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Can you hear me? Ok, I can hear you. Amazing. Ok, I shall get started then. So um hi everyone. My name is, was I am a final year medic and today we're just gonna be going through. I know you guys have already started fifth year, but just a quick overview of what to expect for the year. Um I'll go through kind of the big three placements and then I'll kind of skim over some of the other placements that you have as well this year. Um And then I can go through kind of path specialties and paces as well, which are your three main exams this year. Um And at the end, um I've got time for Q and A if you guys have any questions um either put them in the chart or at the end, feel free to kind of unmute and ask as well. Um So yeah, I'll get straight into it. Um I can't see the chart while I'm doing stuff. So if there's anything that comes up, just let me know. So as I've already mentioned, these are kind of the things that we'll go through. Um And if you have questions. Just do, let me know. So in terms of your placements, obviously you have your big three, which you might have started already or you might have coming up, um, which your pediatrics, O and G and psych and then obviously you've got your other firms. Um, and then your path weeks I think are the same as, um, the ones that we had. So you have one after this block, one after block 21 before Christmas and then your last one during Easter. And I'd say generally for, for placements, you probably know how best to get things out of placement by now. But more so than third year, they say you just really need to get stuck in, the more you put in, the more you get out, as we always say with placements. Um, but this is a kind of a year where you really need to get involved and get comfortable with clerking patients, examining patients and not kind of waiting to be told to do that. So, you know, you are respected on the ward and people know that as 50 years that you need to get certain things done. Um, so I'd say kind of get stuck in, get involved. Um, try and make friends with the f ones or the, the junior doctors, um, and ask questions, just make sure that you kind of get stuck in really? Um, I would always take a notebook with me and just note down anything either that I didn't understand that I could ask the doctors later, um, any kind of important things that I thought would be relevant for exams. Um, and I also kind of noted down anyone who I thought was a really good teacher or someone that might be useful to contact later on if I had questions or if I was interested in, um, something there and then in general also try and get your dops done and your sign offs done early, try not to leave it to the last minute just because you want that time to focus on your revision. Um And usually for the big three, you'll have loads of docs for each one. So I try and get them done sort of by week three or week four. So you're kind of coming up to that time now. Um Just so that you're not worried about it in the last couple of weeks when you need to think about your consultant sign off as well. Um I've put on here, hopefully you guys will get the slides afterwards as well, but I've put my placements on here. If you have any kind of site specific questions, I'm more than happy to answer those and um as well for my S EP which I did the Royal Brampton. I'm very happy to talk about that later or if you have questions, you can just email me. So um your sign offs, which I think have changed a little bit this year. You have a whole host of them that need to get done. Um, most of them are fairly straightforward in terms of where you can get them done. So the first few, you know, venipuncture, wound care, swabs blood glucose, you can do them in A&E you can do them on the ward. They're usually happening kind of regularly. Um, some of the other kind of more niche ones, a pregnancy test just don't make the mistake of trying to get that on ONG because everyone already knows they're pregnant. I think the best place to get a pregnancy test is usually A&E um, anyone who's sort of AAA female of childbearing age, if they've got some abdominal pain, um, that will usually mean that they'll need a pregnancy test. So try and get that done somewhat other than O and G I'd say female catheter, you should be able to do on, er, OG, um, for Gyne, the in, uh Labor ward. All of those things, you should be able to get them done. Male catheter can be a little bit more difficult, um, this year, but you can get them done in A&E um, local anesthetic. You can ask around in A&E before they're doing sutures. Um, you can ask to put in the local anesthetic. Sometimes when they do ABG S as well, you might have to put a local anesthetic in before. So just kind of, uh, look out for those ones. Subcut injections. Uh, you would have had it in third year as well, but usually subcut is the, um, heparin that they'll give on the ward that usually happens around six o'clock. So, if you want to get it done for definite, you can stay a bit later and get that done. Otherwise some people might have insulin or other things you can look around for it. But generally they are kind of, er, doable, as I've said here, look for an F one or a junior doctor who is willing to help you find sign offs, give them your number, ask them to let you know if things are going on. Um, so that you're not stressing about them later. So in terms of, uh, your big three, the first one that I did, I put that in, in my order was peds. Um, peds is very heavy in terms of the content, there's loads of conditions and likely you won't cover all of them. So, you know, you probably won't learn everything on firms and even in terms of reading, it's really, really hard to kind of learn absolutely everything. So there are a couple of key things that I think are useful to know and are likely to come up in, in exams. I put here kind of know, knowing your developmental milestones, vaccination schedule and normal observations are useful to know on the ward or in A&E just so that you're not having to look them up every single time that you are needing to use them. And I've generally split it up into your different clinical environments, which I think it's really important to get a good range. So in A&E I found that the most useful because you're seeing a patient for the first time, you'll get a low kind of a whole range of different presentations. It might be kind of respiratory. Um It might be M sk it might be gi but you are the first person to see them and it means that you have a good sort of fresh start, you have to ask all of the kind of relevant questions. Uh and it's a good place to practice presenting as well to kind of the next up. So either an F one or a reg or a consultant if they're free. Um And it's also I find it quite useful to kind of try coming up with a plan um and kind of talking to the consultant or the reg about what they think and what they would want to do as well. Um It's very useful, it can be very long days. Um And you know, if you get a good placement, you might be able to just clock every patient who comes in and then talk about them with um the doctors on the ward. But it, it's a really good place to also understand what's their threshold for admitting a sick child, which I think is a really important skill to get this year. And in general knowing when someone is looking like they might deteriorate or when someone doesn't look sort of quite right. That's a good, it's a really good skill to get in A&E and you'll see the doctors kind of deciding whether this is someone who can go home with um, kind of outpatient treatment, whether they need monitoring or whether they need to be admitted. It's also a good place to get your um mini texts. So all of your different examinations done in terms of the wards, I think it depends on where you are. For me, the wards, there wasn't a massive turnover of patients, I think because it was summer time. Um but it's good to get your kind of case based discussions, your ethics sign off as well. Um You might be able to pick up kind of the different monitoring that they do fluid requirements is another useful thing um to kind of pick up on the walls as well. And obviously your bees and parking presenting, you can do that as well clinics. Um Again, I would say a site based if you can get into maybe like a diabetes clinic, an asthma clinic, something like that. It gives you a really good idea of how chronic conditions are managed and how they're monitored. Um and kind of the MDT aspect of things, but there's maybe less of the kind of mini CEX and C presenting cos they usually will have quite a busy clinic that they need to get through. Um I think it's also important at this point to kind of highlight your developmental milestones. Again, you can get to uh child development clinics which I think should be kind of scheduled in for you. Um And it's really, it's a really good place to kind of be able to figure out how old the child is based on the different things they can do and what is normal for that age. Um And the last thing I put on here is the neonatal ward. There's not as much I would say on the neonatal ward. Um there's a couple of conditions, things like neonatal jaundice, er, and prematurity, all the conditions that come with that are useful to know there. Um But aside from that there, I didn't find there's much else to do on the ward. Um you can do your NIS so your need neonatal examinations on the neonatal ward, you can also do them on the postnatal ward um as just a thing to kind of get them signed off. Um I've kind of just highlighted again, the key things to pick up are your ABCD E approach with anyone, especially in a child. Um And understanding when they're going to deteriorate cos they can kind of tolerate a bit more in Children, um which is also really important for Pacers. So my first Pacer Station was an A two E approach for a child. So really important to be able to pick that up while you're on placement. Uh, as I've already mentioned, what's your threshold remitting someone looking at the key guidelines? So nice guidelines, er B CS guidelines. If it's asthma, um knowing your sepsis, six, it's not really six in a child, um, is a little bit different. So you also need to do lumbar punctures, you need to do chest x rays. So just being aware of the kind of general, um, investigations they would do in a sick child and generally understanding how to clock a child because in your cases, you won't have to do, you won't actually have to clar a child. You won't have to take a history from a child. It'll usually be the parent, um, or the guardian. But I think it's a really important skill to know how to manage kind of a younger child if they're distressed, if they're not wanting to cooperate with examinations and things, knowing how to deal with that is a really important thing to pick up and then onto psych, um, is kind of generally more chill as people will say. Um, but, you know, it's still important to kind of appreciate the different, um, teams that are involved in psych, the different parts of care and which kinds of patients each team will see. So if you can, um, I know different sites, arrange it differently, but try and get a good feel of inpatient psych community, psych, liaison, psych and cam S as well. Um If you can, because all of them kind of come with their own different lingo and different things that you need to pick up. I'd say the most important thing to do in sight or skilled to pick up is to learn how to do a good mental state examination. Because in your cases, inevitably most patients, they will say perform an M SE on this patient and you'll kind of pick up that. Actually you wouldn't, you won't go through each of your headings, like you might have done kind of in third year or when you're learning about it, you need to kind of pick those things up as you're taking your history. So know each of your headings. So you kind of appearance, behavior, speech, mood, um thoughts, perceptions, cognition and insight. So basically be able to rattle that off. And as you're taking the history, kind of just put in the different aspects of that and be able to do that kind of quickly Contin so that when you get to your paces, you're able to do that kind of um second nature. So you can do that in clinics, you can do that on the ward. Um I've put in no, the lingo, basically, a lot of psych is knowing kind of the key things that they're probably gonna ask you about. They're probably gonna ask you about capacity. They're probably going to ask you about a mental state examination. It's really good to know your different sections. So the key ones you need to know um especially kind of as an F one or, well, an F two would be your section 52, which I think is one of your sign offs as well. Uh So know what kind of um criteria you need to kind of put someone under a section 52 and know what it might escalate to. So section two, section three and the other ones that might come up, they can come up in VRS, they might come up in kind of when you're discussing management and cases. Um And then also your risk, risk to self risk from um others and risk to others is super, super important, important. And it's one of the things that is kind of like a, a fail question if you don't, if you don't ask about it in your cases. So make sure that when you're taking histories very early on kind of after your presenting complaint, history of placenta complaint that you're asking about risk. And in this kind of in, in terms of thinking about your threshold for admitting someone, the answer is always gonna be a risk. If you think someone is at risk to themselves or risk to others, that's gonna be reason enough for you to admit them. Uh And which is really important for your cases. In terms of management, you would have heard it before. But biopsychosocial approach is kind of your gold standard thing that you're gonna always say when you're thinking about any sort of management, um for psych on Fridays, you should have the Fridays off to do lectures. They go through kind of all the main conditions that you need to know. I found them quite useful. I think the last session in the ball groups can be a little bit waff, but I think the sessions during the day are quite good. Um And I didn't really have to do much extra reading on top of that because I go through all of the key aspects of like the um obviously also look after yourselves. There can be quite upsetting things that can happen, things that can be quite triggering. So the team kind of who the teaching fellows in psych are really, really lovely. So reach out to them, talk to people if you're feeling comfortable. Um And always remember that, you know, you're still a student at the end of the day, if anything is feeling out of your realm, um if you're feeling out of your depth, you can always leave, you don't have to kind of stay for things that you're not feeling comfortable with. So just a note about that as well. So O and G is uh probably the most intense, but I found it the most rewarding placement. Um It's, it can be a lot to kind of prepare yourself for. So I kind of before going into O and G, just be mentally prepared for quite an intense placement, er, and seeing lots of things. But also, like I said, it's very rewarding. I've put in a thing about dot S cos there's, I think this is the one that has the most do s um, and sometimes it can be a bit difficult to figure out where to get all of them done. So I'd say by manual you can do in theaters. The one thing you need to make sure is that you have consent forms on my first day of um going in theaters, I didn't have any consent forms and I got roasted cos they were like you should have gotten all of this done already. But basically, I would say print out a load of consent forms, go to the ward beforehand if you can and try and consent as many people as you can for a bimanual. Um And that means that even if I know you'll need to get one for the sign off, but you get to kind of appreciate um different conditions and know how to do it properly if you can get kind of three or four people to consent for an examination. Uh Same for speculum, you can do them in theaters. Uh but you can also do uh speculum in Gyne Clinic, Colposcopy Maternity Day Assessment unit are all good. Places to get them done pregnant abdomen. Again, fairly straightforward, you can do them in the antenatal clinic or um maternity day assessment unit as well. Your labor CBD S can be sort of notoriously hard to find. I was at Queen Charlotte's where there's a lot of them are sort of uh vaginal deliveries. So it wasn't as hard to find uh cos sometimes they want you to get a proper vaginal delivery and not a um ac section. So for labor, obviously, stick around on labor ward, make yourself kind of known to the midwives, tell them what you're there to do and sometimes you just have to stick it out. Labors can last anywhere from sort of six hours like 18 hours. So obviously, within reason, but you need to sort of make sure that you're staying there and um getting to know the mother talking to them cos it can be a little bit awkward if you kind of come in for the last sort of hour just to see them give birth to the baby and then leave. It's nice. If you've been there, you've been through kind of the labor with them. Um And kind of understanding how that all works. Night shifts as well are a really good um place to get that done. Um A lot of things happen during the night shift, you might see more complicated things like children's social using instrumental delivery, which is really interesting. So I'd recommend if your placements offer doing night shifts or they tell you to do night shifts, I would get them done. Um Even if it's just for one night, it's a really useful experience I found. Um, and a, a night shift was actually where I got to deliver a baby as well with the help of the midwife. So really very rewarding experience. I would highly recommend getting involved. The rest of them. Your other CBD S are already all sort of fairly straightforward as well in terms of other places that you can get things done and learn things clinics. Um obviously your kind of key uh pregnancy associated conditions. So uh gestational diabetes, hypertension, preeclampsia and doing your examinations as well. Um Early pregnancy assessment unit is really useful for things like miscarriages. I think about ectopic pregnancies, hyperemesis. Um and I would pay particular attention to how the doctors counsel because that can very well come up in your cases, kind of breaking bad news explaining that someone's had an ectopic or a miscarriage and see how they break that news, steal different phrases that they use and the different mannerisms that they might use when breaking that bad news. Um very useful place to go. Um obstetric triage or MDA U. So, maternity day assessment unit again, is really useful for your antenatal presentations. So commonly you'll see things like reduced fetal movements, antenatal hemorrhage. Um and it's sort of like a maternity A&E so you might, you'll see patients for the first time or they'll present to you for the first time. So it's very useful to kind of get into the habit of figuring out what questions you need to ask, what investigations you're going to request. Um, obviously with the help of an F one or an F two or whoever, whoever else is there, I also learned how to read A CCG, an MDA U. So if you can get someone to explain how to use uh how to read them, how to interpret them, that's really useful and they're done quite often, especially for kind of reduced fecal movements. Uh So I'd learn to if you can learn to interpret them there, I've already kind of mentioned labor wards. So get some midwives get stuck in. Um I think it's also quite useful to know where different things are located. Generally, you shouldn't be told to do this. But if they ask you like go and get the va tooth machine, go and get this thing, it, it makes you look a lot more involved if you know where to get those things or even if it's just things like go and get me a pair of gloves, get me this thing. It just makes you, it makes you more likely to get involved in, in a delivery or, or the labor as well for surgeries. Um Obviously, if you can scrub in, do scrub in, everything is more useful when you can actually see what's going on and they can kind of teach you. Um, the only thing I would say is as with most surgical specialties, you need to know your anatomy. Um, again, I got, I got roasted because I didn't know any of my sort of vascular supply or anything like that. So, if you can, even if it's five minutes before the surgery, just have a look at the vascular supply, look at the structures. Uh so that you don't get completely roasted. But yeah, otherwise it's um, it's good. I'd also try and scrub in for c sections. Um, again, really useful to see the different layers. I also got my suturing done on um, on ac section. So very useful to do, er, to get involved there. And again, just generally for O and G listen to how the doctors explain procedures for a lot of uh obstetrics, especially when you're kind of explaining ac section or vus or forceps deliveries. They go into a lot of detail about what might happen, the risks that are associated with it and kind of the outcomes as well. Um, and I think it's a really useful place to understand how to counsel the patient, which is something you need to know for patients as well. So gpi know is one of the smaller ones but I think is actually a really important uh placement to kind of get involved in and, and um appreciate that it can help with your paces if you can, I know not everyone is able to do this but ask to see patients who are relevant for the big three. So if you can see maybe a pregnant woman or maybe like a six week review, um anything like that, any sort of O and G conditions gyne conditions, you might see a lot of menopause um and half the patients in GP are gonna be kids. So if you get asked to see Peds patients, um you can ask to see mental health um patients as well, sometimes they might be less um kind of likely to say yes, but it's always worth asking. And I found that when I was doing those cases, I found my day was much more useful because I was understanding what might come into GP and what might be relevant for my patients. Um Obviously, in GP, they might give, they'll probably give you longer for each of your sessions, probably 20 minutes for um each patient, but try and learn how to take a focus history, try and get it within that 10 minutes. Cos that's all you get in patients as well and within that 10 minutes, make sure you're taking your history examine and try and come up with your own management plan as well. Cos again, that's what you need to do with in cases. Um And it's a really useful skill to kind of start to develop. Now it's also important to remember that when you're in a GP, it's not like in hospital and this is something to really kind of pay attention to in cases. If it says on the door that you're in GP, it's going to be a very different situation to say if you were in A&E or if you're on the ward. So you're gonna have limited resources. You won't be able to just ask for a load of blood. You might not be able to ask for different scans and you might need to refer on to a specialist. You might need to send them to A&E. So it's a really important kind of distinction to make within GP. What are the things I can do? So you might be able to do an E CG if they have one, you'll be able to do point of care, things like blood glucose, you can do observations, you can do examinations, but outside of that, you might not be able to do as much. So, it's important to remember. Um I really enjoyed GP just because I started to feel like a proper doctor. Um They'd let us have our own clinics and there were some patients, especially with the more simple management where I could just kind of message the, the doctors and ask them if that was ok, where I would be able to just send them away. Um which really started to make you feel like you have involved, you're part of the team. Um and that you sort of know what you're doing. Um So yeah, really useful placement. As I've already mentioned, you have integrated Pacer stations. So it's really important to know your GP management for your key BR conditions as well. Obviously, you've got lots of other placements. Um They're important because you will need to know them for five year, but in terms of fifth year, some of them are a bit less relevant. So A&E I would say use your sign offs. And again, obviously, there might be patients who come in with relevant er, aspects of uh P I and um G for them, there might be certain rashes that are useful to know um for pediatrics um for your ID and gum placement. Obviously, there's lots of gyne relevant things and there's also in terms of your path, um micro things that are relevant. Um and then oncology again, you have your gyn specialties and also histopathology within path. So there are things to pick up for fifth year within your other placements, but it's still kind of try and get involved in the placements that aren't relevant to fifth year because you will need to know it and you won't get those placements again in final year. Um Again, as I said, you can get some dos done on these and some, they're also a good opportunity to kind of study. Um if you're kind of not having to go in to get loads and loads of sinus done or to learn conditions, you might be able, able to have a bit more time to study for your exams as well. So in terms of your specialties exam, I've put some results on here, but I'll also kind of go through how I tackled it. Um, textbook wise. I quite like learning from textbooks. I found that I could kind of get to the core principles and learn from kind of the basics, which I found quite useful. These are the three that I used. There were other ones that are available, but I think generally these were quite good, they explained it very clearly. Um, and a good level for exams. Um I would say that it's good to start with past med. Um And I'd work through this throughout the year. Um It, you can kind of theoretically go through all of your past med questions, you can do it again. Uh But whatever works best for you. I find it quite good to learn the different conditions because they have good concise descriptions of the conditions that you're learning. Um There's also brains, um, there's rev other but there's loads of different questions, banks that you can use. I would say that the important thing is just to do things regularly. Um because fifth year isn't one where you can cram specialties, there is so much content. So I'd say within each specialty when, when you're doing that placement, try and get to grips with the key conditions, understand the basics and go through past med different question banks. But even when you're not doing those placements, I'd still kind of try and keep on top of things, try and do questions regularly. Um, just so that you can keep on top of things and you're not leaving anything to the last minute. When you get closer to the end of exams, I would say that things like make Medic and the past papers obviously that we write as, as older years are kind of your, your holy grail. Um Make me has very kind of relevant questions and I say are pitched at the right level for fifth year exams, they're a little bit more applied. Um and same for doing the past papers, it's more, I would say more relevant for pa but even in specialties, a lot of the things are repeats or the clinical vignettes are very similar to each other each year. So closer to the time, try and bat out all of the past papers that you can. Um just so you get an idea of the kind of questions, the kind of conditions that come up. Um And there's lots of repeats, as I said, in terms of path, um similar sort of thing. Um I'd say MED GMS is really good for your uh VSA Q. So for path generally, it'll be split into your S PA S and your VSA Qs. So for all of the VSA Q questions, bed GMS has loads of things. It's kind of made for imperial students by imperial students. So they're questions that kind of come up regularly in the exams. Um So I would say that's very useful and usually have descriptions and explanations for each other questions as well. For past me, me, um I'd say that some people find it useful to go through kind of the immunology, the hematology questions, but sometimes they can be kind of all focused on one specific condition. So I wouldn't kind of worry too much about going through all of that. Um I'd say for path my Holy grail was using the MD Ed path guide and it's not sponsored by med EDI just really, really like the path guide. Um It basically has everything you need to know. Um It's all written very concisely again, it's written by kind of past imperial students and it's vetted by imperial students as well. So it's all relevant to the things that you've done and it's all based on the lectures that you get. So I find um some people find it really useful to have their path guide open while they're doing the lectures when you have your path weeks and annotating as you go along. I basically just kind of would go through regularly. I had flash cards that were based on the path guide um and would just go over those regularly I'd say in terms of revising for path, it really depends on how you're revised for, say your 1st and 2nd years because it is just memorization. There's not so much of the application based stuff. If you know the stuff, you know, if you don't, you don't. So I'd say go with whatever technique has worked for you in the past and that should work here. So for me, um I found that I needed to kind of regular revision maybe within the past weeks. Um And then kind of consolidating everything closer to the exam. So maybe a couple of months before the exam just kind of going home, especially during kind of study leave, just not cramming, but just trying to get as much of the knowledge from the path guide and the lectures that I could. Um So yeah, using a good range of questions. Again, there's the clinical pathology book from Mirren, which is also quite good. You can use some of the things are a little bit outdated. So I'd be a bit wary of that, but it's good for getting more questions. And then again, similar to specialties, I would say just do all of the past papers because again, I'd say probably about 50 60% of all of the questions in the exam are repeats. Um And even if they're not exact repeats, they have a similar sort of vibe. So again, all the past papers usually have been written by imperial student like students when we finish the exam. So they can be a little bit iffy. Sometimes they're not quite right, but it's really useful just to get into the swing of things to see what kind of questions you get asked as well. Paces, um is something that can be very daunting, uh especially cos it's very different to your sy in that you now need to kind of history examine and also figure out a management plan. But the one thing I would say to try and remember with paces that all you need to do is be a safe f one if you know, kind of the 3rd, 4th line management, that's great. But at the end of the day, what you need to pass is to just be safe. Um You need to be kind, you need to be compassionate and these are all the things that you kind of, you will have picked up having been at med school for five years now. Um So generally, obviously there are some other things that you need to kind of be wary of or be mindful of going to places so different to AYS is also that you might have more challenging communication skills. You might have difficult patients, especially in things like psych where they might not have very good insight. You might have to break bad news and you might have to give more in depth explanations as to the management that you're about to start, you might also need to know a bit more in terms of medical law. Um things like do your mental health act capacity, phrase the guidelines if you think about peds and obviously the vi the vi might be a little bit more involved than you might be kind of used to in a. So you need to be concise, you need to have a good structure. You might need to know a little bit more into the management and how that works and maybe also things like the prognosis or the outcomes for the patient as well. Um For paces, uh you will have kind of a dedicated paces lecture from me. I believe so I won't go too far into it, but in all, you just need to practice, you need to kind of get used to taking histories incise, doing it focused, start early in practice often, you know, we're only a coup, you know, a few weeks into the year. So it might be, you might still be getting into the swing of things, but kind of as soon as you are able to, I try and set up a group of people who, you know, who you work well with kind of try and get a couple of cases done in the week. Um Just so you get used to it and you see the kind of conditions that are coming up there is a med cases guide, I believe that has loads of cases um on the imperial kind of su bank as well. There's loads of cases that have been written by previous students and also going to the centralized Mark Pas which are organized by S UI believe. So those are really important to kind of get into the swing of doing things under pressure within the really short time frame that you have for 15 minutes per station. And si similar to a you don't kind of only really know the pressure and the time pressure when you're actually in the exam and the kind of stamina that you need to get through eight stations. So it is less in terms of there are fewer stations, but they're a little bit more involved. So it, it's still quite fatiguing. So try and do as many more paces as you can. Um And then also I've put here the me um specialties management guide. It is really useful because they have paces tips under each of the conditions. Uh Generally it goes through obviously, as it says, just the management. So it might not have the things like the history and the investigations that you'll do. But I find it quite useful especially for VRS where they're more likely to ask you about what management are you gonna do? What are the other options that you can do? What are the risks of this management which are all usually kind of listed in the specialties guide as well? So that's very useful to use. I put a couple of extras in this is purely just kind of out of interest. Um Some people want to do these things, other people don't, it's not something that you need to stress about, especially with the new system of ranking, you know, everything's random. So this doesn't actually count for anything. But obviously, if you want to start building up your portfolio, if you're thinking kind of later down the line in your career, it's a good year to start doing things. So, um, obviously you would have just come out of your BSE if you've been able to get kind of an abstract published or even the whole thing published, that's really, really useful. Um, and I try, if you're thinking of doing all those things, I'd get them done a little bit earlier in the year while things are less busy. Um, and obviously you're not thinking about exams. So there's lots of conferences that usually happen around this time. Um, talk to your, er, supervisors if you're interested in doing that as well. Um The other thing that you might want to get involved in is things like audits that happen on your different placements. So, while I was on O and G there was audits going on, I'm sure there'll be ones in all the different specialties that are happening. So if you're interested in that field, just go and ask either the registers, the junior doctors, usually there'll be something going on and they like having students because they can, we can do all of the sort of dirty work and we can finish all of the things that they can't be bothered or don't have time to do. So, um, it's useful to do. You might be able to present an order and you also might get kind of a certificate, something you can put on your portfolio, which is really good. Um I put here, you can try and sort out your elective. It's really only relevant if you're doing electives in particularly competitive places. So things like the US Australia tend to have quite a rigorous application scheme. So you need to have things ready. You need to have a CV, you need to have letters of recommendation. So if you're thinking about applying to those places, I would say just have it on your radar. So look at the things you need to have ready, make sure that you're not missing deadlines if you're thinking about that. Otherwise, if you're thinking of other places, generally, you can sort it all out in final year. Um And as I've mentioned already, starting to think about your portfolio. If you've done lectures, if you've done tutorials, make sure that you've got feedback, make sure you've got certificates. Uh and you can start kind of planning a CV again, especially for thinking of electives where you need to provide a CV or provide some sort of um recommendation. That's where it's useful to have started looking at that this year as well. So it's very quick, very whistle stop tour, I appreciate. But in general, the fifth year is a marathon, not a sprain, which you'll hear 1000 times. Um, you can do pretty much anything but you can't do absolutely everything. So make sure you're looking after yourselves, make sure you're pacing yourselves cos it's such a long year and it's very easy to get burnt out. So whenever you get the opportunity to take rest, whether you, it, that means kind of leaving placement early because there's nothing else going on on the ward or kind of making sure that you're getting involved in extracurriculars, make sure that you're doing that, but equally obviously get stuck in on placement. It's a year which I kind of started to really feel like I was useful to the team where I could actually go and talk to patients and be able to come up with something coherent to tell the doctors or be able to examine someone and actually be able to find signs. So, you know, you can actually, you can gain a lot from placement. Um This year, you have a lot more knowledge and your knowledge will only increase as you go through the year. I'd say try and have a sort of game plan by the middle of the year. Obviously, it's only been a couple of weeks, you're getting used to being back in a clinical environment. So it's absolutely fine for you to kind of find your feet again. But I'd say probably around sort of November, December time when you've done a couple of your path weeks, try and figure out how best you're gonna work. What do you think is gonna be the most useful thing for you to do, how you want to revise your exams, try and figure that out. So you're not stressing by the end. The other thing is also, obviously, everyone will have a different experience on different firms, which is absolutely fine. But if you can get insight from other people who've maybe been on a different kind of surgery or they've had different experiences in labor and you might not have had those same experiences, talk to each other, find out what they learnt from that and kind of share your knowledge with each other. As I said, again, multiple times, be curious, see how the F ones are on firms. Again, you've got a couple of years now, but especially as a final year, the one thing that I've found myself doing more and more is looking at the F ones and seeing how they manage things and what jobs they need to do. Cos essentially that's what you're gonna need to do in, you know, 18 months and you, that's what you need to do in your paces as well. I find it really useful. Obviously, it's important to see what the consultants are doing and ask questions and figure out kind of later on what the management is like. But in terms of short term, the things that you're gonna be doing are the f one job. So it's really important to appreciate what they're doing and talk to them as well. Um Also kind of remember that doctors are humans too and they're there to teach you, they're there to help you. if you're finding things difficult, if you're not understanding things, do talk to them, find the people who, you know, are willing to talk to you and willing to teach and sort of latch onto them. Make sure that they, you know, you can get tutorials or you can get teaching from them whenever you can and of course, do be kind to yourself. Um, it was probably one of the toughest years, but again, like I said, it was probably my favorite year as well, but it's just such a long year and there's so much content to cover so it can be very easy to get overwhelmed. So, like I said, do talk to each other, make sure that you're kind of reaching out whether that's to academic tutors, whether it's your friends, family, whatever it is, just make sure you keep talking to people and talk to us older years as well. We're very happy to kind of um guide you through if there's any questions, things that you're not sure about there'll be someone who is able to help you. Um, but yeah, that's basically all the things that I wanted to cover. If you have any questions, then I'm happy to answer them. Now I'm gonna show so I can see. But yeah, if there aren't any questions specifically here, I've also got my, um, email um, on the slides, do feel free to email me about anything, like I said at the site specific stuff as well. I'm happy to answer the well, thank you, VSA for the presentation. I think everyone learned a lot from it and I don't think there's any questions at the moment in the chart. I can't see anything so far. So we'll give people like a minute more and then your email is on the final slide. Mhm. So I think that will be all. But thank you again. No worries at all. Good luck. Everyone I know it's a long year but you guys will be fine. You'll make it through the other end. And yeah, as I said, feel free to message me about anything. It doesn't have to just be kind of academic related. I'm happy to answer any questions. Ok? If there's nothing else, I shall let you guys carry on with your evening. Perfect. And the recording will be uploaded to the website and will be in the middle afterwards. Thank you so much, Miss. Ok, thank you.