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Medics on Cruise Ships: with Dr Luke McClennan

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Summary

This on-demand teaching session will provide medical professionals with an insight into medics at sea. It will feature the experiences of Dr Luke McLennan, a former medical student, foundation doctor and consultant who has worked on cruise ships, superyachts and in the office of a short-side healthcare arm. Delegates will learn about the responsibilities involved, the luxuries of this type of work and how to set up their own events on the discover events platform as part of medal. Additionally, there will be an opportunity for a certificate of attendance and further discussion with both Dr McLennan and the conference host.
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Learning objectives

Learning Objectives: 1. Describe the purpose and origin of the Virtual Electives Around the World initiative. 2. Understand how healthcare professionals can use Metal to publicize their upcoming events. 3. Explain the experiences of a medic working at sea. 4. Analyze the benefits of working in the cruise line medical field. 5. Develop an appreciation of the challenges associated with working in a medical team on a cruise ship.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.

this'll. Siris is part of our mission, really in reinstating electives for healthcare professionals from medical students, those who have missed I and during cove it. But it's also part of our broader mission, which is to democratize access to greet healthcare training. We're gonna post in the link to our profile page on metal, which has a list of all of the upcoming events that we've got going on. If you run organization, you can also create the same type of list. You can publish those events across our Discover events. Platform reaches tens of thousands of healthcare professionals every month so you can attract healthcare professionals to your course. If you would like a certificate of attendance, we're gonna be picking those like to alrededor delegates at the end. And again, if you're running, course yourself with your organization. You are also able to do that now, using single button on metal. You can set it up for your organization right there. If you're looking for other courses, conferences, CPD events, metal dot org's slash events, you'll be able to see events from hundreds of organizations in healthcare organized in one place. You got something going on every single night of the week. If you want to, you can search by. Topic is really dive in. So without any further, do I'm going on over to Aqua and only who are gonna have an awesome conversation. Hi, everybody. My name is Ali. I met finally a medical student at the University of Warrick due to start work as a junior doctor. Nephi want this August 2021. It's been an incredibly exciting and interesting experience to be part off this interview. Siris, along with my co host Aqua as we've been part of medals virtual elective around the world initiative is to medical students rapidly approaching the end of, um, it's called training. Just hearing all of these different perspectives from these incredibly talented individuals who have so much to say has been a really I opening an enlightening experience. And I hope it will be for you to thank you for watching everybody welcome back to our virtual active around the world in collaboration with metal or as part off medal, I should say, the people who have funding and running the entire thing. I'm sure they appreciate that a little bit more today we have an episode seemed around medics at sea. I'm only once again hosting for you, and I'm delighted to be joined this afternoon by Dr Luke McLennan, and I won't go into looks background too closely here because it's very particular and very exciting. A say. The theme of today's talk is Medics it see. Thank you so much for joining us today, Doctor McLennan. Pleasure. Good. See, you want me? How's things You warm pretty one today. Here? Yeah, I'm in a vest here. I've got the dog by the scientist. So apologies, if he causes any trouble, it's trying to think. I think the agreement we have to make is that if he makes trouble, you have to bring him on camera for other people. It's not normally very commercialized, only pushing up, jumping up and think so we'll keep it at bay for now are enough. Well, as I say, today's today's theme is medics. It's C and that that's definitely going to be the focus of today's episode, because it's a story that certainly I have never heard a Zometa Colistin. It's something I've never really thought about. Would you be able to just start lube? I just running us through as you did for me before we started filming. Just the basics of your medical training and how you came to the way you are. Yeah. So and thanks for eso. I graduated in because 2013 now on, but went through my foundation years in Wales and have to give any actually fretful enough to which is brilliant. Didn't three year. So I was I was looking in on emergency department on, but I think all the way through my training or certainly through the latter part of my training on through my foundation years, I was pretty certain that emergency medicine was my destination s Oh, I got myself onto their training program. Did my ST one year in Devon in Plymouth. And, um, yeah, I guess throughout the, you know, the A Any in the NBA, you in that first year, lots of lots of it's that I did enjoy. I I recognize that there's maybe aspect of it didn't always suit me on throughout my I think probably F two year, I'd sort of looked at a few different options in terms of careers, had a couple of colleagues who went into cruise ship medicine on board. I gave it glowing reviews on, but I did. I did apply, I think is enough to originally to accountable UK. But I was too early in my career, Teo, to take that plicated any further forward. So I just gather together a bit of, um, bit of, ah, tailwind over the next couple of years, made sure that my CV was in line on, but yeah, and then I applied. Probably was yeah, during during my ST one year that they got in touch to say that I would now be an appropriate point to apply, Went down for unopened day, saw the ship. They had some interviews running on the same day. So I just joined the, uh, join the party on. But yeah, I was lucky and successful interviews, so I wouldn't work to see for three years also on a number of different ships working for convert you case of the you know and cannot brands on day since then have taken a job into into the office of the short side arm of the operation on differently working. Is there a medical director and GMC responsible officer? So I guess we'll go into more, decide One thing's been in later, but, um, yeah, I guess in terms of, uh, the other sort of alternative group things I did have a brief on space aren't working on superyachts. Onda also had a company for a couple of years doing doing some prosthetic procedures, those socks and fillers and things. So it was relatively short lived, and I do continue to bits and bobs there, but primarily of them home. And it's pretty hectic work in the canopy in the office. So, yeah, that's something we got here strangely Well, I mean, I say this every single episode, but after the after the introductory Ah, Siris of things that come out, there's so many different ways, you know, so many different interesting things to ask about on. I mean, see medicine, right? Like just just a supply to start. How does how does one as ah well, no. It's a humble medical student in your case, but you know, a relatively junior doctor at that time, presumably as someone with no any previous exposure to see medicine, how does one even begin to process? That is an opportunity. Yeah, it's a good question, really, And I think I think there's two ways of thinking about it. I think you know it. It probably isn't for everyone on. That's the first thing I'd say, but this is a cross section of people that is so well suited to I don't think they realize it. So I was working like I said in in a big of any on from F three year where I worked in a in a small district district general a day that point in time, it was quite common place, especially South Wales, to sort of be an F two or shh oh on covering an emotion department of the night. So certainly my three year I was left a some point a Zometa grade in the most departments of just covering everything overnight, and I think I was relished independent, working. I actually find it really tricky working on M au, not just because the medicine was hard, but also because you then had to, you know, do everything different every morning for whichever consultant might be there, and they will have their own for people's about how things should or shouldn't be done. So I always enjoyed working independently, Um, like problem solving and a small team stuff. You know, you work in some big, big A need apartments. You might not be the same person twice in in a couple of months. I quite like working in a in a small unit. And I think when when? When you have that, uh, bond with the teen makes makes life a lot easier. So moving that forwards to kind of cruising medicine? Yes, it is a different environment. It's a small team. You might have two doctors on board. You might have five nurses on your operating and 24 7 operation that for extended period of time. So, you know, with the same people every day you want, maybe a three or four month contract on Do you deal with whatever comes in a time? So there's a responsibility of the crew on you. Get a really good report with them. It's probably, to my mind, the best angle on general practice because you've got a cohort of young active people want to get better. They don't want to be sick. They're already had a medical. So there's not that many pregnancies in conditions on that really polite, really thankful on, you know, by the nature of their jobs. They're they're they're happy welcoming and one people. So there's a crew to look after. And that's that's kind of your first rule when you go on board. So you're the you're the crew doctor. You do clinics twice a day on there. You're primary responsibility. Um, I've got a cat creeping up here. It's like a zoo in him. Uh, and then, um, yeah, I did, uh, probably 18 months of being a crew doctor and then stepped up to what they call the senior doctor. So where your primary responsibilities? Both managing the medical center. You that your the manager for the other doctor in the on the nurses. Hey, we've got a got a guest appearance on, but I always do the guests. Well, so you look after the guest in the clinic, you and the crew doctor will share your own call, eh? So you might do and you have to to night shifts, and then a day shifts. So and it's hard to say what you're going to end up like if if you were like me, I really, really night shifts in any moving to Christian environment. It was it was different on you are. You might have a good good few weeks where you don't get called it all. And you just do clinic patients. You might have a few weeks where you have a, you know, a really busy spell. You doing the transatlantic, and you've gotten appendicitis and a stroke and something else, and it really makes you work. But, you know, if you if you like clinical medicine on do you like dealing with patients and feel hemmed in by the level of time constraints you've got? Maybe, you know, you need like I did. You know, I was enjoyed the rapid. See, consider oven any shift, but actually did I always feel like I was offering the best to everyone? Does feel like I had enough time to delve into everything. Probably didn't on. That's the single change that I really enjoyed. That you're not gonna stop clock anymore. You can actually get to the bottom of things. It is effectively private medicine. Obviously the crew don't don't pay for the medical care. Um, but you've got the set up in the resource for that. So You know, I really enjoy just having to be able to spend a bit of time with people on dust. Understand? What? What? They're actually trying to communicate or what's actually wrong. So on where was I going with this? We're talking about gruesome. It's in general. Yes. If you are a a broad minded person on you, are you, like, independent? Working on you can get along with a small team of people, Uh, and you want a different work life balance on. But then it's then it's a really good place to go. You know, where I often talk about push and pull factors on, But, um, no, this is no disservice. Then it just I still work with in the chest. I still do. I still do shifts in emergency department and so enjoy, but to my mind, someone who probably struggles to Teo, um, you know, administrative, I self is well, as I could when I'm doing my training. Um, you know, you've got your service provision that you spend so much time doing. You've got your your doctors and your your things that you need to sign off. You got your courses. You're a less you're 80 less. You're a PLX that you got to keep up to date with. You got a book and take the study leave and all the rest of it on. Uh, you know, heaven forbid you would need to take some annually. That's tricky. So going to an environment where I do a three months on and do three months off and you're in the ofttimes is it a part of people that will book my courses for me on They will make sure that my certificates air up today, and if not, they'll let you know. Some people worry about your registration, but we're a designated body and we have a responsible officer and we do all annual appraisals, So the pressure's off. So, um yeah, coming from a really heavy fulltime rotor to doing a three month off three months on, three months off on it for pretty much, you know, like for like salary. And it really felt like like a pretty good deal. And you know, when I when I started comparing what I was doing on my first week, I get on board on crime, someone gets sick, we need to get them off the hospital on were anemic and ask that day. Well, that's a tender pork. That's tricky. So we've got to get them on the stretcher, you know, really working. You're you're sort of first responders. Well, as a doctor in this case, so you might get called a cap and you might find someone in and around the spot, but in this case, very, very quickly. Sorry. As it is not versed. What? Yeah. What do you mean by tender port? Sorry, Crumbs. I'm Yeah, you know very little about it. So let's say, you know, we doctors have Hampton, we tie the ship and we will someone off easy peasy. Get the ambulance on board and get somebody off. But if you aren't nicking us, there's no, It's a dark. It's an island. The ship can't pull in. So you got the little boats like the lifeboats that attach the side of the boat. You've got to get your person from the medical center through the ship onto about somehow and you got a go with him on the boat. And there I was my first week of work sailing off into making us to get on an ambulance with this guy. And you know, that feels different to a night shift in May. You on? Yeah, Perhaps there was a few busy days and few busy clinics where I'd finish in an hour or two late, but crimes you then in, you know, you're in Barbados and you can sit on the deck and have a coffee while you're on call. And, uh, that's that's a nice That's a nice existence. So, um, I think it takes the type of person concede we organ take the positives from a situation. So, yes, you might have been on call. You might have had a busy night. You might have had to be up. I don't know, dealing with in a while child every night. But actually, if you're somebody thinks you know what? I haven't slept that well, but we're in a nice place and I want to go ashore on I want to go and get the plate of, You know, I don't have a lot of muscles in, in in wherever you are. Then you do that. And if you can enjoy those little opportunities, then I think you're all set. So, like I said, I think It's a specific type of person from the medical point of view, but also personality. It's well, so I think I probably only did the answer Now Is this honestly okay? And it's It's a good flow, but that there's a lot that I really want to drill into there, especially with this idea of medicine in it seems, Yeah, I'm hesitant to use the term an extreme environment, because after what you just said about sitting on the deck of a ship in Barbados sipping a coffee, it seems odd t call that an extreme environment. That disparity is is present. You know, you might go from being being there, and maybe the next week you'll be in in, you know, so many Russia and and someone will go overboard or, you know, the lifeboat. Well, not the what it's meant to and some of the injured. And then suddenly you're in a very different position where if you've got the lifeboats going out to pick someone apple, you know you got hypothermia you've got, you know, there there are emergencies that happen that you don't plan for. So there is some extreme situations. It's not common, but I think that the premise of our employment is maybe 99% of what you're doing might fall into a general practice, Remember? But you need to be prepared because things happen on you're the person, you know, when you're in hospital and you start thinking crimes are I'll call the Red Rock All the concern They're not there. Yeah, You need to have a plan on. Uh, I guess that's the part of the throat, but yeah, you do need to be kind of, well, well sent that you know, your algorithms and, um, you know, let's see your transiting through Norway. You don't have satellite signal. Sometimes, you know, you might not be able to make that phone call to ask a help. Your internet might not work. Can't just google something. You either need to know it. We need to know where the book is for it. On, uh, you know, this is why I think, you know, we recruit a lot of people from South African places where where a lot of the medicine is much more independent. Um, so yeah, I think that can worry some people on especially the first responding things. You know, So if you got called it for in the morning, the tunnel goes off and there's a medical emergency. You're half asleep. When you're and you're running something, you don't know what it is, you know. And some situations are tricky on. It's not, You know, it's not like when they come into any there on the stretch of the relapse up neatly prepared by the paramedics. And I think I never appreciated before. He came to see how much they achieve a Zafer first responder to get a person into that lovely little space. There is a really large on just while we're on that subject, Um, Nick similarly for, um, ideology. You know, we got X rays on board. You sent some fun X ray the hospital. It just happens. You've got a broken elbow and comes back, and it's not quite the image we wanted. But you know what? It's really hard to do some of these X rays. It's really hard, you know, both practically on. You know, for a mindset is, well, it's just difficult to get these things and you want a moving ship. Middle of the night rockets all over the place and someone's broken the hip, Whatever. Getting the X rays tricky. And, um yeah, and then you're running blood yourself if you want. If you want, um that I don't know. I don't think we even use them anymore. But if you want to see are peeing after, use the machine. If you want to know the S are you put the blood in the in the tube and you watch it for now and you see how far and you know it Sediments. So it's a bit like house In that sense, you know that we need some bloods. I'll get them. I'll take them. I'll run them. We need next day. I'll take them off. Do them You know, when you see them doing all the different Yes, sometimes how it felt. So you get training for these things, you know that. But this is what I really wanted to get to get into, because this when you were talking before, right? He said, You know, someone might have had a stroke or that there's a hot appendix or a whole goal bladder or something that, you know. All of these things are I guess it even appendix right like this is a common problem. What is? Do you have a surgical theater? What? What can you do? Oh, so no way. Don't do any surgery. I mean, obviously it's not, you know, hearing it a lancet, a boil or something. Fine. Fair enough. That's a minor. Injuries are fine, but but I don't think will be opening anyone's abdomen. We've got an intensive care unit, uh, which will use for, you know, any kind of significant medical cases. Surgeries difficult. And this is where there's more on art in the in the mirror. Maritime medicine. There's an extra layer of complexity. So if you ask me what we'll do with a stroke, you know the first question is, where are you? You know where if you're, um, half from Southampton Way, know exactly what we're going to do. If you're in the middle of the Atlantic, well, that's trickier, and you have to have a real careful thought. And if you're in the middle of the Caribbean, let's say you need to sort of have an encyclopedic knowledge of of which hospitals you're heading to and why which specialist you're going to. Which method of transport, Uh, which end of provider. Who's their assistance company? There's a whole different layer of this expertise that you don't get on land on. And for someone who likes it's implants to think so I can get any. I was surprised at how much I enjoyed that, you know, uh, ringing the captain. Where are we? What? Sergio Graffiti. How long will it take us to get two point X? This is gonna make or break what we do with this clinical emergency and that it feels good when that goes right. And actually, quite often it goes, right. Good measures in place. We've got good support systems on working on the ship. You're held in quite a high rank. You know, your your you come in is a three stripe officer, senior doctors, 3.5. So, you know, in terms of your seniority on board, you do get a seat at the table. And that's nice. It's well, I'm not for a negative stick a perspective, But like I've said, working as a as an essential and hospital, your level of responsibility is very different to being the senior office on board. Where yeah, you might need to call a helicopter for in the morning to take somebody often you might need to decide to send someone with them if they're really sick. So, um, maybe there isn't a consistent thing, but it's a good thing. It's really, really enjoyable work on on. Um, I certainly found that working on board with it with it with the tightness team was generally a good thing. Um, this pros and cons, you get up, you have your breakfast together, go to clinic together. You have lunch together. You do clinic together, you have your evening meal together and to my girl in the evenings together as well. So, um, you can obviously pull away from some of those things. But you need to be somebody that is able to coexist with with with a group of people on B, flexible as to how they how they operate. So and I would say that was one of the most positive aspects. It's just having a having a nice group. People you know where you stand and everyone pulls in. It was like the environment. You're working good. Any doctor nurses just work, He simply there's no it's no doctor or nurse jobs it's the same on board. And so well, let let's go into that. I mean, so let's say that I seem that most of the people watching this video might be might be medical students sale people thinking of coming into medicine. And they see this episode and they think I'm going to be like that guy. I'm gonna be the next Dr McLennan the next ship doctor. What? What sort of person do you have to be? What sort of things might people want to do to try and investigate? So if we're talking about sort of formal recruiting requirements were way. Are we looking for people who have got three is a postgraduate experience, So, know if one I have to know if three of the year after that, um, I want to get to that stage, would ideally like somebody. It's a bit like this jobs where they say, you know, entry level job, but we want five. His experience. What we actually need is somebody with good recent experience in an emergency departments, preferably way could look toe, think about people that have done some keep medical jobs, but ideally, that have worked in any recently and for a least a period of six months now, with what I've said in mind about the general practice scope. Yeah, great. You've got some general experience that isn't the make or break, because if it's a general practice or a routine problem, you do have time to look it up. So we need some with the emergency experience. Onda alongside that, someone with some airway experience. So if you've done a few times a segment in anesthetics, I t U. If that's something that you're doing a regular basis, great. If not, then there's always ways and means you can either go out and look for opportunities. Anesthetic. So generally pretty good, uh, accepting. It's a comments or special interest modules and things. So I get that experience. So, really, the key is any intensive care or anesthetics so that you can manage someone who is sick, sick for a period of time. Package it on, get them off to a to a tertiary center safely. So I think that's where we are in terms of geographic requirements. We've got a fairly large map where we recruit from. We governed by our flag states on the MCAST, where we can recruit doctors from. But you know, you get a Europe, South Africa, New Zealand, Australia, America. They're all within this catchment. So it's a fairly broad net. Onda, uh, I'd like I said having that GMC designated body status on a responsible officer means that you can hold that GMC registration and, uh, on because they're getting that revalidation and appraisal done is is a much smoother process when you've got a group of people behind you making sure that your training's up today making sure that you don't your COPD you're doing all that on board. You see any doctor will be training sessions on a on a weekly monthly basis. You're writing for our We've got a a quality improvement paper that comes out every month that we will ask our medic's to contribute to go. You're getting into a journal every month. You're doing your courses, you know, everything's everything's right there. You think of tips, so, yeah, you need to be relatively driven. You need to be able to work a number of days in a row. You don't get weekends on board. You do get some much lighter days than others on obviously you might get a couple of hours off imports two or three times a week. So if you feel somebody that can, like I say, take the rough with the smooth and I really enjoy the good times. I just grin about the times when it's busier, those busy times a probably much better than a busy time in hospital with something that you mentioned earlier. Was that you, from the sounds of it, that you left clinical training? If I understand correctly, you had a training number, which he then left, But you still work in the NHS occasion. How have you? How have you found that transition back into more pedestrian terrestrial life? If if makes sense, Yeah, so full disclosure. Really? I left the training after ST one. I took her out of program experience on that program Break. It was actually started a year out to go and do some cruising and said, Just make sure that I was doing what was right by me because I still so a strong sense off on attachment to medicine. It's and that was part of my character. I enjoyed the specialty. I still enjoy the specialty. I'm passionate about it. But I found it really hard to manage spinning all those plates at once. Eso the clinical work was enjoyable. Doing all the modules doing with separate bits Felt that other welding at times. And by the time it paid for my courses and looked pain for the exams, I thought comes What? What my actually achieving here? I can do this now. But if you ask me in 40 years time, do I still want to be doing these shifts? I wasn't so sure. So I took I took a nap Program break actually then went back into training on Did a portion of my ST two year during a break for my work A carnival. Um Onda, you're right. Going back into that sort of terrestrial. Is that the right word? Land based work was a bit of a culture shock, to be honest, Um, especially being a super numerary staff member in anesthetics, Which was great, too good experience The team. Lovely. They looked up being really well, uh, but it's just not the same. And I really miss that sense of purpose on having a deep involvement in every part of somebody's care where It's really what I was doing. Integrating patients that better. And and that just isn't me. So I thought, you know, if I'm gonna get through six months of this six months of intensive care, then another year and a need to just get me through to my registrar post Well, I'm already a senior doctor at See, You know, I actually, I'm not sure you know what, my losing here. So I actually went from there and worked on a Not for awhile, CPR, which isn't I don't think another another career that people probably don't know a great deal about. But there are individuals in the world, the owner large yard that want the one medics on board, and it's probably not that common to do, but it was a really interesting process. And, um, yeah, just one of those things that was on my kind of tickets. So it's it's It's so to be clear. So far we've been talking about cruise ships. Write these huge, but that's something I meant to ask, and it completely slipped my mind because he said that there might be 1 to 3 doctors on board and maybe a handful of nurses. How big is your patient population that you're actually responsible for? So I'll give you an example of other other good size cruise ship that we operate. So if you think about something like pretend you, for example, Scott, maybe 12 or 1300 crew on be a good few 1000 passengers, maybe 3000 passengers. So you've got a potentially a population of 4 5000 people that you're responsible for. Um, And if you've got them on board for a couple weeks, you take 5000 people for two weeks of maybe a broad entrada, um, potentially some older people that to, um then people gonna get sick people gonna get sick. That's, um I can probably say hand on heart that I I know that the care that we provided to any pistes and that that came in was as good a job a better than I would have been able to provide on land. You know, you get cases. I think I've mentioned before where Lady comes to mind, too. Trips in Brooklyn. Um, now that's a five hour visit to any You know, it's a Saturday and I it was eight o'clock, and she was in an hour and half a now and you know what I mean by that is we saw her. We x rayed her. We made sure that it was examined properly. Put a nice soft plaster on again. It's something that we just have to go through the POSTOP and she went back to a cabin. And then she comes back for reviews because she's only two minute walk away so you can bring the back for reviews often. Is it like you could see them whenever you want afterwards? You don't have that anxiety having any we think crimes. What if this person gets compartment syndrome? Whatever. No, they're two minutes away and check up on your ring them anytime you want. They're right there. And it's not a huge burden to work. Load? No, my dear, your priority. You want to look after them? So, um, that's it. It's a nice way of working that allows us to Segway very nicely into, I suppose, other than you've obviously mentioned some pretty challenging environments. What what are would you say just for the sake of balance, the challenges or the the downsides? If you like? Yeah. So I think, being diplomatic, it's it's, um, each their own way, being away for three months at a time, potentially not having brilliant phone signal for that time. That could be challenging. And if you've got family you got loved ones on, then that can place a strain on those things. What I'd say to counter that is that you know, companies tend to have really good policies in terms of allowing visitors or friends or family to come and visit and stay. So there are opportunities to coexist with your loved ones on board, which can be really good for both of you. So there are measures in place to allow for baseline easier, I guess the other thing that is difficult times is that, like I said about the positive you're working in a small team, it goes without saying that you don't get on with everybody the me on. But if it s that happens that you don't get along with somebody in your small team, then you have to make it work. And, um, most people very good at that. You just adopt a professional relationship. But it's challenging sometimes because if if if I call you after a 12 hour shift on then on, then wanted to call you and say, Can you come back to work and just do X Y and said You might not get the best response from someone. There are hard based there. Sometimes on some days you do have to ask a lot of people, So that's challenging. Um, and it's similar, you know that it's a double and everything's a double edged sword. It can be really stressful when you're not sure what to do in a real difficult scenario. But I think there's an R in even just saying that. You know, we're in a difficult situation that isn't a good answer here. But let us work through what the best of the bad is on involving the team, and that is usually a good way of doing it. So, yeah, there's a few hair encounters where things get difficult, but I think it's a good it's a good test of character and like I said, it would be, it's It's a really good thing to the right person. It's an awful thing to the wrong person, so it must be lower you. I mean, I'm thinking about the A Someone about start at four. I want, for example, myself. I'm thinking about the traditional sort of apprenticeship model of medical training, but this it sounds to me like because he also independent. You have to make these tough calls. You probably develop enormously as a doctor. I think so. I think so. And I think it's easy to feel alone, and I think it's very easy to get carried away and make your own decisions. I think the people that probably gonna fall to hear the ones that just do what they think is best what you've actually got there is probably accrue Doctor that might have come from the NHS. You might be a consultant in any. For example, you might have a senior nurse. That's work to see. For 15 years, that's common place on your nurses worked all over the world. So you've got a captain and then that that knows the landscape. You've got a hotel manager that seen this 100 times before, so you got a group of people that have a wealth experience around you, So yeah, there's a lot of shared learning. I probably took quite a direct path on through the ranks. Not for any credit. Just just just because, uh, sort of chance happenings, Really? But there was a team of people around me that have shaped my practice. And, you know, if I look back to when I was crew doctor, I was blessed. I had absolutely fantastic senior doctors that are, you know, still good friends Now that I never would have been able to afford to that kind of relationship in the NHS hunched over a desk in any writing your 57th set of notes. You're not gonna have a chin wag on a on a beer with that person after work. You just know. So, um, yeah, I think I was relatively inspired when I came to see where I was actually thinking. I'm gonna leave this after a year. I'm just coming away for a break by the scene is that I worked with that. We're just so, uh, smart and broadminded and you find yourself in the most or positions because maybe it was someone stuck in a small space and you need to get them out, and it's like they just pass it off and make it easy you think? Wow, that is really exciting. Really interesting. And you get a great result. Got this is satisfying on. Like I said, you get this report with people, you get the same guess coming back three times in a week, and you you get better and better with them. Yeah, I really enjoyed being after have that relationship, But I think coming back to what I was saying before is that having a relationship with your colleagues in the tea That's great on the crew on board, they look after you. You know, they really look after you. Uh, if if you you got the away and make sure that I don't Galleys chef is looked after well, or the hotel assistant or the head waiter you can you can get your your meal salted for the next six months. You'll be really, well, it after there is this given take on board where everyone is positively trying to look after each other, which I hadn't felt in the last hospital I worked out. It felt like people were trying to have always worked because their life was easier that way. But people really are going over above on board on the ships I've worked on, you know, Canada. Okay. I think the culture is exceptional. Exceptional? What an environment. And I guess that's going to bring us on to the sort of final talking 0.0 r. Discussion. If you, like, tried to ask everyone some variance of this, which is, if you have any sort of golden messages or Ky learning experience is from your career that you'd like to share with our with our audience today. Golden messages. I I still I feel, you know, maybe like everyone else touch of impossible syndrome here. I don't feel like I'm sort of through my career. I you know, I've traveled a few years into interested in industry on D. I like where I am. I guess the key message, uh, is this for somebody wanted to come into this career powerful. Just as a doctor in general. Think we'll split into two. Maybe for a doctor in general. Uh, it just keep your options open. Uh, you. I was very, very heavily set on emergency medicine. I think if I carried on that path, I would have been wrong, and I would have been doing myself an injustice, and I probably would have been unhappy in time. Um, so I think it would be brave. You need to recognize where you might not be getting everything you want from your job and just keep your options open. And I was told many times this would be a dead and roll wouldn't enjoy it. Might do a year. And then then what? Well, there's an awful lot more to it. And, um and really, I think what we often forget is you know that you're doing your career because you left the career. Maybe, but you do a job because you need to have a quality of life, so always seek that balance. Um, my view of some of my colleagues ists, you know, they get into training. They finally managed to get that interview down. They finally managed to get on the training program. It work on that stuff to get their exam salted. They get everything signed off. And Christ, you're in red straining. Brilliant. Then you're in red straining. You doing the same thing again? Exams, training, uh, service provisions. And then way. You know, if you do that 10 years, you get to be a consultant, and then you've still got that surface professional look after. So I think this isn't doing it down because there is a vast majority people that is a really, really good A on. They'll be happy with that. But just be conscious that think about where you heading to on what you actually want, your goal to be. And if you want your goal to be a comfortable life, good quality of life, a job that you enjoy satisfaction, then there's alternatives. And as a doctor, you got a good ticket to a lot of those eventualities. So, yeah, keep keep that on your mind. I think I like that. That's that. That's a good message. I think that there is, um, the NHS and the treadmill to consultancy. Perhaps, as it were, is no is the right route For many people. It's not necessarily the best route for everyone, and it sounds like you've had a really fulfilling and interesting and exciting alternative experience. Yeah, I think I have, um, I definitely wouldn't do it differently. I definitely wouldn't do it wouldn't do differently. I am also incredibly thankful for the experience is that I've been afforded kind of okay. I just even looking back. Now, I still get excited to the, You know, the day I had the interview that first day on board the first contract is still exciting now, and, um, I I'm unbiased, obviously. But I just think, um, if more people knew about it that they be many more people trying to get this chops, I just, um I just can't believe it's still exists. A zero that, you know, anyone who's finished their F two was done a year in a knee and maybe some on anesthetics experience. It's quite common place. They can do this and even just want it for a year. Just again. This other other depth of experience that they can do it, I just it I know why didn't do it. Because I had a had a plan. I have intention. Um, but yeah, Like I said, I think people just need to maybe keep your options open and just think about and and trying to achieve lovely. Well, that's where we will bring this episode off. Virtual elective to a close. That was medics at C with Dr Luke McLennan. What? What interesting story had anything quite like that. Thank you so much for joining us to. Nice pleasure, Really. Get to see what I've got. Loads more stories. But, um, yeah, we'll say if they're well, I'm sure that there will be there will be ways and means if anyone has been, many people will be have been inspired by this story. I'm sure they'll they'll contact Carnival, the UK and apply to become the next wave cruise ship Doctor's Just get online. Give a sander at the moment, looks after it and just just submit your information because we're recruiting. We're looking for medics we're looking for doctors were looking for nurses on, um, you know, thinks things are moving. Um, it's exciting times. You know, there's been a huge falls in travel. There's been a huge break in in people being up to get away. This people been under huge straining the NHS. So what bad thing to do? Jump on a cruise ship on, uh, things that things are getting moving so exciting times I'd encourage anyone who's interested just to get in such perfect Well, thank you so much, Doctor McLennan. Thank you all for joining us for this episode off virtual elective around the world from medal. Take care. We'll see you all next time