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If, you know, feel free to put your camera in my conversation. Seven or or handover. All right. Thank you. Exactly. Um, my name's of acid. Does Ava have? Somebody said I'm 62 more speaks of a minute, and I'm just going to show my screens. We can get started with the power point. Everyone can see that. This is cool. All right. Say okay. And so, uh, yeah, thanks, Family. Welcome to the P four CS event. Um, busted. It was a vaginal basics the ST to in the Northwest region at Manchester on I'm the asset northwest week representative is Well, eh, So we're gonna talk about German orthopedic surgery, just give you a little overview of what it entails, you know, have to get in or the source things the trials and tribulations that I've experienced and also what to expect when you come in training on diffuse any questions. And just fyi, you fire away, Feel free to ask anything. So, um, what is German off? Be excited rate. It's a good question. And I think different people have different opinions of it, but I'm gonna give you sort of my overview of what I see as trauma orthopedic surgery. So it's essentially as the definition. It's a surgical subspecialty that they're losers. Surgical subspecialty Such a general surgery for a six, etcetera. This is one of those sub specialty of surgery in general on Essentially involves the most important parts of the body the bones and the joints on day that you normally that's a bit of a joke. Actually, In general, the body can't hold herself up without the bones and the joints. So it's it's quite important. But within that you got trauma, trauma surgery, you know, from a broken ankle. Teo Major Trauma four from 30 m and you know, broken legs and arms, Those sorts of things that's covered by trauma. Orthopedic surgery. Then you've also got elective surgery. So you got elected bone and joint surgery. Such a knee replacements, hip replacements, all these sorts, things nice, elective. The attar's quite well. I like elective orthopedic surgery. Trauma surgery is very interesting on that's the mainstay of kind of my part training and red straining. But eventually in the morphine you become, the more you can start to Segway into elective bone and joint surgery. You also got spinal surgery, which comes under German orthopedic surgery and the two routes in the spinal surgery, neurosurgery and metformin orthopedics. You know there's in itself. It's a physical specialty, but it's sort of seen a semi separate from general orthopedic, such as hips and knees and elbows and wrists. And they're sort of things. And then you go off the plastics as well. So I'm kind of really new hand surgery. Nerve surgery. Those sorts of things come under or third plastics on, so you can obviously, is the name suggests come through that come to that through plastic surgery or orthopedic surgery, although usually it's orthopedics with a bit of plastic surgery training in it. So to start with, um, what people think of trauma North big surgery, what's actually like now? I think most medics think that this is trauma orthopedic surgery. So you're Bob the builder you bring your talkin on. You just hammer and chisel away at people with it without, you know, um, looking at what? What they want No particular patient in general. But this is how I feel for the big surgery is as an S H. A. Life isn't hugely got glamorous is very tiring on. So this is me on most days apart from today, we're actually managed to do more than just Sharon. Okay, um but in general, it's pretty exciting. So you've got the major trauma, which is represented by this picture on the top left corner. You've also got this really cool kind of prototype of spinal surgery happening in this picture here on the right, and then at the bottom. It's a nice guild. Ah, I see. I don't know what that is. I've never seen that before. I think it's ah, looks like a tap or something or some sort of fixation device on on the knee. But anyway, so that that's that's kind of strike, a bubble suits of things that we tend the West. That's an example of kind of theater, but it's great. I feel like it's goes of exciting kit. They're sort of like a bit like McConnell. Oh, you put things together. Doing an ex fix is pretty much drilling into the bone and then getting some scaffolding around the bone. It's it's all it's all really cool stuff, and then the more needs things like Laminectomy is and spine and doing, You know, actual off arthroplasty is and things are that they're also quite exciting, but it's a hugely very specialty. Like said, you've got all the plastics you got. Skin graft, onda nerve repair. You've also got spinal surgery. You've also got hips and knees. You also got upper limbs, the shoulders, elbows, wrists and within the each of those things, you can specialize in just one part of the body. So your risk 100 risk specialist and you only operate on the right hand so you can go quite far in in your career. Mr How Niece you get. Um, so it is incredibly varied, even though it it focuses broadly on bone and joints. There are lots of bones. There are lots of joints on days like sexual, and so you could be a trauma specialist or you could be an elective orthopod. But it's it's great, and it's very rare. Varied lots, of course. Kit on. Very interesting. So how do you become a T e n o surgeon? Well, you start with medical school a Z concede here roughly five or six years. Fast forward to foundation training here, and that's two year CDF. I want an FBI to then you sort of come into this threshold. Really? And once you cross cross this threshold, you're into surgical training, and that starts with coarser Joeckel training on ST One and S t two. So course surgical trading is two years, and that involves getting a flavor of different surgical specialties they now have, or they've had for a while. They have Femcons surgical training where you can have a trauma. Orthopedic seemed called surgical training in which you do 18 months of tea and a surgery on gum. Six months of another specialty so you can have ent plastics. You can have general surgeries of mine was general surgery. And I thought I found that really cool and exciting and really interesting because it helps a lot with exams. It gives you good underlying knowledge of surgery in general on a good appreciation of what it entails. Broadly speaking, So so that's course surgical trainings. That kind of gives you an overview of surgical training. If you can imagine, Foundation year is about, um, been gaining or your competencies on becoming used to different clinical environments and getting better, simple clinical things. CST is and sort of the initial stages of run through training are very much kind of laying down the foundations of surgery so that, like the foundation years of surgery, then you enter Reg training at this point after two years. And then you do six years of registrar training, and that's Mork kind of. I'll give you an example later on. But it's it's more specifically terminal pedic surgery on the new CCT at the end, and then you need to do a couple of years of fellowship on average. So that adds another two years. So if you can imagine from ST 32 s, t eight and then consultancy, it's about 86 to 8 years and then you become a consultant. So that's it. Um, but for now, I think obviously we're talking about quite a quite a junior level. So in terms of the CST application process, I thought I talked to you. The timeline. So in Oriole and well roughly opens around October, November time, and then you got the application been window between November and December. Then between December and January, you get invited to interview on. Then, between January February time, you get an interview period after which you then get your job offer in sort of fed March April time on day. So that's a typical timeline of CST. And if that's where you are after the minute and you're looking to apply there, so that's what your upcoming few months is gonna look like. Um, on all the application process has done the Orioles. This is mine on dumb. Yeah, looks like. And I'm guessing, um, if you've done a clinical fellowship or something like that. No, I think that's true track track jobs. I maybe foundation program was to Oriole. I can't remember, but anyway, this is how you apply to see ST. That's what it looks like. Say, is it competitive? CST is pretty competitive, but as you can see here, it's there on sort of, you know, over 2000 applicants for around 600 posts, and this is the 2020 compression ratio and it was about 3.84. Now it's nowhere near as high as community sexual and reproductive health, which only has six places with 100 applicants. Basically, the number of applicants of really, really high on the number of posts, a significantly lower than the number of applicants step that come through. And in general, the caliber of applicant is actually pretty decent. So you know, you're you're battling amongst some very, very competitive people in the UK, as it is on internationally, but it's not the worst. You know there are 600 jobs available, and if you competitive in a few will get in on, you know, call call Medical. I m T. I'm two years, 1.74. So it's significantly lower in 2020 then then see ST but things like run through cardiothoracic. So this is really high, broad based training on Bend. You've also got near a surgery, which is really high there, so it's 8.46, or CST doesn't include neurosurgery, but but yeah, it's it's reasonable, and this is kind of the picture of the Diener e. So you've got this is actually the local a picture to show the local educational training boards, which sort of probably put it northwest, he south southeast kind of thing on breathin those there are beanery, so this is the that's Northwest. I think that's the auction hum and that's New Northeast. So that is just I just know because it's relevant to me. But you can see where they've got those lines that divide those. Each of those local educational training boards intervene. Aries. So you apply once you rank it, jobs you apply to it's specific Diener E. And then you get Get in through that. So I thought would be worth talk about a typical working pattern in all honesty at C. S d level. It's a very busy, orthopedic, busy shh job. The the reason it's busy is because you're responsible to do the ward rounds. You do the on call. You have limited diet Simon Limited Clinic time, and it obviously depends on the hospital because some hospitals offer more clinic time and bedtime than others. I've suffered kind of both sides of the coin, so I've had virtually no clinic time on do a very little theater time in one placement, and currently I'm on a major trauma center where I'm getting regular clinic time and fear time if I'm on call. So that's very beneficial, unfortunately, or fortunately for registrars. But unfortunately, trainees the registrar's are usually non resident at night, and what that means is that they go home at night time, and so you're You do have the support. You can call them up, but you're very much kind of responsible for running the show overnight. And so this kind of contrast with general surgery, where you have a Reg overnight and the resident and they're just probably sleeping upstairs and one of the one called rooms if they are. If not, they're probably with you. And so there's that kind of support. So there's that comparing contrast, where you know is very much kind of essentially lead, whereas general surgery is kind of spread between seniority on. I had sort of break experiences, and I kind of preferred the general surgery set up. And I haven't minded the orthopedic set up, but it's just you got to be mindful that you can call your rich, but they will have to come in and so sometimes bit tricky, and you sort of like I don't call them. Don't call them say you could be tricky, and sometimes it's variable day register our support, and that's not the registered because, you know, it's just a racing issue. But on my last trust, we didn't have a Reg for, like three months or something. So we're just doing their oncologist by ourselves and then trying to find someone who would roughly help us on. But it's not common. It's I don't know what it's like other places, but say where I am at the minute. We do have restless sports during the day so it can vary, but sometimes it might not be one, and it will be very much Sholnn on call, you know, accepting referrals, those sorts of things. So just be mindful of that and, you know, on call. I say this jokingly, but it's also quite seriously you You are the orthopedic on call, but you also the medical oncology. You also the anesthetist on call because you have to sort of, you know, look after virtually everything. Um, it's Yeah, it's it's tough. You really have to have your medical hat on on. Also intermittent is you get squished on the orthopedic side of things. So how did you reduce this? Would would you reduce this? You know, how do you fix this? All these kinds of things and then the medical side of things like why they got heart failure Can you know, sort out. What did you do for them? Called medics, that sort of thing. And then the knee stiff side of things I have you got chest X ray of your make sure that they can walk up stairs. What's the exercise? Tolerance? All these sort of things. You get cuisine literally everything, and it's quite intense. So you have to be able to do all three of those things quite well in order to be a good TNS a day. But then Registrar training comes along on then Usually that involves clinics theater time. He have someone calls but, you know, expected to kind of run around my you with the S H O And I said Thenar, call this non resin estimated trauma center. But that reason upper gastric stairs, because my current placement is in the medical center and they're not president there. So that's cool. But yeah, they tend to just stick around and come in anyway. And so this is an example off my own lucky pattern from my last hospital Ondas. You can see the colored boxes. The aren't blue Ah either zero days or on calls. Ondas. You can see if you sort of chunk through and look at the number of weeks. I was roughly on call for about four months straight in six months, and that's that's just the way it can be. Um, so it is. It is tough, and I'm sure there are other surgical specialties, another trainings today who have had exactly the same experience. But it's not sort of smooth going. It's hard work, but it's some. I think it's worth it. We'll see. And so work life balance. Ah, it's a good question. You sort of get work. Life balance entirely depends on your rotor. How much you're on call. There is a less than full time option available, but that that does the lawn get your training slightly. However, just in surgery and generalists, it's worth being mindful of the fact that there are often lots of extracurricular engagements because you're just building a CV outside of work you're doing or disrespect presentations, papers, leadership positions, those sorts of things. It's all part and parcel of you trained, but it's not really acknowledged within your your plan. And so it's all extra on, so you have to make time for it. And sometimes That means that you might not see your family, loved ones, friends. Those sorts of things might be scared to events, but it's important to still retain it because you can just sort of throw it away and say, I know I'm gonna be a hermit for two years then know, See anybody, because that's just unhealthy on. Do you have to maintain your hobbies, continue to see your friends and family and book time off? Um, Andi. Overall it it's not too bad if you are organized and can manage it. Well, then it's not too bad, but just don't expect it to be completely smooth on Blaine sailing and that you'll get lows and those the time to do everything that you want to do because it's not quite realistic, but obviously just manage your expectations appropriately in it, and it doesn't feel too bad. I'm sometimes been frustrated, but most of the time I'm I'm okay. And so it's not all demon glee. So why she's drawing orthopedic surgery? Well, because it's the best. Just just is, um, obviously is the best. Exactly. You know what's better than methalonic blood? Basically like hanging with your boys, but you basically get to do all the time on gets because life is about work on what better than to be a work all the time with your boys. That's not it. All right, both because, said he. The reason you should choose it is because it's a very specialty okay on. But it's turning a page, Um, for years on, it's notorious for being so, but it's been a bit of a boys' club on. It's been very polarized toe one side, and now it's changing. So I think this is why I'm proud to be in orthopedics because it is changing and it's exciting and they lose a cool things, eh? So he was here. Just a couple of examples of prosthesis is that you're involved with. There's the make Oh, that's a new so no endorsement or anything, but that's just the sort of new new replacement robot that's come out. Any chest. Pride is a fantastic thing to be proud of. Anybody working in the NHS on do, um you know, people like Mr Mom had always ah, really, really inspirational people first what? From what I know. First transgender orthopedic surgeon working in the UK operated on the Queen Mother on Dwimoh in Orthopedics is also a fantastic initiative that's, you know, helping to diversify orthopedics from being an old boys club, being something a lot bigger than that on geek up also or so is worth just having a look on Twitter instagram. Just a so what they do if you're interested in orthopedics, because that should form a mainstay of your, you know, practical knowledge of what's going on in the world of orthopedics because it's part sexual assault in the restaurant in orthopedics. And it's really, really important to know about it on day, how to cope, combat it and how not to be a bystander, etcetera, and just hear people's stories. Because that's the reality. And this is the anywhere that will be This is going to change, so choose it for the right reasons and use it because it's something that you're gonna be a part of in a diverse and cultural community. And, ah, accepting community is what's important to take away from this. Um, so I've got some top tips on. I think he's a, you know, could be applicable to anything, but I think just for this presentation. It might be nice to sort of look through. So I've always thought working hard, working, smart, not hard is is important. You've got to be efficient. And if sometimes speed is an efficiency and accuracy, look after yourself first. Like I said, arranged time to see for my family and friends and make sure it's book annual leave. Also, look out for your colleagues. It's really important to know that they are friends, not your competition. It's really, really easy to get caught up in this whole image of like me, me, me, me, me. Everyone's my competition. I need to fight them all. Know you know they're your friends, treated with your friends and you'll work together and you'll get through Fine. I'm always escalate. When in doubt, that stands to reason. Thank yourself in your colleagues. So in the each shift each day, anything you do always say thank you because 30 for you, thank you. And medicine, unfortunately, so just be that person who changed the game. Keep doing the things you love. As I said, keep doing your hobbies. Keep the caffeine and check. I might be contentious, contentious issue. But over caffeine, a shin only service to increase anxiety and education. And it makes you better or quick. It just makes you more anxious. Okay? So just keep the caffeine and check. Don't know caffeine? A. Have a coffee sometimes, But, you know, just be mindful of the fact that it might just make you more stressed out and nervous on regularly. Remind yourself of the after mediation that you are significant. It's quite easy to lose sight of this during training where you sort of think you're just nothing. You're just a slug of the bottom of the pile, but you're really not. You're very, very significant, and you are value. So value yourself a swell and stay humble. Um, you know plenty of egos flying around, particularly orthopedics. Just be one of them. Stay humble and keep going. It will get better a promise and, I hope, say, I think the next picture speaks 1000 words. Um, it's it's, I think, to be a surgeon to perform surgery is a privilege, but it's also it also comes with great responsibility. Um, you're working with patients who are vulnerable. They're wearing a tiny little gown. They're about to undergo a procedure where their body will be in control under the hands of some other humans who are very, um good or what they do because they've learned how to do it very well and it could be a frightening process. And so, with great responsibility, you know, it's it's good to be accountable and to be mindful of what you're going through to stay humble and, yeah, retain sort of, you know, diligence, humility and humanity on Be excellent. And just remember that you might be working long hours. You might not see your family and friends sometimes, but you organizing the time to see them on DA. Just remembering where you are in your position is important and how it does carry a lot of responsibility. So thank you. Contact tells on the left arm. Bassedas, Avon Twitter. That's my email address that smaller plate and then this is my instagram handle. So you just give me a shot if you have any questions and I'm happy to answer any questions and now thank you. Wasn't that thanks so much? Vasas. That was an excellent talking. A lot. I like the way again. You know, orthopedists did have this sort of reputation of being like boys club rugby boys and very lot of people. For a long time, it was an unacceptable specialty. So thank you for bringing up a swell. And I think in the interest of time And if anyone wants to put any sort of messages, you know, on the chaps and on the medal platform for Vaseline and then we can answer them or he can and then we'll be moving on. But thank you very much for that talk. That was them. That was That was really inspiring. Thanks. Just see. Thanks. So? So our next toe will be by Mr Back a Fisher who's and I.