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Right. We'll make a start. Um So, yeah, so today's talks on uh wanting to be an orthopedic surgeon. Um And so what we're gonna go, what we're gonna go through today is, um, we're gonna go through a bit about the society and then we'll go into the um nit and grit of what we're trying to try and achieve today. So, so, um we developed the orthopedic society uh a year or two ago, um about a year ago, it was, and um want to create one because um my background, I'm a graduate physio and um it's quite important to have that holistic approach um in terms of orthopedic care um in as it requires a lot of physios and nurses. O DPS, which we will learn at, um which all study at University of Leicester. Um But also from a patient perspective, uh as you may know, when you go to orthopedic wards, um the doctors, uh especially the junior doctors have um a less or so important role in managing the patient. Uh after the orthopedic surgeons have done their bit and the care then tends to be majority nursing and the therapy led. So also we wanted to give a bit of further exposure at the University of Leicester, er, scrubs do a great job already, um, at doing that and, er, allow an opportunity for continued networking. Um, talk about audits and publications, er, which, er, er, Secretary Matthew is, er, planning on doing a talk next week on the, er, surgical training portfolio pathway. Er, and we'll plan some fun and some socials. So let's carry on. So, just a discussion point. Um, so just before you, er, write, you can use a chat function but you can ask a question to yourself. Um, but what made you attend, um, this talk today? Is it something that you want to achieve as a career? What limitations perhaps do you, um, have in terms of, um, the career itself? Um, and what makes you wanna pursue orthopedics and maybe I'll discuss a few things that I enjoy about orthopedics. Ok. Right. So I can't actually see the chat function which isn't, er, ideal. But, um, yeah, just have a think yourself. Um, and then we'll, we'll, we'll go from there. So, trauma and orthopedics um encompasses two. Right. Yeah, a and a, a pathway that's both trauma and elective. Um, and, er, as you, when surgeons tend to then go into subspecialties. But the trauma side of it is something that we're exposed to in our third year at medical school. Um, and based around fragility fractures, as you know, at Leicester, there's a hip list every single day in fear to three. You also see a, a fair few sports injuries and you see trauma fractures. Um but then orthopedics itself is an evolving career where it, there's a lot of research coming out. Um especially if you look at the journals such as the bone and joint journal, the other various journals that orthopedic literature has written in. Um there's a vast array of, of, of research that's out there and things that we can get, we can delve into very easily as medical students. Uh, it also encompasses specialties, subspecialty such as sports and exercise, surgery, spines, er, oncology, um, pediatrics, um, orthopedics is quite interesting. Um, and at Leicester, we do get a fair few pediatric cases, upper limb wise, there's hands, there's elbows and shoulders, um, and there's also lower limb arthroplasty in hips and knees and foot and ankle as well. So there, there's a, there's a vast array and, um, as you go through your uh, specialty training, um, from my understanding, you get to rotate through various posts with various different consultants. Um, so you get a good taster before you, er, um, do your CT, so why pursue a career in orthopedics? What do they do? First of all, um, they tend to treat and prevent M SK injury. So it's not just the surgery part of it, there's a lot of preventative, um, uh, there's a lot of preventative care orthopedic surgeons also do. Um even in Children, for example, there's a lot of sorry, there's a lot of um managing uh le leg limps, for example, um also managing fractures, dislocations, soft tissues and uh arthroplasty, which is fairly new um evolving over the last decade. And now there's advancements in hip replacements and now there's even superpath hip replacements they're doing in Leicester where um the incision is a lot smaller. Um the prosthesis is slightly different and patients tend to get home quicker and have slightly better outcomes. Um So it's quite a rewarding and satisfying career, in my opinion. Um You see quick if you're someone who likes to see results, if you're like someone who understands medicine but doesn't always understand it cos it's quite something that can be quite techy. Um It's, you can see orthopedics, it's very visible and it's something that you can go and get results with. Again, it's innovative and creative, there's cut and edge of research happening. Um And it's very goal centered. So it's patient, patient s specific. So um you're centering around a patient's goal specifically. But um for the one thing that I think as, as students, we don't get as lot, as much exposure to is the MDT. So I know we, we get told we can go to the 8 a.m. draw meeting. Um attendance probably isn't as good as it could be, but there is always a vast array of MDT members there and when you discuss cases and you can understand the breadth and depth of knowledge that's required. And of course, there's a growing demand. So people are living longer um especially in a country like the UK arthritis is rising. Patients are, are neon arthroplasty a lot quicker um in comparison to previous decades. So there's a growing demand and not just that trauma is gonna happen all the time. So this, this is a quote taken from the B OA. Um if you don't know what the B OA is, do, check them out um and their um medical student. So um er branch which is called BSA. Um So a career in all in TN O combines theoretical knowledge with practical skills, but it also involves an interface with technology industry and a multidisciplinary team unmatched by any other specialty. And I feel that orthopedics, this is probably one of the best ways to sum it up. So, and I'm sure from the discussion point earlier you've got your reasons. Um and, and do be sure to share them with your peers and get as many people as involved in orthopedics cos it's a great specialty. So the trading program II, as I assume a lot of us um at this talk today are medical students. Um so we bearing in their, in their years. So we get exposure in our third year to orthopedics er for about six weeks and then in fifth year as well, we get a surgical block as well. Um So the way it works is we do our F one and F two. an NRF one F two is encouraged a talk that Matthew will do um next week about the portfolio and breaking it down itself. Um is that you can choose seats that have orthopedics. So you have your 84 rotations per year and um you can pick when you rank your options to um, try to get orthopedic roles. Um, and there's an f, there's an F two at Leicester at the moment who got a junior orthopedic role. Um, and he also got an orthopedic role and research at Leicester. So, so, yeah, do be sure to check them out if you're traveling from abroad, um, pathway is slightly different. Um, so, yeah, um, I won't go into that. Um, and then, so what, what at the moment you have to do is you have to go into core training, so call surgical training and that's the talk that Matthew's doing next week on, um, maximizing your points, um, and understanding what's included and what's not, albeit that can change by the time you get to that stage. Um, so that's for two years and then you also pick, you pick your seats during that time and, er, that, that will last for various different specialties and then hopefully you try to pick the orthopedic ones cos that will tie you nicely to applying for specialty training So during your time, um, you, you have to do a couple of exams to get to this stage. So, um, so they recently introduced the, um, MSRA exam first and that's a kind of a sieving procedure. So people out of that get interviews, um, but it's also a, um, people also want you to do the, er, MRC S um, part a quite early on and then part B by the time you finish core training ideally, so then you go to specialty training. Um so that can be, that's from, so just going into it. So it's F one F two CT one CT two. And then you go straight into ST three subject to getting in for applications, which I'm sure there's another um pathway that I haven't looked much into, but there is a different set of um procedures, audits, um research you have to do to get into that. So that's for six years. Um That's probably one of the most stable time you'll probably have in a surgical specialty. Uh given you might have to hop location to location. Um And after the six years, people tend to um do the FRC S exam and then post CCT where you apply your, your basic led to be a consultant. Um You people tend to go on a fellowship, whether it be abroad um to learn new skills. And then obviously, there's, there can be a bottleneck in terms of consultant posts around the country. So people tend to do local consulting and then you tend to find a consultant, post um to work publicly and privately. So all in all it takes two years of foundation training, two years. So that's four and then six years subject to this is all subject to get in, in and you're not taken with f three year, um it can take over 10 years um including the fellowships and uh being on local consultant as long as it does come down to luck and, and how, how, how it, how it unfolds for. So this is the er 2023 surgical er self assessment scoring guidance. Um We're not really gonna go into it much today. I've got a few sa bit of an, an overview of it later on in the, in the presentation and um yeah, like we said, Matthew's gonna go into it in a bit more detail and see what medical students can do and how to get ahead of it, how to get ahead of the game now. Um, so that we can have better C STP portfolios. So just going into this, um there's, there's, it's broken down into commitment into surgery, um, prizes and awards and various other topics. Um Some of this would have changed. Um, this was a slight use from last year. Um, but don't worry, Matthew's gonna go into it. So from what I can remember from the top of my head is, it's usually going to three conferences as a minimum, um, getting over 40 cases. But I'd, I'd encourage, if you're passionate about orthopedics, don't just get the 40 cases and, and just allow it to keep going, make that network in links with, um, the people at your various hospitals, um, get scrubbed in the more they know you, the more they'll let you do things, um, getting surgical experience. So that can be during your F one and F two years. Uh, but if you are passionate about something I'd, I'd encourage to go on an orthopedic elective and if you're in your final year now, hopefully you've got an elective elective sorted. Um, a quality improvement and clinical audit project. That's something that you have to get involved in. Um, hopefully in F one and F two. because it's part of the, er, um, the part of the program that you're in, you have to do an, an audit but it's good to get involved in how it works, er, the methodology, um, the cycles involved in it, how to collect data, how to present it. So all those things you can do as medical students, um, you just need to, you need a, a consultant to back you up in it, uh, teaching experience. So, um, you, you, you have to have a, a regional impact um, in teaching. Um, and, yeah, publications are ideal, um, whether it be first offer or, or second or third offer they all look good and then presenting these at national conferences and, and things like that. So I won't delve too much into this. This is something that Matthew's gonna do next week. So that was just touching a bit further into um foundation training. Um So it's an o when we, when we obviously it's a system called Orel, um and 50 years probably know about this more than I will. Um So then you were ranked, but now it's a bit more randomized um which could be an interesting, interesting way. Um So then you obviously get your provisional registration from the GMC during your F one period. Um And then you take your M RM M SRA exam, your a part A of MRC S people tend to do this in, in foundation training if they can. Um And then once you get your full registration at the end of F one, you then are eligible to apply for core training after F two or during F two. And then the way it works for my understanding for core training at the moment, er because there are some run through programs, I think in Scotland, I think it was a pilot. Um But I'm not too sure. I don't think that's happened yet in England. Um The entry method is obviously is essential for recruitment. You obviously need your full GMC registration from your foundation year and you should be able to do your MRC S part A. But then people also do their part B during the core training years and on completion after core training, you have to do both part A and part B. So that's kind of the process. So obviously at medical school, we're kind of in touch with examinations and doing exams. But it's quite clear that whatever specialty you go into, whether it's orthopedics or something else, you're still gonna have to do exams and, um, stay up to date with the literature and things like that. So, especially training. Um, so obviously there's a, there's a separate application for this. Um, you then get interviewed. Um, people tend to apply usually different to different locations because of life circumstances, et cetera. And, um, for this, you kind of wanna do your MRC S both part A and part bi think, I think it's a prerequisite. So you have to, um, and after successful completion of core training, um you'll be a candidate for this and then you obviously do your Fr CS at the end. Um, and then you get awarded your CCT. Um, so after, so, so I think, I think what tends to be put a lot of people off surgery such as it can be a very long process and it's a lot of challenge in terms of moving locations, not again in first time round. Um, but I think what's, what, what is an amazing part of it is is you get to, you get to, you get to operate. And I think that obviously we're all here cos we enjoy that side of medicine. So, um so this was a pilot done in um 2020. Um And there's a, there, there's a registered guy I was talking to at Leicester and, and she's on a run through program as far as I remember. Um And this is something that might come into play by the time we get there and might be a bit easier for our stability in terms of um in terms of life at that stage in life. Um But that would mean it's a whole eight year program as opposed to the two and then the six. but we'll have to just watch this space and see how we see how we go. So I think we can just discuss um amongst your, among you can just ask yourself what, how would you describe orthopedics and commonly, how would you describe your, your, your opinion on orthopedic surgeons? Uh I asked a second question um because following a few of my peers, um people orthopedic surgeons have maybe in the past got a bit of a um a rep for um the way they, the way they might handle medical students, et cetera. Um But there's a massive culture change happening in orthopedia. There's a great literature out there to, to read the quality of the information about this. So do be sure to check them out um, I describe orthopedics as fun. Um, and, um, I think orthopedic surgeons are great and they're a good laugh. So, this is a, over the summer I opened as a physio on the orthopedic wards in Leicester and got to know a few of the F ones and F twos and getting their, um, getting their, you getting their timetable. It's a rough timetable. It doesn't always work like this. Um, it depends on which consultant you're with, et cetera, et cetera. Um, but tend it tends to be trauma meeting in the morning. Um if you wanna attend. Um and then you, you obviously do your ward rounds by yourself, but then your consultant might turn up, um just do, or a consultant might turn up for patients that are in your base who tend to get allocated one bay each. Um There is opportunity to assist in theater, um subject to you having your base sorted or maybe one of your friends or your medical colleagues on the ward can take over your patients for maybe a, a case or so. So you can get that er, experience. So in Leicester, there's three trauma theaters that are poorly assigned to orthopedics. Um Yeah, do be sure to go. And the team's lovely and they'll, I've, I've never been rejected from orthopedic theater. Um So it tends to be ward round in the morning. You do a handover on the ward as well around usually 1011 o'clock. With the MDT to see what plans are for patients and then you obviously do your ward jobs. Um Sometimes you can assist further and usually the afternoons are a lot more chilled out in the mornings. Um And there it is time allocated to your professional development portfolio. And as F ones you do get teaching as well, um which is um led by registrars and consultants. Um It might be different in other places you go. Um, and you do, obviously tend to work on calls. So the way it works in Leicester for the juniors is, um, they tend, there's three orthopedic wards in Leicester, um, covering around 30 patients each and you, um, are on call usually as an F one, between, uh, you do your day shift so you do your nine till five and then you're on call till nine o'clock. So it's a 12 hour day. Um, and you tend to, you can be by yourself but if you're lucky, there might be someone else there. Um, and there's obviously a, a reg on call and a consultant on call. Should you need them? Um, and I think the weekend rotor is one and six. so you were one weekend and six. But obviously that, that might have changed by now. So, what jobs do, do you need doctors do in orthopedics? Um, cos, yeah, it's not a lot. It's not gonna be operating all the time. But you can, you obviously can collect patients depending on your role. Um, you admit and do a lot of discharges, um, and discharge paperworks. Uh, you do a lot of TT O SS standard as you do as a, a junior doctor and other specialties. But you can get involved in consenting patients if you're with a reg, um, you can prep patients for theater, making sure they're on the right medications, making sure some are withheld, um, shaking, making sure that they understand the procedure. Um, and I think a lot of the care comes in postoperatively such as pain management, um, er, bowel management. Um, sometimes patients are not as mobile um, understanding, er, and, and managing any other, er, post operative problems that can occur. Uh, you can also carry on doing your audits at the same time. Um, and if you are a consultant to back you and again, you can go assist in theater and be the, be the third pair of hands. Um, and sometimes it is very, very, um, they, they tend to tend to like if you're keen. So where does a, a career in orthopedics, uh, lead? So you can obviously be a surgeon, um, and you can work privately as well. Um, and there's a great scope, um, with elective private work, um, you can also go into an academic role. Er, people tend to do like a APG cert, um, which is a post graduate, um, course, go into teaching, um, teaching such as uh medical students um and junior doctors um go into research. Um Some people can then uh go into SAS roles, which is like the most senior reg role, but it's not a consultant. Um I know you can go up the hierarchy of the hospital itself and go to the directors of surgery, medicine, quality improvement and things like that. So it's a very bro, bro, broad career and it's not just um it's not just uh what we probably get exposed to um at medical school. So the MDT and I think this is one of the most important part of, of, of orthopedics. Um So you've got your medical team, you've got your consultants, you've got your s you've got your juniors. Um, you've got your Sh OS and then per ward, there'll be a physiotherapy team. It tends to be two physios per ward. Um And um you can have occupational therapists as well. Um You might think what, what do occupational therapists do? We don't really get much exposure to that whilst we're at medical school, but occupational therapy is very, very important after the um orthopedic patients such as planning discharge, um making sure the patients that got the right equipment um to facilitate their discharge. Um and understanding when they can go back to work and, and doing all the things that are the occupational side um from the therapy perspective and the physios tend to be on the mobility, doing stairs giving exercises, uh, making sure the patient's pain is under management, um, and progressing them accordingly. Um, the O DPS, er, in theater when, as medical fortunately get scrubbed in, we see everyone around us. Um, the O DPS are great because they know a lot about the equipment and know a lot of information that we can learn a lot from, especially just with the kit. Um, and nursing. So you've got nurses a pre assessment um, before a patient has an operation, if it's elective, you'll have a scrub nurse in theater, um, who are always very keen to, to, to teach and give you tips, um, wound, er, they're also involved in wound care and reviewing the patients. Um, as they're the ones who tend to escalate to the doctors when their patients are not doing well and there's also advanced nerve specialists. So, um unless there's, there's um CN SS in, in um frames. So sometimes they can do external fixation where you have a frame around your leg and there's pin site care that's required. Um, because it's basically pins going through one side of the leg to the other and then around that is a frame to heal tibial fractures. So, one thing I think as junior doctors or as medical students, um, we should really be focused on reading is not, we're not, we don't have an expectation on operating or anything like any time soon. But I think what is great you can use apps such as touch, um, um, touch me, touch me surgery. I think it's called, um, or AO surgery. Um, where you can literally flick through, um, slides and they will teach you the processes of surgery. And as a student, I feel sometimes you can, you can get scrubbed in and you think. All right, I don't really know what's going on here. Um, it's this, this, this is this and something in a high pressure environment, you don't always ask those questions. Um But sometimes it's good to read the operation notes or sort of common operations such as um a hemi, for example, which happens a couple Moity, there's probably a hemi happening once a day at Leicester it um because we get so many knots. Um It's good to read the operation though. It's good to read the approach they used. Um It's good to see who did this operation, the an the the anesthetic side of it. Um Looking at the findings, looking at the technique um seeing how they got to the fracture site, um seeing what prosthesis they use, if they did what plates and screws, they used what these milli millimeters mean, for example, um and things that are perhaps if we got access to packs, we can look at the um the postoperative images they take with um the, the C arm or the ii during theater. Um It's good to look at tourniquet time. Um um Cos that um can definitely um indicate for maybe for more. So from the first therapy side how a patient is gonna be pain wise POSTOP. Um but it's also great to look at the POSTOP plan. Um because juniors tend to have a junior doctors in orthopedics tend to have a tendency of um of not really knowing the therapy side of it. So knowing what non weight bearing, partial weight bearing, full weight bearing is and things like that. So they can describe it to the patient to get early mobilization and also just reading the POSTOP instructions um and making sure that's all done for their, for their discharge. So, yeah, I do read the operation notes. They tend to be a, like a pinkish color in the patient's notes. Um And I'm sure as a medical student will have to go, will have to go. Um I go and read those. So that kind of concludes our, our, our, our chat with answer any questions uh in a little while. Um But so plans for the year ahead. Uh We're doing a talking talk series at the moment. Um This was the first one and we'll, we'll run that um once more before Christmas and then we'll continue after Christmas. Um We'll also get a few junior doctors, a few core trainees registers and a consultant maybe later on in the year. Um And we'll try to do a few simulation days at Leicester um at the L ri um and we'll talk to you a bit about how we can all get involved in perhaps an audit um seeing who's keen to do one. And it's just an opportunity for us to network. It's an opportunity for us to get involved with other students and collaborate with physiotherapy students at Leicester DP students to build a collective um in terms of orthopedics. Um And yeah, collaboration wise, Um um We work together with BSA. Um do check them out. Um There's a Midland Division uh and there spins regions, um scrubs, do a great job um at Leicester for things, surgery. Um Most cla well, expanding to Claro, other, other Midlands um university societies such as Kiel and Warwick. And also there's, there's, we're trying to, we're trying to talk um with a few tech companies to strike from at artist to get a few uh practical workshops going and uh that'll be something that would be great for us to, to move, move forward. So um we have got a quiz um but I'm thinking we could perhaps save that for uh for another session. Um So, yeah, if you do follow us on, on Instagram, um we have got a mailing list. Um You can join on the SU website. We do have a mem um there is a membership. So if you do feel generous to buy a membership with us, it will go a long way, especially when we plan to do um er workshops, et cetera. Our next events will be sometime next week and it'll be a medal like just like now. Um And if you wanna take a session just, just DM US and there's no reason why you can't, we don't, it's not committee based, anyone can take a session. Um This is our society and um you're all welcome to, to, to chip in basically. Um But thank you very much for attending. If you've got any questions, do feel free to ask in the chat function. Um Thank you very much.