of hours later the next day, um, and then as they improve and as they get close to discharge, which can be anywhere between sort of three days to two weeks after a surgery, you see them less frequently and then decide when it's safe for them to go home. Um, an average week again, it kind of depends what placement you're on where you're working. But broadly speaking, as a surgical registrar, you're going to have hopefully a good amount of operating. Um, that would be ideally maybe three days a week, four days around that you will have your responsibilities to the patients that you've already operated on. So you'll still be doing ward rounds, which means going to the, the inpatient ward or hospital that patients are staying and seeing your patients in the morning before your operating. This starts in the evening to check on their results and follow up things that you asked for earlier in the day. Uh, you'll have your clinics, which is where you see the people that are not physically in hospital, they're just coming for an appointment either before surgery or after you have a lot of admin admin. So when you ask for a patient to have a scan, to determine whether they're suitable for surgery, you then have to follow up the results and see, make a decision on that. We have things called MDT S Multidiscipline team meetings, which is where we meet with our colleagues from different specialties to have multi expert input. So that could include your cardiology colleagues, anesthetics, intensive care. And it could include physiotherapists, nursing colleagues, anything and everything really depending on what department and background you're working in. And then also there will be a degree of kind of self directed learning and preparations. So when we have an operative procedure, you need to make sure that you have an idea of how it's going to be performed major steps. If you're going to be performing them, pitfalls, things that you need to avoid critical parts of the surgery to know when you need to really focus a lot more intensely than, than other times of the procedure. So there's a lot to balance week on week. Um The good, a lot of this has kind of been uh covered really eloquently by the presenters before me. But you know, ultimately being a surgeon is a very unique and privileged experience and it is hard work, but it's hard work for a reason because you're asking people to trust you whilst you tell them that you're going to temporarily stop their heart and, and you know, remove their valves and replace them and then restart their heart and send them home to recover. That's a big responsibility and it comes with long hours, that's completely unavoidable. You have to be incredibly self motivated, incredibly proactive to balance, not only everything required of you in the job, but all the kind of, you know, work life balance and having a family life and the things that are so critical to being a well rounded functional person. And that can be really challenging sometimes. But ultimately, if it is something that interests you and you would like to devote, you know, a portion of your life to then um there's really nothing else like it. So, um I think I'll leave it there. Nice and brief. If you have any questions, please put them in the chat. If I don't answer them now, I can either come back or feel free to email me or contact me on Twitter because my details are on the screen here. Thank you. Thank you, Georgia. Sorry to keep you late. I'll keep an eye on any of the questions and we can um, so that so that you can dash off, I'll um I'll make a list of them. If there's any specific ones, we can maybe get back to them later in the week. Yeah, that would be great. Thanks. Yeah. All right. No worries. Thanks so much. Bye. Please feel free to still post your questions in the chat if you've got them, it's just Georgia had to, had to rush off. Um So if you've got them II, I'll make a list and ask Georgia later in the week. And we can either send them out via, um, via email or we can maybe come back to them in the other lectures later in the week. So if you've got any questions for Georgia, she is actually a little bit further down the pathway and is, you know, doing heart and lung surgery on the, on a regular basis. So, any specific questions for her, then I'm sure she'll be very happy to happy to answer them. We're just waiting for our final speaker to, to join. We can't, I'm afraid Dean. So there is a really good question about um considering how competitive cardiothoracic surgery, specialty training is, what can we do to improve the application um and whether they should choose it to proceed in the future. So they're currently a medical student and want to know how to improve their uh portfolio. But we can answer that later if um Mr Zumbar wants to be. Yeah, that sounds great. I think. Um sorry Hean, I'm just um I'm being he's voice for the evening, but um we're delighted to have Mr Zamba who's one of the consultant cardiothoracic surgeons in Edinburgh join us this evening. I'm sure he'll be also very happy to help with that question in terms of applying for cardiothoracic and making yourself competitive and all of that kind of thing. Um But I'll just hand over over him over to him just now to introduce him just bear with us for the time being. I'll, I'll come back to that question then. So about, um, uh, we aren't able to hear, hear you. I'm afraid at the moment. Ok. Can you hear me now? Oh, ok. OK. So, uh, first of all, thank you, uh, Kirsty, uh for the introduction and thank you for asking me to come and speak to the audience here. Can I, can I just have some background checks? So who, who is the audience here? Are they mainly medical students from Edinburgh or from? Um So these students are actually predominantly school students. So they're four students, 14 to 15, up until early medical medical students and they're from across the UK. Ok. Ok. Excellent. So, so I suppose there are students here. They, they are here because they want to join medicine at university. Yeah, exactly. Ok. So um uh so hello. So just to introduce myself, I'm a cardiothoracic surgeon. I work at the Royal Infirmary of Edinburgh. And uh so by cardiothoracic surgery, I mean, I do operations on the heart and the lungs. Um So when I trained in the 19 nineties, uh we trained in both cardiac and thoracic surgery. Nowadays, the training has split up. So you either have uh surgeons, training to be cardiac surgeons or training to be thoracic surgeons. So there are only a few of me still around who do both cardiac and thoracic. Um So coming to uh life as a cardiothoracic surgeon. Uh, I think, uh, uh, rather than talking specifically about cardiothoracic surgery because many of you are school students and are considering a career in medicine. I would say if you want to, to be a doctor, it's a fantastic specialty. It's a, it's a fantastic career to be in. Um, it's very satisfying and like the previous speaker said, the hours are long, but it's fun. And when you, when you enjoy something, then it's no, it's not a job at all. And secondly, um, long hours, it's not only doctors who spend long hours, you know, in any other special or any other job. If you see, there are some people who spend long hours, you know, if you have any of your friends or lawyers or bankers, they spend, you know, much longer hours. But, but that's the nature of, of any career. If you want to be successful, you have to a enjoy what you're doing, you and you have to be willing to put in the effort and you have to be good as well. Um So coming to cardiothoracic surgery per se, um um it's uh uh uh so II work at the roll in FM of Edinburgh. My typical week uh is Monday, for example, today I did uh two thoracic surgical operations. Um Tomorrow again, I'll do Thoracic surgical operations on Wednesdays and Fridays. I do cardiac surgical operations. I have a clinic on Thursday morning and throughout the week, we have two or three multidisciplinary meetings where a group of doctors come together to discuss patients and their management. For example, tomorrow morning, we'll have a lung cancer multidisciplinary meeting. So patients in the Edinburgh area, every patient who has lung cancer gets discussed at this meeting where we look at the x rays, the scans, uh we discuss um potential treatment options and then decide what is best for the patient. So that's multidisciplinary team working. It's a relatively new thing. It was introduced just about five or 10 years ago. Um It was not the norm when I was training in the 19 nineties. So Kirsty, what else would you like me to talk to the students about? You? Tell me and II will, II will, you know, talk on those topics before you? Ok. Uh uh Just one more thing I want to uh want to make before, you know, I let Kirsty ask me questions. Um It's a myth that cardiac surgeons uh work very long hours. It's, it's not true. We work long hours, but then we work as many long hours as anybody else does. You know, if you, if you talk to a pediatric surgeon or if you talk to a GP or if you talk to a lawyer or if you talk to a businessman who runs a restaurant, everybody works long hours. The people who are, you know, committed to their jobs or who are successful or who are really passionate about what they are doing. They work long hours because they enjoy it. So it's a myth that cardiac surgeons are always in the hospital. That's not true. And it's a myth that cardiac surgeons can't have a family life. You know, like I have two daughters now. Of course, they are grown up now. But when they were in school, both of them I attended each and every parent teacher meeting, you know, without, in fact, I attended more parent teacher meetings than my wife. You know, we would always go together but there were times when she would miss them. Um So it's just a question of arranging your timetable of having good colleagues at work and prioritizing things. If you decide you are going to be free on a Tuesday afternoon evening to go to the parent teacher meeting, there's nobody who can stop you. Um And um you know, we go on holidays, we have, um we have six weeks of annual leave, uh 2 to 3 weeks of study leave. So the NHS is a really very good employer. The working conditions are very good. You put in as much time as you want to, but at the same time, there are lots of benefits as well. So, uh so it's a myth that you, you do not have a family life or you work long hours all the time. Uh It's just that you spend more time because you enjoy the job and you're having fun? Ok. Ok. Kirstie. Any, any queries you have? No, I'm, I'm glad I didn't interrupt cos I think that's probably, you know, the best, the best piece of advice that you could give really and the best insight into what it's like to be a consultant within the specialty. I guess. I, I'm a, I'm an F two so it's difficult for me to kind of see that far ahead and that light at the end of the tunnel. But from your perspective, I suppose you've touched on it already. But what do you think is the biggest key to having work life balance now that you're kind of not at the end of your training, but you've kind of reached the peak of, of your career, so to speak. So, so, uh um even from the beginning, II, II had, you know, two things were equally, II was equally focused on two things early on in the career. I just wanted to make sure that I did my exams in time that I committed the number of hours I needed to study for my exams. But later on, uh you know, a as, um you know, when, when we had kids and as the ch and I started, as the kids started growing, I made sure that family would be equally important as my career. So I never, uh I, you know, I never gave something one thing more important than the other or II never gave anything less important than the other. So I think it is possible. And uh, even if you see, uh, doctors nowadays don't work very long hours leg by legislation. There, there is legislation that prevents doctors from working more than, I don't know what the number is, maybe 48 or 52 or 60. But when I was training, we routinely work 100 hours, 100 and 10 hours a week. Uh And it was, and actually we thrived in that. It was not that we were, we were always tired, it was not like that. But even now, uh there is a limit on the number of hours that the hospital will allow you to work, which is a good thing. So you can have your own hobbies, you can do other things in your spare time and you can have, uh, you know, your family commitments as well. So everything is possible. You just have to prioritize things. And, uh I'm lucky because in Edinburgh, I have excellent colleagues and we always look after each other if I wanted to, for example, take a day off. I, all I had to do was put it on my whatsapp group chat. Look guys next Friday. I want the evening free. Can somebody do the on call for me and I within, within, within an hour, I'll have two or three people volunteering to do that on call for me that day, you know, um, So, so it, it, it, it is good to have nice colleagues. Not everybody is in that lucky situation, but, but I am in Edinburgh. Um ok, so, so uh my advice to anybody starting off is you, you have to have your priorities, right? And you also have to be committed to what you're doing and, and if both things are ok, you'll have a good work life balance and you'll be successful in your career. And even though uh I never practiced it, but you must always have a plan b. Um when I was uh when I was young, I wanted to be a cardiac surgeon and there was nothing else I wanted to do so. Uh but that is not advice I would give to any of the juniors today. I would say you should have a plan B. There are many other interesting things you can do besides cardiac surgery, cardiac surgery is interesting, but there are so many other things you can do and you can use the skills that you learn in surgery or, or in your cardiac surgical postings elsewhere. I think one thing I, I'd probably really like to know selfishly. Um Can you think of a really memorable case in your career that you think will always stick with you or a really challenging case that yy, you kind of, you, you learn a lot from or that you think you, you would reflect on? Yeah. Yes. Uh Excuse me. Sir. So we come across, we, you know, the cardiothoracic specialty is, is such that we come across challenging cases very routinely and the practice of surgery has changed over the years. So when I was a trainee, when I was a register, what we learned to do, um, at that time, that's not what I practice now, uh, things have changed and I have continuously learned new things I have either learned by, um, by going on youtube or uh or reading from journals or um or, or then there are some specific things that uh there are specific training programs. For example, we just had a uh a robot um installed in our hospital just last year. So uh we started doing robotic surgery in thoracic surgery. And uh one of my colleagues and myself, two of us uh started training in th in robotic surgery. Of course, we had formal training. Um the company that makes the robot uh took us to two or three European centers where we saw robotic surgery being done. And then I had a surgeon from London come and assist me for five full days. So we'll do two operations every day. He stayed with us for uh he came on um over a period of three weeks, he came for five days and was with me for my 1st 10 operations. So that was the kind of training that I had for robotic surgery. And now uh I do uh robotic surgery. So this is something that I had never imagined five or 10 years ago that I would be doing it. So, cardiac surgery and thoracic surgery offer you all these opportunities, uh, to learn new things. Technology is constantly advancing, constantly changing. And, uh, and if you really want to make use of that, there are uh options available. Um, and coming to your other question, oh, there are so many patients I can remember about, you know, when what I did made a difference. Um uh There's one particular patient I remember um I uh this was II think I operated on him on in 2006, he had a uh he, he, he was a patient who had a very poor left ventricle. He had a very severe three vessel disease. He was a very, very high risk patient who had been turned down for um for surgical revascularization options. And um I discussed the risks and benefits with him and I operated on him and he did well and about four or five years after the operation, I think in 2010 or something, I got a letter from his wife saying today, five years ago, you operated on this man and he's doing so well and we are so grateful, et cetera. And since that time, every year, in the first week of November, I get that letter. So I've now had it for uh I mean maybe 14 times now since 2010. I and I operated on him in 2006. So that particular patient I remember and there are many, many other patients we operate on patients with lung cancer. Lung cancer is a very nasty disease. Uh, about half of the patients are, uh, who have lung cancer are actually dead within three or four years of the diagnosis. But then there are some patients who have had surgery and we follow them up for a number of years. And there are some patients who, you know, um, write letters and on the anniversary dates of the operation and it's nice to receive those letters. Uh, and they say they're still alive and thank you very much and, and I think that uh that adds to the job. We just have a couple of questions in the chat. Ok. Um, so I guess one of them is just having an idea of what the role of the surgeon is outside of operating. So what kind of things would you do outside of surgery? Is it you that assesses the patient preoperatively and who looks after them in the recovery and, and that kind of thing, the different members of the team that are involved. So cardiac surgery surgeon is just one person. There's a big team. Um, so I would typically, um, I will see the patient in the clinic. The patient will be referred to me by a cardiologist, let's say a patient has three vessel disease and needs coronary artery bypass graft surgery. I would see him in clinic on a Thursday morning and I will discuss, I will show him the angiograms. I will discuss the various options available to the patient. And nowadays, the GMC good medical practice mandates that we give the patient all possible options including the option of no intervention. So we, we tell the patient what he would expect, what to expect if he decided not to have an operation and decided to stay on medication. Um, we will tell him about angioplasty, um, as an option as well. And what are the pros and cons of angioplasty? And then we'll discuss surgery. Um, so, and, uh, we tell the risks of the operation as well, like cardiac surgery is a high risk procedure. So, and there is a percentage of patients who will not survive the operation. Uh, so we tell the patients about the operations and nowadays I, in my practice, I actually give written information about the risks. I put them down on a piece of paper and give it to all my patients. So that, oh, I think you've just muted yourself. Oh, ok. Oh, I'm so sorry. It's ok. We had, we had most of that. Ok. So I was just telling, uh, uh, uh, I would, uh, talk about the risks of the operation to the, uh, risks of the operation to the patient. Tell them about the risks. Um, and then once I've seen the patient in clinic and I've put him onto the waiting list. The waiting list can range from two months to six months depending upon the seriousness of the patient's condition. Uh, once he's on the waiting list and his, he comes nearer the time when his operation is due, he will come for a pre op check in our department where we have a team of, uh, doctors and uh, physician associates, nurses, liaison, nurses who will assess the patient and make sure that all the investigations are done. We have a checklist, the checklist, make, make sure everything on the checklist is ticked and that is the time when problems come up. Like some patients have poor dental hygiene, they need to see a dentist. Uh some patients have other problems like they are on dual antiplatelets that will have to be sorted and then when that is done and they're ready for surgery, they come the day before they get admitted. Can we just finish with with one final question? I think I'll, I'll put the last two questions together if that's ok. I think people are really interested about hearing of the role of, you know, we've all heard about chat GPT and all of those things. But what kind of technology do you use in your surgical procedures? So I guess maybe touching a little bit on the use of robotics, especially in thoracic. And then also how do you think artificial intelligence can be used in healthcare in the future. Well, ok. So technology is moving in leaps and bounds. What we have now available today was not available to us five years, five years ago, just to give an example from today, when we staple arteries and veins in the lungs, we use a stapler. Uh until a few years ago, we would just use an ordinary stapler. We put it across the artery and we push the button and it is stable. But today in robotic surgery, I was trying to staple a piece of lung, lung tissue was quite thick. And therefore that the staple actually paused for some time. And I could see it on the screen that I could see a message that stapling has been paused to put more pressure. So we had to wait until the staple actually put more pressure on the lung and then continued the process of stapling. So the machine actually decided that the lung tissue was too thick for that staple. So it had to put more pressure on it and, and it did it. So we have technology that is constantly evolving and we have the robots, excuse me, I have a cough. Um So we have reports that help us uh doing the operation. And I think it's very difficult to predict how A I will evolve in the future because uh what I can tell you for sure that we'll all be surprised with what A I will be able to do for us next year and it will be, you know, something that we can't imagine today. But one thing I can tell you, it will only make our life easier and better. I just wanted to finish my experience. I obviously haven't had that much experience of using robotics myself in surgery. But one of the things the students might not know is that sometimes in robotics, they're really, really good for helping train other doctors in surgery. So for example, they have this machine that um has lots of robotic arms that would be inside the patient, but it has two controllers if that makes sense. So if you picture your controller for your playstation, but but much bigger, you can put a headpiece on and sit at that controller. But your supervisor, for example, might be able to sit at the other side of the room and see exactly what you're seeing. And at any point, you could stop that robot and your supervisor could take over at the other side of the room. So similarly, you can do that in simulated settings where you're not doing a real operation. But you can practice using that robot on a fake patient and practice using the, the equipment and all of those kind of things. So that's something you might not have been aware of. But something that amazed me when I first saw it. Um So we have, we have a stimulator in Edinburgh, you know, if any of the Edinburgh student want, want to practice on it. We have one in the clinical research facility, the postgraduate education center. Um So I'll just pop I think probably that's the evening drawing to a close really. Um Thank you so much to all of our speakers this evening. Um So as you probably all know, we've got talks for the, for the rest of the week, um tomorrow night, we'll be having our, our transplant talk. So we've got two patient speakers that will be joining us to give their perspectives, post transplant. And then we also have a transplant surgeon joining us for the evening to talk about that. Um Wednesday, we have a thoracic surgery evening where we'll be where we'll be talking through some, some case presentations of patients. Um Thursday night, we've actually got a heart dissection. Um So we'll go through some of the anatomy of the heart through, through real animal tissue. If you're a little bit squeamish, you're more than welcome to just join for the second half of that evening, which will be, there will be no dissection or animal tissue, but we'll be talking through common cardiac surgeries. And then on Friday, we'll hopefully be bringing everything together and doing a bit more of an interactive quiz and something called a case based discussion style learning, which is what you might experience when you go to medical school. Um And that kind of thing So all of the lectures will be recorded. We'd love you to join face to face if possible. But we understand that it might not be possible to join every night this week. Just please remember to check your inbox for the feedback. After each session, check your junk mail. If it doesn't come directly to your email, and once you've completed that feedback, then you'll be sent a certificate for each lecture that you attend. So you'll be able to talk about all of these kinds of things that interview if you're thinking of applying to medical school. Um And that's something you should be able to include on your personal statement as well. Um Thank you so much for everyone that's joined this evening. Please feel free to get in touch with myself or the um in sync email if you have any questions in the meantime. Um And we hope hopefully will see you later in the week. Um We'll hang around for a little bit of time now if anyone has any outstanding questions, but please feel free to go and enjoy the rest of your evening.