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Hello, everybody. Welcome. Welcome to the seventh session of a day in the life surgical specialty sessions. Um We will be starting in about 3 to 5 minutes. Um You guys can take a minute to answer the polls in the meantime. Hi, everyone. Tha thanks for answering the poll. Uh I can see uh so far no one has put not in, not interested in urology. That, that's good. That's, that's what all right. Thank you. Thank you, everybody for joining. My name is Jefferson. Um I'm one of the junior doctors in the Royal Shrewsbury Hospital. Welcome to the seventh session of the surgical specialty teaching program. This teaching program is conducted by the West Midlands Foundation trainees Surgical Society in collaboration with the Surgical Society of International Doctors. So we initially started this program um as a means to introduce junior doctors and medical students to different surgical specialties in the UK. And we wanted to tell them about how to enter each surgical training program. We also wanted everyone to understand the basic day in the life, a review of common cases of each surgical specialty and that's where we started. And we found that we had attendees from all over the world, India, Bangladesh Pakistan, Mexico, Malaysia. Everyone was interested in what we had to say and that's what has kept us to continue doing these sessions. So today the session will be on urology we have here, Mr Chaya Desai. He is an ST three urology trainee in the reputed West Midlands scenery. Now I'll hand over to cha so that he can carry on with the session. Thanks. thanks Jefferson. Um Let me just get these slides uh somehow. So what do I need to do? Is there any way I can share the uh a different window? So if you had to share your screen and then window click on window, yeah, it doesn't seem, it just seems to give me that one, one window. Oh, here we go. It was there. It's gone again. Let me just try again. You will just share this. Uh And you guys can just tell me if you can see this. Can you see this? No. Ok. Uh So yeah, if hi, by the way, my name is Chase Odes. I, I'm ast three in urology in the West Midlands. Um For those of you who may not know what that means. I'm a registrar and I've just started uh my registrar training. So the talk today is about urology and the career itself. Um a bit more about how to enter the training program and also why you should consider a career in urology. Uh, I can't see any of you guys or the chat. So if there's any questions throughout, uh, please enter it in the chat box and Jefferson, uh, can just highlight them as we go along. So, uh, I'll just start with a bit about me. Um, I went to the University of Liverpool and I did my medical degree there, uh, and I did an intercalation in, er, law as well. I had very minimal exposure to surgery if I'm being honest with you and being a PBL course, we, we didn't have much anatomy or dissection teaching. So it was only when I started my fy one job, er, which is my foundation training, my first year outside of medical school, er, when my job was in urology that I realized what a career in surgery could be like. Um, they say that often the first job you have in fy one is, you know, has a, has a impression on you and ends up the career you, you know, you end up choosing. But in, in my case, I decided to keep an open mind. I did some jobs in medicine, uh GP training as well, er, in F two. But I realized that the career that I was more leaning towards was surgical minded and I came to that through various reasons. Um, but an important bit of advice that one of my consultants told me is that uh no matter where you are on your training pathway, whatever job you end up in, you should always try and get involved uh in, you know, as much as you can and show an interest because often the thing which we do as an fy one or F two doctor isn't actually what the job involves. And I tried to do this with urology. I uh did some research, uh did some audits, tried to ensure that I was understanding ward rounds and why the registrars were making the decisions they were asking questions. Um And ultimately seeing what the consultants uh day to day jobs were like, what kind of lifestyle they were living. Um I did apply for urology in the end and I ended up getting a, a co training, uh co training placement in the West Midlands, um of which I was able to swap my six months to then get 18 months of urology and general surgery for six months. Um Although it may seem like why do general surgery or other sp other specialties in your core training? I found that actually having exposure to something else can be quite beneficial. Um A lot of skills are transferrable, especially at the basic surgical level. So I wouldn't be disheartened if you're in a position where you've got one particular type of surgery in mind and then you end up with maybe a, a different job for core training or a different set of rotations. Uh It's still w you know, worthwhile experience. Uh, then I again applied for ST three in urology just by this point. My, my head was pretty much set on this is what I wanna do, er, and managed to get a job in the West Midlands, er, this year. So, what does a urologist do? I think this is a simple question but one that I didn't know much about when I was a medical student and I'm sure you guys are all aware, but just as a quick recap, um urologists are surgeons. We don't just deal with TI S and catheters like people think we do. Um we are surgeons, we operate on the genitourinary tract. So that's all the organs from the kidney to the urethra uh in helping patients void and also the the male sexual organs as well. So test to the penis. Um when it comes to the operations, there is a, a wide breadth of operations that you can do. And I think urology has something for everyone. There's the opportunity to do robotic nephrectomies for cancer, for kidney cancer. Um And these are seriously cool procedures and if you ever get a chance to even, you know, be present when someone's doing this operation or even watch it on youtube, uh like someone, you know, like I might do one day, then this is, this is the the operation to definitely um look into and you also have operations which are a lot smaller open procedures such As here, we have a penile implant being put in for someone with Pay Ronis disease. Um, and there's also the option to do um, operations for female patients. A lot of people think that urologists just deal with men. Um, women also have voiding problems, uh difficulty passing urine incontinence, post pregnancy. And this is an example, a diagram of an operation where the rectus muscle is used to make a sling around the urethra very complex pelvic surgery. Again, it gives you the the options to do that. Um Just wanted to highlight the, you know, these are just some things I could think of, but the wide array of subspecialties that you can go into. Um and urologists love technology. Um They are the predominant specialty to be using robots in the UK. And almost every urology center in the country has a Da Vinci robot for performing uh on uh uro oncology. So removing cancers from kidneys, prostate bladders. Um There's also a huge push towards tech in other fields such as in lasers for stones, for cancers, um and brachytherapy template prostate biopsies, et cetera, an image just to highlight um again, the, the the context of how complex some of these surgeries can be. This is a a renal tumor on the left side which is extending into the inferior vena cava leading to an IVC thrombus, very complex uh requiring an MDT approach and uh very interesting work. Other just things I wanted to highlight were 25% of the current urology trainees uh are women. This is a 2021 study and in the West Midlands, this number is far higher. Um Hi highest number of less than full time trainees compared to other surgical specialties. This just means that you have the option to have uh you know, more focus on a work life balance if you need it. The on call demand is not as high. And in the UK, uh predominantly a lot of acute urology can also be done by general surgical team overnight. So you may be only called in for a, a minimal amount of cases and I'll talk you through my, what my week looks like. If you guys want any more information on the career path or even what urology in the UK is like, I'd heavily recommend uh the bau website, the British Association of Urological Surgeons and this is just the, the web link for bs.org dot UK. You'll find all the information there. So um a bit about my life. So right now, ward rounds start at 8 a.m. This is like any surgical specialty in the UK. Um And often in urology, they're fairly straightforward if any of you here have done a medical job. Um You may know what I'm talking about in, in the difference in times that it may take for a surgical ward round. And this was personally something that I preferred. Uh I get about 1.5 to 2 theater days. What I mean by this is, uh, 3 to 4 sessions, morning and afternoon. It depends on week to week. And, um, also the, uh, the context of where you work and how many registrars, how many core trainees are on the, er, rota clinics wise. Um, you get a, a huge variety of clinics in urology. You can have clinics where it's procedural based. So, uh doing prostate biopsies, uh doing flexible cystoscopy and then you get clinics where you're handling two week wait, cancer referrals for things like hematuria, uh renal masses, uh as well as benign urology, which is your um often patients uh waking up at night to pass urine often, too frequently having incontinence, et cetera. Um when it comes to night shifts, luckily, urology have non resident nights in almost every center that I've heard of in the UK. That means you can go home um, after 5 p.m. you're, you're on call but you can be at home and you get called in when. Uh and if you need to be often why people call you in is testicular pain uh presenting in A&E, in a young person and they're worried about torsion, um, or someone who's acutely deteriorating with a kidney stone with an infected system and who needs stenting. Both these operations are fairly quick, straightforward. Um, and it just makes the, the night a lot calmer than um some other surgical specialties catheters are unfortunately the, the, uh, the, the thing that urologists don't particularly like to be called in for, but it happens. And, uh, the one good thing about these, these calls are usually, is quite a simple fix, um, courses, conferences. I see a time. So these are again. So at the end of the week and you'll find time to do these things as, and when you need, um, and just to let you know when you do the non resident nights, you have the next day off. So it's a, you know, it's a great time to get, get into theater or do this management if you need it. Uh, when it comes to theater, this is just a, uh, a screenshot of the curriculum for someone like me at an ST three level, you know, and, and maybe an entry point for where you guys might be entering. So you've got such a wide breast of operations that uh you'll be doing and this goes all the way from, you know, big oncological work. Like you may be assisting in steps to take out a bladder all the way down to a circumcision, um, uh, a pediatric urology, et cetera. Uh If there's any questions, just, you know, uh Jefferson, just let me know. Uh, if not, I'll just, I'll keep going. So the route to entry, um, this is the bit that probably most of you wanna know, er, or you may have already looked into. So you do your F one F two, then you apply for CST, which is your two years co surgical training. Then you apply again for ST three to get into your five years of specialty training. Uh This can be your into urology or any other special surgical specialty in urology. There's two phases to higher specialty training. So year 34 and five. So your your first three years of being a registrar is called phase one. That is when you build up all the necessary skills, uh data experience, all your portfolio needs to then apply for your Fr CS exam, which is normally starting at this point. And for the last two years, you work towards your Fr CS, your final exam to then finish training and become a consultant. Two things I'd recommend which I, one of these I did do one of these. I didn't so set in your MRC as part A as early as possible. I didn't do this. I did this in my core training. The reason being that I didn't know that I wanted to be a surgeon until a lot later. It didn't hinder me too much because I was able to balance my time. But I know uh the MRC S especially part A can be quite difficult in terms of it doesn't really assess how good you are. Er, it just assesses how in somewhat your luck on the day. And if the questions favor you so doing it early means you have more chances to repeat the exam if you need it. E log book. I did get told by a registrar to do this and, and I was grateful that I did because this is a really important website, even if you're in medical school just to get started on um and log every operation that you've assisted. Uh or if you're performing them, then use this website. This is what the UK er accreditation uses and this will continue your whole life through, through training and even as a consultant, so make an account if you haven't um some competition ratios. So uh Jefferson, I and I were talking about this earlier that the CT one to get into CST, the ratio seems to be about the same. It does fluctuate some years. Uh I think 2022 was a bit less, but in general, there's about 600 jobs, about 2500 people applying ST three urology. Something very uh very interesting happened where the competition ratio dropped quite a bit uh in this year and it dropped to, to about a three but the numbers of people applying are increasing but the places are also increasing. So um that's something to bear in mind, but it's not a bad ratio. Once you, if you've got into CST, you should hopefully be competitive enough to get a job in ST three as well. Uh Some other specialties here if, if you guys want to just, you know, have a quick look and compare this is from 2022. But as you can see, they've, they've stopped a lot of these, uh the run through jobs, which is why some of these might be different. So how do you prepare, um from the poll? I could see that some of you are in the stage where you may be thinking about applying for CST or ST three. Um What I would recommend is to obviously look at the self assessment um and target the areas you need to work on. But beyond that, the practical advice I can give you is to make sure you consolidate your knowledge with guidelines and actively participate on ward rounds, whatever level you're at what you need to try and focus on is why is the registrar or consultant making that decision? Not just let me go take those blood tests, but why are those blood tests being ordered? Why is that scan being ordered? Those are the questions you sometimes may have and sometimes no one will answer. But the way you can answer them yourself is by going on these websites, the European Assoc Association of Urology Bao or nice check the guidelines for someone with a kidney stone and then you realize, oh, that's why that particular scan is being ordered um clinics. So one thing I'd recommend is if you are interested in urology or surgery in general, and you need to get your log book numbers up. Uh I think they needed 40 procedures to er, meet the, meet the maximum points for a CST. Then a great way to do that is to go to a flexible cystoscopy clinic. And after some observation, you may get a chance to even do some of them and each of them counts as one procedure. So by attending uh clinics in one week, you could hit the 40 procedure counter that you need. Theater. Goes to that saying, um you know, assist as much as you can learn the basics by basics. That could even be um the, the wh O checklist, uh gowning and making sure that you've done um your laser certificate. If you want to be a urologist, cos that's, that's really important to get be anywhere near um using laser for breaking down stones, attend MDT. So, um something I didn't do much as a fy one doctor, but I started doing a lot as a court trainee. The reason being that you get to research and present cases from the ward, which not only help you understand again, the guidelines for why cancer is managed in the way that it is and, and understand the consultant's decision making process. Uh But it also helps you identify cases that may be interesting to write up. So I managed to get the case report just from attending MDT and finding an interesting case um audits Q IP research. So again, audits and Q IP should be something everyone here can, can probably do relatively easily. Um because it, you can, you can choose simple topics that are easy to do multiple cycles on something like VT, like, you know, DVT assessment, BT assessment, uh checking surgical drug charts research, however, is slightly difficult to get. And when I applied for CST, I didn't have any publications. Um and it's something which if I had started earlier, it could, it could have really helped. Um One thing I would recommend is looking at the best collaborative, they uh produce a lot of papers on urology. And even if you collect a small sample size of patients in your local hospital, you get um added to this collaborative and, and last time I checked, they were counting collaborative research as a coauthorship. So you still get the same point but minimal effort. Um And this is something that I'd really, really recommend. Uh no matter where you are in your stage of training. If you've only seen surgery being done in ad GH, then it's really important that you try and get yourself a taste a week at a tertiary center. Um I did this by emailing um someone who gave a lecture, uh an online seminar. I emailed this person and, and they were working at a, a big center up north. And I said, you know, I'm interested in urology. Is there any way I can come and shadow you. Um I ended up spending a week with, with the unit there, which was my annual leave. But II decided it was a good thing to do. And not only did I make contacts, um got a publication out of it by being around these academic uh clinicians. But I saw that the job they do is something I'd like to, to strive for cos that's the pinnacle of uh any, any field that you're in the the tertiary centers. And yeah, on the question, is this the job you see yourself doing? So applying for CST. Um I think the guidelines on this may have changed. This is last year's but have a look at the website, look at the self assessment scoring guide, mark yourself, see where your weaknesses are and focus on those. Um And the M sra uh revision. This is just a question bank. Um We luckily didn't have this but uh I think now it's really important to get on this. Remember point to the point. Don't waste your time getting that first order publication which may take you three months of data collection. Um Instead maybe use that time to do something for a collaborative and work on completing your audited loop. Um You know, this is basic theater etiquette. Um I don't know if basic surgical skills are still being done as a course, but I would really recommend that because they will teach you all the basics that you would be expected to know. And when you go to theater, even as a, as an fy one, you'll seem a lot more proficient than, uh, those who, who just turned up because they, they're on the surgical placement but they have no idea how to suture skin. Um, and things like that be official with clinical responsibilities if you can, er, safely give your bleep to someone and get some time to go to clinic or theater. Make sure you do that. Let people know that this is the career you wanna pursue um within reason uh organized with conference dates, taste to week selectives. Um This, this is a conference that really helps me ace it. Um It happens every year. They, they do accept a lot of work and the cost of going to the conference is fairly cheap. So I'd really recommend applying to ace it with any work that you have. Um And just yeah, keep those dates in mind, book your annual leave, early study, leave, sorry, early um fine and contact local CT FS. So uh clinical teaching fellows, they're present in most hospitals and they're the people's contact if you want to get the points for the teaching organization part. So email them, say you're interested, you want to set this up. It could be something as simple as um how to uh you know, look at, look at scans for fy one doctors, basic scans or um catheter training, you know, something like that, which is, er, minded may be really helpful to, to get your points up and they'll give you a proper certificate at the end of it. The self assessment has very clear wording if it says it has to be a, uh, something you've l designed implemented and make sure that the certificate has those three words in it. Um, because that's ultimately why people I know haven't got the points that they deserve because the wording wasn't right on the certificates or letters. Um ok, applying for ST three. So the same thing, look at the self assessment. This is the urology one. That's what it looks like going through it early. I did it in CT one, just start checking through it mentally. Have a note of, I need to work on this and then try to get it into your day of. Ok. Somehow can I, you know, get this into my day because I need this point for um you know, audits or flexible cystoscopies, et cetera. Um The RSM, they can be a really useful resource. So can um the West Midlands uh FT SS and the West Midlands Surgical Society because the prizes are really difficult to get. And unless you've got some medical school, um it can be very hard to, to find where to get a prize. This is a good website to, to do that. They have loads of competitions like essays and things. Um So you've made it to the ST three urology interview. What does that look like? So, if you've made it and you're in part of that, uh, 120 100 and 50 that they interview every year, this is what the, the stations I had. So, you've got an outpatient station, emergency, er, communication skills. Each of these are about 13 minutes, er, long and, um, they focus on different scenarios if anyone has specific questions on these happy to answer them at the end. Um Some resources I'd recommend Medi body. This is a really good website with um questions and answers based on previous scenarios. Uh the Fr CS urology book. Now, you might think why are you using an Fr CS book to enter training for some reason, everyone uses this book. So if you wanna stay with the competition, this is where they're getting their papers from, they're quoting papers, they're quoting um you know, statistics for consent forms, things like that. Um And you can find a PDF online that that's what I used um study partners. So just like the part B of MRC S practice saying out loud what you want because that is the best way to be confident when it comes to the real thing and ask registrars or consultants um to mock examine if possible. This is that book that I would really recommend. Um Again, this is a quick run through, through the whole uh through my life basically. But if you guys want any more questions answering, please, please let me know. That was fantastic. Thank you. Thank you chair too. Thank you. Thanks. Thanks for that. Cool. I've got, I've got a few questions. Um So, you know, for ST three urology, when you apply, are there any specific procedures that you need to have done, you know, to score points for general surgery? It's, it's appendicectomy. Yes. Groin cut downs. What about urology? Yes. So there, there's four main procedures. Um one is cystoscopy. So that can be flexible or rigid. And again, this is something that you can even master as a foundation doctor. But you need to get uh this at a level four. So they put a level system in urology. Level four essentially means that you can be left to do it independently. Um My honest advice to you guys is if you wanna do urology, getting the level fours is a must and it's something that it doesn't make any sense because level four, when you enter training, equates to consultant level. So when you become a registrar and no one gives you a level four, but to even get into training, you need the level four. So it makes no sense. But cystoscopy is one thing. Then you've got your scrotal procedures like Hydrocele, um uh epididymal cyst excisions. Um then you've got circumcision. Uh and you've also got um a to normal more stents. So your uh ureteric stent insertions. I believe that's the four, if they've changed anything though, they will, it will be in the self assessment. Ok. Thank you. So that's, that's four separate procedures. Ok. Right. We, we have a question here from uh Ravi Patel. If you were to do the process again, is there anything you would change or do differently? Thanks for a fantastic talk, Mr Disci. Yeah. Hi, Rob. So, uh anything I do differently? Um I'll do the MRC SA lot earlier cos that was significant stress in my core training years. Uh and I could have used that time to focus on building up operational skills, other things. Um And I think that's probably the, the main thing that caused a lot of stress and I think I'd advise anyone who's, you know, at that stage, get, get the MRC S done. Yeah. II remember meeting uh here in the operating theaters once he was stressed out about his part. B Yeah. Yeah. And he was operating, it was a painful experience, actually, very painful experience because working on an on call rota and having to revise it's difficult. Ok. So Abdul Hashiba said I'm currently working as resident urology in Pakistan. It, it is my first year I have done. My Mr CSI would be applying for urology ST three in 2024. How should I prepare? Yeah. Hi. Hi, Abdul. Uh Yeah, I mean, the main thing is it's basically a tick box. So, go through the self assessment. Uh, if you type in urology ST three self assessment on Google, there'll be a, a PDF that comes up from, uh, yeah, that one from the Yorkshire and Humber, that the Jefferson has put, er, go through that and just start taking them off as much as you can if you, uh, you know, find that you have a lot of points in one area, focus on other areas. Just try and, you know, that's the only way that's how you get the interview. Then when it comes to the interview, that's where your clinical knowledge. And uh if you're already a urology resident, I'm sure you'll have a good background. Ok. Now, I've got a different question for you. Now, um do you think uh entering urology training? ST three is any different for international medical graduates maybe applying from inside the UK or even applying from outside the UK? Yeah. So, uh I was actually quite fortunate. Uh to be honest, I was, I was doing interview practice with one of my registrars when I say registrar, I mean, he's a, he's a trust grade in uh stoke, but he's done a lot of training in India in, in urology and as an international medical graduate, if you have that experience of urology in your, in your previous training, then that, that is really good. Uh because his, you know, his knowledge and his answers were a lot better than mine coming straight out of being an sho um but there are areas that he really needed to work on. And the biggest area I'd say is there's a station called the Communication skills station. In the interview. I think communication skills are not as well taught from what I understand in uh in India anyway, but in the UK, it's prioritized in medical school. So I would really ask that if you are an Interna International Medical graduate, look at uh resources to help with your, you know, communication skills just so you can get through that station. Well, a and also I would say one other thing is just look into the uh some of the medical legal law and things like ethics. Um Those kind of principles which UK medicine is based on. Uh They, they like, oh thank you. So um can you tell us about what uh what your communication station was on during your interview? Yeah. Um So I had, I, if I can remember, I think II might have blanked it out. Uh But I think it was on essentially breaking bad news to someone with bladder cancer, but they didn't know that the procedure they had was even to look for bladder cancer in the first place. So it was a, a tricky one because they start out at not knowing anything, not, not even knowing why they had the tur BT, the, the resection operation, they were told it's just to look at your bladder and you're at a point where you're gonna break to them. This is, you have bladder cancer and it's muscle invasive and you have to try and bridge the gap of knowledge, uh which can be very hard in an interview. So, practice that with your friends because that, that's something that helped. Ok. Thank you. All right. Uh Is it, uh is it true that urology, uh I mean, entering the urology training program, it's, it's one of the specialties where, uh, the more experience you have, they don't penalize you for that. Uh, unlike other specialties like general or vascular. Yeah. Absolutely. Absolutely. They, there isn't a, uh, I think, I think they call it a, is it like a dividing number that they divide the number of years you have by, uh, a set number to kind of negatively impact those who've taken years out? But, but urology at the moment has nothing. I haven't checked this year's application but I'm, you know, I'm pretty sure they won't suddenly. Yeah. No, that's perfect. I mean, that's very useful for, uh, international graduates, uh, who got experience in their home countries and they're trying to enter the UK system. I think this is quite helpful for them, right? Um Are there any other questions from the audience members if, if, uh, if there aren't any more questions? Uh, I'd like to ask one last question. Um, you know, you said you did a taste a week in a tertiary center. How different uh were the procedures and the cases that you saw in the tertiary center compared to the D GH that you worked in? Uh Yeah, really different, really different. Um We, I mean, in that one week I saw things which uh the hospital that I was at, they weren't even offering patients. Um for example, there's a procedure called PCNL Percutaneous Nephrolithotomy, which is done for big, big kidney stones. Um The center that I was at it didn't even have that option. Um So they were always referring those stones, which meant, you know, II never saw those patients, never saw the post ops, things like that. Um But also the center had a lot of andrology work. Um So they're putting in penile implants and uh procedures which as a urology trainee, you, you do uh need to know a bit about but having that early experience uh can really help. OK, that's, that's nice to hear. Um There's a question here from uh A DK. Again, he's asked what procedures are we expected to have performed at the time of interview apart from what you have mentioned and how do you validate your E log book entries? Yeah, so I think the procedures, they should be all on that self assessment. Um But yeah, they are mainly those four procedures that you need. Uh the GMC E log book. Um look at the self assessment criteria very carefully. So when I applied what they wanted was uh a signature at the bottom of every validation sheet. Um and they wanted a uh like a signed signature on, on the front cover page as well from a consultant. So that, that's and then you just have to scan those on. Ok. Um I think uh it's the same for co surgical training as well. We just get a consultant to sign it on every page of the log book and the consultation report. Uh Can you share a taster weeks certificate? Yeah. So II actually didn't get a certificate for it. Um II just got a letter from the consultant saying that I'd attended the week uh and he signed it. Um but yeah, I II think, you know, a letter should be fine as well if, if we can get that from. Yeah. So essentially something that says this is to confirm. So and so on these dates. Uh and his performance was good or he was sincere or whatever. I think something I'd, I'd really recommend as well is if you start reflecting on these things, people like reflections. So, um the letter is really good but say also in your evidence, you had a reflection or just a, a word document saying these are the procedures I scrubbed in from, this is what I learned. This is what I enjoyed. Er, it, it can help er, add some more bulk to what you've done in that taste. A week and then. Ok, so I can just see this question, laser certificate. Um There is a website called uh e-learning For Health. Uh Let me just try and find it. I'll just link you guys. I don't know if this is a A UK only thing, but essentially to do any laser work in the UK. You need a laser safety certificate. Um It's not for P CNL, it's for any like laser work. So you might be doing simple things like uh a ureteroscopy. And you know, the consultant may give you some chance to do the stone, uh laser, the stone. So you need this either this certificate to an online resource or you pay for a course. But, but this is free. So I'd recommend this. Ok, thank you. Uh Do we have any more questions? Have we convinced all our attendees to go for urology then? Yeah. You know, and, and you know, next time someone asks you to do a catheter, just, just remember, you know, that's how, that's how we will start and we eventually build up from that. So, uh Chaia, what do you want to subspecialise in? Where is your, um, what is your keep? My, I'm keeping my options open. But I think, I think what I've found to be the most interesting surgery is, is the nephrectomies. Uh I think personally I've always had a soft spot for general surgery and this is the closest you can feel like a general surgeon. So uh yeah, that's, that's probably what I would like to think I wanna know more about, but I think it's, it's still early days. Ok. I think that's, that might be it potentially for the questions. Can you share your contact info in case I have to contact you for any further assistance? Sure. Sure. Sure. Uh Yeah, there you go. This is, this is the email and I'm desperately waiting for the 2024 applications applications open next month. Are they already open for ST three CST opened yesterday? Yeah, they, they usually open around this time. I think November is when the the window opens, but they release a self assessment before, don't they? So, yeah, yeah, if anyone has any questions, anything else just email me? Um And uh yeah. All right. So uh I think that brings us to the end of the session. Um Thank you everybody for attending. Uh Thank you for doing a great session. Um I think I might do urology. That's one thing anyway, in the, in the coming years. Yeah, good. Very exciting. In fact, uh my, my clinical attachment was in urology. II. Quite enjoyed it. Ok. So um can I quickly remind all of you that you will receive an email uh or a link to the feedback form if you fill it in, you will receive a certificate for attending this session. Unfortunately, that's how met all works. You don't give me any feedback. We don't give you any certificates. But anyway, I hope you guys uh enjoyed the session and we'll be back soon. Thank you. Thank, thanks Jefferson. Thank you so much for organizing this and everyone. Thank you. Thanks guys. Bye bye.