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Okay. Good evening, everyone. Thank you for joining us. Yes, Another webinar. Now, Pediatric Siris. Once again, it is my absolute pleasure to introduce Doctor Helen Armstrong, who is a consultant in neuro disability this evening. So you were telling us all about from careers of pediatrics? On Also will be touching a little bit on specialty applications. Um, so I will come over so you don't go on strike. Thank you very much. Um, so careers in pediatrics say a little bit about me. They have you have seen other presentations? I've done well, probably already know that I've been a consultant for about four years now. I work in cold out, which is Halifax, and the head is field trust. I'm a generic instruct course instructor, and I also teach you on a p a lesson and less. I'm part of the instructor team for the step, which is part of the Yorkshire in pediatric school teaching program. A volunteer with the other McCarthy try stays to be a trustee on a Children's holiday. Um, but they refined reptiles. I actually just owns find reptile. And my dream reptile is a little chameleon. Like this guy down in the corner, Um, tough mother and sees yesterday is is probably, um, a little bit more excited than I am about it. I do love doing it, but it is also shocking. And I love gigs. And I would say seven skateboard in March Is that time? Um, just a weird from us. But this is COPD mean, I'll I might let James do this. I can see him just popping up now. Absolutely. So, yeah. See, Beating me is currently our sponsor, which allows us to upgrade the website. That we have one week dot com, which makes it run more smoothly, gives us more service based. But what they provide you goes is a 50% discount, so only 8 lbs for entire year and access to a where different CPD accredited webinars so quite similar to these, but on the entire variety of different subjects. And really good. But we'll you foundation doctors, you need to build up a portfolio non core teaching and learning on for entire year just 8 lbs. You can do these thousands 1000 free webinars, um, on that is it. And I'll have back to, you know, actually beforehand back to you I'll just say, if anyone does have any questions as we go through, I will be monitoring the chats on the side of the screen. So you just stick it in there and I relate it. Cross street. Okay, that Thank you. So I Look, I have to say, this is probably looks like a completely random slide, and but I love the Christmas Eve seems so much. I just couldn't help myself. And so, unlike your traditional and medical school lecture have not done a aims. An objective. Essentially, I'm going to talk to you a little bit about how to get into pediatrics. I'm going to talk to you a little bit. About what did you when you're there? I'm going to tell you a little bit about the day in life is a consultant. Um a little bit about the doors it can open for you and the subspecialties. You can think about leaving if you'd like to talk a little bit about the process of applying for specialties on, Of course. Answer any questions you have, or do you just answer literally any. But if they are pediatric base, that's probably easier. Say how to get into pediatrics. It had a timescale off a day. I didn't change that because I thought it was funny. So I think you need to wake up with some enthusiasm, I think enjoying a challenge because, let's be honest if you don't think pizza is going to be a child Angel, probably not aware of what he needs, is I think that's probably true of most of the medical specialties. But pizzas ask yourself, Why is pediatric see? Because if you don't know the answer to that question, then when someone asks you that interview, you're going to be struggling, then always make time for lunch. I am the kind of person that gets hungry on so lunch is very important, and it's been a few brain and your patient consider things like E P l s, which is the European pediatric life spot or a P L s early. Now that doesn't necessarily meaning you're F one F two unless you're super duper keen. I I know people that in fact, I did eat a last one was up to you saying COPD mean I did it. Um, you don't have Teo do them a Zonis s itty, but they're quite fun on. But if you're really, really thinking about Pedes, it's something nice to say that you think of them you could even consider doing caught one of your MRI C p C H, which is the the foundations of of pediatric practice. I remember when I was an F one, my best friend was doing, um, M O C P. And he'd done part one part, too, before the end of the one that was like, What are you doing? And that actually, it's not such a terrible thing to start now. I probably wouldn't do enough one. I'd probably have a look into it and maybe think about doing enough to. But doing it used to be called one A. They now have clever, weird, shortened names like A K T. And things that I don't take the understand essentially what used to be one A, which is essentially the like the background of pediatrics. Um, it's where we kind of your physiology and all that kind of stuff that you're probably super good at because, you know, long been out of medical and, uh, say think about it and then we'll say, haven't idea what you're aiming for on don't mean you need to know where in pediatrics you're going to end up because I don't think I did when I went into pediatrics, and I don't think I did when I was in ST three or what I thought changed over that time. But they will ask you that kind of thing interview on. So it's good to have an answer, even if it's, you know, it's not set in stone. We're not saying, Oh, once you say that, you could never be anything else. Uh, it is a really good idea to to have these things ready, then things not to forget on By this, I mean things to include in your application or things to be thinking. I've got an extra r 02 of my time in my life. I'm sure many of you don't. But if you have think about all those fun things or life enriching things that you do, that could also show that your a a good human on, be that you might have a commitment to a specialty. Now think of all those wonderful colleagues you have that have wanted to be surgeon since they were about to on have, you know, been doing like surgical skills and, yeah, placements with proximal things like that. Now we don't expect that impedes because, well, we like dedication on a softer level. And I'm not soft in terms of we don't want you dedicated, but just you You don't need to be hard core as a human. And But if, for instance, you have done some kind of work with, say, your local church with the Children Greep or you run mom's and toddlers or if you're really good, it be unless you've you've, you know, during, Well, you guys went the old enough, perhaps to have been out there when there was the junior doctor strike. But I was on. I essentially spent an afternoon in the church hall and teaching resource teacher kids recess to parents. It was amazing. But all those little things that you might not think, Oh, that's a really good thing to talk about him to be, Um, but think about all these things that make you stand out from your peers. Um, because those are the things that looking for they're looking for you is around it. Human. Um, on and also that you could We have some interest in the specialty you wanna give. Auntie, we don't necessarily expect you to know everything about pediatrics. I'm pretty sure I didn't when I with an f one f t but like I, as in my two DUIs gave a pediatric job ago, the kids and sadly, where I was I couldn't find a job that have the three things I thought about cause I feel about GP. Any impedes can get those three together. So we ended up doing GPA. Any impedes surgery, which was close enough because to be honest, by the end of my F one, even though I was doing gentlemen and John surgery, I was in the d g h on when I did Genser Gery none of the other ones wanted to go to the peace toward on there was like a potential appendicitis. And I was like, Oh, yeah, I'll go down there So you may find yourself as someone that's watching these webinars thinking about pediatrics, that you kind of just fall into these things anyway. But that just great things to talk about when he comes in three. Then, of course, because I have to think as someone that reads applications. Think about doing a pediatric related or D or Q I project on. That's more doable. Then you think even within F one in Ft. Or even a cement student, it's essentially tailoring what you've got to where you want to be. So I remember when I was a an F one. Like I said, I did. General surgery hated it. But what I did do was an audit off the appendix cases in Children. And then when I went to GP, I also did, in order of how many pediatric patients we had come three on what conditions they had. So much like order is more fun if you have any enjoyment in it. And I would also say, If you're looking at particular career and that's not just a pediatric, that's the whatever area of medicine you finding want to get into try your best to tailor those things that you have to do you for your port failure off a progression to woods. What you think you like to do, because a shows that you're interested and be, actually gives you a bit of a flavor for what the rest of your life might be because I'm sad to say guys that Q Y and order it doesn't go it well, wish it it. It just becomes, you know, something you accept and then volunteer. You don't have to go in here. Number one. You know, I know lots of absolutely wonderful pediatricians. You don't do any voluntary, and that's cool because he felt other things in your life and that's all right. But what I would say is is the thing that probably made me want to do pediatrics most with help me, totally realizing it. So I started doing this and gels Holiday. What? I was a fresher at university, and I love to the holiday so much that I then went on to volunteer with action. It leads the university. I then went on to lead the holiday after I graduated on, then become a trustee, Um, on. Then I ended up doing your disability because we took away kids but her traditional needs. And I'm sure there was some kind of subliminal messaging that happened all over that time. That led me to now, because you, you know, actually kind of gravitate with the things you enjoy the kind of people or patients that you you really to and enjoy spending time with or enjoy helping the makes say the crooks and you will see that this theme comes up a lot in this presentation. Think about what you enjoy and what you are good at, because that is where you will thrive on where you will have the most satisfaction on enjoyment off your work on glyph in general, What's expected of you now I'm sure my colleagues would probably say very similar things, but these are things that I expect it to be. And this is once you become a pediatric training. So I would love my F one. F two used to be equally dedicated, though perhaps not get your Marcy PCH done. So I would love you to have enthusiasm. And that doesn't mean you need to be like a shining ray of some every day because we will have bad days on be. It is work. We do understand that on you know, when there's 2025 patients way to, um, assessment unit, we can't always theory of sunshine. However, that doesn't mean you're not enthusiastic on it. Easy as, um, I more see as when when you're in a teaching fashion, you appear to listen and that you have questions when there's interaction that you make some effort to interact on. Do the When you're interacting with Children on ward rounds, they're in clinic that you seem to care about the interaction and, as it pays to it, being something you're scared off, which I do see from up. So I we have lovely forth. Your medical students from from Leeds than 30 medical students from Sheffield that come through cold gel on did. It's really lovely, actually See it seeing the transition from week number one, Teo Week number six or eight, which usually it comes in two forms. It's either they thought they'd like pediatrics, and now they love it or they are terrified and then not quite so terrified any mobile, because there are people who are scared to pick up babies on baby, they're actually more robust than many older Children. So and easy as um is good dedication because, let's be honest, you haven't got this far by not being dedicated mist if you happen, and I'm afraid that doesn't stop because pediatrics at least in its traditional form, is an eight year specialty from from Starting ST to the end. Now, to be honest, RCP ch progress, which is the new curriculum is, is shortening that encouraging flex. So essentially more than ever, you have the ability to make your pediatric training what you want it to be. So if you want to go 80% or 60% you don't need a special excuse for that anymore and buy a special excuse. I largely mean having an illness or having Children. Um, you can now just be someone that thinks I'm quite like to have more of a life in my life on day. So 80 80% 1 of my friends has just gone 80%. It's the best thing she ever did, she tells me, and I, as a consultant, work 3.5 days a week instead of five. Love it highly recommend it, and so that there isn't so much this this set path that you have to do that some key. Listen, chemo I'll stones and for bit like Children. And but there's lots of ways of getting to the same end point now, which is brilliant. You know, more than ever, they're encouraging that if you think yourself food what I like to be a GP with a special interest in pediatrics. Well, then there's ways of going both ways for a little while. Or if you think well. I wonder if in the future, as many of us are wondering whether actually a lot of pediatrics will be even more in the community unless in hospital on. Actually, you'll see pediatric specialists as part of a GP hub, so you you might do the clinic in a GP practice. It's really good, therefore, to approximates and GPS on D worked with a clinic with them, or try and set up a joint clinic on. There's lots of facilities within the progress curriculum to really encourage that. There's also lots of opportunities out of program experiences. Um, that we do like them to be well not not necessarily educational, but enriching to your life is a human. As long as you can justify what that is, then most of them get approved. So if you say, want to go abroad for a year on Go and do tropical pediatric medicine in Africa, which I had a friend that did, and or if you want to go into your project and the that looks after Children on the other side of the world, you you can do that. Or if you just want to go the six months in work, say Liverpool Institute of Topical Medicine. Oh, if you want to go down to GOSH and do a specialist placement because they're the only place in the UK that has that super super super specialist, um, that you're quite interested in and then that's really possible. So there's a lot more flexibility. There's also a lot more flexibility with time in that it used to be quite rigid for the eight years now. Actually, there's a lot of points that you can shorten if you want to, so you conducive. And so it's if they now call it cool and poor specialty and then specialty. So you're ST 123, which you can actually do in two years. Your core is two years. That's that's That's that. Is it your first two registers on then your specialty years, which you can do in two years instead of three, so you can actually do the whole thing in six and let's be a list. Don't rush no unless you really want to. Um, some people have lots of good and relevant reasons for wanting Teo finish specialist training. But what I would say is we'll spend kind of 45 years doing adult medicine on maybe at maximum two months doing pediatrics. Give yourself time himself. Time to embrace pediatrics, you know, Remember how that Children aren't small adult on. In fact, there's lots of differences and sometimes times helpful. For that. I really enjoyed my time. Is Registrar on his message show on. I don't think I'd try and fast forward it if I was to go back but each to the red. Just know that there's lots of options getting back to my list of things and punctuality is a big bugbear of mine, mainly because I'm always early May because my parents told me to you that way. But all I want in life is everyone to be on the is to be ready for 100 over that Hyundai the time on. If everyone could do that, I would be well east 50% happier human, So punctuality doesn't matter What specialty just try really hard. You know if if parking at your hospital parking at my hospital is horrendous is bad. Just leave early. I eat breakfast at work because I know that parking best dresses me out. You're expected to get your MRI C p. C h Done within years 13 of a specialist training. Now that involves and to written papers on Do your clinical. The two written papers are actually more like three written papers because it used to be part one A and B part two and then the clinical. They now have a So I said funky names, but essentially consistent dual of part one on one day, if you want to. You want in the morning one in the afternoon. If your suckers for exams like mysteries are and and then do part to you Amend. Your critical life has changed a bit because of pave it and, you know, for the last year was so clinicals have been online, which I still let's be honest. I'm not sure what I think about that, but my hope would be that by the time most of you come to do your clinicals will be back to him and face to face, because I really think that the way you can tell someone can examine a child is to see them examine a child rather than them, tell you how to examine a child, which I think is a very different thing and finding findings yourself off. It's very different being shown findings that you ask someone to look for anyway. Then, after after during, you might have decided before ST four. Think about if you want to subspecializes been now some special tea is a little bit like some specializing in adult medicine. If you have a burning zone, it to be a pediatric cardiologists that's up specializing. And but you might not want to be a tertiary pediatric cardiologists. But you might have uninterested cardiology on. That's where Spin comes in. Spin is essentially you wanting to develop a specialist interest, but not necessarily wanting to be the tertiary hospital of lead for for specialty. So, for instance, um, I could have done pediatric neurology on now to be fair, uh, so a couple of years ago, but is no a pediatric, uh, your disability, and it's especially tea within grid. That's what we're talking essentially good training. Um, but there's also spins the base of those things and actually letting you into a little secret. You actually have to do either of those if you don't want to. And because if you take a lurch, the job see pick or the jobs that with you and your T P d and your educational supervisor pit towards a certain area, then as long as you have the competencies, you can still do that job. So I didn't actually. Do you spend for your disability? I thought about it. Well, I actually thought about doing spin for neurology, which is why I have my pet training, which is pediatric epilepsy training, Um, on the chat chat, which is great. Which is the two Children? Headache or, um, but actually, there was a lot to be said if you're going, if you plan in your life to work in a DJ age to having a fairly generalist approach because and if I think about my own group of colleagues um, my roommate, Dr Rock. She started off doing PT gastro when she started. She's nodding, peed any and he's gastro's gone to one of my colleagues that prefers to do that. And then he did that for a while. He's now doing pizza, aspirin allergy, because that's what he really wanted to do. So essentially, you contrarian up to do almost anything. Number one, I always say, if you have enough skills too, get you a consultant job, you can then change your job plan. Um, build that job plan into what you want it to be over time, as the service allows you to. We'll come back to that a little bit more in a bit. The sub specialize a shin when it comes to. If you do have an idea around ST for what you would like to subspecialized, um are there son specialties that are more competitive than others? Is it, um, you know, depending on what is it? Training posts that come up with just consultant drugs. Okay. Excellent. Excellent question. So, um, sub specializes thing if you really want to subspecialized, you're talking group training. Grid training involves having a grid number. Having a good number involves good application. Great application is essentially you nailing your colors to the master, for instance, saying I want to be anywhere near little adjust um For each region of the country, there is a set number of specialist iced. So the good training. So if reaching and testing in a clean that you may have seen a wet and, um, there may be two or three of those posts. Still, those registrars that a grid registrars on the rest that will be generic sounds awful. But general pediatric registrars who are going through the night it's a part of their core training. So what you do around ST four if you have just all before then because it's never too early to start portfolio going about these things, and it is to start building your port. Failure towards that subspecialty to start doing more CPD towards that sub specialty. Because grid training is essentially like your M M task form on dure, your pediatric specialty form, and your then consultant application form, which essentially goes through all the major areas of life. So kind of tell us about why you want to do X and tell us what audit projects for what research you've done into X and on then, much like everything you get ranked on, do you then get several choices which is, which is another interesting thing about grid. You can decide whether you will only do it in your region or whether you would accept, so that you conducive specialty you want you to go and do It s where, as in weather of around the country has a cap depending on where you're ranked in comparison to your peers. So, for instance, metabolic medicine, Pediatric metabolic med from their hubs, our nearest one for your sugars. Manchester, they are fantastic. They do outreach clinics and Bradford etcetera. So if you want to be a grid pediatric metabolic training, the nearest you're gonna go is Manchester or you're going to go north all further south, you know, burning in London. So it depends. How many should be your area is in terms of being competitive. Yes, of course, there is some more competitive than others. To be fair, a lot good training is moderately competitive because there's always more people in specific places, but things that are particularly competitive and the units mainly because lots of people want to do me and eights, but it does have a grid program. Um, so I would say for every neonatal place, there's about 445 people going for each place. And what I would say is I know at least one excellent neonatal consultant. He was working in the tertiary unit who did it via spoon. Um, so she wanted to do grid, didn't get grids, did get spin and didn't manage to get all her competence is through spin because when she managed to get jobs that lined up with what she needed when in did a fellowship three year in Australia, in, in the in its came back got a tertiary neonatal consultant job. So there there is still some of when you're working in units that you like along the way. If it's somewhere where you want to work, just just be good to them, as as you would normally is a human, because that will come back and be helpful for you is a known entity. Later doesn't mean you'll get a job over a better candidate. But if people know you on, know that they want you as part of their team, that's a good thing to have. Okay, thank you. Know that's very interesting On with his Well, if you apply as nasty poor is a you competing with ST 5. 66 is or is it kind of? You either go in at this point or you carry on with spin. Yes. So? So what it is, is you. You start great at the end of ST five. So it's your ST 678 years. The you're great training. And but because it the application starts at the beginning of the year. And then there's interviews Essentially, you need to think about if you want to be doing Redoing ST for the Kids ST five is applying for it that so usually as lead time for all these things. And so that's when you need to be thinking about it. Okay, thank you. That'll make sense. Thank you much. And then much with anything. Get involved. So, you know, if you're in F Wonder and FT thinking or a med student thinking, I really want to do pizza, get involved when you're on pizza or get involved in the pediatric elements of whatever post you are doing. So we had absolutely fabulous student recently who was on when all chaos was breaking loose on the assessment unit and she essentially field. It'll phone calls from my bleed, Uh, just just related messages to May and she was fabric. And that gives you some experience of kind of what it's like day today to be doing that job on. Then also, you know, if you have the opportunity to help out with blood, so can you LA's. That doesn't mean you have to do them. But actually, getting that hands on experience is gonna be really valuable for when you come to do it. Because instead of thinking, Oh, my goodness, never seen what it's like to try and put a cannula in an octopus because she'll drink can be octopus. Um, then it's much easier because you've got an idea that a nice bear hug works really well or that wears Willie or a tubal it what's really well, And then we're card. Essentially, Um, I don't mind if you don't know everything, because I definitely don't. But I do mind if you don't put the effort in. So as long as you wear card, most of it's in pediatrics will get on absolutely fine. Um, and then please, please ask when you need help. I think that's true of every specialty, but it makes pediatricians air pretty darn friendly. You know, it's one of the great things about the specialty, and we we know it's different too many of the specialties because it's who helped a the whole extra layer of extra people involved. You know, parents as well as the Children. Um, there's all the extra shoes around safeguarding and all those kind of things. So please, just that's the help. If you need it, say a day in the life. Now let's me on this. This is a day in my life, rather a day in the life of Virginia during Pedes. But, um, when it comes to be talking about hot weeks essentially the same. So my typical day on a normal week is that I get in early, I I'll check my trusty mail. I'll read and respond to the post and letters. So when you consulted, you essentially get in. But in in Tray, where every single test result you may have ever rewarded comes ta, and then you have to kind of write letters out to parents toe talk about results, or you need to action those things. Do any man that she training. You need to do, and that comes around hay faster than you would imagine, You know, kind of moving and handling these kind of things, and it's searing parental phone messages. So I remember when I first came a consultant, whole idea that had a secretary was really bizarre thing, and I still find it a little bit bizarre. Let's be honest, but she'll send beautiful messages on E p R, which is our electronic system. I am about parents that left messages about medicines or queries they have on, so we'll spend some time doing that. I'll check my letters. It looks like dictated from clinic in. And make sure I haven't said anything ridiculous because that's purist we will do at times. And sometimes it's checking, spelling and things like that. Um, these with colleagues, lot tricky cases. That's my favorite thing to do. I remember when I was and most of your stage I used to think that consultants knew everything and that they were somehow magic because their brains must be in saying Liebig. But what junior doctors don't tend to see is that actually, consultants just ask each other. You just don't see it because it's not on the ward. So I really where I work well down one straight corridor on What happens if there's a really tricky case on the ward or really tricky casing clinic? Is that well, essentially, just come about out of our rooms and stand in the corridor and because it's a close corridor will essentially just discuss it on. Then my list that was like a five point plan will then become a 10 point plan. But is really Rebus, too, because about seven people of into it and is it's something that happens all over the country on Yeah, I think, gee, doctors don't realize how much it's happening, but it's wonderful on it means that actually, you're getting the very best of those patients. But you're not on your own tread. I think it would make it less. What do I do about this patient? Because usually you won't be there, do you Haven't done nothing will be like I'll have done it. Got this child with pyrexia of unknown origin. We've got urine that's normal. We've got an LPN. It's normal. We've got blood coaches, they're normal, but they're still spiking all the time and I'll say to my colleague Khalil, who echoes of that. Can you echo just to make sure there's no vegetations you got? You have course no. One of my other colleagues to be like, Oh, have you Have you checked EBV? And, uh, that won't know heaven. And, you know, you have these kind of great logical back and forth conversations. It is a brilliant thing. And I'm actually, as you become more senior is a great thing for you to do is a register or is that kind of and senior? Shh, because I still in my head working old money. Um Then the other things I do data is when my clinics So I do when your genius, it's going to sound crazy saying 1.5 nearly disability clinics. But what that means and consultant time is that I do want to reduce ability from the caffeine week and then maybe one every other week. And then and then I do a general clinic every week. And then all your other roles that come into is called supporting professional activity on your job plan. So I'm Century one of the teaching leads for our med students. Um, I am the designated medical officer for send for our CCG. So I actually go to meetings at the CCG and talk to her the powers that be about funding or services and what we need a new disability and and try and advocate for my patients and which is great on. Then I instruct on what's recent score says, which I largely do, because it's good fun. Then day in the Life Party. What weeks known calls. Now, this is probably more akin to what you're gonna be doing day today, when when you're on the ward's except maybe not the latter. T So hand a vir, I I essentially, um let's let the genius run hum fever on, then usually add in things like, Who did you do this? Oh, what's the answer to this? My central role in 100 chief questioner. And because I'll have little bits of of things that I want to know because their pen into my in my thoughts and standing on a patient there aren't necessarily part of your s far topped it for life gets brought down because it's gonna help you in a while, your specialties and in a while your jobs with the medicine on day. When you find a consultant at night, all your registrar, if you can give them a quick cystic too little s bar. So that's situation, background assessment and recommendation regarding your patient. Well, everyone will love you, plus also a it When you wake someone up from sleep, it's a really good way of getting them focused. And there would round, say, would rounds. A big part of your life on hot weeks on a big part of your life is a junior doctor. Now, when you are F one F two, you're probably not gonna be running any war drowns that. Let's be honest in the heart of winter when it is crazy crazy, we definitely let or if one's enough to you, see all long term patients on. By that, I mean our CF patients that just in flight too expensive I optics and and things like that so you might end up seeing urine water on patients. But usually it's the off of being a really good documentary. And if you haven't come across soap before, which is your subjective, objective assessment and plan, that's a really good way of laying out right in, right in your ward around, notes. The My wonderful registrar taught me when I was in left, one on day. I've used ever since, you know, and you can add into that results back and drugs that kind of job. But it's a great kind of basic way of sorting out your walk around life and then taking referrals where I am. We, as consultants, deliberately hold the referral bleed during the day on. But that is for one main reason. On it is to avoid excess referrals, because we know that we can bounce a lot more than you guys come. Let's for two reasons. One because GPS didn't give us a much a chip they give you, because when you say the word, there is a doctor arms from pediatric consultant. They suddenly don't think they're going to fight asthma. Choose. They do when it's one of you guys. I knew this because I've sat next to one of my genius taking a referral. Somebody has been quite rude to them. I've just said to them, Give me the phone, take it over and suddenly people are very nice. And but it was, um, it means that uneasiness streaming at the busiest times of the day. But at night, the registrar's hold hold the referral. Beat on In some places, I know the shh, hold the referral, bleach the GPS and it actually is a really interesting thing. Um, it's probably that's scary to start with, but getting you feel of where your levels should be for telling someone to come in on also of the way you respond to challenge. You know you'll get many opportunities in life to respond, to challenge with it within medicine and on. Do you learn a lot about yourself when you see how you do it? And I essentially find myself being the disappointed mom. Figure Ah lot. So when I speak to any and they tell me that they've given nebulizers to a child under the age of one, my my colleague just go guys, really just don't do that ever again. Where's I tend to take them or disappoint to the pro cycle? You do know that they don't have the receptors, for there is right. Maybe next time just don't do. And so you learned a lot about your ways of dealing with stress. Then Do you have any urge of messages which usually involves? My secretary is really sweet. She essentially spends a lot of time when I want hot week tracking me down. And I honestly think she should try using my mobile phone, which is with me all the time, but because our ward is just one big circle and I'm usually on it if I'm not in my office and she just walks around until she finds it, um, and usually tells me of things that the agent and then going to resist as and when needed, managing stuffing. Oh, my days. This is something that nobody tells you about it medical school or any time in life until you become a consultant, which is essentially that while you're in hot week. If any person in the teams down it is, then your responsibility to some half excellent now this doesn't mean that you have to necessarily find some to replace them. But you have to call medical stuffing or your race coordinate whoever it is to try and fix it. And also you'll be the one that gets called sometimes in same times of the day to be told that someone can come in. I had a vehicle five am once from a gyn, you doctor, too fat. They were ill. But I was a gold telling me that they wouldn't be in a like That's okay. You could have called you take it to tell us this, But you know the game to them. They were giving his prior warning. Um, on. You know, it is always the jury when you're trying to manage, actually patients and the load coming in that you're also trying to manage the fact that there's no s h o will register on call for the evening. Um, on what you gonna do about And so I'm sure all of you have had the jury is experience at the consultant asking you if you could stay on on thinking, Oh, gosh, that ask again. Trust me when I say is equally painful from the other side, because we have a or been there on also, no, nobody wants to be asked me all know that it's often you have lives, but we also know that it is genuinely terrible to be on call with a star. And, um, there is occasionally a tendency to be like, Well, the consultant should fix it would do it. I know this because I've done five registration. It's on two S H O shifts in the last six months forgot. And so where I work consultants more than pull that weight. And what I would say is, we always appreciate when you guys cover when there's gaps, especially if it's illness because you know long term gaps. I appreciate you guys shouldn't be expected to cover that. So trust issue, not your issue. But when it short term, well, no, it's the same people that always helped cross cover. Hopefully, it's the same group of people always do it any and then teaching a fund it like I always love at the end of a ward round if we've got time. And if it's not absolute abject chaos to have kind of 10 15 minutes where we either talk about interesting cases on the ward or we talked about theme again, usually that's this been present in the world. There was there was one day when we had the theme off, fairly to thrive because we had a least three babies in that were kind of June, destined had weight loss, and any one of them have genuine failure to thrive, has a place to just they need a bit more milk, Um, and say we have, like, a little spider diagram going on various different causes, which, with, um, no say then the hot stuff. And this is the bit that people don't like about pediatrics. If you noticed, it's not great and other specialties, either. But they're some of the particular challenges that maybe put people off, which is safe, guarding and breaking buddies say day today, and there is a safeguard in clinic. This is true of May. Stressing and eyes. Your weekdays obviously didn't afternoon. So essentially any calls that come in from Futural workers or GPS, that concerned. And if someone has a bruise or something like that, they get put into the safeguarding critics so they can have a formal medical assessment. Now, as a genius doctor, if the ward of calm enough you are always welcome in these clinics on that will usually always be a with us. It's usually a community registrar that allocated to that clinic, too, so there's lots of lots of opportunity for you to gain some experience in doing that, and then it keeps safeguarding. That's the things that rock up to the wart on that side of things have come through any be that an injury or a concern that come, as I said, usually directly to any or if there's a child on the wart that's coming with something different on the safe guarding concern is raised from whatever corner. Now that might be that I still remember when I was ST one, I was seeing a child. It was asthmatic, fully strip them and they had a linear bruise on their back. And I was like, Oh, yeah, Oh, I tell my register And thankfully, the registrar looked after that. But of it, well, I just looked after the nebulizer side of things and yeah, but just have it in the back of your mind. It is challenging. We did a whole other weapon or and safeguarding. So I'm not going to get into great detail now. And but it is something that people find challenging. And as I said, the baby, the universal really be. It could be honest and be clear, and you'll be right and then breaking bad knees. The things that people find hardest. I think our cancer I'm suddenly and it's not common, which is good, but it's more common than you'd like it to be. I see at least one of them I the usually blood. So I usually the Kenya or solid Children. That's usually, um, a Wilms or in your glass labor most frequently and on the the West, The West worms When either it's been not recognized for that for a while. Well, we're still they come in just because they suddenly had been tempted the edge forever. Reason on. They come in and you essentially have to have to tell him again. Universal rule will save you from old things. Um, I I usually find that with challenging cases like this words such a Z What? What do you think? Going on quite powerful and letting them tell you, because parents are actually a lot more stooped than many people give them credit for. On most of the time when they bought their child in. Even if they don't know what's bad, they'll know it's bad. A lot of the time. I can only think of a couple of occasions when I've been racing Bad news about cancer on parents haven't already known that it's pretty darn serious and and actually by you gently leading them down that path. It's easier than going. So your child's got leukemia and which I wouldn't recommend is a name of a 10. Uh huh. And on my other top tip, especially because I did six months of peas. Oncology is, um, if you are not working in a pizza oncology unit on this is going to sound crazy, be moderately of age. And now you say this because you want to give a plan on by that. If you know that that patient needs to start hyperhydrosis thing with fluids if they need to have a blood transfusion on, if you need to get them to the oncology unit, that's what to tell the parents. You don't want to be saying, Well, they have to get to the oncology unit tonight because that doesn't always happen. You don't want to be saying they're going to have a CT tomorrow because you can't promise that. And actually, the West Thing that you conducive is work. This poor family, who already really worked up more, and I think unless you have worked in a pediatric oncology. Know what? You don't realize this their time span is really different, What you think it would be. So they do want to get things done quickly, but that quickly is usually within a week. Not that day, because, of course, so So it's an acute pediatrician. That's not an uncle. Just I feel like a solid tumor. And I'm like, Hell, that means starting right now on day like, Oh, no, we can see that within the next 2 to 3 days. And you like, really, you're gonna let these poor parents think about this for 2 to 3 days before you do your CT and confirm and take your samples of whatever you need to do more like, Yeah, because But they do that because then they they set aside specific time to do it and they make sure it's the consultant that can do it. And so there is good reasons for it. And don't get me wrong. If someone's acutely sick, if you've got, you know, a child with leukemia, he's potentially having white cell breakdown that's causing and problems then. Then they get them across the seniors the human they come. But I have seen a good few families who have been told, um, lots of detail with great with good me with good intention by DJ Churches. Who? The oncologist I'm slightly frustrated by and then having sat in clinic with some of our fantastic oncologists until they know the fine detail, they they are very general general, the better word than baby. You want a clear plum, but a very general plum and pretend babies. I think that's the other one that worries people when you have to go in council about 23 weekers and suddenly, even in our days of excellent technology on Even in the days when I have a next 23 week on my books and that survived go to Boston, he managed to get every single neonatal complication you can imagine. Al has just started walking about 3.5, but he's with us on. He is a joy because he essentially Noel Preterm Baby's looks like a T, but he does lesson, Um, he's a bit of a diva, So, essentially, when is who he, when he's in about maybe just covers his face with it is one of my favorites that I can't imagine the conversation that, um, that the register on had with my mom because you still have to say for 23 weekers that essentially 50% mortality because it's, you know, you know you're not ready to be born yet on there are a lot of work. That conversation, unlike the conversation about cancer, is all about detail. You essentially need to prepare them for the fact that mortality is high. The Rop. So they retinopathy a prematurity and is a really possibility that that sepsis and problems with feeding might happen but that they can still express them. That that's really important on those rule tricky conversations that my top tip would be a watch, an expert doing by next that I mean a registrar of it's done it a few times. One of the neonatal consultants, because the best way, much like you know, the best way to be glad to get good at history taking is to see lots of different good ways of doing it. Then pick your favorite bits on a doctor in style and then of suddenly there's still quite a few other breaking bad news things because, let's be honest. Any chronic disease, to an extent, is is bad knees. So I would say the most common one in pediatrics is diabetes. Telling a child that they're gonna have diabetes for lie on, that they're gonna have Teo. Think about the carbohydrates the eating inject is is a big lifestyle change, and it's often a bagel. I still change the family, giving them time for that to sink in and then and explain the ins and outs it that, you know insulin helps the powerhouse and of your body to maintain Teo to control this it sugars come can be tricky that, as I said before, follow the universal rule and you'll be right for all of these things. You can be honest to be clear on, then, even if you don't know what the answer is, you will set yourself in great step. So we come back to picking some specialty. What's been Really it comes back to what you love. Um, I would say that for specialty picking in general, as in you know, whether it be pediatrics. And I'm sure I would love to see lots of you become pediatricians and but you need to ask yourself, What do you enjoy most? Do you have a burning passion of the cardiology or knee and eights? If, say, good training might be FIE. And but good training isn't foreseeable day and say it might be that you want to be in, Ah, TGH and a spin much would be more up your street, and I spend much. It was essentially getting the key, um, skills you need full and for a certain of the sub specialty without doing formal grid training. To do that, you need to speak to your training program director and your educational supervisor, and together they will be able to help you down that path. There isn't spin for absolutely everything on there was Sittin and Dina Reason we're doing sentence spins reason of the others. Um, so there are more popular. There is certain popular spins, say, within pediatrics, diabetes and endocrinology is a popular spin. Teenage and adolescent medicines becoming quite populace been. Mm, epilepsy is a popular spin. Um, the way to find out more details about those is that when you start your pediatric career, discuss it with your clinical supervisor, discuss it with your educational supervisor on. Then they'll let you be able to help you pick jobs in line with your training names. One of the roles of a TPD as well as to, you know, essentially put together the jigsaw that is trainees in jobs is is to try and help you, too, and to pick or to do jobs that will, um, make sure you get the competent sees you require to do. I spend that you want to be. And I'll say, Remember that it is okay to keep things broad on open because this sometimes gives job job opportunities because my other top tip is pick your place, know your specialty. Now I know that's easier said than done. If you would agree training and you've done the in eight, I don't mean don't pick any in a unit That's crazy. What I mean is, I largely picked where I wanted to work based on my colleagues know on the job that came up and actually, because I had done general pediatrics on actually done a bit of diabetes. I don't a bit of renal. I don't a lot of neurology near a disability. I was very happy doing a job that did general on nudists. And then you can train or do courses toe Boost your skills and ability in those in the areas that you are then taking on once you that because it is much better to have a supportive group of colleagues that you get on with that occur he sieve, then have your perfect job immediately because the job has started doing four years ago is not the job I do know. And each each year you have a job plan review on Do So from your one I took on teaching lead. And then I, uh, your to I added on being the designation medical officer. So I dropped to clinic and I added on, you know, speaking to lots of people at CCGs um on then your three, I decided that I actually wanted about a work life balance and so dropped one day a week. But it means I can now do more research teaching, which I love. Um, and you know, I go up and down the country doing recess teacher, which is great fun. You get to meet lots of different fantastic people in different specialties, that which is great Say, you know, nothing is set in stone. I would say Think about what you want from from your job in the end and how to maximize your opportunities of pediatrics and as a disclaimer, any Children in this presentation, all my nieces and nephews who love being in this job is I know this because I gave aversion of this talk. Teo, the first RCP chf one conference in September on they were in the room literally involved trying to get them off screen at times with tricky. Okay, as I've said before, what do you want from your career? Do you want to be a high flying profit? Then get get your head into research. Do you love leadership was in. Do you want to become, say, the head of y at which is what one of my colleagues Same pediatricians is the place to be a so which is the West Yorkshire network. You know, he talks to head of trusts around the region about key things throughout the trust, not just with in pediatrics. Do you have a burning desire to be involved in management? If so, you know, you could think about being CD clinical director one day on micro clinic address is an absolute legend. On balance is his clinical duties with his management GTs brilliantly. Do you like me? Absolutely. Have a burning burning passion for teaching If, say, there are shed loads of opportunities be that the wonderful mind bleating be that, um, LSG and the recess teaching Council. Be that medical student teaching or pear teaching or research. You know, I think everyone should do a bit. Um, just because a is it's, you know, evidence based medicine. It's the way forward. But now all of you have to be principal investigators on this today, you can just be someone that's really good at recruiting and sister days and, you know, and speaking to families about a study that you're center is involved with and recruit like I I used to take pride in having high recruitment of this even though I do not want to plan my own study. No, no, no, no, no. I'm very happy for people to put in research proposals me to just be involved in it. I love I love being involved, but not necessarily the one writing hideous grant proposals. But that might be your jump. That might be where you really want to fake issue energies. And let's be honest within a lunches of medicine, you need more than one hat as my wonderful who clinical supervisor started telling me around ST 67 before I started to play the consultant job. Essentially need to think of yourself. What is your critical on for me? That with your disability on? Then what is your non clinical niche of me that's teaching? Um, on, you know, start thinking about these things early. If you love teaching, start teaching. When you're in ST one, there's nothing that should stop you doing that. I I have medical student teaching groups. When when I was less a J on, then just built it up. Over time, I make connections. You know, you, James is currently it and an F one and he is doing this already. How awesome is that? You know, Star, start speaking to people from around the country doing the kind of things you wanted to do it in. Get involved when he go to conferences, speak to the people that are doing what you want to do on find out how they got there because that's the way to kind of direct your parts. Utilize your unique skill set my any excuse that is slightly interesting in the, um I'm quite good at drawing. The reason why the picture of my hundreds on here is because me and my niece has had a day were so my niece is really love, um, kind of those transferrable touch, ease. But we ran out on, So I just started drawing extra ones and with my sharpies. Okay, say one of the things I I do and you'll see on the next page or say is the Halloween. This was Precose. Did I hastened Fact on, but Children in needs. If I'm not in clinic, I'll go on to the ward for the other half of the day. That's not a clinic fashion, and on I will face pain. And it's too much fun. So much fun. In fact, I I took over a patient recently from one of my neonatal colleagues because as a neuro disability, consult that you'll often inherit people so they have them until they're about to. They looked like they were developing cerebral palsy and say they got past to me. Anyway, I hope you know I have this new patient. My list didn't really recognize the name. I don't recognize all many patients names. Obviously have not met him before in surgery. And on this lovely, lovely moment, this lovely little tear or came through the door. And she was like, Oh, you're the face painting one, aren't you? Yep. They've met me. Why? I know she was on the ward with their from killed like fits, and I was face painting in the corner. So whatever makes you you utilize that it is more the blessing than you. Republi realized how, But you are who you are for a visa in on. That will be ideal for on area off medicine on an area of work. And and it's all about finding your knee. Take any in organ learning opportunities. I would suggest to you that all the opportunities can be good, depending on what you take from them. For instance, one of the questions I was asked at my pediatric interview, um, to get into ST one waas. So your church has 33 bits of delivery west, which is leads bad foods. How that's south, which is Sheffield Bombs Lee bathroom on East, which is how now, funnily enough, you can perhaps estimate which area of most people want to be in because lovingly Yorkshire pediatric Diener asked the question. So if you end up in the least desirable area of the Diener E, no one says hell out loud. But we all know that's what they mean. What would you do with it? And so being able to think that you can always take good things from intriguing situations on to be fair, how hospital beautiful and actually it's pediatric department is brilliant on their recess department is the nicest one I've been to to teach her, though hilariously as an aside. When you teach on their GI, I see they have a pie. Day in a curried day never changes. There is no variation. It's just which day is a pie on which day is curry? I love the North. It's brilliant. Then you know, I took one of our F ones. He wanted to be a pediatric, a new PSA test if it with me to put a long line in because he told me that he wanted to be a pediatric in East. It's so I knew and so I took him with may tell people what you're what you want to do and they will try and increase it and then went card and have fun because let's be honest. Work is hard enough is it? Is try and enjoy the base that you come like, Um, I was teaching on a PPI less the other week. No, no, it was when I was teaching mg. I see a pa less was good fun, but GIC was even more fun. And, um, the medical director is like guys, there's a lot of laughter coming from your room. And I was like, Yeah, we're having a great time on That was because by the end of the day, when we dust the candidates, if they wanted any particular style of candidate, we've gone through kind of nervous and overly confident. And my co instructor was a fantastic and, um, the PSA test from Wales called Steve. One of our candidates have decided they wanted to see party Steve accept. It wasn't Steve turned to be the country. It was mine. So I had to be party Steve on put on my most terrible. An amazing Welch axon While doing an analyst scenario. It resulted in everyone nearly crying with laughter at all. I could see in the background of poor Steve trying Mark Well, his shoulders going up and down is grateful. Mentions great guys. You've picked an excellent correct That's that days, but there's many mortgage on then a career in pediatrics can open all kinds of doors view. So let it. If you want to do something, go out, grab it. So I teach in unless a pill sng I see, um, again Precose did. But I think shortly again when things improve GIC and unless have been talkin camera in Africa in various members of my clinical team, go out and teach it and doing medicine abroad or placement of orange, giving that to a local community on fundraising. So, um, chf tea is money. Medics of around tough mudder. Three times we do to do again in 2022 we've raised money for our Children's. Would we raise money for one of the local projects on you know, it's great for highly recommend it. You don't all have to like do 10 miles. And for the obstacles whatever you find more satisfying, you know a concern about the beans if you want whatever you like. But do challenges and team building my favorite thing to do and the end of my hot weeks again. This was pre K bit on my Friday morning Hyundai ver we do a quick game on day was one week we did fluffy bunnies. Best thing I've ever seen. Which was the standoff between our pediatric ST one of one of our GPS T ones as the last model standing in flux, the bunnies, each other about 14 marshmallows in the mouth. It was chaos. There's a billion video on Facebook. I will send you a link if you really want it makes me cry with laughter every time I descend. I've also, um, recently, Uh, so I'm gonna be the medic by terrifying tightness crew leader and the medics, like, real easy for two of the other McArthur sailing trip next year. Um, so we take away kids who have survived cancer on essentially remind them that life is still you can still live life, even even as I kind of person that's in remission. Um, you sent You have come fires and sale. And thankfully, there's a genuine captain who knows how to say in the shit, because I may have posted as my Facebook status. Watch out for cancer survivors, we might think, say, if they were asking me with sailing. The voters well is looking after their medications, which I have more than capable of doing something. As I said, Be yourself. You can only be you and I would encourage you to be nothing less but nothing more. And bring it the things that you find joy out off your dreams of what you want to achieve to work, because it's going to drive you to make change. Change isn't always easy, but is really important if you think like anus. There are too many Children in the UK that are obese, and we know that that is a national problem. Well, then, think what you can do to make it different. Oh, so recently recently, Um, I I'm sad in the clinic, but, um, rest bite services for Children with newer disability have been eating away by various different things, so volunteer organizations haven't been able to sustain things through the condom it soon, things like that and say me in a group of my colleagues. They're trying to set up a little charity where we take kids out for days out. And I do that based on the skills that I lived through, doing everything else leading up to now to be It's going to be your biggest effort on then Pediatrics genuinely is great. So I think these pictures, uh, this was the first time I saw my nieces and nephews home after the first lock down, and essentially all three of them wanted to settle money at the same time. The beach. My sister was like, You work in a hospital. I will only meet you outside, which is fine and sit on the beach. Then the middle picture is One of my beautiful patients with epidermal is is below za. So it was a face painting day. We could paint his face because it's skins too delicate. So I had hair sprays on his mom was like, Yeah, absolutely. And so we rainbow Sbragia's hair. Brilliant. Um, and then this was Halloween. When we use that when I essentially went around painting, these are just the doctors put me on. We painted the other doctors. Peed is one of the only truly general specialist yet specialities left. You can essentially do any area of medicine within pediatrics or all of medicine within pediatrics. If you want to be a general pediatrician. As I said, you could make your final job what you want it to be over time, kind of work, and you only can be fun. I I would say more of my days that I go into work. I enjoy that I don't enjoy. They're always going to be elements that you don't enjoy. But thankfully, they are less than the things you do. I would hope. Do you do the seven Chul's? You still need to ward it. You still need to do governance, quality improvement and research. Medina Fun stuff, too. For me, that's fundraising and face painting. And you know, we have a yearly out into on Towers at three. Father is just the consultants, so some of our group kids want ours every year. It's great fun. We we cause jealousy within the ranks of the new medical team who haven't yet got themselves together to data and but in the summer, will will arrange will you will find uneven where where as many of us as possible can go. We'll go to the local pub for a couple of drinks with all the consultant team. But it's just really lovely. And I would encourage you to find a Greek with colleagues that you get on with where you will look after each other. It is the best thing I have found. Say that is enough in the rabbit in on. Is there any questions? I'm just having a quick look at the chats. If things so if you do have any questions, please do stick in there now. Um, but thank you very much. I found that really useful. Really interesting. Uh huh. And also just I mean, I've seen it from careers talked before. It's just so nice how pediatrics very much considers you as a person and a whole personal isn't richest tick box or cramp you into their box. Thing is the way to get the most out of people like you can do the things you enjoy and the things that you want to do on Do find a way to make that into kind of your day to day and that's that's really nice. Okay, the moment I can't see any questions coming through. But if anyone does have nothing to do, stick it in the back. Or, um, you can always postal toe the mindedly Facebook page. We'll try and get out of that. Okay? So thank you very much for the secret. Strong. So I we we always at mind the bleed. Really appreciate your feedback. Good, Bad. Constructive. Please. I would like to think that anybody is always constructive. So you Please, Please, please. Um, do you take some time to fill out feedback for us? Because I really do techniques of it. I know. So portfolios, I'm afraid guys never cease. They just change what? How they look over time on this genuinely goes in my port failure. Yeah. We've had really, really good feedback. So are actually really useful stuff. Specific, detailed doctor and said we really do appreciate it. So I've posted the link in the chat on the video on the the the feedback form is normal life for about week after the event. So if you are watching this several days after the event, whether on catch up on metal or a new tube. You can still go fill out this feedback and you'll get so difficult to your portfolio as well. To say you attend to be event. And I've shown interest in a career in pediatrics. Okay, I will just finish the stream that