Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Hi there. My name's Barranca. I'm one of the surgical trainees based at the Walton Center and on the kind invitation of, uh, Korea of the Walter Reed and the Neurosurgical Society. I am going to be presenting this talk on finding research and research mentorship within the field of neurosurgery. So, in the first instance, um, the talk is going to discuss, you know, what research is? There are different, um, types of academic work that you can be getting on with their often treated as research. But strictly speaking, there is a set definition for researchers, and there are other definitions for the other stuff. We're also going to talk about why we should get into research or academia and what methods there are to actually conduct it. Well, then, be talking a lot more about whom to go to to find this research and what other stuff, you know. Well, what specifically you should be getting on with at different levels in your career. And then I think the key takeaways are going to be how to actually get in touch with supervisors and what key traits to look for in supervisors Going forward. I would like to start with this quote by Carl Sagan So somewhere something in credible is waiting to be known. Uh, this essentially refers to how we, you know, process knowledge and how we, you know, turn, uh, you know, the unknown into something practical that has a benefit for humanity. And ultimately, that's what research is. It's formalized curiosity into the world around us, and without it there is no progress. Um, as I said, it's the term in medicine has a formal definition. We'll get to that on the next slide. But there is a bunch of other academic stuff you can be getting on with that people often call research, try and keep the terms kind of separate as best you can. You'll see them all in the next slide. But and all forms indeed play a part in developing your complete portfolio, all of which are assessed, uh, more or less when it comes to applications. So original research. The true definition Effectively, what you're doing here is evaluating or practice current practice or comparing alternative practices with each other. And, uh, the the whole point of this is to contribute your body of knowledge to determine you know, Um, why are we doing this? What benefit does it have? Uh, and what should we be doing? It will often be a single cycle. It can be more. But for the most part, it's of one cycle. And it often requires ethics to be procured, especially if it's dealing with injecting people with medications or if it's requiring consent for various procedures and so on and so forth. And good examples of this are case control studies cohort studies, which are the most common ones you'll see in neurosurgical centers. Your, uh, commonplace single center retrospective cohort study is it's everywhere. Neurosurgeons. Just how it works is a a relatively small tertiary, uh, slash quaternary specialty and, of course, randomized controlled trials as well audit. Now we're getting on to those things which are relatively, um, which are adjacent to research. Basically, an audit is essentially a way of assessing, uh, current practice against a standard to see if you're actually meeting that standard and achieving best practice and, uh, seeing what And then, of course, the way you act on that is, you repeat a cycle with an improvement to actually see, um what, uh, you know improvements are being sustained or not. Ultimately, quality improvement is roughly similar in this Regarding that there isn't a formal guideline to test against, um, you might often do multiple cycles. They tend to like three cycles or more over time. Audit loops tend to be to They used to be two loops sort of a few years ago. I think they're moving more towards three now, Uh, so and we'll get you know why? It's important to start all of this stuff early. If you're wondering, how am I going to do all of this? Um, just because yeah, the the system does favor you. Obviously, the earlier you started, the more time you can invest into these things because these things do take a bit of time. Literature reviews. So here you'd be summarizing kind of the key points in the literature top, uh, papers in a given subject, for example to provide an overview of that topic. But a systematic review is a much higher level because you're actually formally synthesizing the findings of these key papers having strict inclusion criteria rather than subjective ones. And you're trying to answer a focal clinical question with the intent of actually implementing the answers of the review in clinical practice. As such, you're when you're synthesizing like all the best papers. You can imagine that being a higher level of research and a meta analysis basically is when, in a systematic review type of context, you're using statistical methods to summarize the results again. It's of an equivalent level of evidence. The levels of evidence you can see are here, so systematic reviews meta analyses very much. At the top, you can see kind of content and qualitative cohort studies, and such would be below that are CTS would probably be a high level just because of the level of preparation required. Blinding etcetera that would be involved would be a high level of evidence. But of course, since they're single papers, they would not have the same level of evidence, for example, as just a natural abuse. Naturally, anecdotal evidence in case studies tend to be a lot lower down the hierarchy. Incidentally, I have been known to speak relatively fast, So if you've got any questions at any time, um, I mean, obviously this is a recorded presentation. But, um, please kind of note them down or you know, pause the recording. You know, if you if and when you have to. Um And I'm sure the conveners will be happy to kind of answer any questions at the end as well. Um, and now we're moving on to why you should do research, because ultimately, um, I mean, we have to speak from a portfolio perspective, because research in general, whether it be if you're a professional, academic or somebody is trying to get into a competitive specialty, research is commodified. Um, not only are you scored on the research work you do to get access to academic tracks, but yeah, it's very, very money based you. If you ever try to submit to an open access journal, you'll know how much that will end up costing. You will know how much. Um, uh, you know, uh, you know, you'll be, For example, if you try, Ever try to get funding for a project, um or, you know, seeing someone getting prizes for these things. Um, it's a competitive landscape where you need to kind of present, you know, the most relevant stuff or what is perceived to be the most relevant stuff to attain funding um, you know, in a in a relatively novel way, because that's how I can d may ultimately survives. It is very much a business. And just for the individual trying to work within that system, especially if you're as I say, are flying for a competitive tracked. You have to be honest and say that if you don't publish, you're not likely to be seen as relevant compared to colleagues who are doing so. And this has led to skill, grief and consultant posts because there aren't that many jobs, as you might know, something like seven consultant posts a year in your research. And so, uh, it's not just academic qualifications, and such is going to be used to differentiate the best candidates know very yes, the and we will go on to this the foundation program. Certainly, if you're a U K medical student or someone you looking to apply to the UK system from abroad, the foundation program is trying to minimize all of these things, just in terms of getting people jobs. So things like extra degrees, publications and such. I think they're moving towards that now, Um, just so there's a bit more of a level playing field. However, this is absolutely not the case at registrar and consultant level. These things absolutely do matter. So, um, it's probably it. It remains true that the early start the better. And, um, it means you'll just have to, uh, you'll be in a situation where you don't need to take as much time out, um, to get to the same level as other people who may have started earlier. Um, um, you know, it's very I I can't really stress this enough. The system is biased against you, the longer you leave it. So although it's doable, admittedly, I only started relatively late on in my 50. I only realized I was interested in your research around that time. So fifth of six years of medical school. But, you know, I still managed to get a decent amount of publications getting the neurosurgeon experience the Masters. Um, it's and multiple, you know, international presentations and such. So it's very doable. So, um, it's just been a bit more stressful, I suspect, than people who may have started a bit earlier, and we do not want you all to be stressed in this process. It's competitive enough as it is so really, honestly, a start as soon as you can. Once you know you're interested in something. Um, publishing, presenting, getting the data ready can take ages. And not only that, but author support can be variable depending on you know how busy your authors are, What other projects they have? Chances are you will be one of many people, but, uh, you know, ultimately, you need to look out for yourself. So the easiest thing to do is to start as early as you can. And that's why this presentation exists to give you guidance on how to do that. Um, this is just kind of to reiterate the point. These points are taken from the specialized foundation program application. Um, this is different from your normal foundation program, because they do ask you for all of these kind of various features that you've taken part in, all of which will make you more competitive, as if if you're if you're wondering loads and loads of neurosurgeon people have done academic foundation tracks just because it's, um it's it ties in with kind of the more competitive specialties. A be a kind of grants you more opportunity to do all of this stuff in protected academic time. Um, and it's, uh, and and as you can see, um, even though the normal foundation program is taking away this stuff, um, it still bears relevance within the specialized i e academic foundation program. So, um, definitely, like starting research early and getting a lot of it will have benefits. Um, even at kind of the bottom of the chain, so to speak. And to be honest, this is this is our pathway. You actually get asked about how well, you know this in your academic interview. So, uh, bear this in mind, um, there are also books, especially there's this one by Rory Piper about how to pass the academic clinical interview. A very strong recommend from me. Um, essentially, what happens here is, um, you know, if you have you've you've done medical school you're doing academic foundation program for, you know, you might have a four month academic block. You might have it spread out over the two years. It really does vary on location, but most people would get the four months academic block. You then apply for national selection. You can do F three or whatever, but just make sure for neurosurgeon that you have 3.5 years of experience a maximum of 3.5 years between F two and we'll applying. Plus equally two years of clinical experience. You're only allowed a maximum of two years of clinical experience before you actually get near research with a a year of neurosurgery included within that. So yes, fine. Now you've applied for national selection. You get a national selection. You've had your academic interview. What? You What essentially happens now is that you, uh, you work as a clinical research training fellow? Um, you identify your supervisor across these first couple of years, A name to get to PhD, uh, funding in and around ST 32 s, t four. Um, so you learn how to do brands and stuff and apply for funding successfully. And then, you know, once you do that PhD over the next few years After that, you come out to ST five as a clinician, scientist, fellow, often as a clinical lecturer. Um, you then kind of continue through to see ct and so on. Um and then you kind of can move towards becoming a tenured academic. E a professor, Um, that is a broad overview of the pathway right, moving from kind of medical school to foundation to kind of core training, all the specialist specialty training ultimately and, uh, then kind of on to kind of PhDs, registrar level and consultant. But that's a little bit far up in the future, I suspect, for this audience. Even so, that's that's fine. It's always worthwhile, kind of having that background knowledge just because it'll help you plan your life going forward. But in the more in the short to medium term, if you're worried about having a little time because of your multiple responsibilities and studying burden as a medical student, how can you do research? There are many ways to do this. You can do the research in conjunction with your studies, i e. You know, BSC projects and step or as part of something like a uh, we call it a sample of the University of Liverpool. Uh, I can't remember this specifically means, but it's actually a specialist, uh, specific academic project that you do on rotation. Um, either that or you could do it in parallel your studies, you can pursue your own interest. You know, write reviews, do work in departments. You might not be on rotation informally. You don't have to. I mean, almost certainly people won't get any research rotations all the time because you might not necessarily get that tertiary center experience. If that's the case, then um, it is often on you to kind of go to a neuro surgery center and do that work. That was certainly my sort of luck of the draw when I was in uni, I did not get placed at a neurosurgeon oriented hospital. I had to go there myself and get my stuff. So and the other thing is, you know, making the most of your elected placement. So I went to Sri Lanka An elective, uh, and in it would be neurosurgery placements at the two major hospitals in the country. Incidentally, the best ward I've ever seen in my life is the Sri Lankan. Uh, sorry. The Candy General Hospital Neurosurgery ward. Oh, my God. It is so extra. It has a marble statue like between, Like the two wings of the war. Weather staff pray in the morning and even walking towards that because some dude was like so he had a chronic subdural or something, and then he was really rich. He donated loads of gold, filigree and everything. There are lines of fish tank. It's like a hotel lobby. It's amazing. But in all seriousness on your elected. Besides marveling at the architecture of the wards, what you can do, what you can do is, um, do projects in these centers. You do audits, you can do original research. Um, and, uh, you can present that either locally at your in center or kind of work with your team abroad to kind of publish it nationally or internationally, and, uh, the other. Of course, method is to do research degrees that is to say, an interrelated BSC, or, indeed, an interrelated MSC or M raise MD or PhD um either self funded or funded. Um, it can be challenging to access, as we've discussed, but there are a whole bunch of benefits besides, obviously like having above portfolio. Um, and one of the things that is quite nice is that research grants you expertise in your specialty. People who site you will treat you as sort of an authority, especially if you've done loads of stuff in that field and they will come to you for that, Um and, uh, you know, you can also, through the process of research, learn high level transferrable academic skills, such as in statistics. If you're the kind of person who does starts to people, people will come to you And it certainly it, you know, bears relevant to become proficient in things like S, p s S R. Statham at lab, um, graph pad prism. You know which whichever one you know takes your fancy Often, you know, the majority of people seem to use S p s s or are, um, so, I mean, it's definitely worth like taking a course, maybe a skill show or something to kind of get better at that. Because if you do, it's just going to serve you so so well, kind of, um uh, both in your kind of academic work and kind of going forward into the future, the opportunity to travel the world. So I recently came back from Belgrade. Oh, it was such a bang in time after presenting it, the European Association neurosurgeons and, uh, yeah, it's a really nice kind of meeting your colleagues from around the world around, you know, the continent getting to know them, Um, and effectively, especially if you're starting like, quite young. As you know, most folks will be, um you sort of grew up with your colleagues if you keep seeing them at conferences. So it's an excuse to kind of, you know, kind of build kind of lasting professional, um, and personal connections, after all. Like, if say that you'd kind of gotten to know this guy who was really, really into neuro-oncology became a consultant somewhere. And then you're really stumped to the complex case in your kind of consultant work load. It would be pretty cool, right? To just be like, Oh, yeah, I just need to call my friend from, uh, that was called the Netherlands. He's going to have this absolutely banging kind of opinion on this, and it's really helpful to do that just because it can bail you out. You can help bail. Can other people out So on and so forth. So you're benefiting your patient's through all of these as well, as well as kind of getting friends and colleagues for life. Ultimately, we have to say this research as primary purpose, especially in the medical field, is to bring benefit to patient's. It's not just, of course, to just buff the individuals who is doing the research. Ultimately, there are people. There are people being treated at the end of this, and you want their results to be as meaningful as possible. Um, and then I suppose the last point is, you know, uh, medicine is right for the imposter syndrome, especially like a super competitive field. Like, uh, I don't feel like I'm good enough. Oh, my knowledge. I feel like I've got holes in it blah, blah, blah, blah. The thing is like actually doing the research, actually becoming that authority. Newfield answering those questions where people might, you know, have holes in their knowledge. It's a good position for your confidence. You worked hard and you've earned your place at the top table, and I think it's really great for your kind of presentation skills as well. So multiple benefits, besides just kind of having some lines on your CV. So I had to actually find this research open to interchangeable ways. The first one is have an idea and seek support. This is the harder option just to use an example on my end. Just because I really like sustainable surgery. So I've read papers, seen talks, for example. But like in my particular units, like, you can't really do that much in your research yet. Just because the the the nature of the equipment a be this general culture, it'll get there eventually. But in general surgery, where I've, you know, previously been placed, Um, I did scope the units for kind of applicability, consulted interest in all these things and have managed to kind of apply for grants successfully to kind of get funding for sustainable surgery stuff. Um, in these centers. And it is very nice from that perspective because you actually have control over your idea and the ability to follow it through without interference because you have, like, you came up with the idea or the progenitor. If you have consultant support, they're there to kind of back you, and that's a good thing. Enough in and of itself. But, uh, but ultimately, you know, you have, you know, it is your idea, and then you can actually control where it goes or where it doesn't go, which is nice, the easier option just because it's often kind of hard to kind of get into a specific thing kind of by yourself, or just have that knowledge gradient advantage, especially in Neurosurg, because it's so complex, getting and productive supervisors and work in their labs or research teams. There are many ways to do this. So my uni we had a university neurosurgical society which had this mentor scheme where senior surgeons be there registrars or consultants would offer to mentor students and get them up and involved in projects. They're also kind of up and coming national and international young neurosurgeon networks especially, you know, once you become a trainee so you can join up the you know various people and do collaborative projects. Um, and you can also ask around departments, um, and express interest, because that's going to be the most practical thing to do. Often times. So, you know, once you kind of made yourself known, you can either email or you can actually ask in person. And ultimately, the key advantage of this is that you'll be granted insight into that complex specialty. It's almost certain that you'll have insights that you're missing and it will open new windows beyond your current understanding, which is really, really, obviously very useful. And who knows? You might find something that you weren't initially that interested in, but develop an interest in overtime. So how do you again? Top tips, scope your department for people who actually line up your with your areas of interest. Let's say that you really like NeuroOncology. Makes sense to approach like the academic leads within your oncology. Um, get an idea of the team structure. So who is doing the research? I You know, if you can stalk someone in LinkedIn or research gait or whatever, Um, you know who is actually doing this stuff? Who is the first author? Um, is the first author like a registrar S h o. Whatever. How might you fit into this team structure as well? And it's worth kind of once you've done the research kind of explaining this to potential supervisor and say that, you know, I've looked at this stuff. This stuff is pretty cool. Um, I've noticed that X Y and zed is doing this. Could I get in touch with them? Um, could I kind of help and contribute. And it really helps if you have a very supportive department culture in this regard. So are they trustworthy? Uh, they supportive. And a big thing is, will they follow through on their ideas? I have fallen victim to this, uh, supervisors who have, uh, those and loads of ideas, but they get really busy so they don't. It takes ages to kind of get the senior input, and thus it delays everything. So we you you I mean, if you start early, it doesn't matter so much. But it does matter once it comes to kind of crunch application time. So definitely kind of try and find something on that regard. What you can do otherwise is scope the literature, inform your interest and then share your passions. Um, you know, asking for any projects. It it's not necessarily bad. But it's if you have a specific thing and you look informed in it, it shows you thought about the topic, and it is it does show commitment. So, like, Oh, hey, this guy's actually read up about NeuroOncology. Oh, my God, He knows something about the nature paper about medulloblastoma. That's amazing. So he might actually have a lower barrier for entry for my medulloblastoma projects. Do you see the logic of where this is going? But ultimately, you know the best thing. And the most important thing is trying to find a latam of like minded people at your sort of level. Who can support you? Because, actually, if you do have a research crew, you can cycle through first authors and that spread to the workload eventually burning out and keeps everyone at a sustainable level of productivity, which is really very, very useful. Um, in a kind of high pressure environment. But one thing I should say, you should never, ever compromise in your integrity. In the pursuit of research. It's not worth it. It makes you feel crap. And yeah, you do end up kind of looking over your shoulder in the process. Uh, I do have some stories on people who have tried to make me do this, and I refused. I'll go into that in a bit. As I say, never compromising this when you're old and creaky or you have left really is your is your family and your integrity. So, uh, yeah, how do you contact Supervisor Okay, fine. We talked a bit about email. Easiest thing to do. Low risk, low reward. However, consultants. And I suppose this would be an excellent money making, uh, consultants, uh, kind of really do need some help in terms of checking their emails if ever there was a resource to help them do that or make it more efficient when that change change the world. But they often do have, like, thousands and thousands of, like, unready emails, such as the way kind of fairly old people, unfortunately, um, And, uh, so, you know, to kinda get around this, you can talk to secretaries find, you know, when the operator and clinic and attended elective less than three it You could also directly approach them as part of their day to day, often after award run, express your interest. You know, as we previously discussed and say, you know what opportunities are there and, you know, it is often good to have, like, one or more ideas that you're into just because that has a Because you you can't obviously guarantee what a particular center might offer you mentorship schemes. Okay, cool. So, yeah, as I say, we've discussed that you're often your uni societies are going to be offering these, um, going to conferences again is really super useful because you might actually meet the consultants or registrars or whoever who you actually might want to work with in the future. And you know they'll recognize you, too. And it's always good to kind of be known for a certain thing. Now what is Is there such a thing as the best research you can get on with getting get involved with? Ultimately, there is you some certain projects if you are lucky enough to get onto them just because of, say, the perception of, Oh, this is going to have really great value to the patient's at the end of them. Um, you know, the funding goes to these big beasts, um, as do these prices of conferences and such. But that doesn't kind of invalidate everything that you do. Um, in fact, if anything else like, think of it as, let's use the example of, like the Siberian tiger, it's a very rare animal. Very charismatic animal attracts all the funding from like conservationists. So, like, obviously, you're not just protecting tigers from being shot, you're like looking after the areas that the Tigers, living right and so endangered animals or interesting animals such as like the world's largest hour, for example, also lives in Siberia. Um, that animal kind of gets protection and therefore a sort of trickle down thing as a result of funding that goes towards the tiger. So in many ways, actually, research can work this way. So if it if a grant, for example for a certain thing has been given to a department, you know, chances are there might be kind of satellite projects to that so that you can kind of latch onto, um might not be directly relevant, but might be tangentially so. And they might, you know, be generating their own work as a result. So you know, there's something to bear in mind. Um, and you shouldn't really worry necessarily about what you really get on with. Ideally, you want to be doing the things you want to do. But, um, each center will have expertise in different things. So, for example, Cambridge is very, very big on neurotrauma. Manchester is massive. In terms of NeuroOncology, um, Liverpool is kind of a mix between kind of neurotrauma neuro-oncology, but it's also one of the biggest spine centers in in in the country. Uh, be mindful of this, like during scoping a center, uh, where you want to kind of get research at. So I mean, but I I do stress that, like, these things do tend to win prices. Like even at the conference. I was at the thing. That one was at the satellite project, sort of to a medulloblastoma in terms of the best presentation and, you know, so high impact and often high volume stuff will will be getting attention. I should also make a point of saying that, uh, glioblastoma has loads of research thrown at it because, uh, I don't know if you know about Roger. Stuck in the stock protocol a brutal if modestly successful regime has been in place is 2005 to help treat the most aggressive primary brain tumor in adults. And yet the life expectancy is still terrible. Something in the range of you know, 12 to 18 months, not good. So if and and often times, you'll get seniors at this conference and saying, you know, the greatest regret we've had in our careers is not making that much progress in the management to glioblastoma. So this is why these things get interest. And often you can get a project in that magnificent. It might actually contribute towards, um, meaningful patient care in some way. And, you know, the same goes for kind of high volume Urotrol because other people are going to be in their heads all the time. People are going to be getting an accident all the time. People are going to be popping aneurysms in their head all the time. Um, so you know, these things are very, very important, so and and often will have research attached to that. And it'll get interest at conferences, too. You should also be mindful the interventional radiology neurosurgery of becoming more and more entwined. Interventional is taking a lot with some of the neurosurgical burden. For example, in terms of coiling aneurysms, it would be very interesting, for example, to kind of work with neurointerventionalist, they will have their own kind of, um in relationships with neurosurgeon. It would be interesting to kind of look at that from a numeric perspective in terms of the research, um and also, you know, big data is becoming far more of a big thing these days. Um, especially if you have collaborative networks. You can get multi center outcomes with bigger data for comedy conditions. And it's you know, it helps if you're really good at, like, stats and stuff, because this all feeds in And I suppose, But ultimately, you know, if you're interested in particular thing, do your best to try and find something that interests you. You don't want to be like selling your soul. It can be tempting to do that. But ideally, you you don't really want to be selling yourself or something you're not that interested in because that ultimately will impact your mental state, which is the most important thing of all on your physical state. Equally important and your productivity to um But it is very good to be known for something like if you're for example, um, you know, as a consultant, for example, uh, let's use the example of Professor Duckling Pang who I was lucky enough to shadow when I did my masters that you see a great Ormond Street, uh, via U C. L. Um, he invented multiple different pediatric neurosurgical spine diagnosis because he is that much of a legend. And, um, he's published loads and loads on these various, you know, diagnoses, management methods. And he's really influenced patient carrier result besides writing like textbooks as well. So this is the kind of person that becomes kind of an authority on the subject. It would obviously be useful from an academic perspective for you to be kind of, um, for yourself, I suppose, to have the confidence in yourself, but also for your colleagues as well, to have that level of knowledge that you can share it and help, you know, spread beyond knowledge beyond your center. Because it can be quite tempting to silo yourself off just because of how neurosurgical centers are often arranged practically in the country. Um, but, you know, it's, um, different study types, research types. I mean, you can choose a certain area, but it doesn't have to. All the original research certainly shouldn't be just audits and quality improvement projects. You want to be as invested in the multiple areas as possible because you are assessed on this stuff eventually, um, at a student level, you know, it doesn't really matter what you do, so long as it's neurosurgery aligned, even gen surge aligned. It all counts. Um, the aim is to be getting higher impacts. The higher up you go. And if you know, uh, in terms of impacted that what I mean by this and I'm sure the other colleagues in this course are going to talk more about it, it essentially means, you know how many times your papers are gonna get viewed and cited, Um uh, depending on the power of the journal attached to them. But ultimately, you know, all of this adds up when you become a consultant. So when they're hiring you, the department would want to know what you specifically versus. Gerald from over there is going to be able to offer. So if you can, you know, create a convincing case for you yourself. Um, magnificent. Now, in terms of what to look for in a good mentor, first things first. They have to be a professional People. I have had the misfortune of having several unprofessional supervisors. Um, one of them asked me to falsify data. I told him no way, and there was a formal investigation into this sad times. Um, but You know, ultimately, you never want things to kind of get there. Because if you get to that point, you know, trying to commit fraud by altering patient data just to look good on an abstract for some arbitrary reason compromises everyone from yourself to the conference to the patient at the end. So we don't want to be doing that. We also don't want somebody who behaves like a gaslighting person. Somebody actually treats you like a slave because you know, you're not there for that. You're not there to kind of give lines to their CB. You're there to work together. Ideally, um, you have your own life to get on with. You're not just an accessory to this, and to that end, you should be treated as replaceable if you have other priorities. I mean, you should be good at prioritizing by virtue of being even interested in this, uh, presentation, for example. But, you know, at the end of the day, um, you should be kind of you shouldn't be kind of threatened with. I'll just replace you with someone else. If you don't like work to your deadlines, you should be walking to your deadlines anyway. But you shouldn't have kind of extra deadlines foisted on. You should be able to stand up for yourself in that regard. A good supervisor in any case, won't treat you like that. What they will do have invested interest in your well being as a person as well as an academic, your health, mental and physical is the most important thing in your life. Academia, work, everything. You know, it all comes secondary to that, and I suppose relationships as well. Um, so they would want you to do the best you can. And they should also be able to happy happily answer any questions you have and direct. You're learning, which is great. Um, I mean, if you if you're curious enough, that's great. Um, they should also be able to point you in the right direction for the right stuff. And once you know, you demonstrate how good you are with them. If you can demonstrate, and they they will demonstrate and reward loyal your loyalty as well. Um, I I hate to kind of teach my own horn here. Um, certainly I I, um it's not, uh I don't say I I don't say this just to kind of, you know, big myself up. But it's just an illustration of how I suppose I would like to be treated. Um uh, for our recent kind of presentation in Belgrade. Um, I've been doing the project with an elective medical student at the time. Um, you know, I was the lead author and everything, but at the same time, you know, even when we got the presentation, I knew that my colleague hadn't had a an oral presentation before, and I've I've had this before So, um, one of my priorities just like you know what? It doesn't really this this it would be so cool to kind of get you up on stage, because that's, like, massive tick points for you going forward. And, you know, we managed to arrange that we had an absolutely great time. Kind of, um, you know, with the initial as well, She was one of the co authors on that paper. Um, of that presentation, Should I say, um and, uh, yeah, it was great. For for everyone involved, it was fantastic. Um, and I suppose this is why I always say Like, you know, my my my student colleague were really hard on this. And, uh, you know, I really wanted to make sure that they got the opportunity. If you have a supervisor who treats you like that presumably, like if you put loads of hard work in, you'd like to get something out of it, right? If they if they kind of treat, see your value as a person and into in your work, they should treat you appropriately. And also, you know they would have a good reputation in their own department. If you find out that there snakes who try and steal stuff or falsified data or whatever chances are, it won't be as extreme or obvious as that, for that matter. But often the good people you will find out who they are very quickly. But what does a good mentor look like at different training stages? So consultants are the most informed port of call it any training level, but they can be often very busy because they're often supervising master's and PhD students. Uh, to that end, you know, senior registrars are often the best of most people because you can actually access them more easily than consultants. They'll have pressures of their own to publishers that they're going to be having stuff to do. So they'll have information such that you can join them in doing that. And, um, often, house officers and s h o will often need projects to It'll be the same sort of situation they need to publish and need to kind of establish themselves. And you can ask the student if you want to be involved, Chances, though they will say yes if they're not mean people. And so this is, uh, come to the end of our presentation. Um, thank you very, very much for listening to this. I, uh, really appreciate the opportunity for having been able to do, uh, this talk. And I hope that you've got some value out of it as well. Just some final points. Um, we all know that you want to do neurosurgery search. The fact that you're even looking at this kind of presentation in this series of talks means that you're keen you organize your dedicated you need to now just build on that starting early publishing and presenting takes time, effort and money. So to avoid stress, get on it when you have minimal other commitments. Other commitments often get in the way of your progress. Because you're just like my mind is a scattered, uh, try and finish things. You know, as much as you can as quickly as you can as you go along. Um um, just to make sure that you actually have lined in your C V rather than a bunch of to do lines on your CV, I mean, ideally, try and tell your research interests, uh, to your specific interest as much as possible. It's more kind of valuable. The more senior you become. Um, just because, you know, you can become more of an authority on this and become more valuable as a result. But, you know, as a student, it doesn't really matter that much. Just make sure that you're keen. You show your face around the department's read up around the stuff and make sure that you can present this information to consultants or registrars to to make sure that you know they know that they're getting the right people involved. You really should be working in teams. It's not good to be that kind of snake who is bad at communicating or forced work on to other people to get credit for themselves. No, no, not about that. Be loyal. Be timely. Be, um, constructive. And, um, kind of make sure that you're kind of supporting everyone else in your in your team to kind of be the best that they can. It can better feel. Sure, but if you're really all very good, then there shouldn't be very little doubt in eventually You're getting the right positions, the positions you deserve at the end. And, of course, make sure that you're scoping out good departments and mentors with good characteristics. Thank you very much for listening. This is my email if you have any questions, Um and I hope you find value in this talk. Thank you very much. And good luck to all of you.