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they worry thinking. And so we move on to our final talk of the day. And so this is the plastics talk that has Bean and moved from the earlier session to to now and said this will can you be presented by Ms Lucky? We are, um, who is the president off asset as well. And so I'll have the floor over to her, and then we'll have a closing address for about 10 minutes, and then we'll let you get on with your Saturdays. Thank you. Thanks, Emily. Um hi, everyone. Just before I start, I want to do a quick poll just to kind of gauge what the audience is. Kind of what training raise. The audience is made up off. So fill if you could please put the pole up and then we'll see what the X is. Because that's the kind of affect How ask you the talk. Say she could please all vote, and then we'll be able to back home. Cool. So polls being posted in the chart on day or you can just type in a code from above. So it seems like everyone's managed to keep them coming. Okay, so it's looking like we are majority kind of F two f three. So looking, like, kind of applying for core stage with some medical students, A few others. Okay, Okay. So that that does help me. Right, sir? Thanks, Phil. Let me share my screen. You can get started. Okay. Right. So welcome, everyone. So this is the kind of talk on plastic surgery so I can show my screen. My connection is not very stable, so I need to be off s so I'm gonna be talking about plastic surgery today. So because my screen's up, I thought I'd show picture of me while I was on holiday on tell you about myself. So I am one is Lola. I'm a past. It's pretty strong. I'm just turned s t three currently working at the role London Hospital on the pan terms of the London Diener E. I'm also present of acid in my spare time s So I've kind of pretty much changed. Trained in London for the whole time. So I did my F one F two in Northeast Thames on did my ct one and two in London as well. I currently present assets are stepping last minute. And this is my Crestor presentation from last year when I was first president. So plastic surgery. So it is kind of it's it's a massive field, and I didn't even I didn't even know that passage survey waas until I got to f 11 after my MRCS and kind of some of the questions came up, came up to it, and I still only really found out what plastic. So he was kind of, I'd say, in c T. One c. T. Two when I was actually doing the specialty. So the kind of the a lot of what we do is breast reconstruction on. So that's for patients who have having mastectomy is due to breast cancer. On what the comment, The most common thing we do is that the up front, which is a free flap so you take the tissue, the skin is getting back from the tummy and you plummet into in to the intermittent into your memory vessels to actually give the blood supply to the breast. We make a new mount like you can see in the picture. You do some implant reconstruction. We do a lot of skin cancer, so like, I think most of what you do in plastics would be skin, hands and breast. So skin cancer we do kind of from taking little moles out to doing full on. BCC is taking them off the nose on reconstructing, making, and you know, so that's using that. So that new nose has been made with the skin from skin from the forehead on some cartilage, probably from here, the ear or the or the rib. We do a lot of grafting. Kind of boring piece paper is basically what plastic surgeons about Ondas cleft surgery. So cleft palate is done by Canadian T. Mack Truck's in plastics. He gets work. What's babies? If you like to hand dramas? I said, that kind of the brunt of your normal work is handling. Or so people who do things like kind of cut their avocado injury where there silly, as I would say, trying to get this stone out of Vicodin with a sharp knife and they cut their nerve. We repair that to some people who get into bigger injuries. They cut their fingers off, they cut their hands off, they cut their arms off, and we have to put them back on in this dupixent. So that's kind of elective hand surgery where we're kind of working on older, older patients. There's facial palsy, so people who have heard things like Bells have been on for long or dramatic injury. So facial nerve we reconstruct. Either that kind of the muscles are being supplied by new nerve or we do lots of things. Just give people back there. Smile. Then there's cosmetics. So that kind of that's something that most people don't think about when they think of classic surgery is going esthetic surgery. But that's only a very small portion of what we do on, but it's kind of it you can do is much or as little as you want. So that's kind of like blepharoplasties things like that faceless things like that on burns. So Katie Piper obviously had the kind of been able to kind of advertise or kind of make people more aware off what happens when a patient is burned. So that's a big front of our work as well. And then So that's what I'm currently the London, which is obviously a major trauma center. So what we do is a lot of lower limb drama. So you've got patients go bike verses, Laurie, their legs smash up. So in this leg probably would be worried about the blood supply to the foot, first of all, but once we've source up blood supply to that for obviously this skin and muscle is just or out and dead. So we work together with the orthopedic surgeons. Orthopedics only probably put a frame and ex fix around to kind of fixed the tibia and fibula. And then we would need to put a flick free flap similar to what we do for the breast in that picture just above it. And we need to kind of cover that wound with a free flap. So the average day, what does the plastic so do so Saturday, you kind of start a half seven or eight at the moment. You see, if you want, If you're in theater, you will see your pre ops consent them marks and get them ready to the POSTOP from like the day before. Anyone else you need to see, then you're going to be a two. You need to be doing elective operating, so that's kind of like hand skin breast. Well, you might be doing trauma such a like hand drama on D s. So you kind of be doing either theater or clinic. And if you think if you're in clinic you be seeing kind of pediatrics, you'd be eating at all to be in seeing all sorts. If you're in theater, some generally we could do a lot of three sessions. Just operating would be kind of operating till about 67 or eight. If you're including you, probably finished about four or five days are very short, that kind of more than 95 and operating days and more kind of like the half seven or seven until six or seven. So but that I think that's kind of similar across all surgical specialties, really on. Then when you're on call for plastics, we do a 24 hour on call, so you be resident about kind of five PM or eight PM, and then you go home in your own call from home. Onda. The only reason I really you can get called in Sorry if there's kind of a hurry plant, so patients cut their finger off animal bite that need to be washed out of the night. Open fractures like that leg we saw. Ah, free flat. That needs to go back to the attacker. There's something wrong with it. Those kind of things that we operate on it night. And that's part of the reason I did plastics because I like operating in the daytime as an essay as an F one. I think of no f two. Um, I was doing urology with generous general surgery on call, and I notice that every run of nights I had the consultant came in at least once, and that just wasn't something. But I really wanted to do, um, at the register. I don't really want to come in at night, Lantus. Consultant. So that was kind of kind of push me towards a specialty? Quite a bit. Um, so those those are things that call you in. And before you go home, you need to kind of look at all the free flats have been done today on. Then you're on call over night, and then in the morning, you do a kind of around to look at all the missions that Septra is admitted overnight. Anyone? Any flaps to make sure they're well and kind of anyone else needs to be seen. The natural on call done so, As I said most of the time, this is a picture of me on call on my nights I can. I can easily do it on call where I go home at kind of six ish. If there are no free flaps on, then I obviously have my phone allowed. But I wake up north time in the morning because there's been nothing to call me about overnight. That's fantastic. The problem. The only downside of 24 hour cause is that if something like so the quote unquote, my longest on call where I had about two hours break in the 24 hour period was when I had a busy day and then we had a replant come in. So a kid who had pulled his finger of climbing over a fence So he came in about seven, probably about six, but he wasn't starved until nine on. Then, when we finally got into better, there was a crash call outside of the nieces had to go out, so we didn't actually start the report until midnight on. We didn't finish until about half past five has going to all the paperwork. Make sure that was fine. I got into bed at six, and then I had to wake up at seven. I had to wake up about seven again for hand over. So I was pretty tired and kind of working under the microscope at like 4 30 AM, joining Vessels back together that was quite talking about any. I absolutely loved it because it's really that's what I like doing. But after that, after they're 24 hours, I walk 25 hours. It actually I was naked, so it kind of you get swings around much, really. So past six in general, What the pros. What the cons of the pros, I would say, are the variety. We are truly the general surgeons. I know general surgeons will kind of laugh of that. But we generally do operate all over the body. We operate on any age we did. We do basically everything that's on the body, and also we kind of train in. We could. We trained to the end and everything. We don't declare a specialty during our training, so I my exam, my exam, I will need to be safe to be a day one consultant in all of our separate specialties. There's nothing that I say I won't do. I can then go on to apply for any consultant. Post basically has lots of in specialty working. So I said we worked with the orthopedic surgeons with fractures in breast cancer. Work very closely with the breast surgeons in cleft. We work with Ent and Max fax in head and neck. Cancer matter Accidentally, anti sodas will do. The reception will fall off and do the refried flaps in skin. We work with the radiologist and the oncologist like and in hand with orthopedics as well. If you want to work with lots of different specialties, plastics is great. I've put on scope a private practice because that's what people think about. And of course, there is a script for practice. But realistically speaking, if you want, if you're going into surgery to make a good part practice and there's nothing wrong with that, that's completely fine. That could be what you want to do. I'm not sure that plastics is different. That necessarily the way to go. You may be because of the cons. But something like orthopedics, for example, has a great progress. It's just doing hips and knees. You're you're you're gonna do whatever you need to do. I think in in, in any specialty, you can have a very good and rich private practice. I think plastics is just what people think off instantly. And kind of why I got into plastics actually is because I was at the time considering moving to, um, the Middle East or Nigeria, where I'm from on. But I wanted to do a time pediatric plastic service. I started pediatric cardiac, so I just definitely wants to do the nothing. When I thought about moving to somewhere resource poor, um, I like having the set up that X ray machines. There is confusion issue that I do. You need a lot of infrastructure of cardiac surgery. What? One of those certainly room field was saying the plastic. You don't need any infrastructure all you need or yourself and your loops magnifying glasses and you're good to go. So that is useful if you're kind of talking about working around the world on also has lots of volunteer work, so it kind of things like projects. Small, changing faces be first, has lots of kind of burns gonna, um, surgery that you can go and do some volunteer work. Cleft palate. There's lots of volunteer work. If you wanted to Cons. It's pretty competitive. Like I worked, I didn't in medical school, I basically played sport on. Then in my spare time, I'd go to Elektra if if I could make it, um, so I wasn't really that kind of academically minded in medical school. But once I get off one, I kind of had to get the ground running. And I worked very. I won't even try and check it later. I worked very, very hard during F one. Do you have do my whole foundation do my my core training? Kind of. I still would go to Friday drinks, but I would make sure that I could have stayed at work and to kind of like half six toe work on my order it to work on my exam to revise and do something else before I went out to meet my friends. Um, a lot of I didn't I think the first holiday I went on without taking my laptop to work to do some work was probably at the end of CT to maybe, actually, probably after that, probably in my trust. Grade. Year was the first time I went on whole day without my laptop. Um, there's a lot of people want to do it. There aren't that many places, but it's very rewarding. I don't think I don't not saying you should put you off. But if you kind of just looking for something easy to do, I wouldn't say plastics, is it extra, graphically restrictive? So I'm in the London Diener E, which goes from Chelmsford in Essex all the way to Slough in. I don't know what county that's in but far west of London, all the way down to the store instead, which is near Gatwick. So I wasn't expensive for two years then I was at the role free in Hampstead, north London, for a year, and now I'm in East London like you can't and I was. I was commuting along along where you can't really have one base on Dworkin. All of the hospitals in the Diener e so better in mind, and there aren't plastics. There isn't plastics in every unit, so you will be restricted us to where you can works. Quite so, like in the Southeast, for example, you've got London hospitals and you got Easter instead on. Then you've got Brighton and that's about it until you kind of get all the way, like, really further down. So you will be restricted on where you from? Work on post see City fellowships I put down. Although it's becoming less so. So I actually know three newly appointed consultants who just got there who just got their CCT. It used to be the case that you'd have to do at least 123 post CCT fellowships before you got your consultant job. But I'm very pleased that with moving away from that trend that moving more that you finish training and you're ready for a consultant drop. You don't have to hang around for a few years. So my tips. I'm starting at the start. Try and do a plastic selective you can. As I said, I want to do pediatric cardiac surgery, so that's what I did. I didn't do any plastics before. If one if you can do a plastic selective mainly see him kind of meet people in the specialty who can kind of give you projects just to get to know people who couldn't give you things to do. Apply for bursaries for your elective. So asset back press the bit of burns So she a shin on a vicious cycle surgery, the hand all do, um, bursaries for your elective. Keep a log book. It doesn't matter what specialty is. Just keep a log book off off cases, you seeing it. Interesting cases. You've seen my heel to write case report, but also just feel core application so you can show that your keen on surgery do it taste a week. And as I said, the taste a week is partly for you to understand more about the specialty, but also to meet people in your local unit who would give you an order you could give your projects who know you. Are you congested? You might find something you can take you under their wing courses. Do as many courses you want to the asset pre conference course we always on a plastic surgery course, the one that this year's gonna be pretty good up napping. Aberdeen Do a micro course and they vary from kind of tiny micro courses. Like one day I did, I did a one day, 75 lbs course under physical microscope. It's in like the one who's in the lab to look at to just kind of practice my micro skills. I did one on Chicken Lakes in lead, an idea. And then I finally did one in Ganga in India on live rats, which was kind of like the gold Standard Micro course. But it was cheaper for me to fly to India on do the course in India that it wants to do the course in London. Um, and in generally be keen, like if you show people that you are keen and your you want to get involved, people will be happy to have you involved. So just kind of walk around, smile, introduce yourselves and you know we'll be good. So application all only briefly touched on this because you're not There are just touch on what can be kind of worked on before. So we're we're plasty three interviews, portfolio management, physical in communication. The ratio this is racing from 2019 was basically 4 to 1, which isn't terrible but they're in my own box. People just don't apply because I think it's quite but portfolio. You get marked. You get points for having less than five or less, or less than five years or five years or less in practice. So you have space to do one gap here so you can do an F three. You can do a CT three. After that, you start getting penalized. Start. Just just collect all the evidence in one place. Doesn't matter what it looks like. Some people like a fancy port for you. I had that one from Staples. Some people walk around with flown like carrier. It's up to you. You get marked on kind of if you're going to go into the it, I just start looking at hand hand trauma, nail beds. Let's tendons, fractures, digital nerves. Burns. Try and get involved in some sort of burn management. Burn surgery you get. You can get mark for both of these, um, skin cancer. Excising be cc's, but in a skin graft on putting this plaque on ordered it. You get maximum points for having done. If you go straight through, you get maximum points are having done to order it. So don't go crazy with your order it unless you really enjoy them. Don't do them for a while. It's safe because you only need to really, or 33 maximum. I mean, I did eight. I did not need to do eight. I mean, it just it too. Teaching in training. So, um, try and write some letters to do some teaching use. Um, being, um actually demonstrated a friend that did it that anatomy demonstrated in London. You get see? Because we have That's part about work. I am in my trust. I reapplied. And in my tracks Kedia. I wrote a book. I wouldn't really recommend it because I didn't even get that maximum points. They just gave me the d because they said they went when they said editor of such context. But they meant more like Grey's Anatomy, which obviously I didn't right management leadership be mess president, organized rotor. Try and get on a committee or national committee like acid. Um, higher qualifications. You get the maximum points having a PhD, but that's the same amount point of doing to order it. So I wouldn't run crazy on this if you want to do a higher degree, do one, but yeah, it's not that many points. And maybe if you want to try and start it part time enough one. So you've got it by the time you get exposed to three again if you want to do. I did a diploma and advanced difficult in medical education. Get you some points again if you're interested. If you're not, don't worry about it. Prizes. Try and get priced somewhere. Submit everything to everywhere and hopefully one of them you will get a price. Cool. Um, publications. Try it that way with it. Friends for plastics Is that getting maximum points of being first off? The problem it or the next? Stepping down is being first author and not put med or not being first off in a pub med. And then case reports and letters are completely separate. So case reports don't need to be in a public indexed. Um, General, we think there's about 445 category presentations present. Present anything you've got, you get points for those directly related to past six, and those not directly related to plastics, obviously, or post or presentations get more points but posters count too. And that is it. The whistle stop tour off plastic surgery. If you have any questions, feel free to email me. Tweet me. Drawing plaster. They run lots and lots, of course, is a swell. Um, yeah. I can take some questions if we still have time. Yeah. Thank you, Layla. That was That was really nice talking on plastics. And so exactly what else? It offers outside. You know, when people think of plastics taking things like aesthetics. But actually, there's a lot more, too, in terms of trauma burns and functional quality of life stuff for patients that I can't see any and any specific questions at the moment in the chart. But feel free if anyone wants to put these through in the next couple of minutes on, but yeah, I think Oh, on one more. Do you have any advice for med students interested in plastic surgery? Yeah. So go to your local. Uh, your local still probably should have plastic somewhere on. Just go and speak to someone in who's like head of education on. Just tell them that you're interested. Maybe doing sec or what they're called anymore. SSM I don't know a special stress of special module in plastics if you can. But if not just kind of right to someone in the department and ask them to give you a project. And then if you have, like around the department a bit, people can start getting to know you and things like that apply for the for the elective Bursary doing elective either here or abroad is very rare use for hear it. We used to it because you get to know, you know, into maybe, like, you know, people start. People trust you more and they can offer you more. Going abroad obviously is useful because you get to take a holiday. I went to Canada and Jamaica and had an absolutely amazing time, and I wouldn't change it. But there definitely are benefits to staying in the country for your elected