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And finally for this morning, I wanted to ask uh fill macclenny for Medal to come and give us a few thoughts about how we develop education across the world. Because really the one thing that every time we travel we see is a demand for high quality education. So Phil, thank you very much. Thanks Alberto. I'm in a black T shirt because I'm running around with a mic. But I'm medic by training and it's really great to be here with you today. Um uh Why do we do what we do at Medal? That's what I want to talk about today. You can kind of see a little bit about what we do. But what you don't see in the room with you today is that 221 colleagues from lower middle income countries, 43 48 middle in low and middle income countries who are joining us here today. Um That's what we do. But why do we do it? And this is why we do it. We need to train 18 million more healthcare professionals by 2030 but it takes 15 years and up to three quarters of a million dollars to fully train a surgeon. And when you combine that with what the lancet described as severe institutional shortages in our healthcare training capacity, we have a toxic combination. We don't have enough resources to train the doctors. We already have never mind scaling up the amount of education we need to provide on planet Earth by one third and where resources are at their least, the need is at its greatest. There are 11 countries on the continent of Africa which do not have a single medical school for the entire population. There are 24 they only have one medical school for the entire population. But it's not a problem confined to somewhere else in inverted commas. It's a problem that affects high income countries as well. We're all familiar with these types of headlines and the association for surgeons and training in the UK talks about the cost of surgical training to the individual trainee here being between 20 and 26,000 lbs over the course of their training, 1300 lbs of that spent on courses. And every year, 41% of those people get absolutely zero recourse from their study budget combined with the reduced buying part of doctors' salaries of between 10 and 20% depending on the source that you read. Um shows that we've got a problem here in high income countries as well. What does that result in Maria Prial from the widening participation? Medics network describes it really clearly as a widening participation. Doctor money is and always has been tight. Study budget covers one big course or maybe 2 to 3 small ones. And so the court surgical training needs, the wealthy can easily to, to as a tick box exercise with little actual development is that the doctors we want to be training. Do we want to teach the richest, the most well connected or the people who live in the right places? I don't think we do and that's why we do what we do at Metal, how do we make healthcare training more accessible for, for, for people in high income countries, but also importantly for people in low and middle income countries. And how do we do that at scale? And actually, when we looked at how things were happening in this digital world that we now live in, we saw some really amazing things happening. So the pandemic meant that what was used previously, a meeting in London now became a meeting in London, Uganda, Bangladesh Chile Bolivia, the US candidate. We're welcoming people from around the world to regional national meetings that were previously completely on accessible. And when we say not accessible, we really mean that. So we've surveyed 1000 colleagues in lower middle income countries, 96% of them say that they've actively felt a barrier as a result of ticket costs or travel costs, which means that they cannot attend teaching or training, which they feel is essential to their career progression. But when we saw that amazing stuff happening, so we saw all of these people suddenly being welcome to um events that they had never been able to go to before we saw that the organizations who were doing that we're using technology that was just not um uh the right sort of technology that they needed to use. It was time consuming, it was clunky. Um And, and we, we saw an opportunity to actually help organizations like world orthopedic concern like the British orthopedic orthopedic trainees association like gas talk to actually streamline their teaching and training. We typically saw them taking registrations on eventbrite, bouncing people to a zoom call pinging in a Google form to collect feedback, ubiquitously. There's someone in an office or a training somewhere called Steve who copies and pastes names from a Google sheet into a Microsoft word certificate template saves as a PDF and E mails on every single attendee a CBD certificate. Some organizations are using mail merge. 30% of those certificates, land and junk mail. It gets deleted after 30 days. And the doctors reached out to say I didn't get my stirred defecate. They download the video from Zoom because there's now gigabyte of storage and they've only been able to welcome 100 to 300 people because of an institutional Zoom license. So we can't really scale us up beyond that, that level of attendance. They download it from Zoom. They add it to youtube or Vimeo. And then they added another Google form link to collect feedback. What on earth are we doing? We need to train 18 million more healthcare professionals by 2030 and we ain't going to do it like that. So we took that process, we automated it end to end. So the organization can welcome people from registration to on demand, automate all of their certification so they can focus just on training more people. We blew the limit so that we could welcome up to 10,000 people to an individual live event. No more institutionally zoom license barriers. That's really important if we're going to scale up the amount of people that we can actually train. And this is a quote from Dr Tedros that really motivates us. Ask yourself every day if your technology works to help the poorest in the world and to reduce inequalities. If we're going to do this as a medical community, we've got to do it together. And one of the beautiful things that that technology can do is is just blow the, blew the roof off the building, right? So we saw organizations really wanting to welcome colleagues from lower middle income countries to their events. But they, you know, they might have offices that they need to to pay for. They've got team members, they need to pay for, they got travel, they need to pay for, not everything can be done. For free. But what, what they did want to do was they wanted to say, well, actually, if you're from a lower middle income country, we do want to welcome you for free or significantly reduced cost. We just don't want all of the admin of actually checking whether you're actually from a lower middle income country. Right? That's perfect for technology to solve. So we did was we built a scheme called Fair Medical Education for organizations. We do have to charge for the events so that they can offer a ticket for free or significantly reduced cost on our software will automatically check. Is that colleague from a lower middle income country? Yes or no. And if they are, it will offer them a free aura, significantly reduced cost ticket simple. And we've seen some amazing organizations like walk like gas walk, like go to like the British Association with pediatric surgeons like asset actually begin to lean into this. And this is the power of community. We know that life is amazing. It's, it's it's a live virtual has really opened up um the opportunity to to reach so many more clinicians around the world. But we know that it's not a magic bullet. And that's why the on demand pieces is really important. If you live in an area that has low internet connectivity, that doesn't necessarily need to be a lower middle income country. If you're just from northern Ireland, like me, it's also equally as important. And so being able to watch on demand is really key. And so we've, we've helped organizations with a single click, make their content available on demand for those colleagues to watch at a time. And importantly, an internet connection that suits them, they can give feedback like you can for attending live and they can claim a C CPD certificate in exactly the same way automated. So by working together, what does that achieve? Well, in the last 18 months, we've helped 1900 healthcare organizations run 6000 live or on demand courses to serve colleagues in 172 countries. That's not us. That's the amazing organizations who are leaning into this were simply helping it happen with software. But of course, it's not all high income country to lower middle income country that's really important. And one of the proudest moments and, and a signal that this is becoming a more mature ecosystem is when we saw the Nairobi Surgical Skills Center actually beam out their education using metal to the rest of the world. And the surgeons in Nairobi had amazing education to share and they saw cases that, that perhaps we would never see here in, in the UK or in a high income country. And we must as a global community learn from each other, this cannot be a single direction and technology begins to make that possible as well. I'm just gonna play a really short video. Thank you. Um First and foremost, my name is Tom. I'm from Kenya. So medal has enabled me to be here. So thank you for that. Uh So my, my question, uh my question, it, I'm playing that because that was a comment at Gas Up conference and it was one of the only comments and a two day conference that got a round of applause. It wasn't the smartest research question. It wasn't a question about statistics. It wasn't someone bragging about how much they published. It was something saying thank you. I've been able to make it as a result of you making this available uh to me and, and collectively, I felt in the room that we noticed. Actually, we're doing something really positive here as a community. We're doing something really positive. I just want to share one last story and then I'm gonna finish up because I know lunch is waiting. Uh We verify folks who are joining events online on metal. It helps us understand whether they're from a lower middle income country or not. So we can offer tickets on a fair medical education program. It also means that the organization can go to time on welcoming and telling people about their event with fight the challenges of zoom bombing and all of the complexities that come with sharing links on the internet, right? Good internet hygiene. So we verify those people and it also means that we can, we can really make this accessible. But occasionally we get people who reach out and say I can't verify myself for whatever reason. And we have a manual process that helps those people. So um it's uh we get maybe 22 to 3 people a week reaching out to say they can't do that. And uh sue who's joining us in the background virtually helps those people every week. I actually get access if, if appropriate. But in the single day, we had kind of high tens into the hundreds of people reach out to us in the spring of last year to say I can't verify myself. And when we reached out to, to those people to ask, why can't you verify yourself? Uh We got a consistent response. I don't have access to my institutionally mail address right now. And you know what, I didn't think it was that important for me to get a letter from my dean to say that I could access medal before I fled the country. Thanks very much. And these were colleagues from Ukraine who medical students from Ukraine who had had their entire medical curriculum kind of flipped online at a moments notice. Uh an organization, a wonderful organization called the Crisis Rescue Foundation had actually recruited 250 doctors from around the UK in partnership with the Ukraine Medical School Council to provide medical education for 2000 Ukrainian medical students every single day, seven times a day for months on end wouldn't have been possible without using digital technology. And we're really proud to see them use metal to help them do that. This is something that one of those professors in Ukraine said about that program. Thank you for everything you're doing for knee pro and for all the people who are trapped in this situation, we can really make a humanitarian impact with some very simple technological interventions. It costs less than having bamboo plates at your conference. And we see that as important nowadays for the same cost, we can welcome colleagues from around the world. We need to train 18 million more healthcare professionals by 2030 and we believe by by sincere and generous collaboration, we can begin to make that possible if you want to join us, we'd love to hear from you. If you run teaching or training, uh we will help you were collaborative. We're passionate and it really doesn't cost the earth. Um reach out to us. We'd love, we'd love to hear from you. Thank you. Thank you, Phil. Thank you very much and uh on behalf of everybody, thank you for supporting us. Uh thick and thin. Over the past few months, it has been a very interesting but also a positive journey, especially the fact that we have all these colleagues across the world joining us.