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Yeah, keeping everyone. Thank you so much for joining us at the visuals. Dash Recruitment event. My mind's clear bridge on on one of these straws working in Manchester in the northwest. And I'm going to be hosting tonight. We've got some. Excellent. Because I really kind of agreed to take me to get some of the evening to talk to you about career and gum. Got lots of enthusiastic because a gram, So we'll try and keep the time as much as possible. And I'm sorry, working from home. Doing this from home means that you can him a dog barking the background. Sorry about that. Um, great. So if you have any questions as you go along, you can postpone the chart. I can pose them to each of us. Because as we go along, because people may dip I/O as the fashion shows a long battle that it's quite part by January so it may not have to get every single will try and prioritize most important ones. No, I'm going to start just by doing an introduction to the event, talking little bit about the gum recruitment timeline. When with metal, we have to do a bit of a quest, witty, kind of slide share situations. So I'm just gonna wait for my colleagues to load. It slides on. We'll start properly. Thanks for you much in there. Brilliant. So other saying, Welcome to the stash Recruitment evening. We can go to the next slide. So just to go through our time table today. So I'm going to go through the recruitment timeline a little bit about, um, agreement about interviews. And then Doctor Ryan Makowski is going to talk about the day in the life off expiring gum and got to Elizabeth a Cat. There's gonna be a three day life of a consultant test market. Kingston is going to introduce the new curriculum, that part's good training in 2022 and then finally, only choke. It's going to talk about travel during out of program options are combining career and gum with other interests. Finally, if if we've got time, I'll talk about a little bit more about the program options and then we'll close. Thank you. Thanks light. So this is the equipment timeline unit that I kept all of the The timing's vague. This is because each specialty appetizers a different times, but this is a rough I'm lying. The mid November is when specialty advertisements are published on then mid November until the second week of December is the application period. So you got a reasonably tight three weeks the application period then between November and January, long and short lasting. Take place. So this is where you want really hear very much until you find out whether your bean shortlisted for interview between January mid April is the interview period. And then in the third week of April, the first offices sent out you have the hold offers us with confrontation jobs and of the jobs. Um, may is the deadline future, except your decline. Any offer, this is broken. Any medical speciality? Not just so how next light, please? Very brief overview of interview. We are going to plan another Requip event event in October. Time to do a little bit more about interview people who are thinking about applying you might be in the i m. T. Three year. Basically, it's let into four different scenarios. One is an ethical scenario, Um, one is a clinical scenario which tends to be going more hatred. The specific. They'll be medical registrar suitability, which they highlighted. So this is quite new, but they're highlighted. This will cover clinical aspect will cover more of the management side of general medicine, for example, managing a cube, take or managing flow through a busy medical clinic. And then finally, this chance to do a five minute presentation, which is entitled, Why? I'm interested in a career and go on there. That gives you a chance to show all the things you've done to show equipment. A specialty. Why you're suitable. Why you want to do the specialties. That's really the chance to sell yourself much as possible. We can talk about that in more detail if you come to the next event. But for now, I'll handle to Ryan Makowski. Thanks very much. Um, so, Ah, however, on my name's Ryan So I'm an STD three. A new yes t three from February, based in the Northwest injury. Um, so you have next light, please. Eso I currently work at the Royal Liverpool. You could see the beautiful building there. Um, but I should probably gas, um, go sky sacks on them originally from dairy. Um, next light. Great. So um, my discussion My presentation today is is a day in the life off being a good mess, PR and what has been like for the last 45 months for me. Um, I think to kind of appreciate what a typical day and, um was like, It's it's good. The to kind of review. What kind of skills? Someone who wants to be a government. SPR should have, um, so many of these skills you probably will have already acquired in your training or your your work. So far, um, these are taken directly from the specialty recruitment website. Um, it's obviously be known judgmental. Um, you may meet patients who leads very different lifestyles. We come from very different backgrounds to yourself. Um, it was really important to have that skill. Excellent community communication. Um, in our job in general. Urinary medicine, meat. Very vulnerable patients often very frightened. Very embarrassed patients who it's good to be able to manage. Um, the anxiety efficiently being a team player. So gum brings people from lots of different backgrounds, been able to kind of jail those skills on experience together and kind of provide a service that sufficient adaptability given the evolving nature of especially, I think that's nevermore. Sure relevant on the night when you we've got, um you know, gum is leading the management of monkey pox in the UK So it's something that we've had to adopt to with staffing levels providing alternative services. Um, not being easily embarrassed and having good sense of humor, I think that's, you know, pretty straight forward. And, um, um, makes sense. Really? Next line, please. Um, so this is what a typical week in work would look like for me. Um, so incorporates 5 to 6 come clinics, um, one HIV clinic, um, then several admin or normal clinical sessions. And then there's opposite it. Opportunities to do research. Hold it on education. Um, educational activities as well. Um, there's also a once weekly journal club sessions. We have junior teaching. Um, Onda, uh, then we have ah, multi disciplinary HIV meeting on the Friday there. So, um, that's a good idea of what the average week looks like. Obviously, this will vary between, um, various regions and services, so there might be slight variation, depending on where you practice. And so next light, please. The experience of working a Zagami. Just our gives you the opportunities to toe work in very different areas. So we deal with ST Isaac's contraception, dermatology, managing patients. They're living with HIV. Um, you practice public health. We work closely with microbiology. As I mentioned before, we see very vulnerable and underwear represented groups on. Then there's the opportunity to develop special interests as well as the academic and educational site. Uh, next, let me please. So I'm just going to talk about, on average thirsty. You're really for me. So, um, morning session starts off, kicks off with a journal club and nine am So, um, in the Royal Liverpool, we have, ah, week a journal club session, and that's that's a tendon by by all the staff. So, um, you know, doctors, nursing staff, advanced practitioners, um, the Claritin alone, admin staff, um on Do you know it's a good opportunity to, you know, to listen to a wide variety of different speakers? Um, we have an attendance people from all the peripheral conexes. Well, so it's you get a good idea of what's going on and another clinics in the region on it's It's just a very it's often very good learning experience for everyone. Um, at 10 o'clock, um, I have and go on. And we have We have junior cheating teaching, so that's focused towards, um, we have ah, I m t doctors and have three doctors rotating through the unit on. It's a good, uh, good opportunity for me to kind of refresh only common medical conditions. Um, prior to my S c three post, I did the especially doctor post on gum. So two degree. Some of the conditions were quite from a year for me. Um, it's also a good opportunity before I go into my next clinic to kind of discuss complex cases, maybe a result I'm not quite sure about. I've been able to stood to discuss with a consultant, um, how they might manage something differently or in a better way. Um, I think you have to remember and go. Malu is very teamwork based, Um, you also because his clinic place based, you also practice very independently. Um, so I find that, um, it's really important to kind of, you know, check yourself and on, do get some feedback, and sometimes you actively have to pursue that, um, because of the way we work. Um, next light, please. Um, so after the the first couple of fashions, we have a team huddle, which is something that we do every day on. That's kind of come around because of Kobe it on. But everyone is based in the clinic again. Nurses, staff, doctors, admin staff will. We'll have a 10 minute discussion, and it's really to give any updates, staff about patients coming in, and then the East staff absences. Any meetings that might be, um, held or any urgent updates. Think it's very important because, obviously, with monkey pox guidelines are updating, um, and very rapidly. So it's to make sure stuff are aware of any big changes. Um, and then I I do my HIV clinic, Um, 11 o'clock until two o'clock. Eso managing patients were living with HIV. Is is a is a new experience for me. Really? Um, I didn't do it on my specialty coast. It's especially given that, um, kind of learning about management on the range of, uh, the retroviral medication is quite extensive on learning about about the history off. Highly drugs have been derived s o. It's really good to have two consultants on clinic with me, and I can you know, the advice I need is is ah, 100. So a moment. See, up to six patients in this three are so we get 30 minutes per patient than on this particular Thursday. Most of my patients had a nondetectable viral load. Um, we're well established. Um, on and off the renter Viral medication. Eso I was focused on Morshed Oh, on on you know, the psychological aspects of their care. Making sure that, um, you know, I was in appropriate diabetic. Um, cardiovascular risk assessments do and coo risks making sure that the other vaccinations up to date, Whether that's cool, it vaccinations or hepatitis B. Um, Onda. Yeah, that was until this all my final patient, who am I present is a bit more in a complex way than the others. Next light, please. So, yeah, this particular patient Damn. Hadn't Bean teo have attended clinic in quite some time? So the last script for the after your retroviral medication was was issued about a year ago, but it was unclear from speaking with them if they even taken that medication, um, behind very complex, um, social issues which you know, provided a great barrier to them accessing their care. Um, and it was clear that, you know, all all wasn't well, so they were complaining off shortness of breath, but really, weren't Ah, a very helping position, being in clinic. And we're very uncomfortable. When we did some observations, saturations were 92% and, um, became clear. We're quite concerned that, um, you know, thats patients. Um, HIV correct. Taking the depth. And we want to do urgent bloods. Consider getting a chest X ray done and on been way. Wanted to organize a possible that mission under the infectious diseases team. This all to quit sometime because the patient was very reluctant to command and have any further tests. Um, but it was, ah, case that I discussed, um, at length by consultant on. But we were able to deal with quite well, but in example, off of how you can You can see more call complex patients unexpectedly. Ah, Next stop. Slight, please. Eso in lean afternoon or three o'clock is due to start. Um, my, uh, general gum clinic. A service arrived late after my, um, dealing with a more complex patient. Um, so it's an integrated service. Um, but our partner service kind of tensity and more with contraception. Contraception on. Although we get a variety of presentations, um, we tend to do them or with, um ST I see eso a goto pick up my first patient. Next light on the first patient is a referral for majority. So it's ah, a referral from a local women's center in the city. Um, and patient has unfortunately being trafficked from Eritrea on the consult. Consultation is done through language line. It's quite a challenging consultation trying to identify this patient's risk of ask the eyes, but also specifically of HIV. Um, patient is very understandably just stressed on. It takes quite a long time, too. Do an examination. She's presented with some symptoms of normal pain on discharge. So we do a symptomatic screen. We do, um, a little vaginal swaps, high vaginal swaps, and do my crossword be in clinic as well as doing a point of carry HIV test. Um, this is clearly a very vulnerable patient on, um, it's someone that we feel needs to be discussed with safeguarding team as well. So all in all, it takes about two hours to Teo, you know, to deal with the complex issues in this patient. Uh, next light, please. Eso The second patient I see in the clinic appears to be fairly straightforward. Um, it's listed on on the database is needing, um, gonorrhea treatment s. So what? I see the patient. This is a young MSM patient who has self past it at home on. It's fine to have, um, gonorrhea from his urinary knots test. Um, so we will be given I am cataracts. Um, however, he's very, very distresses. He's recently find out that his long term partner has has had multiple sexual partners. And this is ah, social. Great anxiety and the stress ask for him. And obviously, it takes some time to counseling. Reassure on discuss, You know, various ways off doing further testing, put in window period tasking and on giving someone reassurance. Um, next light, please. So the other patients are seeing in the clinic. One is a patient that I start happening. So postexposure a proof of the Lexus, Um, for a patient who's hard unprotected sexual intercourse with a high risk patient. Um, I also review someone who's already on prep on, you know, do some bloods, Um, the renal function. Give him a further prescription. Onda. I assist there I am to you on doctor with treating someone for general warts with cryotherapy or liquid nitrogen. Um, so it's it's quite ah, um, put a very presentation on this particular day on next light, please. So just draw your attention to kind of the variety of off different sessions that we have during the week, but also the correct limits changing from August 2022 s. So as of August, the new gun problem will adopt um, Jewell training model leading to Jewel accreditation in J A. M. On Do you have, um, and for me presently, that bull's during three months of G I am per year for the next four years. Um, Andi, as part of that idea Monthly Sachin And am you leading up to my three months later on this year where I'll work entirely in G. I am with a monthly going session. So that's something you Teo the curriculum and also muted, especially really. So there are, you know, quite a few changes. Um, evolving on. It's just to be aware off, uh, for applying to come. Um, next line, please. On. So just as a change to to my daily regime, there's are obviously other events that happen, Um, on a monthly basis or or otherwise, we have department that'll clinical governance meetings, monthly regional teaching, national teaching. And there's conferences like Bosch and Beaver as well A Z I am teaching. It just gives you an idea of the experience and opportunities. Um, you can have a gun registrar on, but I think so. I have. I gone slightly over time, so apologies for that. Thank you, Ryan. That was really good. That makes me miss working in Liverpool with you. Thanks for coming. I didn't get any messages in the Jumper. I'll keep an eye out for any. Great. Thank you. Thanks. I'll hand over to Dr Lizbeth. A kitchen l thank you. So? So I'm a little Ketrow is that says on the side. I'm a consultant in sexual health and HIV, and I work in the hands, which is a murder side, but based almost start buying the middle between Manchester on liver. Cool. So I'll give you I'll be giving you a brief summary of what my life is like and I think, actually, thank you, Ryan, for talking about. So the date today, the clinical aspects. There's a lot of that which I have a lapse with what I do. Clinically, I suppose the bulk of my talk is some of the things that I do, which she might not be aware off. The consultants do in addition to your car. Clinical. So next light, please. I was just a summary I'm going to talk with about the clinical aspects of being a consultant. We'll discuss a bit about some of things that I do locally for the leadership management. It also some of my responsibilities on a more national strategic level. Um, some of the opportunities that I've had both of Registrar on now is a consultant in research on do education. And then I think it's really important when you're choosing a specialty to have an idea of not just what the Reds trials and the other trainees do, but also what a consultant, what I think is important, certainly in my life as a consultant. Next line P, please. So I've been working as a consultant now for almost two years, so I started my training as a gun registrar, Chelsea in Westminster, sort of the year there before moving to, uh, the Northwest. So I trained made me in around Ran Chester up until 2020. So again, largely similar to what Ryan said day today, outpatient work is usually seeing HIV patients managing S T. I Z, and also I do quite a contraception. And as a consultant, obviously there's a degree of responsibility. So coordinating clinics and supervising nurses and doctors who work with in the service is a big part of the actual chart. Um, as a consultant, you to get some perks in terms of getting things that you want in some respects. So I found that quite strange when I used to request the CT scan and I usually would get rather than a surgeon, you doctor battling to get through the doors for certain patients and same thing with the Ferrell's, but also just in terms of just the usual things that registrars tend to do. So as a straw, um, at Chelsea was expected that you would lead the virtual and DT's on. But that's pretty much religion is a gun with a straw in Manchester, so I used to help coordinate, lead the MG teas and that stuck stuck me in good stead when I became a consultant. Because again, that's one of my main roles chairing our local MD tea but also presenting cases at the regional MTT, which is the one that Brian attends with the report. I do a special interest clinic, so I do like appointments, which is quite nice in terms of having a bit of variety for practical procedures. So I'm a coil better on an implant fitter. But I've also now got a faculty registered trainee trainer status on able to train other doctors and nurses throughout the service on from a planning an implementation perspective from a clinical logistics perspective, we've had a lot of issues recently in terms of monkey pox. Is Ryan sort of alluded to S O. Clinically, I'm one of the few people in clinic was actually seeing patients with suspected monkeypox that's involved things like pee pee getting fit tested eso again. A large part of my day to day work in the last few weeks has been trying to work out the districts of how we can safely do that. Next line, please eso leadership management again in terms of MM group. It entered my local responsibilities and then my national ones. Eso On a local level, you have the opportunity as a consultant to lead on certain things. So when I first started only lead in a sort of couple of areas, that was mainly because prep wasn't something that was really being delivered. In a lot of large scales are there are a few patients from what was called the Impact trial, which was a trial of the King implementation of prep for high risk MSM but compared to other clinics. And Helen's was quite behind on that. So I've actually in the last two years been able to lead on, um, the implementation of rolling that out for more of our MSM, but also training non medical non the doctor star. So it was any doctors that really seeing prepped a shin, so been able to get the nurses involved, and we've now got a rolling program. So it's actually quite rewarding when you see your vision is a leader come to fruition, and it's something that I'm really proud off, certainly in terms of where we were and where we are now. We've got a lot of patients who are on prep, which is really important. Um, I'm lead for came sex. We don't really see that many cases compared to what I saw when I was in Manchester in London. But I do think the experience and training that I had working in a large center that means that I'm experienced that using the terminology and also realizing the psychological on physical issues that might happened with patients engaging in Come sex. Um, I'm currently leading on monkey pox implementation locally on diet. Also the clinical governance lead. Which doesn't mean that this additional meetings that you have to attend, and it's making sure that a department are we, you know, in line with policies and procedures. But there's always, um, opportunities to learn and develop in and take on more more responsibilities and rolls that you want to as a consultant on kind of make the job work to to your interest. Certainly all those areas of things I was already interested in some really lucky They're supposed to work in a service where I'm able to do something locally that I'm I'm interested in. Externally, I actually do quite a lot for Bash Onda. That's the reason why I included the racial minorities seeing. Is that something that's quite new to my role? Certainly, I think working as a trainee doctor, um, kind of looking at who was above me. I didn't really see that many people who looked like me. So I'm always really keen to put myself forward for opportunities. Just say that, um I suppose physically as a back woman that other people who are ethic minorities might look at, you know, people bash, stick your of the national level on think Hang on. This is something that actually, I could maybe go for I'm definitely keen not to pull the bladder up behind me. You know, I'm not quite active on Twitter on diet, have tweeted on behalf of bash as a training, but also done a few things as a consultant. Eso You know, I'm always keen to if you ever want to reach out to me and another month or two people in the call that already reached out to me before and because that's something that's also quite important aspects of the consultant, that if you are doing stuff fatigue ically and that you do. You kind of involved others basically trainees as well on I really enjoy the work that I do that a national level. So as well as working with the racial minorities Sig I'm the head HIV and blood borne virus Special interest group secretary, which means that I plan the annual HIV masterclass and some of you might have seen I helped with chairing Go with that for the last few years. It also means that I get, uh, get an insight into HIV strategy at a national level, which is really insightful again. It's just adds a little bit more interested in my in my day to day life, you know, in terms of what Ryan's talking about. Yeah, I remember seeing patients about the first time thinking, Oh, my goodness, what what I do as a consultant, you get to the point where you kind of know what you're going to do, and that the actual day to day work isn't really the challenge. So it's really interesting having other challenges on a national level that do you keep peace time you need to do make you certainly, um, look at what's happening nationally in how you can implement that locally. Um, the media. So I personally haven't done much with the media, but we have hard Granada reports, which is a local my TV kind of based, um, station, which came to do a report in our clinic. Um, and then there is the bashed media sick, which I'm not part off the I know there's definitely opportunities for lots of consultants who do engage in media work. Um, Andi, I guess we're sorry. Next, Like, please, maybe once a research and education, um, I helped with the bashed it come off ski and also helped support with the teaching for the Yeah, she did HIV off ski. But I also am aware that some consultants Teo on things that question writing for post graduate exams. I've done a bit of question writing for undergraduate exams on again. It just adds a a few sort of strings to you both in terms of keeping your interests open. Um, I personally haven't interviewed for specialty training, but it's again something that I'm aware. Certainly, uh, no Margaret interviews or hasn't it in the past? Um Andi. Clinical educational supervision. That's probably what you're most used to seeing in terms of consultant rolls with regards to education. And so I have a student I'm currently supervising for his some project, which is a little poor based student where they have certain time with us, and we've had a couple of them go through and again. That's really rewarding because projects that you kind of think or what we might do this and you get an idea and you get a student is really enthusiastic, and it's really it's really lovely to see that project come to fruition. Um, I'm just finally, just in the interest of time, start talking because lots of back in, ah research. So we do have some trials. I'm in a smaller center, them where trained. But do you have the opportunity to work as a self investigator and principal investigator on trials on Certainly involved that I know other consultants who have been able to use time to work on their masters and PhDs, sometimes alongside their clinical work. But do people do sometimes take time out? It's a spat ical to do that, and Andi, that's pretty much it. Next line peas, Then also, I'm just going to say is for choosing a specialty. Yeah, I think you always have to look at our your consultants happy. This is a picture that was taken in 2017, which is from, uh, the tonic on, and I actually want a prize about. And then you could see Chris Waters. Well, my old supervisor holding a prize. I I think when I was looking at what I was gonna be when I went through lots of other, like, cardiology and spiritually just thought call these people take, like, happy, um, on the teams in the cap either, Necessarily. And actually, when I came to gamble, it just felt like I found my tribe. We do have our good days and bad days, but generally, actually, it's a really lovely specialty to work in. Um and that's why I think everyone should, uh, these consider it. So thank you very much for listening to me on our hand. Over to moderate. Well, thanks, ladies. I'm on that photo. I'm on the far left hand side or a good night. That was We had to We had good for Mary. Um, holding onto Lizzie Nickel. She's keeping me standing up mat Phillips is behind me, propping me, and it was really good. And we are a happy crowd out way, I think. Fantastic. Good, right. So So there's been a couple of mentions of the changes that are happening to the gum curriculum, and so I'm going to take you through that. So I'm Margaret Kingston, and I'm a consultant in Manchester. I've had the pleasure of working with some wonderful colleagues, including Claire of the Moment and Liz not so long ago. I'm also head of the undergraduate program at Manchester, the biggest medical school in the UK, hence the Professor title, which keeps me busy and talks to the fact that our careers are so variable on such a portfolio careers. I also co chair the S A C, which is a specialist advisory committee at the Royal College of Positions on. This is the committed that oversees the training off Highest specialty training is on. Do that with Kathy a prime, who is the training program director for South London and is a consultant in Accent. George is Onda, as it's been mentioned a couple of times. We have recently had a major rewrite of the curriculum, which is being to bring it up to date for GI um content, but also to allow us to Julia credit with internal medicine, which was required following the shape of training review. Don't buy a track all David Greene away, who used to be vice president of nothing in university. An economist off the doctor who reviewed all of medical training and made a number of recommendations. The major one was that we need to be more generalist and be able to deal with the many complications that are patients come to us with this. A agent half many co morbidities eso that we've taken that through the GMC process for a new curriculum. It's being approved, and it's being implemented for all. Trade is from August and then for training is currently in training. Many are transferring onto the new curriculum. So that's what I'm going to talk to you about this evening because if you join us in our wonderful specialty and then then this will be you. So next light, please. So this is the oversight for all of what's called the Group One specialty. So these are my most of the specialties who do a credit in internal medicine. And so things like gastroenterology, cardiology, respiratory, rheumatology, all of them. Um, and in the past, it's been possible to drop internal medicine during higher specialty training with specialties like cardiology and rheumatology have often done that, and they won't. They won't be able to do that anymore in this new model. So the present time foundation training remains and changed into graduate training remains pretty much unchanged, although there is talk about moving registration, full registration back to the point of graduation. But that isn't happening at the present time. Eso Foundation trading remains the same, then the selection into her intercourse Medical what was called medical training is now internal medicine Stage one training. So that's currently in its second year of that new A training program. And then, after three years of that visit with the level of selection into your highest specialty training and internal medicine, Stage two training, which is starting for for a system. So, um, after that was this idea of that you can develop what we call post CCT, so completion of, um, training certificates that you get, which allows you to be on the specialty register and that will be the single credentialing, which is becoming a sort of super specialist. But that's not developed the present time. Um, next slide, please. So this is what it will look like for us. So your foundation training is the same. Internal medicine is the same as it is for every of the major medical specialties. So you take your, um, RCP at that stage, and you need to have completed it successfully to make it into the next stage. So no change there. Um and then you you go into our joint training, which is four years. Remember, you've done additional year if I am t So CMT was two years long. I am taking three. There's two exams we required. You're in that time for you to pass up the diploma in genitourinary medicine diploma in HIV medicine. Um, there's also the the diploma in the the faculty that the Faculty of sexual reproductive Health provide, which is recommended. It's required that the minute, but we're not going to require it in the new curriculum. It's not blue Mark. It's not blue prints it to our curriculum. It isn't designed for our trainees in the way that the dip gum in the dip HIV. Our next line, please. So the other thing that's different in all of these new curricula is that we're moving away from the many, many, many competences that we have that signed off that the feedback we've had his are quite tick boxy. So we've moved to these high level competences. In practice, there's four levels one is can do, want to direct supervision for is conducive independently, so you need to before and all of them by the time you are signed off. So there are generic ones. So the generic professional capabilities, which is common to all curricula on there, around patient safety. Q. I teaching research, that sort of thing. There's eight internal medicine ones, which are things like can manage the acute medical take. For example, on there's a list of specialties included of conditions from all specialties, including hours in there on. Then there's eight from our our specialty. Um, next light, please. So these are the confidences in practice. They're they're not in draft anymore. Actually, they were really to change. That's like they are all completed on Deacon. See what they are. They're we added in the management and commissioning set because that's become a major thing for consultation. It's in our specialty to be passed off, which is quite well, quite unique towards really so we thought that was important to add that in there So all fairly straightforward, um, high level competences. Next line, please. So in terms of implementing it So the speaker before talked about the idea of doing blocks. We thought this was important so that people were able to have a time when they were, um it immersed in their specialty and not being constantly pulled out into the acute medicine. Take eso. We've gone for blocks, but with a longer TUNEL aspect. So things like doing a twilight a see you shift for example, uh, or doing a ongoing eight during your GI um HIV block, or doing an HIV clinic or gum clinic during your internal medicine blocks just so that you know being D skilled on a regular basis. If you do as part of your training and HIV or infectious diseases, attachment and then 33 months of that can count towards internal medicine, so that would bring your internal medicine requirements down from 12 months to nine on, we've come up with a number of flexible models that will let what we've got. Four, actually, which can allow for local implementation and amendment, so we don't be too prescriptive. We know the way our services that delivered varies across the country. So our model for training needs to be able to be flexible as well. Next line, please. In terms of implementing there. So you need an internal medicine supervisor and an A or cpt. Now, in some areas like London, they're going to do the two together. Um, so you'll have one I RCP and they'll cover both things and they'll be I m t and go from there. But they do need to be recorded on D s separately because they are a dual CCT No, a single one. Workplace based assessments will proportionately represent the time that you're spending an internal medicine or on the timing of the exams need to be planned, um, around the way you're doing your blocks. And so it may be that trainees need to work between different providers because sometimes gum isn't in the same trust or even in the same sector. It may be provided by a private provider, for example, Now we're not on our own with this palace of meds. Um, are definitely in this in this book it with us because hospice is there. All charity. So and they already trained in this way. So we've taken a a fair amount of learning from the way that they deliver. There's there are palliative care confidences in a little curriculum. But we're not going to be sending you off. The hospice is and those will be achieved through your general medicine. Possibly most likely an internal medicine. Eso you won't need to specifically go often. Do that next slide, please. This is an example of option A, an option B of how you can divide you blocks up. There's a couple of other options as well. Next line, please. On Here they are next slide. So it be up to you and your trainer how you get this sorted so transition principles Now we've tried to be really, really flexible with this for trainees because we know it's a big change, and we know it's a big challenge. Next line, please. I just flip over the course. You will be on the do the Duke curriculum. And but we've, as you can see with gone through it like this, eh? So that there's transition and different options for everybody in trading at the moment to keep it as flexible as we can. Next line, please. Okay, so people who are completing the trading will single credit. That's nice and easy, but they can do Caesar, which is completion of equivalence of certificate, of the equivalence of specialty training. And so that could be done in this it. There's a number of people doing that at the moment in termites and next light, please, um, again, people who are less than a year until August 2020. We anticipate that they will stay on the old curriculum. That's in line with current GNC principles, which is, if you see CT's within a year of a new curriculum. You generally stay on the old one, but they can transfer. And again, there are a least three trainings that I know off locally who were doing their snacks like, Please, you do need to they already be doing a fair amount of the general internal medicine at the minute next light, please. Um, if you've got more than a year over until you see CT than, um, the ah principal from the GMC is that you do transition. However, we have successfully negotiated with them that they will be particularly flexible for our trainees. So if it's good reason not to, then nobody will be forced to do that. Next line, please. On then, um, majority of those in in the first year of trading will transfer. It's exceptional Not to again. We have managed to get agreement that from the GMC and from the Post graduate Dean's that they will be particularly flexible is it is a big change for our specialty. Next time, please. And, of course, for everybody who's joining us after the summer will go straight into the new curriculum. So it will be really very straightforward next night, please. So the people who were transferring over or coming to us, who may have done CMT but not doing a I am t three year, which may be some of yourself, and then you do need to do this gap analysis on to see if you meet the thean. The levels of interest mint feet. I am yes, three, um, and that's available on the Jr cpt website. What you need to do. Okay, next line, please. So we think that the future is bright for our specialty. It is a time of transition is a big time of challenge. But it will mean that we will be more flexible than we have seen before. There's we think we will see people taking it roll such a Z integrated sexual health and HIV services for targeted populations. And listen, I mentioned this in certainly in some of the bigger meal areas, this opportunity to developed really specialist interests. And we have consultants who do just HIV impatient work, uh, who do a variety of blood borne viruses who worked with, um with people who have a specific concerns such a Z transgender individual. So you can get very specialist. But you could also remain very generalist, a swell, so lots and lots of opportunity there. And of course, you know, you can also take some take on leadership roles in lots of other organizations. I have done it, the university. But other colleagues have drawn in societies, in colleges, in charities. One of the trainees who was a consultant about the same time I was his now deputy director of Public Health of Scotland. So who knows? You might be the next Jonathan Bantam next night, please. We've got a number of videos that we are about to host on the backs website, from some of the good in the great in our specialty, who talk about about what listed really about what it's like being a consultant and being part of our brilliant specialty. Weevil found our tribe is just a wonderful job to do. That's interesting and different every day on day. I hope this new training pathway means we could be even more flexible about what your opportunities will be. Feet for your future careers. Next line, please. This is what some of the people in those videos say on, But you know, it is. It is amazing on I'm really excited for the future. Will specialty on day, you know, come along to some clinics. Do bit work with this and see if it's for you. I never look back on. Um, I I hope we can offer you a lot more opportunities as the years go by. Thank you so much. Thank you very much. For that was really helpful. I'm sorry. Finals Well, over the me off. I know Speaker family is where this Jiminy. Hi, everybody. I'm gonna talk a bit about my experience of broad and on. It is not really connected, but some of the I guess the scope for doing other things outside of medicine, which to this specialty, I think kind of allows. So I work about health. Next line, please. Um So, like in a while trying programs, there's the opportunity to do out a program on day course. There are lots of benefits in enriching your training experience, um, to experience what things are like a broad and obviously in sexual alternator IV. You know, a lot of burden of HIV is actually, you know, we don't tend to necessary experience in our training, So it's a good opportunity to do that. Um, the research, PhD, teaching management, lots of different things on. It's a way for you to acquire and develop skills on just to get a change of scene. Really, If you've been on the treadmill for a long time, next light, please. So for me, I wanted to go bald into to get to visit the developing world setting. And, um, I was on your was an academic, um, in terms of research, but But I, uh I enjoy teaching. I like clinical. So I decided I would try and find a way of going to Myanmar because, um, for my circus reasons, I my mom's from they're on, but I had never would've lived there on my thought is good way to combine experiencing that as well as doing, you know, enriching my training experience. So first we'll just spoke to people about their out of program experiences. Tried various avenues. I applied to MSF and BS. So but eventually I found my own way in next side please on did a mission with green shoots. So basically, this is an organization that has lots of different programs. A lot in Southeast Asia, some nutritional educational on. They have were developing a training program for new doctors specifically working in HIV in Yanmar, so the idea would be that would be managing the team, supervising them on developing a training program on it. Six months on. It wasn't paid all those supported in terms of your coordination and travel. So I guess that's another factor to consider in, You know, if you're going to do something where you're volunteering aboard next slide, please. So that's, um also, you can see it's sort of nestled between, um and you're trying to Thailand Lower. Um, excellent, please. So this is quite old data, but to be honest, I don't think it's going to change much on also given what's happened in Myanmar with the military coup on Cove. It, um I expect things. Oh, yeah, have taken a sort of a backward step. So, um, in 2000, it had pretty appalling ranking in terms of overall health system performance. Um, there's really low percentage of GDP spent on healthcare. Most of the healthcare expenditure is by individuals privately that they would pay for their healthcare. So, yeah, you know, government spectrum health is was about $3 per per per capita versus you know, at that time, 3000, um, in the UK So clearly they struggle with a lot of basic health problems. Next light, please. Yeah. Eso in the public hospitals, government hospitals, they pay for everything in patient stays about $20 a night. It's quite difficult to visit public hospitals because they didn't want to see what? I didn't really want you to see what they were doing. Next. Light, please. Right eso private health care providers A bulk of care. It's quite variable quality. However. Junior doctors has paid much better, so they would be paid about 204 $100 per month versus maybe $100 in in the government setting. However, the disadvantage is that the experience in private healthcare doesn't count towards trainings. If they actually wanted to, um, progress on become a consultant, they would have to do their time in government. Low paid drops basically, next side, please. So in the organization was working. It's called Medical Action Man March set up in 2009. Still going now? Um, they have five HIV clinics, which of which three are around? What was the capital young Gone on? Do. That's where I was based on. They have, Apart from these extra B clinics, lots of primary healthcare programs throughout the country. So many providing, you know, nutritional support for Children. Get basics or primary care antibiotics, bit of women's house. And so next light, please eso. This is just to illustrate s a younger one That's the sort of the I guess, the where you can see the word younger. And that's where the center of the former capsule is. And then the the clinics were sort of outside in townships where there's a lot of factory workers slums. So there's, like just a lot of health need there next night, Please, um, just just to show the increasing number of patient consultations over the time since they started 2009. So as you can see you, probably about a third issue was HIV tea to be related. And then the rest of mix of Children, um, family planning, general patients and so one. That's like please. So in terms of the doctors that I was working with who were providing the care in these clinics, they were about two or three years post qualification. They had really had hardly any HIV or TB in their curriculum at medical school. Most had never really encountered HIV. Um, I mean, the TB thing was really astonishing because those lows of TB and mammal uh, anyway, they're training involved in induction for four weeks with assessments. And if they pass those assessing, is that the end they would start work. There's not really any training program beyond that point. Next light, please. So I could mention the patients. Very poor, most in manual labor jobs, poor education, many heterosexual low CD four. Count of presentation on D Basically, everyone have TB. That's like, please, um, as you might imagine, there was a lot discrimination that the HIV patients that so some pro hospitals refused to admit them. They would charge them double, and there's no nothing to protect them, really, for many discrimination. Next light, please. Eso just in pictures now. So this is the clinic one of the clinic waiting room, So basically they just walk rock up. It's a walk in the Q. There. Wait for ages. They have these 20 little books, which the doctor's writing. Next light, please. So it's made with one of the doctors. So I started off kind of sitting in with them and sort of assessing their needs were on learning about. You know what might be beneficial for them? Next light, please. So, apart from the outpatient clinics, they didn't have inpatient service, but they would have like a day care unit. So this is kind of the room as it's about 10 12 beds where patients could receive IV antibiotics they could miss. They could get number punctures, um, fluids. That's a little thing. But if they needed to be, if they were sick, then you know they need to go to hospital. And really, that was on their own steam. Uh, it's like, Please, um, Andi, they ah, we're able to do Um uh, obviously that for a while that lots of Asian have low CD four count. They need fundoscopy. So, um, doctors very good at that. Onda. So there's kind of yeah, a lot of ice screening and, uh, I treatments. That's like, Please eso This is me trying to do some teaching in the kitchen. So, you know, there's sort of basic things. It's like, Where you going to provide? Teaching does not really anywhere on actually just finding the time where you consider down all of you and have the opportunity to do things. Um, it was quite difficult. Next light, please. So spit bloated. But it's just me. And there was a retired Dutch chest physician that for some of the time he just wanted some of his time with chronic. It was just really nice to have him there because I did miss kind of discussing. Case is just having someone else to do. Yeah, like it's supposed to have an MD tea with next light, please. So, what I did was that time assessing what I felt there needs. Well, what they felt there needs were. And I set up a formal teaching program for the existing doctors. Um, didn't really have a decent induction program, So, um, I kind of drafted something that bit more formal, and then they had a donation of are you D's? Um, from a some kind of global donor. So I set up some training and protocols for that. On the other thing is, yeah, they made them do some orders because they weren't really ever. So we'll talk about that sort of thing on day were very keen. So So they would have to take it on. Next light, please. So, in terms of what I got out of it, actually, the kind of a cool experience was really amazing because you got to see lots of pathology. The other thing I realized was I actually knew more than I thought I did. Um, Andi, that was kind of nice. Management experience s Oh, yeah, I guess it's coming difficult to get that in training, but because I was kind of line managing and not just the training aspect that some of the team dynamic issues. So that was quite useful experience. Uh, yes, I said I reflected in one like that. Actually, I had. I did know. Well, then I think for you. Next line, please. The other thing obviously I got to do is travel a bit, because naturally, that's what you're going to do. So in the South says that will. Certainly, at that time, there were lots of areas which were pretty on on unvisited boy tourist. This was in 2014, I should add, um and then it opened up much more to tourists. And obviously now it's unfortunately probably know a destiny nation. It's necessary. Higher people's left something until things kind of improved and settle down. Next line, please. Okay. Yeah. So, in terms off, the life outside of menses are trying to make it so fairly related. But not really, I guess. Um Teo Co What more would said it's the best specialty. Um, of course, there are times if you're busy and difficult and challenging, but I think for me personally, it's ah, the I guess the sort of way that you can have it more. Sort of a predictable nature of your job, depending on what you decide you're going to do has enabled me to have other interests you know, have the time on the brain space to your other interests. So, do you like cooking? Onda Certain that's Burmese food. So it's supposed it's related to my house program. Um, Onda, over the years, I've been able to host events on D. I don't know if this this is this was meant to be an animation. Maybe it's not gonna work. Um, okay, so I think it's the order is a bit messed up. So yeah s Oh, my sister and I, she's a psychiatrist again. Psychiatrist. Perfect. Especially where there's good work. Like balance on. We written a cookbook so you can see my daughter. They were the cookbook on Do, um you know, uh, had opportunities to meet people and food. And, um, but at the same time, I would never change anything. I would never Ah, I would never stop doing medicine. That is Ah, you know, sexual health is is the best specialty on I'm really happy doing it. But I think is definitely scope. And there's lots of people colleagues, former colleagues, um, you know, they're able to nurture other interests. And, um yeah, so the world is your Royster. Basically, uh, I think that's the end. Thank you very much. Um, really, I was just laughing as you characterized writing and cook because I do a bit of cooking. Thanks very much. That was really inspiring. In the interest of time, we're going to skip my final talk because, I mean, we've covered a lot of information off program already. I just wanted to open up to see if anyone have any questions for any of us, because I think I've got a question for those to kick things off. I just want to ask how you want to do so many leadership things, um, in so many different roles and do you clinical stuff along with it. Sometimes I ask myself the same question. Eso it all kind of started offers one thing. So, in terms of how I got to this level. Um, I hadn't actually done sexual health or any kind of hate to IV medicine as, ah, training eso I done. I had a bit of experience as 1/4 year medical student, an infectious diseases on, but it was part of that. I went to North Manchester Hospital and spent an evening and gums just like this is amazing. You've got sort of like microscopy. You can get a diagnosis, you give it to a patient. The patients were really interesting and fun them. I just was like, Wow, this is This is really good. And then that was kind of it. I was sort of pulled out of that. Went back to the idea ward of men was on sort of General Medical General Surgery GP kind of train. Um, Andi So kind of later on, as when I asked, I'm thinking, What specialty? Um, I do you know, I did my foundation training CMT, and then I was actually enjoyed gum. So did it taste the on a little project just by sitting in a little work to my local sexual health connect? What can I do in order on do a week has a taste and they were like, Yeah, that's fine S So we tried to submit a poster got rejected. So again that's really important. Sometimes if you get rejected, don't think that that's a bad thing. It's all the good experience at the fact that I did. The audit meant that by the time I got to my interview, I was able to at least show commitments that specialty. I had gone out of my way, you know, to try and actually get experience. So actually really helped me. Um, and then I had a Christmas would Who's the bash? Conference secretaries? My educational supervisor and he basically, um, said to me in our first meeting What I think is really important for you to do over the next few years is to Network Network Network, and that's what I used twisted for, actually quite a lot in terms. That's good educationally. But, um, it does give you the opportunity to speak directly to people, often people who are in power and I say power loosely because if you speak to you know, people that lower waters cleared using that they're actually really approach for people, but they hold quite a lot of waiting. They're very keen that actually, people do get involved in things and particularly trainee so that you really look at the conference is now. Actually, there's opportunity for things like stash toe have a platform and actually giving trainees and students those opportunities early on and gives them a foot in the door on. That's pretty much what happened to me is a trainee. I was given the opportunity so well, there was They were open opening. Invite the HIV be be be training rep. Um, I kind of got I think I'll get this and Chris, it'll go on apply for else. Like Okay, fine. Applied for it, Got it. And then before I knew it, they were like, Right, your trainee, Do you want to help organize masterclass then, um, I portfolio. It was like TIC had organized a meeting, organize a conference. So it's and then you do that, and then somebody else there's always like to do this, and that's kind of how it all starts. So I've got the flexibility now that I can do what interest means. There's certain things that I joined the back cpr sick, but I just don't have time to do that, so I don't really contribute to it. But the things I d, um, are things are genuinely I'm interested in, um, Andi say it's it's not really been that I've, um you have to be in the know kind of thing. It does also help if we know people that networking and going to events and putting yourself out there. That means that people do start to kind of recognize you and and actually, you do start to be invited to things. But as I say, please, I don't want anyone to think that I've, you know, had a leg up or anything. I've have certainly just made the most of it, but there was an opportunity. I've taken it and run with it. Um and that's to say how I kind of ended up, um, with all these multiple hats on. Thanks very much, ladies. So take any opportunity offered couple questions in the chart under First of all, with Hello and the current three go May try is my tops of US specialty Choice by a mile often hear people are not in specialty saying that, um is a medical speciality. That's something that is something that will no longer exist in that step number of years that I will become nurse lead. How true do you think this is? Um, is this something that Junior's your thinking of off the ceiling government should worry about? Did it and Emily or Lease have a comment on that last year? I think is not worth worrying about because things change so quickly on because I remember when I was applying for training, I think maybe that was similar type. Things were being said Well, clearly like it's over 10 years later. Well, you know, you shouldn't don't do it because I won't be any jobs. There are jobs, so I think you can't really worry about too far ahead. I mean, and now look with, um, monkey pox like, there's plenty for us to do. Um, and of course, you know, without our nurses way, they they do a great job. But I don't I don't see that we're not needed. I don't know what this thing. No, I completely agree. I think, as you say, a complete respect to a lot of nurses. I I definitely can't do the job that I do but they they're limited to a coin in the Unless they do things like nose prescribing, they're limited by PG DS. We The training that we get on a medical background as well means that our approach to the specialty is slightly different to a nursing background. Um, I completely agree with the Everly. I was holding back to the same things. Do it's in this waste of time. HIV will be something that you know, even be something you'll be dealing with. Um, but you know, actually, we do still get those talks plasmosis patients rocking up on the PCP. And actually, you need to know how to manage that. And I just don't see that being outsourced. I mean, very enough. Maybe things might change in the next few years in terms of stable patients going to GP, but ultimately there will still be a role for the sexual health HIV consultant dealing with. You know, we talked about medicals, specialties, aging populations. Frailty is a big issue. We've got a lot of our patients who are aging badly. Exactly, and I'll cohort eso you know, that magical experience behind you as well as your government HIV experience. means that we I think we'll always have jobs and, you know, it's just people always say things, but just I'd learned to ignore them. And I think somebody had the nail on the head saying that it's people outside the specialty saying, That's it's easy to make a comment about another specialty when you don't have to be really solve it, isn't it? You Thank you. I was really good question. Victoria last in additional questions. So I thank you for, um, amazingly helpful talk was wondering if there are many a CF so clinic clinical jobs available in gum will the changing curriculum to include G. I am give a scoop for flexibility. As a consultant, I am. I think this is a great question for Margaret. He's had to leave the chart. So what I might do is posed this question to Margaret on. Take your email, if possible. Victoria. If you could write it in the chart in the Northwest. I'm not aware of any specific actinic trainees, but I have program is something that you can use to perceive academic Impressed on Research is something that we do alongside Aquadeks is everyday basis, so let's said she's p I and they're of investigator Are most of investigators for the Eagles trial there? Multiple kind of research opportunities going on in clinic on. You can also use you PhDs, masters. What kind of things you go along in our program time that they're also I mean, I only know the experience of where I mean, but they're certainly in a cf it, um c n w l and I think they'll be wanting parts as well. So I'm sure there must be more than nine. Yeah. Three be apple. Also, get Margaret to weigh in on that as well. Thank you. Any other questions? I think that might be everything. Thank you so much. Every for coming. Thank you again to our speakers. Coming on like the hottest, most lovely day of the year. I hope you get chance to have a bit of a relux. Um, for the rest of the evening. Thank you again. Best of luck. See you next week. Yes. Yeah. If anyone's that bash, come to come and say hello. I won't see you there. Yes, I I everyone by right