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sorry, sir. I'm trying to sort out some people. They are having issues logging in. That's okay. Yeah. All right. So I think we can start now. Okay. All right. So before we start, I would like to just briefly do a very short introduction about Speaker. So my name is Armstrong. Nicholas, but, you know, be a moderator for today. Um, our speaker is, uh, Mr Benjamin. Oh, maybe. And, um, it's really an honor to have him here speak to us, because for a couple of months, I've been trying to look for people that would help put us through in regards to the training pathway for characteristic. So during the UK and I was lucky enough to come across him via Facebook. And, uh, he was, uh, agreed to speak to us today and his portfolio every, uh, it's quite long for me to be measuring everything, but, uh, everything is detailed on the poster. And if you went through the description, the poster, you know that he's not, uh, someone you can easily come across. So it's quite a privilege for us to have him script to us in regards to this topic and offer us guidance on how to go about our our hospital and building are saving regards to cardiothoracic, uh, cardiothoracic training in the UK. So, um, you'll you'll be having the floor announcer and we look forward to getting from you today, sir. Thank you. Okay. Thanks for the introduction. Uh, it's an honor to be here to speak to you guys. Um, if I may might just understand the kind of audience will deliver today If everyone could just say where they are in the training partner or something. Just have an idea whose? My audience. Okay, So, um, uh, for them to speak out have to bring them, uh, phone works. But however, I know most of them, uh, audience. So we have medical students from year 2345 to 6 family medical students. And then we also have early career doctors from house officers also have people that are doing N. Y. C. Then we have people that are post club too. Okay? Yes, sir. And then we have f y to use, like a few f y to cut across. Yes. Uh, thanks for that. I'll just share a slide of mind, and hopefully I'll talk for, like, 20 minutes. Uh, we can share some discussions and questions if I could. There are many. All right, That's fine, sir. Can everyone see my slides, if possible? Yes, sir. Okay. So I'll give you a brief talk on quality part ways to cut it to a six soldier tune in the UK. Um, every one of us have different pathways we've followed to get to where we are. Uh, it's never easy is, but it's it's not impossible for for that way. Uh, I will start to give it. Give it just like a small history of my own experience. So, um, I would say I started training cataract surgery maybe about 12 years ago. Now, uh, to in Nigeria. Say, registrar, you know, more rotation institute, general surgery, and you start your senior posting characteristic surgery after my turn. Nigeria After cataract surgery, I came to the UK to get more experience because, sadly, the experience we get in that's this part of West Africa in Africa is not enough to be a if, I say, a day one world class conduct thoracic surgeon who can do all the variety of cases in the specialty one of the skill that's in Nigeria training to need more even do my training Nigeria to go to the country to India, spend, uh, over a year there to get experience. But in all the case, you're still you're still not good enough. So I came to the UK to get more experience, and I will share the pathways. I believe in the UK for different people in different parts of their career. Uh, first light here just to talk about some of the some of the big names in character surgery just to excite us about, uh, those who have experienced it actually does all these faces, Uh, gentleman here, Uh, it's a guy who people don't know about his name. And it was an apprentice to this surgeon here and this cat allergy lady here who developed the first shots to treat blue babies, people who have signs of heart disease. He was a gentleman who work in the lab who described the procedure in dogs. But unfortunately, when they went to the patient and the only surgery in a real patient, he was in the background telling him what to do. But however his name's we're not in a book. His name is Vivian Thomas. Uh, this is the first half transplant. Don question, Barnard. Uh, these are the 2/2 biggest news in cataract surgery in the United States. Uh, dental Kolia Michael DeBakey. As you see on the the newsletter here in a bitter field. Uh, they had two of them and they didn't get along too well each other. But they're disagreement tend to push the frontiers for cataract surgery as they try to outdo themselves. And they're quite bought a lot of back surgery in their time. Sadly, they're both later now. So what is characteristic surgery? Entire entire thing. It's a It's a large group of things of specialties. So you have correct surgery, you have to ask surgery and you have a cardiothoracic surgery. In some climbs. People are involved in both. In the UK, you're going to train in both, but at the end of the end of the training, you have to specialize in each or one of them. So, in the back surgery, what we do, uh, is from Celtic surgeries to quality CABG, which is coronary artery bypass. Grafting to avia means aortic valve replacement and TV is an endovascular procedure to replace the aortic valve transplant psoriatic valve implantation, mostly done by cardiologists in the UK but in the US and um and Europe, some soldiers also do these procedures. You have mitral valve surgery, and you also have congenital cardiac surgery for traffic. Surgery is mostly for lung cancer, lung volume reduction, track your surgeries, benign thoracic tumors, surgery and also fragile surgery. Unfortunately, also for your surgery now is in the hands of the upper and lower GI eye surgeons. And no more on that thoracic surgery as it were then. Other areas. Transplant surgery, which is combined between correct antibiotics, trauma and now the evolving, minimally invasive and robotic surgery, is born in thoracic and the cardiac surgery. So I'll give you a good description about what you expect to do as in the life of cardiothoracic training. So I'll just give you at least this will be like a preamble before we talk about how to get into this training. It's a tedious life. The TV a specialty. Uh, I wouldn't say it's for the best of the best, but it's the screening process. To get into training is quite tedious uh, there are two parts of this. This puts the whole process of characteristics. Training is one to get into training, and it's two after training to secure job. You don't have a 20 forever, so you want to get trained and secure a job. These are two different parts, and, uh, we'll discuss it for as we go on. So let's imagine Come in the morning to work. Uh, most times you have a team team breakfast, either in the theaters or the I see you teeing handovers where the like 19 discuss it with the dating or the dating because of the theater team, what the plan for the day is and mostly place to start by 7 30. Some place that about eight o'clock in the morning, so it's an early riser for everyone. Then you have the If you don't call him, we'll do the I see rounds. See the POSTOP from the day before and any other problems you have during the day. It's a quick round and around, so you can able to go about this business. And if you're in theaters, knife on skin, just try to try to get on the skin as quick as possible. So from eight o'clock, you're already getting the anesthetic supporting lines in the patient. Uh, 20. You're meant to be observing these things being done. Uh, at times you have to be scoped before intubation of ventilation. You have to make sure the patient has properly positioned and you make sure there's, uh, the conduit. If you're going to do the graft like CABG event graft, chest lean harvest. If you don't evolve, you check your website is okay. If you're doing a robotic procedure, you check if your condo it's appropriate for the procedure. Uh, in the beginning of a 20 McG understand what all this means, but you should show interest by reading before you proceed your computers and you're basically assessing your your swab, your consultant or your senior training during the case. And that way you learn sadly, surgical specialties training is not by textbook. It's my apprenticeship. You learn by observation and you learn by training your hands and the day starts and this is what it looks like in theater. Uh, large team. Correct surgery? Never simple. You have a surgeon, an assistant person surgeon says that sometimes have a second assistance. It could be also a registrar, oil and SCP, which is surgical care particular. You have the Scribner's. You have the emphasis on the head and the assistant. You have a running team. Uh, you have a profusion is Imagine the Bible system, which I will show the Bible system. This profession is here. Imagine. Bypass system. You're just an assistant who wants around for him. If you need something else, it's quite a large Terminator doing the cases. Uh, so nice and skin open the chest is what you see in the heart is is completed procedure already. You can still incision line here possible, and then we'll talk about replacement here. Now, this one looks like a nice, beautiful case. Don't know much bleeding. Everything looks nice and clean about to close up. Uh, these are the tubes to drain the heart and 20 half on this tube. Get the report back on the heart. So is it covered by bypass instituted in this patient on bypass? The heart looks to be arrested here and still an empty ready for surgery. And this is a case of coronary bypass grafting can. If you look closely here, you see a vein graft been stitched on to the vessels in the heart, and that would treat the angina and chest pain this patients would have had after surgery is done. Well, it could be five o'clock. It could be earlier. It could be later, uh, initiated to the I see you most times intubated. You can see this, uh, stack of devices or supporting drugs for the patient. Go to intensive care trains are in and, uh, wait for recovery. All the things you have to do as a register or as a trainee will be to take on calls. You have a device called a blip troubles you all the time. Get referrals from this blip. It gets on course for from this delay from I see from anywhere in the world clock arrest to come to this blip and the last You know the problem. You see the number there and you push down there to treat the problem. You have clinics once or twice a week. You have MG T s once or twice a week. You also encouraged to be involved in research audit, uh, educational programs and being attempt to try to build yourself as a leader and gain management skills doing your training, training and mixed you to be a complete doctor. So you're not just a clinician or a surgeon. The theater we'll say a manager and your the hospital researcher and you're a leader. End of your team. Now, what are the pathways to training? Uh, I would say for I think most of the audience are people who are who are the most part, uh, u K citizens or not trained in the UK So party for training. Basically, I would call it three pathways. According to the GMC, the first part was a national training part way where you get a national N t a number of the national training number and you're even a formal training as a UK uh, training in cardiothoracic surgery. That's one pathway that will lead you to have a C c t uh, C C. C means certificate of completion of training with the CT. Your GMC register. You as a specialist on the GMC Specialist Register register on that one. Once you're not register, then you can apply for, uh, consultant jobs and go for interviews and slug it out with all the other, uh applicants and hopefully get a job. Your lifestyle as a consultant, the pathways called a Caesar partway C e s r is a certificate of, uh, eligibility for specialist registration. Uh, this pathway is most times for people who have had training overseas in the specialty and do not require additional training in that we get as in the international formal training, uh, some of them may need an extra exposure to the UK system. First, get some exams done, and the you you all need to do at the end of the day is to mirror your portfolio with portfolio of the national trainee. The syllabus is same requirements are same. But in this case, you're coming from not the front door. You come from that door. So you need to get in the mirror yourself as a trainee who has been doing training for 6, 78 years and submit the same evidence to the GMC. You are such a document and say, Okay, I think you are equal to our own final trainees. Quite straightforward. A year the you before Brexit a few years ago. Uh, if you trained in the EU system. You walk into the UK and you get automatic restoration onto the register in the UK, and you can apply for jobs. As a consultant, you don't do any exams, don't do anything else. You just apply. And the register, you ask a specialist. So I think it's the 1st 20 pathway, which is the national training part way. Uh, this national training part way, Uh, this what I'm showing you is changing from next year. Sadly, now we have a record your own true training. You want to training whereby you get screened into, uh, national selection program and you start your Phase one training, which is the first two years of junior training. You do characteristic exposures in the world. The I see you and theaters for the first three years. Uh, that will be put on the spots were able to see this one. So that's this part way. The first two years Here you are from ST one. Here you are from applying here we get into ST one, which is S t one s t two s, t three especially is 21 23. During that time, you're going to do your MRC ex examination with your membership example, the College of Surgeons. Uh, during this time, also, you are bringing your portfolio of cases. You are, uh, cases mean either surgical cases or case based discussions or, uh or, um, C section called. Um, when you examine patients in the world, you can get signed up for small procedures, small interaction with patients. And this assesses your progression in experience. At this point here, this transition to phase two, we're now in middle grade training, and now you get to do more in theaters. You're going to take us more. You're doing more cases. You're handling more on course. Now, uh, you're doing on course as a stand alone registrar. Uh, your night shift and I see you just be open and you're there. You're handling research. You're doing the audit you're presenting. National conference is an international conference. Is So you're beating yourself as a med a great surgeon. Uh, and you get to this point here. This is where you have now how to do your, you know, be eligible for your, uh, what you call the f r c e X exam, which is the exit exams for characteristic surgery. Um, it's it assesses you to be at a level in court of a day One consultant, uh, in a sense of decision making, uh, basic operative skill. And yeah, And if you pass that exam and you progressed to the last two years of your training at that time, you could now calm down to either cut back surgery or thoracic surgery. Or you could branch out actually to congenital cataracts surgery. If you so desire after the the completion of 70 years on this point and you have what we call the national training is you have what's called yearly A R C. PS. Uh, ercp is where you assess your progression in the specialty. So every year you have a meeting at your ordinary and what you've done in last one year, So okay, you've done well. You progress to the next year you have a benchmark which you need to achieve before you progress to each year of the training. So at this point, if you pass your exams and you've done enough cases, you go to the ercp. And if you get the out completely, I think outcome six, you progress to let her be sent to the GMC to certify you as competitive training, and the GMC will add it to the specialist register register during this training program. Uh, it's it's not quite eligible or encouraged to African go out of the program. You can take out a program to do your masters to the MD today. PhD Um, sometimes this actually helps to build your portfolio at the end of the day because I end up with a with a plan for jobs were quite competitive. So you want to have all the available I'm a material before you finish your training. So people take their time out of training to do research. Do masters to do P a. D uh, 20 times extended. But you didn't know that. You understand you're doing this. Previously, 20 was eight years. So you've seen seven years year. Uh, training is going to change to seven years from next from Well, obviously from the from the last from this August from the new cholesterol has come out to service now 20 years. But that will effect from next year. Uh, they tried to shock him training. Why, uh, the the the GMCR looking at more outcome based, um, kind of training instead of just duration. So it's about what you can do, not about time you've spent so spending 20 years doing to it doesn't make you make you particularly a better surgeon. But the quality of what you've done doing 20 things to be better. So the reason the time of training, we're trying to make it hopefully more intense this time now, the previous pathway, which I think would not I think it ends this August of this year. Now the last opportunity is the quality on corporate training as as as it were now, in this on corporal training, you most people will not get ST 1 20 sometimes. So when you finish your f y es and you get your quest signed forms, you're going to call surgical training, which about two years and that cause cervical training depends on what specialty can do. General surgery. You can do cataract surgery. You can do anything. It just gives the experience in a surgical specialty that will build your portfolio to apply for ST one and then you can apply. Arrest the one here and you get into the going through so that's a good point here also. Previously there's an S T three entry point, which is, um, which was which ended this August. Last selection for a SEC three ended August 2022. Uh, the three was whereby you could be a foreign are coming in because that s t one You. You're meant to be quite junior to get into ST One. So most of the foreigners coming in here who have who have been spent some time since medical school doing different training, whatever it's correct, surgery or whatever when they've done, uh, you need to speed a portfolio to submit for ST T application, which is a very robust. You have, like, 80 applicants for two posts. That's how bad it is most times, So it's quite very competitive. And over the years, if you do use the three best three, uh, entry points and the last entry point was August last this year, and I think from next year there wouldn't be availability for any S t three positions, it all ends at 61 recently. Also, they've added also an s t four entry 40.4 Jurassic surgery. So if you want to branch out to purely thoracic surgery. You could branch out at ST four. However, you would have been in training already as an ST training before you can branch out. So there's no entry point from outsiders to get into the traffic 20. As it were, however, you have questions apply and slug it out with other candidates for dispositions is new, so I'm sure it will be flexible for now before things to be taken up in the future. Why it is happening now because in the UK at the present, uh, most units are split into cardiac and thoracic, so you don't have a certain doing boat you have mostly on either doing either cardiac or either thoracic and the accident. Why do you have to train as characteristic when you end up doing only cardiac or thoracic? Another argument is gaining ground, and the way things are going in the future, we may have only pure to collect twenties and pure traffic trainees. So I did, uh, most of these slides were from my colleagues that gave over twenties and gave me these slides where they made it into a factor at the present situation of things So for next year two x two application, uh, open in November, uh, and close in December. And there'll be a short lasting around January and interviews will be done in February and offer as we come out the day after. This is a timeline for the next year. Applications. I was talking about your what they expect of you were applying for ST one application. I will stop sharing this slide and open a document to show you something. So can I want to slide? Good. So this is the person specification for the 2022 applications had just passed the parent one coming up for next year is still being not yet published. So what you essentially should have Well, you have m B Bs or equivalent qualification. Uh, you must be eligible to have a full to have GFC restoration and hold that has to practice. You also have completed a foundation year program. Last is your house manship, or foundation program called the UK, and also have a 12 years, 12 month experience, post GMC and what we call the quest for Mr Bit of Wetness to enter training. So this is when you do your treatment experience, you would get signed off by your trainers and this form to be signed a half work 12 months post GMC, and you are like a tier two eligible for training. Uh, these are the simple things you must be. Speak English. Account to GM, says your LTs and stuff. But the fact that you have you must feed two parties with no indemnity issues and doing your your work experience. You show that your there's good career progression. So you're not someone who have been poor of a porker progression like you've been at one spot for the last five years. It tells bad on your progress. You to someone who is moving forward consistently over the years and that thing we should put in highlighted that the the more time you spend in the specialty. So imagine your pen in Nigeria as a as a future house job and work and maybe as a registered in a surgical department or, uh, and you spend four years of medical department, you can do many surgical procedures on your own. You look and see if you feel you're good. Yeah, I'm good enough to get to 20 Sometimes it tells bad on you when you spend too much time. So the more time you spend in as a as a doctor, a registry in the department, the less scores you get in the in the scoring matrix for equipment into training 18 months, the best time you spent 18 months, you get maximum score. You spend less than 18 months, you get lower. Score more than 18 months, you get a lower score. So 18 months is what everybody aspire to do. So people will be in the UK trying to get their portfolio to apply for ST one training now to avoid bleaching the 18 months rule. The smart thing you do is to take a clinical research job, so you'll be a clinical research fellow and you're working doing your MG. You're doing research, so that way you're building your research portfolio. You're keeping an eye on the application for the specialty, And most research jobs are affiliated with hospitals, so you could actually have some. Also some clinical time whereby you have half quicker time halfway such time, and you can use that click attempt to build up your surgical exposure and cases. You need to apply for ST one. So that was more people do. It's quite common to also when you're doing the 3 22. Um then you must have been in 20 before or if you've been trained before, you must explain why you're coming back into training. And and also, you mustn't be eligible for CT or Caesar in any form. So if you have trained in Nigeria or anywhere in Africa, in Europe, in maybe in cardiac surgery, I'm coming to the UK to apply for training ST one level uh, this will tell badly on you because you've had 20 already this specialty, you've had your F works or whatever specialty condition you have. And you're coming in to do 20 again and say Why? Because the idea of the training is to get people who are fresh into training people who are they don't train. It's longer before. So most times I've had seen your colleagues who told me they've applied, they got the screen number. We need to get a screening and tell them so we can give you the job because you already have training before, so we don't. We can not only didn't know, it's just refresh what you have and fine tune your training to get on the register, not to train. You are fresh. Uh, Okay. Uh, will take us back and just look at this quickly. Uh, personal skills. These are all things You just need to explain your management skills. Your i t skills. They tend to like people who are also creative, which are showing some slides going forward. Okay, I'll stop showing this now and go back to the representation. Sorry for the going back and forth. Okay, So on this next slide, um, when you talk about the clinical case and not your expertise, their courses, which you should have before you apply for ST 11, of course, is the business surgical skills. Uh, your HDLs. And you're Chris. Chris, Chris, because, uh, these courses that are available online on increasing courses in to attend them have to application and improve your quality of application. Uh, then, uh, academic prices and stop publications research. Uh, these are things that sometimes you don't take it seriously and they come to hunt you in the future. Now, this this point, this gives points where many people will not have points in. Everybody would do BSS. Everybody would do a TLS. Everybody caves because everybody has a PBS. Everybody has a nice write up a few people who have prices and awards on distinctions. Uh, and you come out different from them when you have this and you have more points than them. And this could just be the only deciding factor of the candidates A and can be for applications. So if you have medical students, put your head down, turn back around those prices, it may come hand in the future, as my friend brought down here said points when prices. So you just have to do it now. This is a short lasting criteria. That's how they score every application. Uh, this was for the last 2021 22 candidates. So these coins from like 0 to 3 and the first thing about the employment history if you have a good careful question, is quite a maximum of two points easy, right? Uh, and this is mostly you found your jobs. You don't. So if you finish your internship, but you get a job in CCS cultural surgery as maybe a S h o or even your foundation here in the back surgery. The month is formal to spend on rotation or the six months plus s h or more. And if the progression is good that your first day you come, you cannot. You cannot put you cannot do anything. Now you're putting change trains. You know you're going to theater, you're harvesting veins. This tell good on you. And yes, you get this course you need. Uh, if you've had a great prices on national awards brilliance, it's called three points. Easy points. If you don't have it, you have zero point. So this is how things come about the prices in research and audit you've had on a great level if you also have done elective. So if if you could be, If you're Nigeria, you can go and do electives. Either in the country outside the country, doing your quotations are going to spend four weeks electives in one center in the UK or in the United States and Canada, Australia and New Zealand. Uh, at least this first world countries, it gives you that good age. You can score the support in your case, you're committed to conduct surgery. Uh, doing when you're in medical school thinking about it. Also, if you have higher degrees uh, the MD PhD Oh, wow. Even better, It's got the highest point. And you wonder, why should a smaller plane for ST one having PhDs and MGs? Uh, these are all the criteria to screen people out. So if you come in with a PhD on nd before you plan for everyone, get high. Score three scores. If you don't have any, you have zero. It looks very, very mean, but that's that's it now, also, when you go to the National Society meeting like we have the society called the C T s, which is the society for cardiothoracic surgeons in England and Ireland in Great Britain. In Ireland, we have national meetings every year and other meetings during the year. If you can come and presented to make us, we're just meeting or s h. O s. And you get an award for the best presenter brilliance. You get a good school for your application. Uh, then if you've had any of that prescribed diplomats, then education or or in research or any other degree, uh, it's also add to your application. You scored two points there. If you have been involved in research National Research, National Audit International Research, because you get points there and any price of academic achievements you've had best in this better than that, um, you get points for these, uh, awards if you have any national or representation. So you had a stent in an abstract or article for toujeo to decide to go into a meter national meeting, a national meeting you present orally or propose that you get scores for those things. If you have some publications and you're the first or second tour, you get points based on your, uh, involvement in the publication. Uh, so at least one national presentation. And if your first paper first bottle in one and three papers in cultures back surgery, it also scores you a good point audit. Sometimes you cannot in the UK system, or it is like it's everything. You must have done an audit. If you've done it close closely, audit. Even better. Uh, what's close to audit whereby you, uh, done an audit and all It is time to find out you're practicing your unit. Comparing the standard with the national standard on national standard. So if you find a problem, you need it. Okay? Mine is not We're not getting achieving the national standard. And why is that an audit? And you find that these are the factors affecting why you're not achieving national standard. Now, those accommodations are not put in place and you're not doing the audit after a time to see if with your accommodations there been any change to practice. And when you do agree, audit and closing the loop, you close the loop on the audit and it gets you better marks. If you also held positions as a leader. So Secretary, chairman, member of, uh, of a society group or, uh, registry 20 Group foundation year group. Anything, huh, Coordinator, anything you've done that helps national level international level is score points on those things. If you're involved in sports, if you're designing designing, you're doing art and cuts. Uh, so you just test people creativity. Apart from surgical medicine, it also causes good points in, uh, training into an application and your notebook. So whatever you've done briefly also in Surgi surgical specialty also make you score points. Uh, put it this quickly just shows how training has been over the last couple of years. So, uh, the excuse me. So this is the blue line should put applied for training. This was sort of state of these will be appointed here is at the ST three level. So initially Australia, Europe, I'd love to have a lot of people coming at three level and over the last few years is creeping down ST one level, you see the red, which is appointed. It's increasing. Unless I've been the trend over the last couple of years to have more s t one and a few s t three Now, uh, this is what I know, but it's got to be confirmed for next year. They're only only be six slots in the whole country. First one, there's no ST three slots and the S T four spots are still being debated. Hum. And what are the numbers? So you can imagine only six people the whole of UK will be in to enter into training in characteristic surgery? Uh, you wonder why it's a small number. The job's not really coming up in the future because, uh, in the whole year in the UK, you may have only be 5 to 10 new carton post, and you have after 20 people finishing training as the trainees You also have. That guy is coming as Caesar. Our plan for the same job. So you have a job for applicants. One job and this has been trained for the last few years, so it's quite difficult. And the training comments here saying Okay, we cannot just be realistic. We get too many twenties. They don't get jobs. They complain of the choir too much. So what we do, we start turning down. To be honest is the number we have of jobs that will be available at the time they finish their training. Uh, so when you finish training before you can get into this register, your clinical experience counts. You should have done or be involved in as a major involvement in at least 250 major cardiac cases, which will be a very big cases. Cabbage, every a mitral valve repair antibiotic surges. You have done at least four publications this international plantations, one loop audit management, cautious conferences and also have passed the FCAT exams. So, uh, it takes a lot of years to get all this done. You could take up to 15 years earlier. People can get nine years. So your medical school now you finished your medical school? You don't have for a while. And 13. Um oh, yes. Yes. You passed that. You get your training spent 1 to 7 years and you're a consultant. Now we can talk about the seizure pathway, which is the other part where if you happened before, outside the country, you come to the UK your senior, you can go back to training again. The UK This is the pathway for most people. This is the part where I am also on two. So that's the title. Uh, that's what I just said. And, um, just demonstrate that you have a single question as a u K. Training, training. It's a non structured pathway in the sense that in the 20 you get nearly a r c e p s and people tell you, okay, you to improve on this input on that? This part where you are on your own, you're you're the driver. You drive yourself, so you have you have to seek information on what you need to take information on what to do. A description of how to do it all in your hands. No one guides. You know, one dies. You, uh, last in last couple of years, they've been instead of doing some courses with some society to guide people what the commercial necessary it takes about if you are from outside Africa. So the Middle East. It takes you at least a few years to get all your documents ready. Uh, before you can apply for this because, Cesar, look at your last six years of experience. Your point experience. I wanted the last six years on your application. So you still want to be a surgeon? If you have the guts, if you have the great yes, you can. And you go for it. Uh, so what we need to do well tuned in to achieve academic excellence. Uh, try to get jobs in the cultural surgery, either placement or foundation jobs or electives. Uh, try and do some of our audits or publications with your team. The more you do the people, the more you get publications. Uh, if you can do MRCs, get it done quickly, without MRCs can be very strong. Uh, even with Caesar or, uh, training MRCS is basically coming. Registrar, if you go around the house here, so you must have for MRCS if you want to ever be a connection from the UK Uh, do the questioning to do business class case HDLs and Crips and reviewed this criteria for section every year. So you can know what you need to do. And when you when you were lacking in what point you need to make so you can match up with everyone else and well recommended that everyone get into training, that won't be a surgeon. That that would be a consultant. Recently, there have been new rules for the energy in the UK What you call the S A s group, uh, staff, great doctors whereby you're not a consultant, but you are a senior doctor in that department. You could have independent rules. Uh, this was going to be They're going to create more of these rules so that they can accommodate most non trainees in those roles and leave the gotten jobs for the Chinese. It's an ongoing discussion, and I think there might be some future in that I'll leave this little few slides. Just society can get information for, uh, to know about some information. You need the most important side to be here. The national training website from the West six. H e r n Chester U k Telling you about, um, yeah, the training, training pathways every year, the equipment time documents require. And also, if you get a seizure information, you go to the GMC website or the J C I u website. You get more information about season what it entails. Thank you. All right, thank you very much. That was quite a compact and well detailed. And I'm sure people have a couple of questions. If you can access the comments section, you can drop your questions so he can read them out. Uh, if I can just say something to you guys, Um, yeah, there are two things you look at. I said, as I want to be in to talk about surgery, The first thing is, what is your desire? Is your desire to get trained and, uh, we go back in the country and work. It's a desire to train in the UK and stay back in the UK and So it's hard to train the UK And when you were in the war to get, uh, to work a surgeon if you desire to continue, okay, to get the experience of the neck surgeon, uh, experience means clinical experience, surgical experience, and come back to Nigeria to apply the experience. Easy. You can tell me I'll get your MRI done. Uh, apply for registered jobs in the UK You come in to the UK Uh, look at the register, pick up surgical skills and get your f l c is done. If you want to be on the register, you can push through the seizure part way. It's going to be on the register, which FRC is. Go back to Nigeria. You have your skills already broken surgeon even we stay back in the UK and slug it out to get certain jobs. Why not come in here? Get the get the training, go to Caesar, apply for training number and, you know, push for it, then even to turn the UK and go and find just in Australia and New Zealand or Qaeda. These openings are bound because people they would expect the UK UK is the first world country. So you also get a reciprocal registrations with these other, uh, countries. I'm seeing a question from Michael. Uh, okay. You just say Okay, I think I just said most of what he's trying to ask about The other part with you can exist yet. So if you don't, If you see ST one, you're gonna be tough to get in to 20 years to one level. You can get two MLS. Yes, come to the UK, pick up a registry, a job in a good hospital. The main thing is to get support, you can work. In some hospitals, you don't have support. So you need to ask the right questions before you apply for jobs in different hospitals. Or as everyone does your first job coming. Yeah, you'll see. It's not very good. Fine. But you settle in the UK, you start into the into the specialty. You understand the politics in the specialty because there's always a call it a rivalry. And obviously I'll say the way just arrived within the trainees and non twenties, the trainees feel they're entitled is, uh, it's all right. It's our job, not twenties. That looks like where I come from the back door going to the world Work. You need to fight for your spot in theaters because a surgeon is what you can do with your hands. Now you can save your mouth. So you to transfer over time, get time in theater to get to do operations and get confidence and get independent. Once you're independent, get your exam done. So you have that portfolio as an F. R. C s with the surgeon. Then you can go back and to change what we're going to chase. But in the Middle East to work, you can go to anywhere in the world, which fr says, I'm sure you were expected. I hope I answered your Michael. Yes, sir. Thank you very much. Um, uh, one of the questions I got in my d m. Um, someone is asking about the first question is about log books because you mentioned log books earlier. So the person would like to know, uh, because, uh, personally, I've heard about you coming with your Nigerian log books. However, sometimes the doubt the credibility of those log books, and I've heard about the log books also that some people use that I recognized. So I don't know what advice you can give in regards to getting logbook, getting them signed and recording your procedures on That was just what? Yeah. Should I go to that first, though? Okay. So, uh, for logbooks. Uh, anything you've done anywhere in the ward would be considered. Now it's What about what is the weight of the evidence you're submitting? And what is the weight of the consideration given to that evidence? Not as much as we can disregard it. Everything is not included, but everything has weight. It will be difficult to get ST one training come from Nigeria. Straightforward. Apply for Nigeria. It doesn't come to the UK before. I think that will be. Just be ambitious. You can apply. Yes, fine. But it will be ambitious. They will find a way to put you up. They always find a way. You you have to make the criteria from outside. So most people will have to be in the UK spent and spent some time in the UK working at different levels to get some UK experience added to your previous experience. Before you can apply for s to one training that is the best and obvious church, So the log book is free. It's available in the Web's on the World Wide Web site. You can download it. Uh, it's a logbook to log in all your procedures, and it's in a format that's acceptable to the GMC and also the society. And also the education site is so when you're applying for jobs of training I used to. So you have your log book. You can download it quite easily, and the format way it is structured fits what they require as their standard log books. Some of us have come in here and let our previous cases we've done in Nigeria into the log book. So they didn't retrospectively. And you can see in the log book. These areas will ask you, where do you do this? Where you did they operate? You surely can Nigeria. Some Nigerian centers actually online already because people have put them before, some are not so just in Nigerian, uh, accepted. The country's also there, so it blocks the form that they want you to submit your evidence us. So that's a good thing to to to use. And when you come in here you also a call the call the I s e p, which is the, uh, surgical portfolio. It's where everywhere every 20 some, uh, upload your port evidence into the icy Be daily, weekly monthly. So whatever you do if you do a CBC with the case discussion if you do If you if you do a, uh a a consent exercise if you do a p d p, which is your progression Developmental progression. Which day of the year? If you do any research or prices, you can submit evidence uploading into the I S E p like a bank keeping all the evidence there. And it's becoming easily linked to all the the the assessors, your GMC and everything to assess what you've done Also in the I S e p. When you do next, imagine you do something in the world and you submit it to the I c e. P to ask you that you assess what you did. I put this person's name and the person receives an email asking him to verify and assess this procedure or this, uh, game this gentleman has done. So I'll assess that person and say, Okay, Yeah, he did it quite nicely. I will score him 8 to 3 or four. Meaning, uh, it's not independent yet. It's getting better is to improve on this, so I'll give you feedback. And you can see how you progress from scoring it to to scoring a four. And that shows your progression over time. So for surgical 20 a log book and I C E p uh, Let's see. You just know there's no you cannot do without them. Okay? Thank you very much. Okay. Someone is asking for the link to the logbook. Yeah, let me just start online. Just picked up, so I don't think there's a link there. You're going to start with your g m C number. I think of the use. You can also use your email it possible. Okay. So, uh, the second question is in regards to the 18 months benchmark you mentioned. So, uh, if someone is, uh, planning to get into a characteristic surgery training and you're in Nigeria, so the advice shouldn't be that you should try and cut down on your surgical experience here. Or maybe if you're a medical officer, you're not gonna residency. Should you avoid surgery postings for a certain number of months or so. Yeah, so that's the thing. If you spent too much time with special specialty, you don't start the maximum mark. If you spent 18 months, it's called a maximum mark. Now, what do you do when you walk in that specialty and you're outside the country? Uh, you cannot lie in applications. You have to be honest and truthful. So you you you know you can't. You cannot take a maximum mark, and you just call what it's called. Also, if you're if you're working in a as a medical officer, not a surgical department yet hour you have to do surgical introduce character surgery. Yes, Nigeria. It is nice to get some Nigeria experience, and the main thing is to if you're moving over to the UK when you get to the UK, you have to focus on the jobs and the time you have to apply. So if you know, okay, my portfolio, I need to do these courses and these courses will take me 12 months of these courses and everything else you need. As per the application to get the maximum marks will take you maybe 18 months with the 18 months you make sure I'm not working over the 18 months time in the UK as a as a specialty or social security so you can take a clicker without a job. You can go and do the masters. So that day you're not working at a clinic up in the clinic specialist at that time where, so that you don't go over that time and lose the maximum marks. So if you have everything else already or you need just time the specialty, they're fine. You come in for 12 months and I applied for a number. So what happens when you apply for the number the first time? I don't get the job. So you spent 18 months apart for your number. I think you came back two months ago and you're not short listed Now, if you still keep working until next year, you can belong 18 months, and I want you to be like 24 months or more. So what happens then? So most people who have been here at 18 months apply for a number, don't get a job. They tend to find a non clinical job. At that time and we do clinical research to go into the MDs to get clinical research job as a clinical research fellow. So your time for clinical work stops. So you maintain your 18 months, And in that time we did a clinical research. You've added more portfolio to your research experience, experience. And if you get an MD in that time, so I understand you're paying for it for the number again, your CV is better. You know what most people do? Okay. Thank you, sir. It makes sense. If you have any other question, you can drop it in the comments section, please. And I don't remember the particular questions among the list of criteria you were mentioning that selection criteria. There's a particular section that had awards prices, research or audit. Uh, and then? Yeah. So I don't know if it's for you to have one of those that will make you score three, or you need to have all of them or what? Exactly? Uh, so if you let me come back up with every single sentence So, uh, if you have an award in, in, in, in in research. So maybe submitted the publication and put an award in the condition going on. If you get an award also in your audit, you've done so. This is the best medicine, your trust. You don't audit and said You want your best audits you've done in department or because you get in a position for that all these are two different aspects of the application, which is because, okay, first you must have an audit that is no debate. All it is is golden. Now, if you have a national price in university as a little girl with Golden, if you have a national price for our representation as a research golden, Uh, if you have the best audits or whatever, you do it and say, Oh, this is the best golden. The more you have, the better. So if you have one fine you get, you get, you get some score. But he has three of them. Obviously, is is there's no there's no gamble know debates. It's it's It's hugely competitive, hugely competitive. It's so competitive. So I'm going to do that. I didn't do national training in the UK I did my training in Nigeria. I got my work, so I didn't even I don't want to try to apply for training. Because I knew for motor from people who have met before, I won't be able to be eligible training because I've had pain before. So I have to do is to go into the seizure part where I put my portfolio and some it to the GMC. Okay, thank you very much. So. So, if they're not for further questions, I'll be sharing the feedback form right away, which will enable you get certificates for the, um, for the for this session. So I've shared it, and I've shared it. Now you can have access to it after you feel the feedback for So So just for taking away now for someone that is post plaque two and it's looking to come in to the UK Um, would you advise? Okay, of course the person can take. Maybe you can drastic, uh, post to just have a bit of an experience. But like you mentioned, if you apply the next, uh, intake for ST ones and you miss out, what are the options you have once you have missed out of those application distant entries? Okay, Uh, what I would say for everyone applying for training or who deserves a proper training coming, maybe relatively fresh and young from medical school, I would say you can give it a maximum of three attempts. That's I would say personally, obviously you're one attempt is not the first, and most people don't get the first time. So I was taking maximal to your attempts and open your mind up. So if the 1st 12 months you're here, we're coming here, try to get your competencies or you need ready and submit application between 12 months of advice. So if you don't get that application, it doesn't work out well. Next application will come in and you're only 24 months. Some it again, 24 months. We'll give you 24 months, and it does not give you too many too much a bad score. About 24 months you don't get. Don't get a train number, and your feedback from the field application is not squeezing. You know your feedback and tell you what you didn't do well where you lose your marks. If it's not that you can improve upon fine and there's no chance of improvement from whatever you're actually where you're losing your marks. From then, there are two options. You think about giving you go one more time, which I think will be your last chance or and think about droughts, understand specialty or you want to do something else. You can do vascular surgery. You can do general surgery. That was because that you can do in surgery, actually, to be honest. But if you want to stay back into reality, then the only way you have to go is this is a pathway. Well, I will tell everyone to if you're coming to you before. If you're a trainee, it's It's much easier life. So it's not easy life, but it's more easier part way to get into see CT. Get into the problem when you get in. Most people get out if you do the right things. If you troublesome and cause problems and you're not picking up skills properly, then you're not finished a program. But it's very rare. Expensive furniture program quite where most people finish the program the end of the day, they're quite very supportive once you're a trainee, so it's just to get a way to get into the program, and it was very difficult. Once you get in, put your head down. Know where your hair You should achieve what you came for. Okay. Thank you very much. Uh, and then lastly, I also understand a lot of the selection process there is, like, a minimum score, uh, based on all those select selection criteria you mentioned. So, like, there's a minimum score once you score. So, for instance, if let's say it's over 60 and you're able to score maybe 33 the minimum score is 30. Uh, is there any significance between you that score that 33? We have made it to the minimum score and some of the schools, maybe 50. I think I think there's there are potentially screening. So when they when they when? When they when they open application out. Um, you, um you have you don't think they close the schools to everyone. Everyone applies and you scored. And the the minimum score you need the maximum maximum score is the minimum score for short listing. So once you you pass the minimum score, you shortly state for an interview. Once you get the interview stage, then they will trim down the list from those are called the minimum score, and they're coming down to the final candidates They want to take okay, but I will still be based on that score on that score. Discovering from the criteria you mentioned the interview. I think the interview might take a more center stage at that at the second time to to select whoever it applied. But, uh, to be honest, the system tries to be fair. But we know nothing is ever fair. That's for the truth. You know, nothing's ever fair. And, uh, I got a paper to you guys you can have a week later. Uh, you can see these are the essay. See that the the senior guys in specialty who screen people and they themselves know that there's buyers in the system. Uh, people have very good support of references, and somehow they just come in and get the number. Uh, but there's a lot of buyers, and you just have to do your best. Do your best. You can get good support, and then I'll put prayers you've got for so for so, uh, his blessings to give you two. It's not easy, man. Okay. Thank you. very much. Uh, in the absence of any other question at this moment, we'll be, uh, sending this session. However, remember that if you do not feel the feedback form, you would not be able to get a certificate. So please just try to do that. And then, uh, fortunately, I still have, uh, doctor Benjamins contact. So in case you have any other further question, I'll be happy to relate it to him. So once again, thank you very much for taking the time to enlighten us on what we need to do to pursue a C. T. S. You training If you are interested in that, uh, I hope and pray that God strength, uh, straighten out your part and give you your heart wishes in Jesus' name. Amen. Uh, all right. So that would be all for now. And I look forward to seeing every every one of us in the subsequent sessions will have