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Hello, everyone. Welcome to another Siris of the mind that bleak careers. Um, today we're gonna be having a little look at pediatrics with ST one on a Jackson. Um, remember to just put any questions that you have in the chapter on. There's an opportunity to get a certificate at the end with the feedback form, and we'll put the link towards the end on the chart. Um, you ready to go on a Yes, I am. Yeah. I'll just have my screen now, Okay? Just so I can get before I get started? Can I check that? Everyone can see the big school? I'd yet That's all good. Didn't hear me. Okay. Yeah. Perfect. Okay, so my name's on on one of the M p. The optic ST ones. I'm currently training in the northern Diener E. And and that just means that I'm in the first year of my pediatric specialty training and something to start by talking about about pediatrics today. I'll start by introducing myself, and so this is me when I kind of started thinking about doing pediatrics. Mm. I did my undergraduate degree at any castle medical school where I got perfect impedance work. I'm kind of interesting pediatrics. In my first year, I remember one of the road first lectures I went to that was that clinical left. One of the neonatologist was teaching the bit about the life cycle and he brought a newborn baby intellectual better and in a cot on kind of examined it in front of us all. And that's what made me initially interested in pediatrics. And I kind of got a bit of exposure during medical school, and I appreciate that is quite hard to do and which is something I'm gonna talk about a little bit later on. Eso I applied to do my foundation program at one of the District General Hospitals in the Northeast, which is based in Sunderland and actually got a pediatric rotation, is part of my F two year, which is the second year of your foundation trade. I really enjoyed that placement, but I wanted a bit more experience. Eso I applied for a year as a pediatric teaching fellow and and that was working for Newcastle University and you because the hospitals. But I spent half my time teaching medical students mainly about child health and the other half my time kind of working clinically. But I realize that that was definitely what I wanted to do. So I applied for pediatric specialty training in the northern Diener E and started in September such as a little bit about me. But now we want to talk more about pediatrics in general. So I've just got a clip here, and people might have seen this. This is from Jordan Hospital and which was on Channel four recently. I've just got this short clip to show you, but about why I like pediatrics and this is actually a patient I looked after and I was actually working on the ward. When they fill in this, I've just got really short clip just to show you, okay? And I'll put the looking for that. Clip them afterwards. I think it's not, um, particularly clearly, but that was just a clip of a little boy that I looked after called Kit to you might be not to see in the video he was a four year old boy who develops cardiomyopathy on was put on to a machine called a ventricular assist device, and that means that they live basically on the Ward and waiting for a transplant. And it was in the first episode off Jordi Hospital of anyone's interested would like to watch it. And the reason why I picked this clip is just to show you a bit about what pediatrics come back like. And Kit was a really model patient because he was always cheerful, always ready to play and so resilient and whatever you throat him, he would overcome it. So I'll put the Lincoln for that at the end. And so what is pediatrics? And so I think I probably didn't fully into some this. And so it started working into this fascist team self, but actually pediatrics cover all the way from conception to 16 years and actually beyond. So a lot of our pediatric specialty consultants work in fetal medicine. So particularly the cardiology consultants and the real consultant, where they go meet families and when they're still pregnant with a child and explain to them about what's gonna happen when that child is born. And we go all the way through childhood all the way up to the age of 16 and actually quite a long time beyond that, and we keep a lot of our Children with complex needs up until the age of 18, and there's actually a move towards keeping em type one diabetic patients up until the age of 25. And that's because actually type one diabetes, the worst control, is aged 19 to 25 that's because they can't guarantee you will get their own houses, and therefore the control of diabetes deteriorates. But it's felt that actually in pediatrics and my mother's not slightly better. The other thing is, you know, is that it's running through training. So what that means is that you apply. And at the start of ST one it's working through for eight years up until you become a consultant. And so it's not like other specialties where there's a split between core, and then you had to be a registrar. You just apply, you get the job and you go all the way through. And then finally, a bit about what you can do is a pediatric consultant. Eso consult pediatric consultants of base in lots of different places, but they tend to be placed in either a tertiary center, which is a big Children's hospital, usually in one of the main cities in the UK and or in the District General Hospital and where they might do slightly different jobs in some beauticians as well a based in the community and or at various genetic labs and things like that. And when you become a consultant, there's two main options. See, become a general pediatrician where you look after Children of it more generally, or you could be a sub specialists with a special interest in a certain area. I think this is slightly different the way it's done in kind of adult medicine, where a lot of most of the consultants will have a special interest. But like over general medicine as part of their role in terms of choosing to specialize, there's two different options, which I will talk of it for about later on. So the first option is really cold grid, which is where you actually become a subspecialist. It's in the area, and so at the end of your general pediatric training, you decide. No, I won't just subspecializes a specific topic and you'll become a consultant in that specific topic. I just kind of got bigger picture here to look at the broad range of topics that you can cover. So I think that's one of the really conscious of pediatrics, is how board is so you can go from being a community pediatrician or potentially being working on the pediatric intensive care unit. But that can all be done from pediatrics is the main stem. I'll just leave that slide up for a little moment to see a little read through. Certainly specialties that I wasn't really aware off before was things like metabolic medicine, which is a big part of pediatrics. Don't tend to have that somebody in adults, because we diagnose and manage a lot of metabolic conditions. When that when told me, you get, um, and also he can work in trial mental health, um, pediatrics as well. So it might be that you wanted to subspecialized and then which case you would do something called Great, which we just talked about. Or some people decide that, actually, no, I still want to be a general pediatrician. I still want to work with Children on the wars or in clinics with kind of general pediatric problems, but I do have a specific interest in this certain area, and these are all the potential options that you can do. Particular ones have no, are things like safeguarding. So you might become a name doctor for safeguarding on work with the police on child protection. Medicals. Or you could have an interest in something like high dependency units, which way you were working a kind of G H and but look after them or acutely on, well, hospital healing. Well, patients in the hospital a couple of our consultants have an interest in HD you and then in transfer medicine as well. So they worked for a transfer. Stay on this and with the ambulances. Trump's during keep going to, well, Children from kind of around the region to the tertiary centers and the final one that what it's just highlight is an young people's health. And so we've got a couple lives and consultants that have interesting that in our hospital, and that's adolescent health. So So, the 12 to 16 year old group and a lot of that stuff is working with kind of Children that have chronic medical problems in the adolescents and that they also run things called Young People's Advisory Groups, which is groups that get adolescent Children involved in creating policies for the hospital on doing things like designing wards. And aside from your clinical work, these lows at all the things you can get involved in in pediatrics. And this is throughout your training but also as a consultant. So leadership and management education, which is what I did in my nine year between foundation and feed after training research. There's a lot of academic options in pediatrics. Quality improvements are things like audits and patient safety. And then a lot of pediatricians work with public health EMS and working on things like they were trying to make the Red Book, which is the book that has all your vaccination records and growth charts that's trying to be transitioned to be virtual so a lot of trainees and consultants are working with the government on that, or you might have interested health, technology and sometimes pediatrics. It is a really good for health technology, particularly as I mentioned in like Type one diabetes. A lot of our patients will have the book to implantable because monetary and insulin pumps, which on is available and for adult patients, so that's a little bit about what pediatrics is. But why would you choose people? Patrick's left this into the positives and the perceived challenges. So the real positives, I think personally of working with pediatrics is being able to work with Children. And I'm not just working with the Children, but also with their families. And you do because they have their families with them all the time. You end up with a really long term relationship with them, and working with Children always has its upsides and its benefits. And it's a real nice to break up the day by just going to kind of play almost about in the middle of your own call shift. And the other day I spent about half. Now I read in a book to one of our patients because their mom had to pop out to go get some stuff from home, and that really made my on call shift as we kind of covered in the previous sides. There's a real broad range of opportunities, both clinically on outside of the clinical environment, but I do think it's one of the kind of rib last remaining truly general specialties. If you pursue to decide to be a general pediatrician. All kind of pediatric teams are really friendly and supportive, and the consultants kind of go by their first name terms, and they're always approach full. And you could have never gonna be shouted out for contacting or escalated to then and then the bottom two things there something he might not think about. And I personally really like the diagnostic challenge that you get in pediatrics. So a lot of Children are presenting with genetic problems or metabolic problems or under kind problems, and that when you work in adults, they already have that diagnosis. But we're kind of at the start, that process and making those mg diagnoses, which is really interesting and kind of piecing together all different bits of the puzzle. And I'm deciding what test to do is really rewarding. And I'm gonna call this a bit more detail. But procedures procedures are bit more difficult in pediatrics doing something on a tiny baby or a kind of non cooperative toddlers a lot more difficult and then in some of the areas. But as part of that, you get to work with the amazing people. So just play specialists who especially trained to kind of hoped Children get through you and painful procedures or things like taking bloods and kind of working with the channels and explain to them we're going to do and they're making that as least traumatic as possible is really rewarding. So in terms of kind of perceived challenges, and I've put this because a spark my role as a teaching fellow I did a research project looking up and why what medical students felt. The barriers were to pediatrics, and these are some of the themes that came up. So one of the top one, which people always ask me about his involvement in safeguarding. And I think people have worried that I'll find that particular challenging and safeguarding is definitely a big part of our role. And it is involved in kind of all aspects of pediatrics, however, is kind of my opinion that that's identify and safeguarding concerns and protecting the child and potentially support in the family is probably the best everything you can do for that child in terms of their long term development and their lawn. Tim Alkums emotionally challenging so it can be particularly emotional challenging, particularly if you've got Children that unfortunately, have a kind of palliative conditions or and potentially might even pass away. It does happen in frequently, but it does definitely happen. And what I would say to that is, yes, it is really challenging, but and the team around you really supportive, really aware of that and it is relatively infrequent. A couple of things that came out there was a bit surprised. Well, where people quite worried about the rotor and that it was quite intense and consultant job could be quite intense. I have to say that's not my experience. I don't think my route is particularly worse compared to my other colleagues at seven with stage of training I think our consultants are kind of around as much as the other consultants I've worked with in the specialties. But that is my personal experience and and you can choose to go down a such a community pediatrics, where you don't do as much on core work. And finally this one's a little bit challenging and kind of related to the mean in the bottom corner. But some people find like working with parents and care is difficult. I have to say I find it the converse True because it's so rewarding to ask Oh, and take a history from someone and they know every single thing that ever happened to them. Where which I found when I went and adults was a slightly different because And it might be that they don't know what their medical problems or what medications they take. But usually parents carrots will know everything about the child, and aside from some of the some cases safeguarding you are using on the same side and working together. So I thought I'd move on a little to talk a little bit about my training so far on kind of a typical day and about it, my down quite do a really all in my training s. So these are my rotations for my first two years in specialty training. And so this year I'm doing three former posts em all in very subspecialties, so just done for months in pediatric gastroenterology and nephrology, which was based on a tertiary center. So I was working with Children who are on parenteral musician, so nutrition through a vein and Children have had kids who are on dialysis or had kidney transplants. But current job. I've just gotten back to the pediatric cardiology ward that you saw it on in that video the beginning, and that's another territory center and were one of the two transplant centers in the UK And then my final job is gonna be in pediatric spirit, you medicine, and we work with kind of Children with cystic fibrosis am Children who are mountain, mental, Asian. So have things like tracking us to me and things like that, and the reason why I've kind of written those am specialties down. It's just a show like how very pediatrics is also am because of the way pediatrics yourself, where this territory can't Children's hospitals and big cities. And it does mean that sit at every single region has like a different special interest. So Newcastle, where I work the cardiology centers really big. We have a very big boom, our transplant unit. But various other regions and very of the hospitals around the country will have their own kind of special area. So, for example, leads has a special interest in liver, and a lot of the pediatric patients have liver problems. Go there and and then in my second year is a bit more general em. So I'm going to do six months on the neonatal intensive care unit and then six months in general Pediatrics, a district general Hospital on that were involved home in clinic M so seen Children as outpatients and also taps sometime in and safeguarding as well. So I wanted to talk a bit about what typical day is for a pediatrician, specifically pediatric training. And I actually found it really difficult because it is so variable s So this is an example off when I worked in general pediatrics and a typical day, and this is at 8. 30 to 9 o'clock a day. So it is a long day on on call day most of your standard days, that sort of 8. 30 to 5 eso normally and every pediatric department of work through this the same if you start your day with half another of teaching and and that's the end of some people night shifts, which can be a little bit difficult, and you don't have a period of fun do for I'm following that, you go on a ward round. Mm. This is another kind of unique thing to pediatric so it tends to be the start off with consultants and registrars can split off. And then you'll come back together at lunchtime to discuss all the patients. And you do kind of ward bored around and coffee and catch up and get the opinions of the consultants in the various patients. Then community gets lunch, lunch before you do you just for the war drowned in the afternoon in most pediatric places. You then do a kind of second war drowned on their cost called tee time reviews. So those patients that weren't quite well enough in the morning but might be well enough to go home now and then seeing again or patients that concerned about that might be unwell. At the end of your standard day, you turned 100 with the um, called Team and then a lot off your out of ours were called Uncle Work may even be based in the pediatric emergency department, which is slightly different in other areas where you work when you mainly toward based and then ending with the handover. And then I just wanted to show you a bit of other things right end up doing during the day So one thing I quite like is when a month cycle. I just want to go to the bathroom to hold my baby absolutely, and always got time to could less more, baby. And we always have medical students around because they're all doing their child. Health blocks him in lots of centers. And the Shoch, the kind of my level of training run the prolonged jaundice clinic. That's babies that remain jaundice After saw three weeks of life, it might be that you have a baby come in with a temperature and you have to do what's called a septic screen. And so that will include putting a commuter and a baby, taking a lumbar puncture and potentially either doing a super pubic aspiration, which is where you take urine from just below the belly button or doing a catheter. Um, you might want to say time to speak to a teenager. He's potentially being bullied and chooses to open up to you about that on. We have a special tool for talking to teenagers about potential social issues that might be happy. There's also opportunities for order in research, and we can get involved with it might be that your consultants doing the safeguarding medical, you might want to go and see that. Or, as I mentioned earlier, you might want to go read a book to a toddler just while then one pops out to get some clothes or some food. And finally, something that I think is kind of unique to pediatrics, particularly if you work in there a big hospital. You might be asked to attend a trauma call as the pediatric representative. And so I've been to like things that car accidents and major burns as the pediatric am dr. And then you all that kind of help with the prescribing of fluids, assessing the child and under cognating the child. So that's a little bit about what am pediatrics is like and why I kind of would chose pediatrics. And but now we're gonna talk about about the application on the interview and just to cover you up to that, um, I applied during the cove it 19 pandemic, and so some things were slightly different. But I would try to include a bit about what it was like before and covert and what it was like afterwards. So just some of the basic application and kind of fax. It's national recruitment, and it's usually at level ST ones. That's the first year of pediatric training. However, there are a few fast track options. So, for example, and there is an option to apply later one to become registrar if you got an equivalent experience or if you've been working abroad in 2020 there were 712 Africans in the UK for our 461 posts, and with the majority of those being invited to interview the data from last year, which is when I apply, it isn't available yet, but there were a lot more applicants last year, but I think that was representative off all kind of specialty applications of the whole empty to the covert pandemic. So it's similar to, or the applying for other specialties. You apply in kind of November time interviews of February march, and then you get offers in April. One of the other kind of Bunches is that you don't start until September. See, you got a nice month off in the August to enjoy yourself before you start your training. It just mean you always slightly out sink with your friends. But under the kind of good thing about it is that, um get all your some Aleve at once. So you know what your PSA really is gonna be until the end of August in advance instead of changing at the start of August. So I think a lot of people worry that they need pediatric experience to apply for pediatrics. And the RC PCH, which is the World College of Pediatrics and child health, are very clear that there is no requirement at a little of prior pediatric experience. And that's because they recognize that this could be really challenging to get. What they're looking for is that you haven't understanding of the specialty of passionate about it and that you haven't aptitude and the motivation to do the specialty. So you have those transferrable skills, and that can be applied to pediatrics, a specialty on that you want to be a pediatrician. So instead of a kind of portfolio, they have a complication form, and this is just some of the stuff they ask about and what they want you to do basically is relate Any experience you have to pediatrics, if possible, and on they use this to decide who to interview one thing that just to notice that in a lot of areas they kind of score them between like three and five on the top marks were for your ability to reflect. And so they really appreciate the kind of scale of reflection and in pediatrics. And that's reflected throughout the application process. So things you can get points or are additional qualifications, which things like like I had my post grad. It's difficult medical education or you could have a master's degree, but that's definitely not necessary. The other thing you can get points for is for doing the MRI. See PCH exams. However, that is definitely not essential. And I do actually know many people who had their exams before they applied. They then ask for transferrable, clinical skills and transferrable clinical experience, and again that definitely doesn't have to be in pediatrics. And they're just looking for a kind of your skills that you have and how that could apply it to the specialty, but then ask about kind of quality of proven hold it. Any leadership of monitoring rolls you've had any at all academic achievements, any involvement in teaching And then finally they just ask for supporting statement where you explain why you want to do pediatrics. So as you can see, it's cracked. General been quite similar to lots of all the specialties, but with no requirement if you having any experience in that specialty. So if there were successfully shortness study that invited to interview, and I just put this into how it was pre coded on post over it. So Post covert it's been a virtual interview. I don't know. Hold on what that will continue by. Imagine that settled will be similar, and there's four stations AM So there's a communication station where they have a child or parent actor and and you have to kind of discuss answering difficult with them. So I think some examples of like a patient with asthma who's wanting to be self discharge or I had a trail to you, and the nurses were concerned that they might have a low mood, and the other one will speak to them about actually speaking to a mental health. A team They don't have a clinical reasoning station, which is kind of like an acute and scenario of a child who's and well. But they they don't expect you to operate any level higher than a foundation doctor. And then they ask you about why you want to be a pediatrician, and they ask you things like, Why would you be suited to this career? Have you got any role models in this specialty? And then finally, they just ask you to reflect on instant you've been involved in, and they give you the questions for that in advance, and I think it just hurts again. How important they you reflection within the specialty. It was relatively similar and precoma it just that they had a slightly different station on prescribing M, and that was the main difference. The portfolio station was very similar to the Korean Motivation station, so obviously in experience isn't required to em. But there is ways to get experience if you want to see if paediatrics see you. So I think just the medical student, the first of all think I would say, is just to make the most of your pediatric placement. When I run the pediatric place, it's wroth and 50 is quite flexible, and if you're interested, they lose opportunities for you to get more involved. Also, pediatrics is not the only specialty way. See, Children, I've got a less difficult. This passage is maybe see Children and at the end of my slides, but just make the most of any place that you have and and take the opportunity to see Children. If you count, most medical stores will have some students like two components or electives. Am I did my elective in child health insurance, and then I did do a machine static really been safeguarding I get. I don't think that's essential. Most medical schools have lots of opportunities for volunteering with Children, either separately or through student societies. So there's lots of things like 10 about hospital, where you go into schools and kind of educate Children about going to the doctors or this. It's lots of societies where urine can be taught CPR with things like that. There is a national UK expire in pediatric society, which I would really recommend joining, and they have lots of lots of conference years, and resource is and talks and and you can get a mentor through that as well. Them as well as each individual medical school often has a pediatric society, which mailing cook with the UK as far in pediatric society or be independent. And they often have conferences and opportunities and mentors through that, and second to last. The actual RCP ch website is amazing. That hasn't made a student. You become a member for free, and they often have prizes on tickets, the conferences and other things that you can get involved with. Side really recommend recovering a student member of the RC PCH. And finally, you could do audits and research products if you would like to. But again, that's definitely no essential. So moving on to gain experience as a doctor, I could just put this up with the foundation doctor. Then Post Foundation is definitely never too late to develop it. Interesting pediatrics, And they certainly look on years out of training quite favorably. So they they definitely don't mind you having more experience outside off our nation training. So as a foundation doctor, you come do pediatric rotations and they are useful, but there's not loads of them m. So they're certainly not essential, and all that kind of said a few times you can get loads of skills from other specialties and see Children of a specialties. There is always the opportunities to taste weeks and most pediatric hospital's. Were you more happy to have you for a taste a week? You can actually even apply from any kind of determine the country to do a taste to make it great on the street, for example, you can do order. It's a research products again, but again, they're not essential. There's lots of conferences and curious events that you can attend through the RC PCH or the UK Expiring Pediatric Society, and you can actually also do some pediatric courses. So when I was doing a foundation doctor, I did the Advanced Pediatric Life Support course, which is the kind of pediatric quibbling off the advance life support. But there are the courses, such as like a newborn life support that you can do a swell and then, after completing urination training, there's loads of posts related to pediatrics and out there that can help you get some more experience. Just if you want to see if this is for you. So this stuff like what I did, which is the teaching fellow post. You could even be a clinical research fellow. One of my friends is working in Liverpool and as a clinical research fellow with spinal muscular atrophy and kind of felt medications, world looked. You could get a trust, great job and in a trust or hospital, working in pediatrics. Quite lost places offer those Indian eights because you don't tend to get that which, experiencing the elites clearly wanted your trading on for the can go work or volunteer abroad. And lots of other training is that I went with the moment of where to need a New Zealand or Australia or quantum work in various parts of Asia or kind of Africa with, like medicines without Borders and things like that as well. So just to kind of little list of other specialties that involve Children. I don't think I fully appreciate this a total until I started my pediatric training. But we went with all the specialties all the time and surgery, probably the biggest one that are surprised about So most surgical specialties will have some pediatric patients, particularly plastic surgery Ent North pedic so, and there is also a subspecialty of pediatric surgery, which is only training through call surgical training. Mm, pretty much every specialty other than kind of most the medical specialties, you will have some of the involvement with Children and the exceptions that our cardiology, where we get involved with our cardiologists and hematology, which cross covers pediatrics, is well, so any of these patients that you're odd you can and go to clinic, explore, try and see Children or get kind of introduce. She's after the consultants, almost straws that work with Children in that specialty. So just a few top tips for applying and kind of thinking about pediatrics, basically just a well rounded CVS Fine. You can kind of do any audits or products they don't need to pediatric specific. And they seem to really light reflection and said, Try and develop your schools in that relate your other experiences to the specialty. So kind of examples I often use is taking a collateral history and care of the elderly is quite relatable to pediatrics. Very similar skills. If you've had a job in urology, you down to love a puncture. We do lots of love of punctures all the time, or, if you've worked for a while, had a place of in a surgical specialties that I ent absolutely go like that and you've been seeing Children as part of that. And finally make sure you join the RC PCH and keep a eye on their website of the UK Spiro in pediatric society. Okay, so just the final section of the talks so bit about the trading pathway just as a kind of coming out before I start talking there is, and the pediatric training is undergoing a transition at the moment, and so it probably is going to change over the next couple of years. The estimated date of it's starting to change is just next year, 2023 but they're not. It's no 100 clear how that's transition is gonna happen. And so I've got the current training pathway, which is what's really get the verb it on the the future training pathway. But you'll see that there's no actually that much of a difference. So this is the current training pathway, and it's eight years, as I mentioned earlier, and it's completely run through. You don't need to reapply any point. It's currently split into three levels s so that's kind of the starting level, which is, you know, one tier three, and that's when you're expected to do your examinations. I'm in the evening to spend six months in general pediatrics and six months in the dates present, the level to which is your three and your fear. Four year five. Sorry and again you do the late in that block. General pediatrics on some community pediatrics is well, And then you could decide to that you want to be a general pediatrician or you want to subspecialized and you do that Level three, which is your 67 years. Eight. So it's essentially call training them specialty training, the training program that's going to be coming in every on 2023 I think they're going to kind of transition. Everyone across to is going to slightly shorter, so it's going to be seven years and it'll be split in two. And the idea behind this is that it's a bit more general and but also that there's a bit more support around you, transitioning from being It's kind of a future or CD a house officer to be the register, and they want to provide a bit more support for this. Also going to be a bit more time to do those exams. So having mentioned exams just a little one through of what their what their relations are so well in, you saw first partly training those three written exams. They kind of am kind of logical in the way that works. So the first one is about, like diagnosing medical problems. The next one's kind of like the pharmacology of the physiology of the conditions on the Final One is thinking about what investigations you write. Do not management you might want to kind of put in place on. Then, after you've done your Rituxan exams, there is one clinical exam, which is like a big boss key way. See lots of different Children and kind of do communication stations of examinations and things like that. What you passed those that's actually all your exams done. And there's no exit exam apart from this started sample, which is kind of like a multiple. Many interview for the training is just before the year before they call a consult to He's not really an example. Of course, it's kind of more em sit down to see how ready you are to become a consultant that if there's any areas in your portfolio that you need to work on before you start applying for consult jobs. So I just want to show this, like because I think people aren't really wear off em the procedures and the wide range procedures that we do in pediatrics. So on the left of the screen under Monday tree those are all the procedures that I need to be able to do within my first few years of trading. And we're probably one of the only of the specialty. The party, like anesthetics and 80 are required to be able to intubate. And we need to intubate, um, newborn infants. Now we also put in a while called like essentially cyber central line through the umbilical court, and those are essential. And procedures for our trading on the right is kind of just a small summary of the other and kind of no compulsory but possible procedures that you could be involved with. Um, particularly common. Interesting ones are kind of putting in the needles, so interested in, you know, switch it into the bone. I am doing chest rates what she do quite often or them they had eight AM of the super pubic aspiration of urine, which I mentioned, which is where your your every sample from just below the belly button. I know. Uh, sorry. I think the audience are having a bit of trouble seeing your slides moving. Okay, We're on the slide at the moment, saying gating experience of the medical Cute and Oh, right. Okay. Sorry about that. I didn't realize that people work in trouble. If it's okay, I'll just sorry about that. All right? I'm sorry. I'm just trying, Michel, I screen. So that's C gaining experience. Is a medical student slide. And is that moving along to the next slide? Yeah, Yeah, that's fine. It's now I'm gaining spirits. The doctor is that other slides moving alot? Yeah. Say that's showing other specialties involving Children. Okay, joints, just quickly recap those sides that we've missed, or I think everyone could still here. So maybe just just to pick up where you where you left off, If that's all right. Unless any other people have to go through anything, just pop it in the chart. Yeah, we can give for it. Okay. I am sorry about that. And so that's just the list there of the conferences that we were talking about, Um, sorry that that didn't move along very well. And so there's just a kind of exhausted list. I'm on them right there. But I did just can't tropic a few of the more interesting ones from the portfolio and and then just final sides. And he s so one thing that run through training kind of scares people, I think, because it's I get along this commitment. So 7 to 8 years and that one thing to say about pediatric training is it is quite flexible. Um, so there's a few out of program options that you can do, and you can do these for foot from ranging from six months to, uh, to three years and the Royal College divide them into these categories. So the first one is a career break. So that's just a little bit of time out of trading to do some traveling or tend to have a family or something like that. And the next one is experience, which is a bit of time out in where you can get experience, and that's kind of outside of working in the NHS. So for example, going to volunteer. One of my colleagues want to work in Tanzania for a year, or you can go work it in one of my concerns, goes and works in the Philippines with the class palate service there, and and they really encourage that on there that you have presets programs to enable you to do that. Um, and the way they defined it is the neighbors help support healthy of all the countries that's awesome and out programs for extra training. So, for example, he work region that doesn't have a special interest in a certain area. You might want to go work in another region for a short period just to see and gain a bit more so colleagues. Last year he worked in Scotland, and then he moved to our region just for six months to work with Children with cystic fibrosis. And it might be that you want to step out of training for a year and do that kind of out of program, posting something completely different and so off work in health technology or something like that, or you can do research so a lot of people choose to do a year and a master's or the right to your three year PhD. And you can do that alongside your training and or take a period of time out to do that. Okay, so I'm sorry about what slides not moving along, and that's my last sides. I'm still leave that for now because I think that's the QR code in the feedback him at the end, and it passes over to Frankie to kind of chair some questions. Thanks so much for that. I know that was a really, really good overview. Pedes. Think I'll definitely let's and things I I didn't know about Peed before way only have one question from the audience at the moment, and it was about the 00 P. E s. Someone just asked what your personal opinion is off them. And maybe you could just tell the audience a little bit more about about those programs after the out program. The out program? Yeah, Yeah s Oh, I haven't am done. One myself and I have had several colleagues have done. Then I think the most common one is research. A lot of people have some time out to do kind of a master's degree, or M a p h d. And that's quite common, particularly people have chosen to subspecialized or work in like a relatively academic hospital. The one that's kind of interesting to me, I think, is the kind of experience one, which is where he gets going, work in other countries on the RC PCH websites got really good page about those and what those are available. And so one of my registrars at the moment, who is a pediatric cardiology training now he went and worked in Tanzania or think for 12 months, actually, and worked in a kind of new nasal unit there and which was like, I'm kind of quite rural, rural and and he was kind of helping with babies have been to live in prematurely and then running like vaccination clinics and things like that, and is relative flexible in terms of taking of career break and empties and training or have family. But you do just need to apply through the or local Diener e and kind of explain why you want to do that. But usually relatively supportive and then it's quite common for people to Diovan do like a fellowship in a sentence this effect topic around the region just because pediatrics is a small specialty. So you can't get away The experience, right? Want him in that particular and regional for example. And quite well, people like to London or I am one of the other big cities to get more experience. Okay. Yeah, that's really interesting. I've never actually heard of those programs before. So you did you say there's information on that in on the off the page website? Yes. So the Royal College of Pediatrics and Child Health website start like a full page on it. And and then the kind of topics on this line I got from the seven Denham Me pediatrics website, which is one of the kind of demon reason alone dead. And they've got really nice pretty town of all the opportunities you can do. Okay? Yeah. Yeah. And they're not that. That sounds like a really good opportunity. Especially if you don't have the chance. You know so much earlier on in med school and one in your F one f two years. So you know, just to the audience, just carry on putting questions in if you want to ask and or any I can just ask any. But, um, I've got a couple of my own that will protect you, help the audience get a bit more information, and then we can pick up anyone else with any of them. Why did you sort of pick pediatrics? And what do you kind of enjoy most about the specialty would use a path. And they, um So I think from from the start, I am. I kind of am, Really? I think it was that, like, trigger, it brought the baby into that to kind of, um, electrical. That really made me want to do pediatrics initially. And then on the back of that, I arranged like to do a project with him. So I went and spent a few weeks in my summer. I'm doing like a research project. I'm working in the eights and on that it was kind of what may be interested in doing the specialty and why it's really more about it. And for me, I think the main thing is working with Children. I just really enjoy it. And I think you could be having the worst day and then you'll see the most like smiley, bubbly three year old who was really ill yesterday. But today is those better, and that just really makes my job with while I really, really enjoy. I'm kind of the diagnostic aspects of it because we don't do that many investigations. We don't do that many blood tests. So if a child comes to a any and we don't just order three Catch six Ray in a blood test and we really think about any tests that we do a masters of that after really rely on your like Christmas skills and under, really think about them kind of coming up with a differential diagnosis before you go ahead and order those investigations and which is something I really like and you also get to see and then kind of at the start of anyone that illness. So, for example, even like type one diabetes or metabolic condition, we're kind of right at the start noticing left, and I'm kind of working with their Children from the start and which is something. I think you maybe don't get as much in other areas, and I think finally I am. I just kind of do quite enjoyed doing procedures anyway. And that was something that I wanted to do my job, and and there is definitely get more challenging aspect of procedures in pediatrics and in terms of making it for it and making it not scary. And then actually, being more technically, comics that a challenge in this world but typically involve the small babies. Yeah, okay, Yes. They're quite a lot of things that you're enjoying buy at the moment, then. Hey, is there anything that you personally have found particularly challenging in your experience so far? And yeah, I think so. I am. I think probably the challenge of its are The main things are being involved, and safeguarding can be really challenging. But it can also be really rewarding as well. So we do see some kind of difficult cases. But I do think I'm kind of advocating that child recognizing those concerns and escape them and being involved process is also really rewarding and also like, particularly in pediatric cardiology, unfortunately, and so my Children don't make it. And there is quite high mortality, particularly in that specialty, and that could be quite challenging. And But because of that, I think people are very supportive, very aware of that, too. And a lot of my colleagues have really, like, close and kind of do lost outside of work are always there for each other. And if we've heard that someone's had about shift, you always track seeing a mess. Check in there, Okay, Iranian to me, off for a coffee. And so although there are, there's try and in aspects of X, and I think there are the positives to and personally like, I found all the specialties quite emotional challenge in Children that peter out just like I'm quite rewarding and because I feel that the kind of benefits of it outweigh those kind of emotional challengers. And I guess it's a bit independent to you and how you feel about that. Yeah, And you think there's quite a lot of support in the specialty, so that balances the hard bit, the headache and and just, you know, as a medical shoot myself. I know that it's quite, um, it's a bit hard to know where to begin with all this, all this Cleo things and how to build an application. I just wondered to the medical students watching, then did you sort of start with your application, sort of thinking about doing things toward your application. And what sort of things did you do, you know, really on to get got bitten. To be honest, I don't think I actively was like thinking about doing stuff, um, application. But because I was interested, I kind of just naturally ended up kind of doing stuff that ended up later on being beneficial em. So I think main things are as as they make the most of the pediatric a place that they have. I think it's very easy because there's so many copies of the only new specialties and only suing new like diagnoses. So they're about to get kind of like I'm drawn into the kind of getting pretty kind of am reading the textbook rather than getting involved. And I think just really throw yourself into that clinical experience and a lot of the consultants of really keen and want you to get involved so it's worth asking them can come to clinic. Is there anything that you're involved in? And then any kind of I look, I decided to do that. But some of Tekturna was like a some of the such product, which I mentioned, and Indian eight, which was really, really worthwhile and and then arrange kind of students like to propose electives in that specialty. And but if you a lot of people come to pediatrics quite late, just because you don't experience it until that made it to one in medical school. And that's fine, too. And but kind of trying to make the most of those experiences that you can is really useful. And the RC PCH website is really, really good with the student memberships. Really good. So it's the UK expiring pediatric society and they've got lots of watch. It is for you. Hey, Fab. Yeah, that's really interesting, I think also, you let you saying that application sounds a bit morphine exhuberante that position office specialties as well. And I was just going to say, Do you want just popping the page up with the QR code? And then people can be newly do that. We've got the link on there as well for the audience. We got the feedback link and there was just two other questions from the audience. So one of the audience members off, How do you keep up to date with your medical knowledge up. You know, now you're in the pediatric specialty and I said, I think one of the things that is definitely different uh, pediatrics is we do have quite a lot of departmental teaching eso sort of every morning between half eight and nine or in currently on my job 8.5 8 and the trainees get teaching. So that's really good. And it kind of means that you have kind of training and teaching every day, and I haven't experienced that with other specialties. Much that's that's really with while. And we also when you're in training, get regional teachings. Oh, mood's actually this Wednesday one day one. You all meet with A with the other trainees at the same level on have a full day of teaching, and you can also take lots of study leaves. So and you could do courses if you want to, or potentially prepare for it comes on. I think having exams at an early stage in your training means that you kind of driven to you. Let it more do you own kind of leading outside and inside of work, and but I think the clinical balance. And because there is quite supportive in the C is quite approachable. It means that if you want to go to clinic other trading shadow of safeguarding medical, for example they usually quite open to doing that starts using the main things. I d. Okay, so lots of opportunities, then, Um and we just got another question asking, How do you manage difficult Children? I can't imagine it being quite different toe adults. So I guess. And difficult just, I guess. Do you actually mean like, if they're being like, um, I guess it's kind of different? 20 On what their ages? I think probably the most difficult age that I find to manage is like the kind of 1 to 2 year olds where you can't explain to them what's going on. So that obviously really scared, and then you're coming out the refund you don't like. I don't like to. So come near me on. That could be quite difficult. And But we have these amazing. The nurses are amazing. I have to say the pediatric nurses are credible on They're really good at kind of helping me with those situations, and so you never do a procedure on your own. Always take a nurse with you and we do have special treaties, a special kind of health care professional. So people like play specialists who are specially trained and also have degrees in essentially play therapy. So and that's kind of making situations less stressful. Food play and most wars will have that. We also have lots of lots of toys in Reblood room. In my current place I work. We have a three D televisions. They get pretty glasses and they can, like, watch this like it's like an under the sea seen. And that's like If I if I exceed while you do the blood tests and we use numbing creams, well, so once you put the cream on the three D last time, they don't even notice what you're doing most of the time. The other kind of side of that, I guess, is kind of the adolescent age group coming kind of child coming quite challenging, and I'm getting the bottoms right of being kind of broken and approachable. Also recognizing that you're in a position of authority could be quite difficult. Getting that balance could be quite hard and But there's lots of resource is, and there's that kind of consultant to specialize in your peoples medicine. They're always approachable in situations. And so I guess that's kind of how we 100 that sounds. So that question that's really good question. Yeah, I think I think it's true, isn't it? Is very different, because I mean, like, your slides, you know that. Think medical students all terrified Pedes. And my experience is it during exams on them, you just have to be so opportunistic and, you know, get them while they're not crying. If it is very difficult is very different, you know? And Roget must be quite challenging day to day what you say you're You know, if you love working with kids and what's you, then I'm just gonna make sure we haven't got any more questions with me. Just one second new minutes left. Wow. I think that's all of the questions from us. And then we have or anything else comes through in the at the moment. Um, so people have got the c that link. Thank you so much for that. That was really interesting. I'm sure everyone really enjoyed it. And if you've got you put your email there. So if people would argue anymore, I just put the link for that video in his while. And well, I can get Use it. You milligrams something like that. And in a while, you don't let me. Well, maybe it's probably quite easy to access, but it's just on YouTube, and it's the jury hospital. Kit him on YouTube. Okay. Sure. And you want me to join me to post a link on the chart? And yet I'm just I just find it really gets me and I go, Oh, you are not going to even pop it on. I don't know. Yeah, because I'm in front of the video. The links, all that. Sorry. Sorry. No worries. And just before we go 11 other question just came through us in international Medical shooter. They're able to join the societies that you mentioned such a z u k a. P s. Yes, I think so. I do think is any restriction and the UK one maybe might be slightly restricted by Don't think so. And artie PCH definitely isn't because, um, a lot of international kind of like training is pediatric training is on the first of the RC PCH and on the international conference is so I think that comforts last year was like in It's Singapore eso They often are here and kind of international. Well, so I don't believe it's any restrictions. Definitely not for th but I don't think so for you k a p s either. Okay, home? Um Well, yeah, Thank you so much to that is the the weapon, or we will be going up one to YouTube. So if anyone missed anything and wants to have a check, they can go on there and have a look when it's uploaded in about weeks week with those time. And then, yeah, you guys will get your certificates if you feel in the feedback. And the link is just in the chat there. So thanks for everyone for attending a Z well, and thanks. And, uh, so we'll we'll side, I think I don't see Like to thank you