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Sorry. Last but not least we have neuro delivered by uh Usher and uh Alan, both of which uh are registrars in the field of neurosurgery. It's a very unique specialty as, as we all know, operating on such a delicate organ. Um but the portfolio of which is similar in cardiothoracic and that is different to the rest, of course surgical training. So is uh Usher and um Ale there. Hi, is Alan joining us as well? I think so. Let me just give him a text. There we go. I'll just invite him to the stage. Oh, there you go. Perfect. So who, who has the er job of sharing the slides? Uh I think Alan does if you guys have any questions about the platform at all, just let me know any issues. I'll be here in the background. Ok. Thanks Johnny. Hi guys. Can you hear me? Ok. Yeah, that's great. So I'll just show my screen here. Ok. Yeah, the floor is yours. If you just press hide on that tab, it'll go back to the screen but just go back onto the presentation. Yeah, that's fine. So I just behind. Is that ok? There Yeah. Uh, is that ok, perfect. Ok. So, hi, my name is Alan Im. The registrar is actually based in Glasgow. Um, I, we kind of did it a little bit differently, so I'm kind of followed down the line and, um, in, in, so I'll kind of do the first half, just talk about what we essentially do. And I think in will for the second half, we'll talk about just how you get into surgery from that point of view. So, um so yeah, I mean, you know, interesting talk from the thoracic colleague there. I think, you know, these, these two specials that sometimes kind of um quite similar in terms of uh com kind of competition to get into. But um actually like most surgical specialties now are really, really competitive to get into. So, um so yeah, that I think you just, the key thing is just need to work really hard and, and try and make a decision unfortunately, quite soon now um compared to previous years. So I suppose just why that your neurosurgery. So I think the brain is always fascinated me actually. Um So, you know, for me, yeah, my understanding is that, you know, from, from law to to finance, to um architecture, engineering, to technology, um sports, the entertainment industry and politics. It's all essentially create some control of the human brain. So that's the thing that essentially creates human civilization as we know it. So, and there's still so much that we don't really know about it really, to be honest with you. So, um, you know, neurosurgery is one of these specialties, it's very much still in this infancy. Um, and actually a lot of the things that, that we do in neurosurgery, it's really about prevention. So things, for example, and um, you know, traumatic brain injury or stroke, um, there's actually quite a few things you can do to reverse the primary injury to the brain. And actually a lot of the things that we do is secondary prevention. So, um, to prevent a deterioration, but yes, that's essentially why II can get a generic surgery. So the two main reasons because of the brain actually fascinates me. So it does. Um, and secondly, because, um, I like anatomy. I like working with my hands. So I think if you combine the two, that, that, that generally seems to fit for me. Um So I suppose what is it involved? So this is really no different to all the other specialties actually. Um, so, you know, it's theater which makes up, um, the majority of our work. And also if you wanna go into surgery, that's, that's the bit that you're, you're most interested in. Obviously, like a lot of our surgical specialties, clinics, um, are very important. Um, it's very, very important to actually get to clinics, um, especially in the lead up to your sitting here Fr CS or even just as a trainee because getting to clinics, um, you get to meet patients and it's all about decision making as well. So, um, even if you're an fy two or a medical student, you should try and get to clinics because you get to them to have to take a history, examine the patient and see how the decisions are made. So, you know, yeah, theater is the exciting part. It's the interesting part. Um, but it's very, very important that you don't, you don't, you know, ignore the rest of it and we'll run the critical care. So that that's the same for all surgical specialties. It doesn't matter what surgical specialty you go to, you know, get away from that. Um I II suppose, um neurocritical care obviously relating to the neurosurgical special is actually very important to actually um the neuro anesthetist. Um Actually, you know, neuroanesthesia actually has more in common with neurosurgery than actually neurology does. Um because we, we actually work a lot more with the neuro anesthetist and also in terms of research, traumatic brain injury, anesthetic engines. So actually, neuroanesthesia, actually, from a neurosurgical point of view is actually a lot, you know, close to more closely related to neurosurgery than National Neurology is, which initially sounds a bit strange. Um administration. So I've got to put that in there because there's no getting away from that. So you, you, no matter what surgical special you go into, um you've got to do administration. So that's documentation, see, you know, um doing clinic letters, all these sorts of things to say, it's not the most glamorous aspect of it, but it's very, very important. Um And then finally, research. So I think this is probably one of uh certainly a new, one of those surgical specials. There's a lot of scope of research because it essentially just to say, don't really know a lot about the brain really and, and, and and kind of relative terms. So there's a lot of research in, in, in your surgery. And I think that's actually one of into a bit more detail. It's being an academic trainee. But um research is actually in your surgery is one of the areas that you ask a lot of trainees. And actually one of the, the second most uh you know, reason to go into it is because of the research prospects as well as operating as well. So, so, yeah, so essentially research is, if you enjoy academia, you enjoy research, um then you're so certainly one of those uh fields is certainly worth considering. So just gonna generally touch on what we do here. So cranials of uh uh you know, the two main uh you know, subspecialties of neurosurgery is cranial and spinal for obvious reasons. So the cranial point of view is trauma. So this is actually a personal interest for me. So I I'm really quite interested in trauma aspect of things. Um So there's, there's multiple, you know, trauma actually operating in your surgery generally is not that difficult. Um, you know, there are some operations that are quite challenging but, you know, things like craniotomy, which you can see here on the left. Um, it, it's a standard procedure. There is an index procedure you need to do as a trainee. Um, and, uh, obviously, um, you know, it's important landmarks, you need to know just like any operative procedure, but essentially the craniotomy and, and raising a my flat that you can see that is the gold standard kind of uh operative uh kind of operation you do for a cranial um procedure. Now, uh hi in trauma here. But any, you know, if you're doing a tumor operations or an abscess drainage, you're doing anything within the cranial cavity, you craniotomy is your standard standard procedure and you can see it on the right here. So one of the operations is uh we do is a decompressive craniectomy. So that's where you make your incision here. You can see on the left. So you start the ear, you make a almost like a reverse question mark, incision, you raise the flap with the, the muscle and then you put some bur holes which you can see through there and then you basically croup just kind of look like a jigsaw. So you basically, you know, connect all these up, you dissect the, the underlying um lining, which is called the dura from the bone flap and you remove the bone, if it's a decompressive craniectomy, then you don't put the bone flat back right away. And that's probably, that's usually because there's a lot of swelling on the, the brain. And um so you wanna give the brain time to, to expand and then hopefully, as the, as the weeks and months go on, the brain will then um settle back down again. And usually what can happen is that bone flap will go in the patient's abdomen and then usually every 6 to 8 weeks' time, that bone will then go back into the patient's skull, so called a cranial plasty, an auto cranioplasty. So that's, that's one of the examples of trauma operations. Um It's interesting to do um these are trauma is very much life saving operations. So, and that's the special I like about it as well. So these patients are very unwell patients who essentially will die very quickly without an operation. So, um so generally speaking, trauma that that's the kind of general of a lot more to trauma than that. But um so this is another aspect of um uh an example of a trauma operation. So it's bifrontal um decompressive craniectomy is uh an example of that. So that's where you basically take the front part of the bone off. Um And to release really, that tends to be more for um uh yeah, the bron contusions with the, the frontal walls are expanding. Um So if you take one side off and it's not gonna be much use. So you need to take the frontal part off. Um the other, um the reason to do it would be a tumor. So as an example, I've just included there as well. So if you got a tumor, particularly lytic groove meningioma or mainly a bifrontal or kind of false tumor, um then you, that's an option to do that. So this is just really just to highlight this is another example of, of the type of, of operation you can do essentially, it's it's a form of a craniotomy. So you can see there's a general, you know, seen here with um cranial operations that craniotomy is very, very important that you need to know how to do that as a trainee. And then you can just adjust type size of craniotomy, the location of craniotomy depending on what you have access. But you know, you've got to be careful because a lot of important veins there. And it, it it's one of these things that neurosurgery. Um even, you know, you, you, you, you want to make sure you don't destroy important structures that are life threating. So for example, some big vein in the the middle of the brain called spinosal sinus, you know, if you hit that patient can die on the table very quickly. But equally because it's the brain. Um even if you destroy certain structures of veins, the patient may not die, but it could end up being disabled, uh vein from, you know, deficit to uh vision problems to cognitive problems. So, it's, um, it's, it's one of these things that you, things in your already know about, you know, causing, you know, life saving or sorry, life, um threatening complication. It's also disabling complications as well. So, um, and uh neurosurgery, there's no orders. It's all kind of quite fine motor, um essentially required neurosurgery. So it's, it's, you know, you do your cranial flap. That's, that's the big aspect of the operating. When you're actually operating from the brain, you taking things um very, very in a controlled fashion, um which is a bit different to other types of the surgery also. Um So this is just a real kind of picture of what you would do. So this is your craniotomy flap up here. You can see that the myoc as far as been uh race back and then you can see the brain. So this is the brain here. You got your brains there. So you can see there that especially in trauma. Um One of the things that we fear in trauma and fear in any operation is um malignant swelling. So what that means is that the brain continues to swell. Um Despite all your efforts in that instance, you basically just need to close. So, um because if you don't, the patient will rest on the table because if the brain continues to swell, so swell, you'll get disjoint, essentially, um disjoint of the, the brain stem and that will cause arrest, et cetera. So, you know, traumas, it, it can be quite difficult. It's, it's, it's quite a high stakes um field of, of neurosurgery, but it's also can be quite as well. Um But that does give you an example of what it's like in real life. So, um uh the other aspect is oncology. So this is a, you know, this is a expanding field. Um So things like this is, you know, like tumors such as glioblastomas, but um also can be low grade tumors as well. So, um and again, we work very much with our oncology. Colleagues here discuss MDT S and things like glioblastoma multiforme, which is very like most aggressive cancer. No one. you know, the these types of operations are, are, are certainly, you know, give the patient some quality of life. But, you know, in the scope of the past 50 years or so, you know, the survival rate for GBM, for example, is 12 to 15 months that's not really improved significantly over the past, you know, several decades. So um there's other, you know, such as glioblastomas, the these operations and sort of these um tumors will not come, will not be cured by surgery. So the these tumors will likely be cured by chemotherapy radiotherapy and also immunotherapy as well. Vaccination techniques or uh or uh vectors. So, so there's a lot of in and this is what I'm, this is going back to the interest in research. There's a lot of research and potential in this field. Um And certainly, you know, college colleagues are, you know, that's one of the things that drives them is, is a research aspect. You're avascular. So, yeah, so this is very much things that aneurysms. So this is getting very high risk surgery because um, the these are uh really kind of subspecialized area of, of, of neurosurgery. Um, you know, you have vascular neurosurgeons there. So it's becoming more and more specialized the days of a, of a general neurosurgery, clipping, an aneurysm doing a cold and all that kind of stuff. It's really kind of dwindling now. So it's becoming more and more subspecialized. So if, if, if you want to do vascular neurosurgery, you tend to have to do a fellowship in that. And, um, uh because vascular neurosurgery um involves a arterio venous malformations, aneurysms. And also the thing with vascular surgery is for example, an aneurysm. So, you know, clipping, an aneurysm is an elective operation. As in the patients been diagnosed with an aneurysm, they come for a preassessment, they're coming and clipped compared to an aneurysm that's ruptured, that's two very different operations because an aneurysm has ruptured plas are different, the tissues are very friable. And so it's, it's a completely different operation. Um So, so, yeah, neuro VSC was interesting. Um again, some people say it's a dying field because, you know, we work with our interventional neuro colleagues who have flow diverse or aneurysms. So mainly invasive techniques for that. But so certainly, I mean, from speaking, from my experience to give you an example. So, you know, a few of our consultants are unit who are in their sixties and 50 sixties. I mean, for example, they said, oh, you know, you were on D five, we like 40 to 50 aneurysms and that's never happening there. But there is no way in any unless you're in a major vascular unit. Um you use a train, you would clip up to 50 aneurysms. So that's, that's never going to happen unless you do a special, you know, a fellowship in vascular neurosurgery. So, so I think the, the clipping again, the, the neurosurgery is not immune to that um caseload dropping because of increase in, in invasive work. But it's certainly something if you, if you like vascular work and certainly if you want to do vascular neurosurgery now, very much, you will know, need to, to co as well as doing the open procedure, which is the way things are going functional. So this is, this is interesting for research, a lot of research potentially here and not most technically demanding operations. So if you like a lot of challenging, demanding operations, this is not really, especially for you, but you need a lot of planning a lot of organizing. And I say research is really, you know, has a lot of potential here. So deep brain stimulation, not only just for Parkinson's now, but for certain psychiatric conditions, anorexia, um just compulsive divorce disorder. So there's a lot of um interesting um subsession research going into that. So uh congenital, so kind of briefly touch. So congenital aspect of of neurosurgery is is a very specialized field. Um So things that involves craniofacial um with our max backs colleagues, plastic surgery colleagues, so, ran and Ston, so you can see it around the corner. Um other things like congenital, cranial pas twin, um abnormalities. So again, these are so, so, so Crans twins are exceptionally rare. So you can, you know, that's, that's not something you can make a career out of that, that they, you know, most ever come across in life. It, it's fascinating um you know, operation uh and then obviously congenital um hydrocephalus as well and the neonates. And so these are all extreme examples, but it's just to highlight that the congenital aspect of neurosurgery is very interesting. It's a very subspecialized and um you know, that the the job prospects and that are are very low, you know, low, but, you know, if you want to do it and it's certainly um you know, you need to build a pediatric fellowship and that and craniofacial one as well. Spinal. Um so spinal is the second sub category so spinal, there's a lot of work in spinal, you know, so again, the big research aspect on spinal is, is is neuroregeneration. So the holy grail of, of, of neurosurgery and in your old and in general is, is trying to repair damaged spinal cord. And so which is no one's achieved yet. Um You know, there has been talk about, you know, you know, hip transplantations and all that and that's the kind of a the right hand corner. I don't think he succeeded. But, you know, you know, it's all these kind of interesting, you know, people talk about these things, but you know, the reality of, you know, it's very, you've got to practice evidence based medicine and there, you know, spinal includes oncology, traumatic, um also things like um spinal dysraphism, pediatrics, you've also got um and say the big research potential in spinal spinal cord injury. So how do we heal the, the damaged spinal cord, um congenital abnormalities and spinal cord, uh spinal um uh is there as well? These tend to be done by the orthopedics? So, the scoliosis surgeons, they tend to not be done very much by, by your surgery, but they certainly can, you know, you can get involved in these sort of things. Um But again, these are all very, very rare um to that degree. So usually scoliosis surgery is one of the congenital, you know, abnormalities, but that, that tends to be done by a separate orthopedic or congenital, um, scoliosis, uh subspecialty surgeons. But, you know, you can get involved in that point of view. Um, so I think that's really all from my, but I've just put this off. I quickly just kind of touched this and take over. So this is really, so how do you get in? So it's slightly different, um, from maybe other. So, you know, you go through your medical school years, you go through your foundation years and then you can either take 10 minutes to some form of research, you go into ST one or you can go to ST two. The final point for me is that from neurosurgery point of view is it really is all about ST one because we don't have ST three recruitment anymore. We don't have ST four recruitment. And to be honest with you, the, the, the the number of places in ST two is very, very low. Um And I think, you know, so, so really, it's all about getting ST one now. I don't know if that's a good thing or a bad thing, but um there are some caveats to that which um the end on. So, and, and there's a course surgical training route. But the key thing is for you guys who are thinking about it is you really have, you can't have any more than 24 months of post F I clinical experience or you're deemed um you, you're basically not eligible to supply for ST one and if you can get into ST one, the prospects of getting into neurosurgery has become very, very well. Um, there's ST two option but as I said, I think there's only like two spaces in the whole, the UK year. So it's very, very, very, um low. But, um, but yeah, I think that's all for me and I'll move a hand over to actually just to talk about the rest. Thanks Alan. Er, so I'm inga, I'm one of the er academic ST threes in Manchester. So, yeah, ex e essentially on, on this slide, I took a slightly different route and did some formal research, did my phd prior to applying for ST one. But as Alan says, one of the critical points is that you must stay below the threshold of clinical experience and that's not only in neurosurgery by allied specialties, which they'll specify in the person's specification each year to try not to end up having to go for ST two. And of course, some people come through core surgical training. Um One of my friends in London did a year of core surgical training, er, did a rotation neurosurgery and then realized that actually he wanted to go for neurosurgery, the sort of alternative and one more pathway that's worth mentioning. So, a significant proportion of trainees will go through the academic foundation program. If you've got any uh research sort of interest, it's a great way to build your CV spend time at a neurosurgical unit if you can get a neurosurgery themed post. So if you can, um and you're interested, I would encourage you to apply for an academic foundation program, which kind of sets you up for the, the academic route. So the NIH R funds um academic clinical Fellowships, which are ST 1 to 3 clinical lectureships, which are sort of ST four through ST eight and will give you protected research time. And there are a few numbers each year in neurosurgery at ST one that you can apply for academic numbers through, uh it's worth bearing in mind that you must clinically threshold through national selection. So it's not an alternative route that gets you out of going through national selection. You still have to at least meet the minimum er, scores in er, clinical selection as well to get one of the academic jobs. Um, but it's a, a good route to go through if you're interested in doing research. So, uh thanks. Er, so in terms of the competition ratios, it's obviously a competitive specialty. So ST one, there are a large number of applicants for about 18 of those clinical posts that I talked about that's halved in about the last sort of four or five years as we have a bit of a uh sort of overbalance in terms of workforce coming out at the end and then not having enough consultant jobs, but that's beginning to level out. So the competition ratio is about one in 20 at both ST one and ST two. So ST two is, we've mentioned is the only other entry point into neurosurgery. It is very competitive when it was one job a couple of years ago. It's about a one in 50 competition ratio. Obviously, you're expected to have achieved your sort of ST one neurosurgical competencies. Um There's no limit to the amount of clinical experience you can have going into ST two, but obviously they're, they're really competitive jobs to try and get into uh next please. So er mostly it's the written application form and I'll go through a couple of those um fields later that leads to a long listing. Um and then the Multispecialty recruitment assessment uh which is of course, part situational judgment test and part clinical examination. This is clinical exam covering all fields including sort of GP. So questions on oral contraceptives, that kind of thing. Um It's obviously a modifiable component of your application. Everyone who's applying for neurosurgery will have similarly competitive applications, everyone will have undergraduate, you know, er achievements, postgraduate achievements. So this is something you can really do well at and you have to make sure that your timing is impeccable and that you're really well prepared for the M SRA as obviously, this is a significant component if you're shortlisting school. And then should you go through that? Then uh I can't remember what the numbers are maybe 100 or so people will be invited for interview and then they'll whittle that down to the 18 clinical jobs, the academic posts that I was talking about are outside of that. So there will be a number of academic posts each year as well. Um But then you do have to go through national selection and uh be appointed through national selection as well. So in terms of the written or the online application form which is hosted on oral, there's a total of 42 points. Obviously, some of them are more modifiable than other things. So particularly with undergraduate experience, if you haven't got a relevant clinical elective or you haven't done any research or audit um at undergraduate level, then those points might not be available to you. So it's really making use of the rest of the um form. So particularly with post graduate achievements. So my advice to you is be pragmatic, for example, it takes a long time to publish a paper. So you want to be savvy about how you're going to gain points and you want to fill in as many boxes on the application as possible. Um So you know, if you do an audit or a quality improvement project that you then present at a conference you publish on that, then obviously that will gain you points in various different areas because a lot of these achievements have long lead time on them. So I think it's worth being savvy about what you do. Um And I've highlighted or I've separated some of the parameters on the right because I want to draw your attention to the fact that the personal statements, three of them are worth nine of those 42 points. So nearly 25% of your application is a white space question that is not based on sort of prior experiences, prizes, anything like that. And I would strongly encourage you to spend time with neurosurgery, speak to neurosurgeons, preferably try and spend time at a unit. And when you come to writing those answers, I would write them early. They're normally very generic questions. Um But it's difficult to strike a balance between sounding aspirational and somewhat cliched. So it might be a question like what difficulties might you face as a trainee? So trying to make an interesting answer to make yourself stand out um and things like uh what qualities make a good neurosurgeon, for example. And I think it's, you know, an opportunity to reflect on why you want to pursue this specialty and an opportunity to, to sort of reflect on these things as you spend time at neurosurgical units. And then when it comes to writing it, make sure that you show it to people who are, who are in the field um and make it an iterative process cos it's worth a significant number of marks and is one of the few sort of pros you know, white space questions that you can use to make your application stand out. Should you get to national selection? Which hopefully you will if you're interested. Um, this is now all virtual. It used to be um in person and you would have, er, three psychomotor stations. So practical skills that's now been removed. Er, the clinical scenario and the telephone referrals will really come a lot easier to you. And I think it often shows if you spent some time at neurosurgical unit, we've spoken to neurosurgeons, then it's a good, um, it will inform your, your answers for these and the most important thing is to be very slick and to be very thick skinned, uh, as they will interrupt you to try and get you to sort of complete all of the questions in the scenario. Um, so it's just about preparing for those and doing lots of practicing the one book I would recommend, er, for the kind of that will inform the clinical and the telephone referrals is, er, neurosurgery for basic surgical trainees, which pretty much covers you up to sort of ST one ST two level, very readable. And if you know that sort of back to front, it's only a short book that will inform, er, you'll be well prepared for those and then otherwise for the other kind of stations, it's knowing your CV very well and being prepared to, to frame your answers using a framework for your answers if you can, er, such as the star framework for talking about um achievements that you have. So once you're into neurosurgical training, um it's split into three phases which essentially, I think, er, most surgical specialties are now. So the intercollegiate surgical curriculum, uh ST one is your sort of ST one and two are your phase one in which you might complete non neurosurgical rotations such as intensive care completion of MRC S and then your central phase ST 3 to 6 when you're really sort of gaining, gaining a lot of um operative experience and developing quite quickly. And there are a number of courses that most of us will do, such as the European Association of Neurosurgical Societies course that runs over four years and then ST six, you're sort of looking to complete Fr CS in the coming years and looking towards fellowship and subspecialty really. So most of us will complete at least one fellowship if not more. And then all you got things to add on this. Yeah, this was just really just to round up. So it's obviously a competitive process. Um and as says, preparation should start really as early as possible, you know, touched on this already spend time with a unit and and also speak to trainees who have actually done it. So one of the, you know, especially if you, if you are unsuccessful one year and speak to someone who has actually got in, you know, sometimes it a little bit difficult, um, to do that, but I think it, it certainly set you up well and see where you have not done as well as that you have and also have a back up plan. So these things can sometimes, um, not go plan, but if you work hard and you, you do the preparation, well, there's no reason that you can't get it from that point of view and finally top it. So, you know, make sure you, you really want to do it. That's key start your CV as early as possible. Uh Make contacts as we've said already and try and bring something different to your application. So as we said, you know, all these applications are very, you know, very high standard. Um but um but yeah, that's probably the, the final point. Wonderful. Thank you so much for taking the time to present today. Well, I didn't even, to be honest in medical school, I never really got taht much about neurosurgery, even a career that you don't get that much experience, even knowing what a career is like. I don't think I ever had a placement in neurosurgery. No, II certainly didn't and I didn't in foundation either and it wasn't an option. I think a lot of people have that experience so it can be difficult. I came to it quite late because I had no exposure and then realized through an F three year. So similar to what I think Jason was saying, going into cardiothoracic training, it's good to help clarify maybe what you want to do and then of course to, to build experience as well. And that's when I realized I wanted to do it. So, yeah, it's a difficult one, but there's lots of events now, particularly from sort of neurosurgical interest societies at university and so on and just speak to neurosurgeons. But yeah, every fe every I think couple of years we have a trainee or two leave the program. So as Alan says, it's also a good way to make sure that it's not an easy life, it makes sure that you really want to do it so that you don't go through all of that hassle and the difficult process only to realize that actually, maybe it's not the kind of work life balance that you wanted. So I would encourage that. Are there any upcoming events that perhaps some of our medical student viewers might be able to attend that coming up recently if you're aware of any? Um I'm not sure if there are any sort of N A SA run lots of events. So that's the kind of national interest group. And that's often people who are kind of aspiring neurosurgeons plus lots of neurosurgeons as well. So any N A SIG event is great and then normally there are sort of small courses run over the country each year. So at the Manchester Children's where I am at the moment, we're in the process of putting together a sort of pediatric neurosurgery course, you know, for a bit of fun as well, you come drill some bur holes on some sheep skulls and try with a craniotome but also to interact and to talk to people in the field and see whether it's something you want to do. So we'll normally publicize that through, say NA MS. And I think there are normally lots of university um interest societies as well. So those are great events just go and see what it's like. Fantastic. We have one question from the audience. Uh Tung Mingo has said or asked, would it be an advantage to apply to ST one neurosurgery if I complete MRC S part A or B during foundation year? Um So I'm, I assume that means would it be an advantage to your application? Uh And yeah, anything you can get done if only to, if you know, you've got to do something further down the line, the more you can do to prepare for it, the better to offload that stress later rather than going through ST two and trying to prepare. Um And yeah, I do think you, you gain a couple of points as well. So it's helpful to have that done if you can and it's very achievable. Fantastic. Well, thank you both for your time. I really appreciate it. I know you're both, I'm sure you are both incredibly busy, but thank you for taking a Saturday to sit through this particularly in the evening. And hopefully you never know you'll have a new neurosurgeon just in the audience. That will be your new new sh or spr No problem. Thank you very much. Uh Oh yeah, if not published, um there's no sort of negative marking on the form. So one of the pieces of advice I was given was to try and basically there were all these white boxes and try and put something into every white box. They're not going to negatively mark you for it. So if you think anything is relevant, put it in there um and then be prepared to talk about it uh at interview as well. Um So yeah, put it in see what happens. So, you know, not it's rare that someone will have the top level of sort of achievement in every single of those parameters. That's fine. Some people will, but most people won't. So just put something in there. I think that's the same for a lot of specialties as well. No one gets 100% in every single thing. Yeah, they'll be the annoying person who's a member of some international committee of some international charity. And these people used to turn up for national selection with these huge s but for us humans, you can only do what you can do. So like I said, be savvy if you, you can use a project that will fill in different boxes. And as Jason said before, I completely agree, there are lots of prizes available out there. So pick a small conference, prepare well and hope for the best. And it's not so unusual that you get a prize. Lovely. Er, Alan. Thank you very much for your time today. I hope you manage to enjoy the rest of your evening. Ok. Uh, yeah, feel free to contact either one of us if you've got any questions. Fabulous. Thank you so much. Ok. Thanks very much, Joy, bye-bye. So that brings us to a close for today. I hope you will manage to enjoy yourself. Um And thank you all so much for being here today. Uh One of our regular well annual preparing for a career in surgery events. I genuinely hope that you found the sessions helpful and inspiring. Just remember as you progress, gaining all of this hands on experience across a wide variety of specialties that is incredibly important. Each specialty offers a unique kind of perspective and challenge and that will shape you into a well-rounded surgeon. That'll also help you find where your true passion lies. So take every opportunity to learn from each experience, whether it's the operating room clinic or s or simulation, attend conferences, network and just meet people, whether it's in your university, your trust or even online. Stay curious, keep pushing forward and believing your own potential. Each of you has the capability to make a real difference. And I mean that I was in your shoes. Thanks again for joining us. We're here to support you at every step and best of luck in your journey, if you've got any final questions, just pop them in the chat. Otherwise that's the end of the session. Thank you very much, Yvonne.