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But the recording will just start automatically. So, hey, guys, thank you for joining. We're just uh going to wait a couple more minutes just to let people join the call and then I'll quickly give a small introduction before we start. All right, I think we've uh waited for a good amount of time. So guys, welcome to the student med, a first edition of the Global Health Policy and Innovation Symposium. This is a new event we've introduced to fundraise for outgoing medical equipment donations. So hopefully, this becomes a tradition of many years today. We have ha uh bringing in three keynote speakers and then afterwards we'll have our oral presentations. The schedule should all be accessible through kind of the left hand side of the screen. And you'll be able to find all the information you need from that section in terms of information about the speakers. What time everything's gonna start and everything else. If you have any questions during the talk, please just drop them into the Q and A session of the chat and then we'll answer them near the end and we'll dedicate five minutes at the end of each speaker to just quickly answer all the questions. And also during the presentations during um in the research section, you'll have one minute of questions. So usually that will just be one or two questions max, but we'll limit it to first come first serve. So if you do have one, drop them as soon as you can, uh please make the most of this event. So engage, ask questions, get contacts, network and just enjoy the overall couple hours of your weekend. Thank you so much for coming here Saturday morning. But without further ado, I'll introduce our first speaker. So we have Mister Naveen Cavalli. He is one of the U KS leading plastic and reconstruction surgeons and he is the current clinical Director of King's College Hospital London where he heads plastics department, but he also operates privately from his clinic in Stone Square. He's also a keen educator and he's a UK representative ISA PS and then also is known for his, he work, he frequently visits Gaza to provide life-changing surgery to men, women and Children who are affected by blast injuries and gunshots. So it's my pleasure to welcome him to this stage. Thank you. Um And thank you for having me and again and again, thank you for coming um uh to this at the weekend. Um I'll try not to go on for too long and um I'm uh gonna be talking about the sort of the global surgery, the, the, the humanitarian side of stuff that I've been doing and, um, what I'll do is I'll just share my screen and I'm gonna end up sharing the entire screen. Um, which is that one? I'll share that and then I'll have to go to my presentation, which is there present, start that. And I'm hoping you guys can see that. Um, if there's a problem, if someone could just pipe up and tell me that would be really useful. Um, but I'm a, um, a London plastic surgeon. I've got an NHS practice as well as a private practice. And I'm currently the chair of this charity called Be First, which is the charity arm of Bare, which is the Plastic Reconstructive Anesthetic Society. Um, in the UK, it's like there were several societies, but this is the sort of biggest one and the, the, the sort of original as it were. Um, I, um, have been going, well, I had been going to Gaza up until recently. I haven't been for about a year and a half because stuff started kicking off even before October 7th last year. Um, so a couple of our trips were canceled and I haven't been back, even though there are others in our group that are going back. I've decided it's not for me to go until things are a bit safer. I mean, with personal reasons, family, et cetera, et cetera. Um, but as I've been going, I'll tell you about that as, as we go along. I will also tell you a bit about be first as a charity and I'm hoping to kind of tell you about, um, how global surgery should work really if it's done properly. So, let's see if this works. Um, now I think this is worth, um, taking a note of go and have a look at this and it, it's, it's quite old now and this deadline of 2030 that was set is only, you know, what, four or five years away or something. It's not, it's not that far off. Um, and so it was something that was proposed back in 2010 and the idea was, um, that surgery and certain operations should be almost like a human, right? You know, we're, we're very good. If you look at the wh O and the United Nations and the various charity things that are done around the world, as far as health care is concerned, it's to do with more medicine rather than surgery and surgery always kind of gets neglected. Um, because it's not, it, it's kind of seen as a last resort. Um, it's not seen as a cure, you know, uh, type of thing. It's, it's not necessarily preventative. Um, and, um, and it's traditionally, you know, global health has been about, you know, vaccination and clean water and maternal health and neonatal health. And that's, you know, if you're talking about surgery and plastics, for example, bones prevention is something that's spoken about a lot. Um, whereas actual surgery up until this, um, er, er, report came out and it was put together by some really, really clever people around the world, you know, at all. Gwanda, who is the author of the checklist Manifesto, there were people from King's College London all around the world put together this report. So, go, go and have a little look at that if you can. And what they basically said was that, you know, surgery is a human, right? Um, and they picked on four operations to start with, um, that's been taken down to three because one of them is, is possibly a bit too difficult to do safely. Um, in, in, in everywhere. Um, and I, and they picked, so they picked four operations. Um, three of them remain on this list. One is, you know, you should be able to get an emergency laparotomy. Ok. You know, somebody should be able to go and look inside your belly in an emergency if there is a problem like appendicitis or an aneurysm or, or perforation or whatever. Uh, the second one was an emergency Cesarean section. Um, sorry, Mister Co, uh, I think there's just one issue where people can't see the slides. Oh, ok. Uh, I'm not, I haven't changed them. Uh, is that sorry, I've been on the same slide? Um, no, I don't think they can see anything at all. So. Oh, ok. Let's have a look now. What have I done? Sorry, sorry, sorry. Any worries? I think it's just something all right. Sharing, what are they able to see? Uh um I think they can see your camera. Ok. Right. So let me try and go to share my entire screen. I'm gonna go to, I'm gonna try this again and just tell me if it works uh sharing the entire screen and that's my camera. And then now if I change to my uh presentation screen present, start presentation, can they see that? Now? It should be a picture of a globe with some numbers around it and things in writing. Yeah, everything's uh now good. Yeah. Much. Yeah. OK. Good. All right. Sorry. Uh You didn't miss much in terms of the slides. Let me just go back very quickly to the previous one. I hope uh that one that was the link that I was telling you guys to all go and have a look at the Lancet Commission on Global Surgery. Um And you can just Google it. To be honest, you can find it still working next slide. Yes. Yes. All good. OK, cool. Um So where do I get to? Yes. Emergency Laparotomy emergency Cesarean section because lots of um uh women die during childbirth because they can't get an emergency cesarean section. Lots of babies die as well. Um And then the third operation was um an emergency craniotomy, you know, a borehole into the skull if you've had a bleed to relieve pressure on the brain. That's the one that's been removed because it's very difficult to do safely. I think people decided that more harm will be done than good. So that's kind of in brackets now. Um, and the fourth one, which I'll talk about is emergency, uh management of an open fracture. Ok. So that's an open fracture is where you've broken a bone and there is a wound overlying the, the, the fracture. So typically it's legs where the, the, the bones break and the bone, the bone cuts through the skin or it could be, you know, a road traffic accident where you get hit by a bus or a car or something and that impact causes a wound and breaks the bone underneath or it could be um, you know, uh disaster related, crush injuries, combat related, you know, blast injuries, gunshots, those are all open fractures, complex fractures. And that's, that's what we do as plastic surgeons. Um Now the side I've got up in front of me, you know, just shows you that surgery is really important and this is why we really should make it a human, right? At least for those three things as a start. And then we can move on to other fancy stuff, you know, that, that we do in, in hospitals in, in, in, you know, countries like the UK. Um Now if you look at the fundamental problem, ok? It's just that there aren't enough surgeons and I've just picked on Africa versus England. Ok. So the UK statistics, the NHS is divided up into the various bits of the UK. So we have, you know, what about 14 surgeons per 100,000 in the UK? Uh The US, by the way has about 45 and a lot of the rest of Europe has more than this 14. So even the UK is lagging um behind. Uh but nowhere near as much as you know, say a lot of countries in Africa are. So we need to increase the number of surgeons there are around the world. And the way to do that is to teach more doctors to become surgeons. And if you're gonna become a plastic surgeon, then you need to teach more surgeons to specialize in plastic surgery so that they can then manage things like complex fractures because complex fractures are something that, that requires orthopedic surgeons and plastic surgeons to manage and very quickly. Just to tell you that combination of orthopedics and plastics is probably now the magic formula for disaster zones, combat zones, war zones. It used to be general surgeons, vascular surgeons and orthopedics that would go out. So if you look at, you know, the Vietnam War, the Korean War, it MSH hospitals, the American MSH Mobile hospitals were mainly general surgeons who did a bit of orthopedics or vice versa. Um And um actually more modern warfare unfortunately, is really, really, really efficient at killing you. And if you generally get an injury to your trunk or your head, you tend not to survive. So if you do survive, you survive with limb injuries, complex open fractures. As I've been dis, er, er, er, um, discussing, um, and to manage a complex open fracture, you need an orthopedic surgeon and you need a plastic surgeon and that's what these charities are that I've been involved with. Map was the one that II went to Gaza with and ideals is the small charity that map asked. Um And we were a bunch of surgeons in ideals that were asked to go to Gaza in 2014 after their last kind of big war um where we had lots of people with blast injuries from the shelling. Um All the stuff that's going on right now. Um And then once that all died down, we kept going up into Gaza about 20 times. Um it then became sort of sniper gunshot injuries again to the legs because injuring limbs is quite debilitating. You know, if you, if you take out um a limb and typically the people that were protesting were young males and if you injure the limb, the leg of a young male, they can't go to work. They're quite often the main breadwinner of the family. Um And so you can take out an entire family. So anyway, you can discuss, argue as to why that is done and so forth I'm not going to get into the ins and outs of, of the politics of the war, et cetera at the moment. But what I would say is if you're gonna look after complicated, um, limb injuries, you might be thinking, oh, geez. Where do I start? A, actually, like everything in life. It's just doing the simple things, ordinary things. Really? Really? Well. Ok. And this is just a quote that I put up in a lot of my talks. Um, do the simple things really, really well and a limb fracture. It isn't all about this. Ok. You might think that plastic surgery is all about fancy toys and technology and it up to a point. It is ok. And in the UK, we love microsurgery where we will join little vessels together, take bits of tissue from one part of the body to another to cover holes. Now, yes. Um, that is modern day plastic surgery, you know, the robot. And let's see what, um, VR, um, a and all that kind of stuff does for surgery coming up in the future. But actually plastic surgery is a really, really simple, um, specialty. All you need is a knife, a fork and a light. Strictly speaking. Ok. You need a blade, a pair of forceps, half decent light. So you can see what you're doing some simple instruments and you can do most plastic surgery operations almost in any room. Um, and that's what we're trying to concentrate on when it comes to, um, looking after, you know, one of those bell weather procedures that I talked about the Lancer Commission, the open fractures of the leg. Um And again, what are the simple things? You know, it, it's, it's documenting what you find. It's communicating it to your team, coordinating surgery and then most importantly, so that things are sustainable, you've gotta, you know, keep learning and keep teaching. And actually, you know, if we're gonna talk about technology and fancy whatever advances this I think is the biggest advance in probably medicine. To be honest, certainly for surgery because in plastics, we don't care so much about the x rays as it were, we care about photos. We are looking after the outside of the body which you can generally see with a good photograph and so communicating and documenting, et cetera, et cetera is um is something that um the smartphone can do and it actually no matter where I have been in the world. Um B first has projects in Tanzania, it's got projects in Cambodia, Vietnam, Bangladesh. You know, I'll show you in a minute. Um everywhere you go, no matter how kind of remote or um low middle income or whatever it is, everyone seems to have a smartphone, they may not have an iphone, but they've got a smartphone and these are all the projects no matter where you go around the globe, people have smartphones these days and the great thing is that if you are undertaking a project in Gaza or in Africa, um, the local teams can update you by sending you photos, you can have whatsapp conversations, you can have webinars like this and teaching sessions, you can have meetings. It works really, really well. So, what are we trying to do in order to, um, do surgery? Well? Ok. What's, what's the best way of, uh, um, of doing global surgery, so to speak. It's not actually just going to somewhere and doing a whole load of operations and then coming home again. And that used to be how surgery was done. And the classic one for plastics is cleft surgery, cleft lip. And, and what would happen was, and the US was the most guilty. Actually, you'd get American surgeons, probably mostly cosmetic surgeons. You know, it could be me, um, who would then take a bunch of their residents who hadn't really got an awful lot of experience because you don't get it much hands on cutting these days at home. Um, and, um, they would go somewhere and practice on the locals as it were and it's what I call a, a surgical safari and they would be doing, you know, fancy operations in somewhere that doesn't have fancy facilities and you can do fancy operations anywhere because as I said, sur plastic surgery knife, a fork and a light. So you can do quite complicated operations. Um, no matter where you are and then they would fly home. And the trouble is with complicated operations, you create complicated complications problems if things go wrong. So the local teams would then struggle to fix these problems. And quite often, you know, you'd end up making things worse. The other thing that was also a problem is that, uh, just, you know, by doing what I call service provision, just going and doing a bunch of operations, you're not really making things better in the long run. Ok? This is what it's about. It's about teaching and training so that the local surgeons can do what you have done. And that's another really good reason for doing simple operations, well, do the simple things well, and that helps you build capacity cos when you're not around, then the local teams can be doing more and more and more stuff. So it's not just for the few days of holiday that you've taken to go somewhere and operate, you are now leaving behind a system that can, that can keep going. Uh So global surgery, this is the most important slide. OK. This is what global surgery is about teaching and training, capacity building. And I've put down in brackets, it's about providing equipment and I kind of criticize this as well because it's really, really, really easy to, to buy stuff and take it over. Ok? It's really easy. So for example, if I'm neglecting my kids at home, it's really easy for me to make myself feel better by buying them big toys, ok. Throwing money at the problem and the easiest way of throwing money at the problem is to buy stuff, buy toys. Now again, be really careful about the kit that you take out and provide to someone. Because if I say send, I don't know, an MRI scanner to a country in Africa that is not that well equipped. Um, and doesn't have an awful lot of money that MRI scanner will break down pretty quickly and the local system will struggle to buy parts to find the engineers that can fix it. And I've seen, you know, so many places where if you look in cupboards in the operating theaters, in places, there are these really fancy anesthetic machines that are just sitting there gathering dust because they've broken down. So there is no point taking a Ferrari to the middle of Africa because before very long, the roads in Africa which are rougher will mean that the suspension breaks. Um And then suddenly you don't have parts, you can't service the Ferrari. So you're much better off sending a very basic, I don't know Jeep or something. So if you're gonna, if you're gonna something um out out there, if you see that, that not the best example, but you get what I mean? So you've gotta provide equipment that is suitable for um for, for the environment. Now, um next thing to say is if you're gonna go and you know, do global surgery as it were, you need to make friends. Ok. The great thing about surgery and the great thing about plastics actually is that you get to know everybody in the hospital, ok. At Kings, um which is the trauma center that II don't really do much trauma anymore at King's. But at Kings I knew know still to be honest, every single other consultant and the same thing is true. When you go abroad and make friends with people, keep going back. OK? Continuity. You don't have to go for very long, but keep going back, keep seeing the same people keep, you know, making links. Um And for example, as medical students, that's what I say. I had a whole load of medical students in my operating theater uh this week. And I was saying to them, look, make friends with all the junior plastic surgeons, the trainees, make friends with each other, start networking. It's uh you know, as we were saying in the intro here, um you know, use every single opportunity things and you know, don't well be scared. OK? Because this is the problem. The first time I went to Gaza, it was really scary. I'm just gonna turn my volume down. I think this is where the slide comes in. Um And I will try and remember to turn it up otherwise someone um wave at me or something or turn your camera on the trouble when you go abroad, it starts with you being really scared. Ok, like all things, you know, doing them for the first time. Um, someone is, I won. Um, uh, um, I, um, it starts on my phone was ringing up. Um, is it one of you guys calling me by any chance if it is? Say so no. Ok, I'll tell my, um, it starts with fear and the trouble is, you know, you're leaving behind your family. Um You're leaving behind you, you're wondering, especially if you go to a war zone. You are wondering if, um uh um you know, you're gonna come back. That's probably why I'm not going to Gaza at the moment because I really think it is a bit too dangerous. Um And, um, and, and so for me, I've set my threshold that there has to be a sustained, cease fire. And, you know, when you turn up, it's intimidating. This is the kind of thing you meet you when you go to Gaza, this is what we call the tunnel between Israel and Gaza. It's no man's land on one side and then Gaza beyond that. And then on the right of your picture, it's Israel and quite often here you'd see snipers on the ground aiming there. Um And um, and firing through this tunnel and all that when I first arrived, it was like this, these buildings, actually, this was 2014, they rebuilt them. Actually, it's just on the border of Israel and Gaza. I bet you they've been blown up again. Um, it's all scary stuff but let me turn my volume up again. Um, actually going there is not necessarily like, you know, we weren't staying in those kind of areas. We were staying in a very nice hotel in Gaza with this sort of view very well looked after guests. This is in Tanzania. You know, you get fed, you know, it's amazing. It's really, really good fun traveling for surgery. You work in, not necessarily in a third world or in the bush type of buildings. This was the surgery building in Gaza. The trouble is, I think this is, yeah, here you go. This is what it looks like now. Um this is for hospital where we used to go. And um and as I said, this is what we were doing. So from 2014 until 2022 early 23 we were going along teaching local surgeons. This is a local orthopedic surgeon. He came to the UK learned how things were done. We didn't just teach surgeons. We also taught the staff. We um taught not by doing surgery ourselves. It's by assisting, teaching local surgeons how to do stuff. So, you know, you, the the teaching surgery is tricky and the easiest way is to say here, watch me do it and I try not to do that. You and not scrub in and you try and breathe down the neck of the surgeon over their shoulder, telling them how to do stuff, showing them how to do stuff and only chipping in if absolutely necessary students, junior doctors teaching each other their counterparts. This is in Tanzania, we're about to go back, um, teaching good practice and they've got to be a bit careful. The UK has been very, very good over the years of being, er, um, colonizers of the world and not necessarily doing the best job. So be very careful about telling people how to do stuff. You are a guest in their home. You may have good ways of doing things and this is the wh o checklist that we use before, during, after surgery, like a preflight checklist that pilots do to make sure that everything is working before they, they start the engines and take off. We try and get the checklist being used in theater varying success because we leave this laminated she behind and every time we went back to Gaza it would be, you'd see it and it was still in pristine condition. So I suspect it was being put back in a drawer once we went home. But you know, you are well looked after guests in somebody else's home. So imagine you're going to dinner in someone's house, you turn up, you might be sat in the kitchen watching them cook and you might be looking at them going. Oh, this is all a little bit dodgy. I'm not. You know, if, if it was my kitchen, I'd be doing it like this and then they might ask you to help them, you're not gonna push them aside and say, here you're doing it all wrong and then start rearranging their entire kitchen, um, and changing everything. You are. No, that's not what a good guest does you might say. Yeah. Yeah. Here, let me help you and then slowly, slowly, slowly you start working together and say, I'll tell you what if you chopped up the onions this way it will be so much better, you know, I mean, so behave like guests in somebody's home when you go somewhere, don't be a colonizer. Like a lot of us have done in the past. It's not just about doctors, as I said, physios teaching physios, um medical students again, taking selfies the same all over the world and it's about building capacity. I won't go on about these numbers actually because I'm running out of time. We do take some equipment. Cos orthopedics is very equipment, heavy suitcases, weighing a ton full of metal work, showing them how to use all the various kit that we've taken. Um, this is orthopedics as opposed to plastics running teaching sessions showing them how to use kit. Oh, you've gotta put together the kit when you arrive. It's really, really annoying. Um, we were up until the middle of the night, putting those boxes of screws together and continuing to communicate. Um, you know, and as I said, you know, it, it, it's teaching the simple things and just to give you a quick example, this is what plastic surgery was born out of. This is Harold Gillies and mcindoe, Harold Gillies was a world war one surgeon. He um, is really a grandfather of plastic surgery. He developed this technique called the tubed pedicle of being able to take pinches of skin, cutting them out, sort of like a rectangle. So you keep them attached by one end of the rectangle, you turn them into a tube and then you attach the other end of the tube further up the body closer to where you want it. And, um, uh, um, and you, um, er, and then three weeks later you then detach it from the original attachment, move that tube up and you keep waltzing it up the body until you can get it to the jaw. For example, if someone's been shot in the jaw, that was trench warfare arch, mcindoe, second world war surgeon because now we had airplanes and um, air to air combat. Um, and pilots were being burnt and so burn surgery was born in the second World War. And as I said recently, it's orthoplastic blast injuries, limb reconstruction. And Gillies has written an amazing book in that. It was relatively late in his career, 1957 with a cleft surgeon called Millard. Um, and, um, and he described, you know, the life of a surgeon. He also described, you know, the, the the summary of his work. And interestingly, you know, even today in a like Gaza where we don't have the microscope or we didn't at that time. Um If you're facing a big wound like this where the ankle has been shot, the joint is now open, the ligaments are all destroyed. There's a great big wound with bone exposed. You can't just treat that with a simple skin graft, which is like a very simple, but I don't know how much you guys know about plastic surgery. You have to do what's called AAA flap transfer and it's a Gillies operation. So you clean the wound, you fix the fracture with a frame with a fixator, external fixator. Um And a couple of days later you come back and then this is what, what we have to do is we had to take the good leg cut out the rectangle. We leave a wound behind that can now be um treated uh with a skin graft. Now, we have this piece of skin, you lift it up, it's got a blood supply coming in from there. The right side of your picture keeping it alive and there are blood vessels that go all the way up there keeping that skin alive. You now attach that skin to that gunshot on the ankle. So now the legs are joined together. This is World War One surgery, put a skin graft on there that you've taken from the thigh up there and then you leave them like that for three weeks and you might think it's inhumane. A lot of doctors look on in horror when they see this, but actually it is not that bad. Ok? He strapped the legs together and amazingly, this guy was mobilizing on crutches on his good leg. Cos you've not disrupted the muscles or the bone, ok. So it's still functioning and it's actually not that painful. He's walking on that leg for three weeks and then three weeks later, we've long gone home. You disconnect that uh connection between because and here you go, you can disconnect it because that piece of skin has now developed the blood supply from the injured leg, the good skin around it. And if you look very carefully, I think, oh no, it isn't. Sorry. I'll try and show you a close up. If you look very carefully, the hair is growing in the wrong direction. It's now growing sideways instead of up and down because of the way the skin has been laid. Um And you know, yeah, keep going back and make friends. You know, you get to know all sorts of amazing people and you know, and we are preventing this basically, which is what happened in the American Civil War. This was the management of limb injuries, amputation, but it's not always a bad thing. Ok? It's not necessarily the easy option. Sometimes, amputation is the best thing for the patient rather than loads and loads and loads of operations. And, you know, I'll show you an example. This is a photographer, um, newspaper photographer and he was in Afghanistan in Helmand and, and got caught up in a an IED explosion and his journalist colleague was killed and he lost both of his legs below the knees and um he was still eventually able to go back out into the field and carry on working. Um um And yeah, you know, we had done quite well up until October the seventh, we had managed to put together a limb reconstruction center in Gaza where a lot of the stuff I've shown you was being done. Um Oh, just look up Gilly's Commandments in plastic or plastic surgery when you get a chance quite a cool slide. We had done quite well. If I go back and put together what was effectively a limb reconstruction unit, nothing big. But it, you had all those facilities that I was talking about. Capacity building, teaching and training was ongoing. More and more patients being treated. But um NASA hospital is one of the hospitals that's been destroyed of, you know, recently. So we'll have to see what, what, what we do to get it all back online. Um Anyway, I'm gonna kind of stop there in terms of what I'm going on about. Um But this is a slide I always like to put, put up is that, you know, when you become a consultant, ok, you're at the top of your game, you're thinking I'm the best. But what you only know is how to is is, yeah, how to operate. Ok. Technically you, your hands are at their peak, what you learn with experience is when to operate and you may have been taught some of this in your training. But you know what you learn when to operate more and more and more as, as you go on, what's really difficult is to learn when to not operate, when is not doing a fancy operation. The best thing when he is doing a simpler operation better and then, you know what, never forget, even if you become a surgeon that you're still a doctor, still be a physician who happens to operate. Um I wanted to very, I, I'll tell you what, I won't talk about that because I know I'm running over time. Um Hopefully one day I will get to go back to Gaza. Hopefully I'll go and get to see, you know, the, the, the, the friends I've made there who are currently, you know, in a really bad way. These are not them, this is in Tanzania. Um And hopefully you guys have been given a bit of a taste. Um follow our be first charity, social media accounts, um get in touch with us if you're interested in helping. Um and um you know, honestly do do global surgery is what I would say. Um I will try and stop sharing my screen. I hope, uh and hopefully we can go back to where we were. I hope I haven't run over too much time guys. Um No, that's perfect. So if anyone has any questions, please just drop them in chat. Um I haven't let me see, let me get, is it the Q and A tab? Is that right? Yes. Ok. Not any coming in, but I do have one personally. Yeah, this is something we already talked about but student med ad gets quite involved with donating equipment abroad and I thought it would be interesting to hear your review on sustainability of medical equipment and yeah, it's really, yeah, be really care. Ok. It's, it's again, it's doing the simple things really, really. Well, now don't start donating. Like if you go and ask a surgeon abroad when we went to Gaza, we would ask them saying, tell us please, what do you need? And we would meet the health minister and, and we'd be sat around these tables having meetings. Ok. A lot of surgery, a lot of medicine. It's boring meetings, um and logistics and operational stuff which I was gonna talk about at the end of there. So when you're doing all of the operational stuff rather than the clinical stuff, the actual treating patient stuff, um you know, it's communicating, asking local teams what do you want? And inevitably they want the fancy toys. Ok. If I ask my teenage kids, what do you want? They want the latest Playstation. Whereas actually, you know, you can't necessarily uh have the fanciest toys functioning in the settings that we're talking about. So when you, when you go and ask people, they were saying, oh, we want microsurgery, we want um we want microsurgical neurosurgery, we want this laser that, you know, and actually we're kind of saying, but you know what, we're not quite at the point where we are doing even the simple things like debriding wounds, cleaning wounds, um, very well. So let's actually start doing really simple lower limb surgery like that operation. I showed you the cross leg flap where we've joined the legs together. Let's start doing that really well. And you know what they, they are and they were doing it amazingly well with the simple equipment that we've taken out and they had just about got to the stage where we were now able to teach microsurgery, which is using microscopes and fancy equipment and all the rest of it. And, um, er, er, and then all everything kicked off in, in October. So when you are sending equipment, it make sure it is, you know, not something that it's just a one off thing. It's gotta be sustainable, it's gotta be continuous. So you might find a packet of really fancy dressings that someone sends you and then you put that in a, in a parcel and send it out great. That might help half a dozen, a dozen patients. And then they get used to using those dressings and then once it runs out, now they're back to using basic stuff and you can't send it because it was just a one off box of spares that someone gave you. So think of it more as how is this gonna carry on forever and slowly grow? Ok. Growth is slow and tedious and boring. Um But that's how you grow. You do, you don't grow by throwing fancy things straight away. All right. Thank you so much for answering. We have one more question um and comes in two parts as someone who's interested in doing global health work, but not necessarily interested in surgery. What would be the next best specialty to make a difference? And you advised to first wait until you're a consultant before or after working abroad. Um No, you know what? Don't necessarily wait until you're consultant because be first has not only the main committee which are consultants and you know, uh um I don't know whatever you wanna call it grown ups. Um We've got trainee committee as well of trainee plastic surgeons and we have a students committee as well, medical students and everyone gets involved. They don't necessarily all get to go out to the projects, but we are taking senior trainees out into the field as it were but the students are helping with, you know, the operational stuff, booking the flights, making sure that everyone's licenses are done, making sure that things like this happen so that, you know, people get aware of increase their awareness. Um So no, don't necessarily wait in terms of specialties to make a difference. Um II think things like public health, you know, the bigger picture stuff, I'm not talking bigger picture here necessarily, you know, it is some of the traditional stuff. If you look, look at the people who work and head up the World Health Organization, look at what kind of doctors they are, what kind of nurses, they are, therapists, operational managers, you know, business people, even financial experts that those are all the kind of alternative things that will make a big difference. So I think public health is not a bad specialty to get into and you can usually do that via general practice. Um Yeah, I don't know the true answer to that to be honest because I'm too far gone as a plastic surgeon. As I, as I said, I've got a relatively blinkered view of the world now. Um because I've been doing my little thing for so long. Um Now I've just seen a couple of there's a messages have popped up. Uh There we go. Uh Would you wait? Yes, so yeah, so that was the other question. Fine. Thank you. Perfect. Thank you so much for coming. In mister. It was an honor to have you here. Well, thank you for inviting me as well and uh I hope it hasn't been too boring. Really nice talk. Thank you so much. Thank you. Take care, take care. Thank you. Bye. All right. So our next speaker is Doctor Bo. Um Would you be able to just quickly try sharing your screen and I'll start with your introduction? Uh Yeah. All right. So our next speaker, Doctor be having gone to Saint George's Medical School. She then acquired a master's in global health Policy from London School of Economics. She's had numerous achievements from being a recipient of the Botswana top achiever scholarship to serving as a project leader for LSC S Global Research and consulting group. She's also had international involvement such as roles uh as Deputy director of I FMS, a Granada standing committee on Public Health and the If FSA Grenada fundraising director. She also served as the ambassador of the French of Ambassadors Foundation, a nonprofit with a Consultative status with the UN. It's an honor to present doctor. Be hi everyone. Thank you so much for having me today. And um yeah, II really like such kind of conferences on global health policies, especially seeing from a medical perspective cause I definitely didn't have that um while I was in medical school, so definitely great for you guys to be here to kind of learn um a bit more about this field. And how to navigate to when you are studying med school and what it looks like after med school. Um And it kind of goes kind of flows quite well with the question that we had from fi about, you know, doing Doba health work and the kind of specialty to make that difference. These are the questions that I had when I was in medical school. Uh that no one seemed to have the answers to besides just the regular, you know, streamlined path to go to residency. So, so what I've done with this presentation, I've kind of given a background of like my career through med school and up to where I am today and kind of give you a step into how I got into global health policy and what are my plans essentially after that um as a doctor. So, and so this is try to put like very consolidated uh image for you guys to see um my career journey thus far. So I started medical school in Saint George's University School of Medicine. This is the Grenada one, not the London one. And that's basically to get into the um a little background. I was born and raised in Botswana and I did my A levels in Botswana before applying to Saint George's University and which I got into then um in 2015, I did AE RP med and then got into the medical school, which is a four year uh course So while I was in S gu one thing I realized I started getting very involved with extracurricular activities, which kind of opened me up to this idea of public health. This was before I even realized there's another step global health. But with public health, I essentially joined the International Federation of Medical Students Association, uh Grenada, which is actually um IM SA is quite a very big um organization of medical Students around the world. Um I, I'm sure the UK has one as well um that you can look up. It's very, very interesting in terms of especially the public health aspect aspect for some of us who are interested in the global health policy route. Um So when I draw Im SA quite early on in premed, I quickly then became the Deputy Director of the Standing Committee on Public Health. We were able to go out for outreaches, do kind of one health clinics in the community in Grenada and so forth. And that really started driving my desire for kind of doing medicine that's more grassroots and pretty much finding out like I want to kind of address the root cause of why people were having these problems to begin with. So then after I finished in Im SA, I went on cause now in med school in S GU, if you know anything about S GU, it has a very, very uh broad region in terms of where students can kind of do clinical rotations, which also solidified that global context for me. Uh in terms of the different healthcare systems I was exposed to. So I did my foundation year. So my basic sciences in Grenada on the island and then I had an opportunity to also do um some work in the UK. So I did some rotations in the UK. My surgery in Psychiatry. I did an AQ AQ uh QE QM if that's uh if I remember the name correctly, that was a couple of years ago. Um And then some at um Kent, I believe at in Ashford as well. So I got to see the NHS kind of system as well. And then I want to finish off my rotations, my clinical rotations in the US and New York as well as in um Maryland and all that from the Botswana, Grenada, UK and USA healthcare systems. It really started to show me that I was really, really interested on a more global aspect of how all these culminates and how I can kind of address healthcare on a global scale with all these problems I saw in the UK in Botswana in grenade, as well as in the US. So while I was still there as well, finishing up my rotations, I got involved in um this youth Assembly, essentially. Uh The Friendship Found uh Association Friendship Ambassadors Foundation is a nonprofit organization that has Consultative status with UNESCO and Ecosoc as well. So once I got involved. I then really found a way to kind of help, I guess in my case, um youth in Botswana who were interested in making social impact and driving like doing some social initiatives, social impact initiatives to kind of come to the conference which was held at the UN in um uh in New York at the time. And through that I was able to hone it the Sustainable Development Goals. And the which one I was really interested in was SDG three obviously for health. And through that, I kind of really started questioning whether I wanted to pursue a more traditional residency uh in the US and go through whether it was internal medicine, whether it was surgery, whether it was, I couldn't really decide because of what I had seen the impact that I had I had through the Youth Assembly. And quickly after that, when everyone else was kind of finishing up writing the USM exams, I decided to put a pause once I graduated in 2020 on my clinical journey and take a risk and apply to LC for this MSC in global health policy, which sounded very, very interesting at the time. And as you can imagine when I started this program on global health policy, it was in 2020 right in this like thick of COVID. So it was quite a mind-blowing and also confirming as to what I really wanted to do and why I wanted to do um global health policy. So as my friends went off to do the residency programs, I was now in this master's program um in the thick of COVID barely going to class because of the lockdown and everything. But I was getting such a holistic experience throughout one of the course, some of the courses that we were doing in this, in this masters were like financing health care, healthcare, economic evaluations. You had um pharmaceutical economics, as well as well as randomized evaluations of health programs. All these skills that I wouldn't have otherwise learned in medical school. That was kind of answering a lot of the questions that I had throughout medical school that obviously for obvious reasons, like we don't necessarily get taught besides, you know, the anatomy and the kin presentation all and all sorts of things, the other side of things like the insurances, how those, all these things work and how our patients, the things that our patients have to go through before they actually come to see us. All these questions were being answered by this master's program that I was now in, in le and I was really excited about this because I was like, OK, this is exactly what I wanna do. Um But trying to also fit how my medical degree and this MSC degree we're gonna work together is something that I still basically working out. But since I had the degree already my medical degree already after my MSC experience, I decided to actually try out this path first use my master's first uh to figure out how it is in this global health policy field to better then advise me on how which program is that? Or residency program was best suited for someone with my kind of interest. So before I went back into or decided to go back into residency, I then decided to apply to a few places. Uh This is where it gets quite interesting when you are a medical student, you're very used to a streamlined like way of career progression. And that is, you know, you have your applications, you either know, you're going to surgery, you're going to pee you, you know, but once you come out from a program like your masters in Global Health Policy, it's so broad and so unclear. There's no direct path, everyone is coming from different backgrounds. So I have classmates who either did anthropology, who did this. I was like one of only two doctors in my class who had, who are, who are doing this masters. So when you get into the workforce, now, everything looks quite different because like I said, there is no streamlined path for someone with a master's in global Health policy, you kind of have to map it out on your own and really understanding your interest and needs and obviously hoping that there are also open positions of people hiring. So that's where I discovered a world of the first one was the medical communications uh that I could do with my global health Policy degree. And with that I went into medical writing because of our background, obviously, as doctors, uh we have so much medical knowledge, which is one of the fundamental things of a medical writer that they have to do. And medical communications, you're basically, there's the middle man between the pharmaceutical industry and the healthcare professionals. Because pharma industries can really communicate directly, especially in Europe and UK, you can't really communicate directly with um the doctors and the patients. You need a middle man to kind of make it more ethical. So we are the people who would then write these documents, whether it is when the the pharmaceutical industries have released a new drug. Uh Let's take, for example, let's say Ozempic or something. The, the pharmaceutical company would then come to the medical writers or the medical med coms companies uh to get their medical writers to basically collate and synthesize all this complex information from the clinical trials into whether it's powerpoint dxs and um regulator affairs would then do kind of like the um what do you call this thing, the the forms or the sheets that they need to kind of get the medication approved. Um So we'd write all these papers and slide decks and so forth for communication with various audiences. And it involves a lot of research and analysis and writing skills and your main clients, other pharmaceutical companies. So that was quite an exhilarating experience for, for me to realize, ok, I could still use my medical knowledge. I don't have to lose it because I'm working every day with these uh pharmaceutical companies in terms of the treatments and the diseases and the outcomes and so forth. It was quite um you know, fulfilling however, another opportunity at the same time arose for me to go into consulting, which I was like, why not? I mean, at this point, I'm still exploring, you know, where I wanna be and what I wanna do um with um what I wanna do with my master's in global health policy or where I wanna take this. So I jumped onto this experience um as a associate consultant for Global Health in Global Health, for a consulting firm that was basically working with SA PP as well as WH O and a couple of other stakeholders. And this, I would say this is where maybe a lot of us as doctors are trying to get to cause I got to see a whole other level of what actually goes on behind the scenes um of how these decisions are made, whether it's for vaccines of Covax, you know how the wo makes it, it, it's, it's decisions at the time I was working as a consultant for that we had the Monkeypox outbreak and getting to see how all those things happen and having a seat at that table was really, really interesting and seeing the impact that doctors could have. And one thing is quite obvious, most of the people are actually not doctors. So a lot of people who are making the major decisions, healthcare decisions are not necessarily doctors. Um there are people who have done maybe epidemiology. Um what do you call this um microbiology who have gone up or just pure public health and so forth? And so as a doctor, I think you bring a different lens when it comes to global health consulting and understanding a bit more depth, especially if you cut forward with a a in global health policy, you have a very holistic view from the patient right up to the policy decision making that you can, we can kind of contribute a bit further. And one thing you have to realize as well when you cut, you get into the consulting bit, that's a lot of stakeholder management. I mean, I was in meetings all day every day but that there's an excuse, the fact that you also have tons of work to do. So consulting is consulting. There are a lot of work to do and a lot of bureaucracy that you get to see, you know, the inside scoop of how W A actually works and how decisions are made and how the stakeholders, which other funders work. Or if it's gabby, if it's Bill and Melinda Gates, there is a whole lot of chatter that goes on behind the scenes before a decision is reached before a policy is passed down and so forth. And that was an experience that II was forever grateful for uh to be able to uh do that. And as I was actually working as an independent contractor, so I was quite flexible in that and that was really, really nice. Um But I then took a break because I had my little baby. He's like a year now. Hence, you know, the skip from consulting to events, I needed something more a bit more flexible because the consulting was quite rigorous in terms of the hours as well as the commitment needed, which led me to the healthcare events uh side of things. And once again with this degree, uh uh mm I have an MD but I can have M BB plus your master's in global Health policy. You will always have kind of a really, you know, bird's eye view of the different elements that are happening. And when it comes to stakeholder management, there's such an added advantage because you know how to talk to the doctors, you also know how to talk to anybody else who's trying to understand a bit more of the health healthcare industry. So when I went to healthcare events, I came in as a conference producer and basically creating a lot of uh CPD courses for whether it's nurses, doctors, uh surgeons and so forth I'd actually do tons of research, tons of research, um, whether it could be doing day case surgery, uh, CPD courses and so forth. And, um, some of them could be like quality assured courses that people can use, whether it's audit as well, auditing their clinics and so forth. That was also a rewarding way to kind of give back and make greater impact through curating these training courses uh for healthcare professionals. So that's what I've done until quite early on this year when I took a step back and decided, OK, it's been a couple of years since I finished my med school and went to global health policy. And by a couple of years, I just mean 2 to 3, I just really needed a, a bit of time to kind of make a decision as to what I was gonna do with my medical degree. And after all this, I finally collated all the research and figured out which residency program or specialty as fi was asking would be best for my next step. And that's where I've no, I'm now have I have now come to which is what I'm preparing to do now. So currently I am knee deep in prep for my US medical residency application. And if anybody knows how vigorous that is, luckily I've already taken some of my USM exams uh cause S gu is pretty much an American like university, they pretty much prepare us for, for, for American residency programs. So not too much familiar with the UK PBS and stuff. So I already taken my step one, my step two clinical skills. And now I'm taking my clinical knowledge exam, which I'm currently preparing for as we speak and preparing to go back into some US clinical rotations to kind of beef up my experience again because I've been out for a couple of years and then come September plan to submit my applications. But now I have a clearer picture of the kind of residency program or specialty that would work with the kind of work that I wanna do in global health policy as well. And that is your Family medicine, Global Health program. However, there is another program which I only discovered quite recently as it is like last year or so, which is your Public Health and Preventive medicine program as well. That's another residency you can go into if you're looking into, go into things of global health policy and kind of being involved in more of that health ever in the US, the Public Health Preventive Medicine program, you cannot get into it quite directly from medical school. You actually need a year of training, either a transitional year or any other. You could have gone into surgery, family medicine, dermatology. Oh, you know, you just need one year and then you can now you can apply for it in your first year of residency. Um As a it's a two year residency program. So if I decide to do family medicine, going to family medicine, now, the Global Health Program and discover maybe a year into it that actually I want to make it more specific to public health. I can always apply that year to get into the two year public health and preventive medicine program. Or I can decide to just continue with the Family Medicine residency, um the Global Health route and just, you know, complete that residency and then have that accreditation and then add on a fellowship with Public Health and Preventive medicine. But I know a lot of people um and colleagues of mine who are now attending in family medicine, who have also done these programs, who have got to travel to many different countries to provide care and kind of still keep that c aspect of it, but also going out into the field outside the, you know, normal 9 to 5 clinics or um hospital experience. So that's kind of like where I've been at right now and where I'm at right now. So I it's I had to really take a pause, the full time work and kind of dedicate the next couple of months to just trying to get in because it is quite an undertaking to make sure you actually do match. Um And in a nutshell, really, what I've learned my definition of global health policy have def definitely been refined as well, you know, um in terms of we are readdressing issues like infectious disease, chronic illnesses, maternal and child health, access to health care on a very global scale. While also collaborating with pretty much everybody. It's so interdisciplinary going beyond the hospital walls to you know, um your NGO S your international organizations and healthcare professionals and some governments as well. Uh We did a lot of in the consulting firm. I was in some consultancies for different countries for that Ministry of Health. So you get really so much exposure into the breadth and depth of what you could do in the Doba health policy field. And when it comes to why you'd wanna pursue this thing. And like I said, for me, when I was in the hospital during my clinical rotations while I was in med school, I just kept not finding the residency program that I felt I was more really in tune with or in inclined to do because I felt like I wanted to have a broader impact beyond just the individual patient. I had so many questions that couldn't get answered by just seeing one patient. I was asking about the insurance. I was asking about, you know, why certain people have access, why others don't have access? Why are policies like this? What can be done? So that's really if you have those type of questions and you also long to, you know, figure out how hospitals get funding or how organizations are funded such that they can have sustainable impact in terms of health care provision for a community or a country. This is the kind of field that you wanna really get into as a doctor and the places that she can work are quite fast as well. You can work for government agencies, ministries of health, you know NGO S my supervisors when I was at LSC, they've only known academia. So she's o only been in academia for example. So you could just stay there if you just wanna be, you know, pushing the paper uh or you can go into consulting firms as well. And I will say this um the skills that you need as a global health policy like personnel really, besides the public health knowledge that we kind of have a foundation of as doctors, you need your product management skills. There's a lot of product management that goes into this work daily. It's almost like if you can do slides and I'll repeat the slides, slides, slides, you're constantly doing presentations for clients constantly, you constantly have to present something uh because you're constantly tuning out um data and results and so forth that need to be iterated every now and then. And you need to know how to do some policy analysis in addition to having such strong communication and advocacy skills and some of the things that set other people apart is doing other like quantitative, having quantitative skills like your data are and so forth. Some of it can even go to path and I don't know, but I'm not quite quantitative like that. So I just stick to my more qualitative research type thing. But if you have a quantitative um aspect as well, that could be one of your strong points to get into this field quite strongly. I know some companies, um, like we and Martin as well. Hi, all of global health consultants. You have SA PP as I said, uh you have G as well med access and a couple other um or organizations and companies that hire people with the global health policy background. But one advantage I would say would be best for medical students. What I didn't have and what I wish I knew is that it is so much better. And one of the reasons why I'm also going back into residency and really sure about it is that it is so much better to actually finish medical school, do a couple of years of medicine, if anything, finish your foundation years and so forth before um trying to go into the field of global health policy to actually start working because your, your experience, your clinical experience after graduating actually sets you apart. Uh because right now I say if anything, I'll say my biggest disadvantage when it comes to maybe pushing a bit further or getting that other job that someone else might get is because it's just that little difference they may have tons of experience in something else. Uh As I said, this program has a lot of people from different backgrounds. So for us who have an MD, if you didn't, if you, if you don't have that clinical experience, it doesn't necessarily make you that much more competitive. But if you're an MD with tons of clinical experience and you have global health policy background, that would really, really set you apart, which is pretty much what I'm hoping would happen in this case. But also knowing that the Family Medicine program that I'm trying to get into um is quite versatile in that, that it can provide a whole wide, you know, range of opportunities to be still doing that while I'm training and also outside my training. And yeah, that's all I have for you today. I'm ready for your questions. Um Hope I didn't bore you too much and hope I didn't confuse you as well. Thank you so much. Um That was an excellent talk. We do have one question in the chart right now. So how do you get involved in consulting or pharmaceutical work, especially if you don't have additional degrees that are outside of medicine or previous experience in this sector? Uh Yes. So with this one, I think one of the easiest ways as I said, if you wanna get like pharmaceutical industry as an MDI, believe you're such an asset, actually, uh you kind of add a bit more credibility to that work because essentially all they're trying to do is turn out this information about the new products and stuff like that to basically get them in the hands of healthcare professionals and to get that drugs and stuff approved to be used on a wider range. So essentially, and getting an MD or M BBS to talk to another doctor, there's a bit more credibility. So the best way to go about it and they have programs for this mind. You like companies like pfizer and so forth. They actually have quite streamlined process for doctors trying to get into it. There's medical affairs, regulatory affairs and so forth and even trying to get right up to like medical director, usually the pre because it would even be a, do you have to be either a doctor or have a family d so for you, it the best thing to do would be to at least I'll say do minimum of two years to three years experience as a doctor. So finish med school, get into your foundational years, practice for some time and then try to branch out that clinical experience. Work is really, really going to help you stand out, especially if you don't have any other degree is the clinical experience. Once you have maybe a minimum of 2 to 3 years under your belt, you can then kind of look into getting into medical affairs field or medical writing and so forth and that's where some of the pharmaceutical companies like companies like I'm saying, whether it's Abfi pfizer and Roche and so forth may be able to take you in. They have some, there are some programs that actually are quite streamlined for doctors to get into. Oh, I think you're muted. Sorry. Uh Thank you for that. So we have another question from Ziad similar to herself. Uh, she did a master's in health and development and really enjoyed it. How did you find the courage to explore the other side before returning to medicine? I feel like leaving the one track path and creating your own can be quite scary. Yep. It is very scary and it is very lonely. And when I say longly, it's because of like, there's obviously no one to really talk to and try to kind of mimic what they did or kind of follow someone else's path with global health course. You're really just map in your own way. And I was quite scared because II generally didn't know, uh II realized that if you know anything about the US uh medical system is that it's so streamlined and you're set for, if you get into residency, you are certain for success. But I was deciding to put that on a pause and go into the something that I had never ever done before and didn't even know how it's gonna look like. I think it's just my passion for it. I really had spent so much time in my extracurricular activities, I had seen some doctors and when I go on these uh international conferences, I interacted with a lot of doctors who are already working at the WH O and in other fields, I had done actually an exchange in Brazil uh for internal medicine exchange that also solidified it for me. So I kind of came to a halt where I said, I really, really know that right now II had just dedicated five years of my life to medicine, to medical school. And for me to dedicate another three plus years to a residency program without being sure I was, I was willing to wait, to be honest, I was willing to wait. And I was like, as long as I've graduated and I have my degree, I know I can always go back in. So why not explore this other thing? It was definitely a risk and it has been uh a risk. Even now as I talk, it's everything is always, it's life is about taking risks. You will never know what you don't know until you go out and like figure it out. So at the moment, as I said, even this right now, like taking a pause in that field and trying to go back into medicine, it's a risk as you know, it's, it's match, you have to match. I'm hoping I match. Uh So I'm doing everything in my pouch hoping that II do match and get back into the field again. Um So really, it's just knowing exactly what you want and planning ahead, as I said, network plan, but enjoy yourself in this whole part. Planning is very, very important in this thing because like I said, there's no path but once you know that this is what you wanna do and how you wanna do it be looking out for any of those opportunities because one thing leads to another and you know, you find yourself seated in tables that you had no idea even existed. So thank you so much again. Uh We have another question from Chem. She says um hi, thank you so much for your talk. What did you do as part of your I FMS A? And what was the best part of this for you happen? I have, well, that was a II would say was one of my foundational um organizations that have really set me on this path. And I, as I said, I was uh the deputy director for the Standing Committee on Public Health. And essentially with this one, I used to, we used to create a lot of public health awareness in the Grenadian community which I would hold like clinics um obviously with supervised by some of our um lecturers or some of the doctors uh within the community. But it would hold clinics where we basically do free BP monitoring, diabetes testing. Some people who are maybe interested in a more like women's health and stuff will actually get to do um, your surgical exams and so forth under supervision, of course. And all these things before we even go to clinicals, we're already kind of quite involved in these things. And I remember doing, um, what do you call that? Do you remember doing? Uh, I started a program actually, I started teddy bear clinic in, for one of the orphanages, which was one of my um keystone projects to basically get kids to have like to be less anxious when going to the hospital and doctors so would kind of bring teddy bears. They will make makeshift uh doctors and patients. They would dress up in our, with our stethoscopes and white coats and so forth. So some of these little programs that we had, but as well, there was a lot of traveling uh for original programs I had gone to like Paraguay, gone to Mexico, gone to Montenegro. I mean, we're all over the place. Um networking with all these students from around the world. I mean, all around the world. Uh You can think of they were there for these programs. And I also did a pro um one of some of the things I did, I was a fundraising director as well for the, the organizations. Once I shifted from being, from being in the same Committee of Public Health for that one, we'll do like international food festivals to raise money to what's the grade and kids going to school? Um, and some of them actually have ended up going to medical school because of the funds that we used to raise in this program. So I FMS A was really such a stepping stone for me. And the best part was just being able to dissociate from studying every day and doing something completely outside my school, my university and into the community where I was actually seeing myself make so much impact, you know, and to this day, the lifelong friendships I've had, I have a lot of friends from Colombia, friends from um um Peru, you know, like things I would have never imagined and let alone a whole one month exchange in Brazil. I had no experience with Portuguese at all. Uh But through that, I was able to spend a whole month working in an HIV AIDS unit, uh you know, working with alongside doctors, treating patients. And so well before I even graduated. So Im SA was such a stepping stone for me in terms of reopening up my eyes to the world of possibility outside of just where you are and more on a global scale. All right. Thank you so much. And we also had a message in from Zed saying thank you and that's exactly what she needed to hear. You're very welcome. Very welcome. Um I have one personal question as well, I think especially as a medical student. It can feel quite daunting that you need to, like, start working on everything right now for your career. Is there things I can get involved with? Is it too early, too late? What would you recommend? I'd say for me, which was not necessarily what other people did. I, medical school is a lot. I mean, even now just starting to, to study again for my board exams, I remember why. Oh, it was so, so stressful. Um medical school is a lot. And for me, the extracurricular activities went so much about building my CV. But more about kind of, you know, dissociating and doing something I actually really loved and reminding me why I joined medicine. And in a way, all those experiences have come to work together to give you these incredible experiences in the workplace. Uh They tend to just happen to be the one thing that actually set me apart from everybody else when it came to the hiring process that I didn't realize at the time when I was doing it, uh that it would actually really matter. But I would say um for, I guess those who are interested in a global health kind of rude, I'd say maybe look out for like conferences, look out for a lot of conferences. Those tend to really open up your eyes into what people are doing, especially youth conferences, what your age mates are doing as well. And this kind of social impact things that you can do with your time outside of medicine and reminding yourself why you wanna do medicine to begin with or partnering with uh other people who are already doing things. I know I'm looking forward to hearing also from like the next speaker. And as, as well as, uh our previous speaker also said, you know, the opportunities if you wanted to go see what they're doing, those things really for me were help, were very instrumental in helping me decide what I actually wanted to do, uh post med school and so forth. So kind of going at it with such an open mind, uh don't be too closed off because even now I have some friends who maybe in med school focus so much on one specialty like p only to realize when they started working that they actually hated peds. Uh But because they spent so much of the med school just focused on one thing, they didn't get to really experience anything else so that not able to make like another alternative decision, then they feel stuck. So it's kind of during this process, if you, if if you really want a holistic experience, kind of opening up yourself up to experiencing very different specialties and experiences outside of medicine uh that are still kind of contributing towards the bigger picture of why you chose to do medicine in the first place. Um And really giving back, I think there's no, no one can ever say giving back is bad. It always tends to come together all like somehow it will show up in your CV one day in a way that you didn't realize actually that, that actually set you apart and doing stuff for free as well. One thing I didn't mention is that I work for this other um nonprofit in Zimbabwe that I helped establish it with one of the founders. They basically want to like create a hospital, a clinic, uh build a hospital in some remote place in Zimbabwe because the mine shut down and everyone basically moved out. There's no health care, women have to walk 30 kilometers away and stuff like that. But that's an experience where I'm not paid for it. But because I can literally hear the plight of these people and the plight of uh my friend who is so passionate about it because she's from there as well. I'm like, actually II want to help these people. II, I'm really passionate about quality access, um access to quality care for everybody. So this just seems like a natural thing to do and it doesn't feel so much like work as much as it just giving back. But then suddenly you have a job opening come up and then you mentioned that you do that and that's exactly what they're looking for. So you just never know, you know, just keeping your eye, your, your mind quite open to experiences, networking as I say and enjoy yourself in the process. All right. Thank you so much. Um uh I think there's no more other questions in the chat, but thank you so much for taking time out of here Saturday morning to come and present. This was an incredibly informative talk, especially for people interested in a career and a full time sort of engagement with this sort of global health and policy side of things. Yeah, I know a lot of people are becoming increasingly interested so this has been really relevant and useful. Thank you so much. I'm glad I could help. Thank you so much for having me. Thank you and all the best. Everyone. I'm sure you're doing just fine. Uh Would you be able to also stop sharing? So, yes. Thank you so much. All right, for our next speaker, we have Yusuf Benter of apologies if I completely, but that he's a final Oxford Stu medical student and he's the founder of the aspiring medics also known as Tams and it's a social enterprise that which helps students get into medical school coming from a council state and going to a state school use is incredibly passionate about widening participation. The aspiring medics help students to get into medicine through 1 to 1 tutoring online courses and the A VA which is uh like a A I virtual assistant, the world's first A I platform for medical student interviews. So it's my pleasure to introduce them to the stage. Thank you. Good morning everybody. Um It's an absolute pleasure to be here. Thank you so much for that um Very kind and warm introduction. So as it has been mentioned, I'm gonna be talking about my journey in terms of one, going through medical school and two, going through medical school and founding the aspiring medics. I'm helping students get to medical school. I've got some slides prepared as well and effectively, I'll be sharing my story right from the start and hopefully also within that giving you guys some pragmatic advice as well. Uh In terms of what steps you guys can also do moving forward if you wanted to go through a similar pathway, in terms of creating your own endeavor. For example, I'm gonna share my slides and the other thing that I want to stress is that um I'm gonna make it nice and interactive. If at any point, there are any questions about anything, please do. Let me know. I'm happy to take questions as I'm going through it. So let's see if this will work. Can you guys see my screen? Yes, we can see it. Awesome. Thank you. So let's get started. Um As it has been mentioned, I founded the Spiric, which is an educational platform helping students to get into medical school. So my journey um from humble beginnings, um I'm really privileged to have been able to study Oxford University of now, finished finals, starting again, work as a junior doctor, this July, so remaining in Oxford at university hospitals. Um and this, it was really the pivotal moment for me in terms of one getting that interview and then two getting the offer through. And that's something that really struck through me. And as I say, coming from a council state going to a state school, having no family members or friends as doctors, it was an uphill battle and I struggled with the inspiration gap, the information gap and also the skill gap in this. And indeed, this story is not unique to me, but we know to be a systemic problem. And indeed, medicine is a highly competitive application process. As you guys all know as medical students and thus successful medical applicants know there are 30,000 applicants each year for 10,000 spaces and only 30% of medicine applicants succeed to get into medical school, which means that um it's a v of different hoops that they have to go through whether it be a work experience u A personal statement. Now they don't have the B map, but they've got medical school interviews which remains a massive massive filter as well as actually getting their a level. So you've got multiple steps to take this becomes a barrier. And indeed, you know, as it's been documented that this is an unequal playing field and this has been clearly reported by both the SORA and also the British Medical Association and that's really the groundwork for and the inspiration and still remains at the very beating heart of what we do with these Spiro medics. I think this is the first sort of key takeaway is just being very clear on your mission and that gives you a sense of purpose. So to clarify these spired is a limited business, but we're also a social enterprise and, and that social good is very much at the heart of what we do because of my own lived in experiences as the founder and becomes everything that we do as a culture. And the word culture has sort of become overused as recently in terms of uh in terms of in business. But I think it's really important to be aware of that and be that mission focused. And so to start the story, what was the origin story? Well, I founded these sparing medics a week before fresher week when I started. So that's now September 2018, which makes me feel really old. Um So I think the key thing that I learned as we were setting this up um is the fact of balance is key. So these are my other course mates in my college at Bali College, which is where I studied. And, and as anybody who knows me will tell you, I live my whole life off of a Google calendar, like the whole thing. So this is my timetable from November 2018. So what three months after founding these paramedics, it was a lot to balance. So blue basically is academia yellow was powerlifting. Um Green was any tutorials. And so it was a variety of different stuff, you know, from obviously like essays to do house viewing or whatever. And this is everybody's life. But I think this is really important to keep in mind because of the fact that if you're creating uh any organization, any endeavor, you're going to be doing so alongside a very busy schedule, whether that be as a medical student or whether that be indeed as a doctor as well. So it's really important to bear in mind this, it's not gonna be a case of, oh, you can be able to go into it full time. So being able to manage your time effectively and the way I do it is through your Google calendar and I just stick to this and I've just got notifications for everything. Um But again, everyone's different. Some people see this and are overwhelmed for me, this is actually quite liberating because I just, I just follow it, it just tells me what to do. Um But again, it depends on you as a person. Ok. Second thing that I learned is to learn from every failure. So at the er outset with the Spiric, we were doing lots of in person school visits and we thought, you know what, this is gonna be great, but actually one, it was very expensive two, it was very limited because at that point, it was just a hardy group of friends from Hertfordshire, which is where I uh went to school, secondary school and sixth format. And we were just local friends from local schools. And so we were just limited by who happened to have a car and who happened to be free that day. And also when it actually came down to having those school visits. yes, the school visits, you know, went well, but we didn't actually end up getting any sales from that. And so it very quickly became obvious that it wasn't going to be a long term solution. We were very limited in scope. Similar thing with Instagram, I was doing that in between like uh tutorials, between lectures, creating, you know, er Instagram stories and posts the return on investment just wasn't there. And so we quickly pivoted away from these two things. So I think the factor is you definitely want to always be iterating and learning and experimenting. You guys all as medical students, healthcare professionals know that's what's all about iterating, experimenting and having that same mindset and business is absolutely key. So here are some examples of the in person school visits as have been mentioned. And as I said, um these were just literally friends um from local schools. The next thing uh that I learned in 2020 was skill stacking. Now we hear about this in terms of building your own MDT or multidisciplinary team. And it's exactly the same here. OK. So it's in terms of the fact that at medical school, you will never ever come across such amazingly talented people that also happen to be unemployed. Ok. So it's an incredible opportunity to make the most out of medical school in terms of the people available. And then the other thing and this is more specific to my endeavor was the case of actually combining Gifford's school sets. So that was in terms of article, writing, graphic illustration, video editing, and the power of that is more than the sum of its parts. I sort of think about it. If you've got three skills, that's extra power. Three, if you've got six skills, that's extra power six. So it's massively, it's an exponential combination of those skill sets. And the other thing just in terms of managing any organization comes in terms of where impossible, automating. If you can't automate delegate and create templates, this is absolutely key to ensure that you're able to make impact at scale. And I think that's one of the other key themes um across this talk is just this idea of impact at scale and making something scalable, particularly when we are all limited in terms of either time or costs. And this becomes really important. And this is to me is what innovations about, it's about being able to do more with less. OK. So that you can really have greater leverage and scaling if you guys have any questions so far, please do drop them on the chat and uh feel free to interrupt me and uh happy to take any questions on anything so far. So from that, we were able to build an award winning team of 50 plus medical students um all across er, the UK, where we were able to receive backing from Oxford University and at that point, their entrepreneurship center, which has since been renamed. So you've got an incredible great network at this point. And then COVID happened and of course, for many um this changed a lot of things and we were absolutely no different either. And so we had to pivot very quickly away from these in person school visits and I'll talk to you a bit later on about what we pivoted to in 2021. I think the key thing was to embrace every opportunity I mentioned about the fact that I was able to receive um support from Oxford University Entrepreneurship Center, which was called Oxford Foundry at that time, in terms of being an entrepreneur or fellow and working in an internship in an A I based start up. And I learned a lot from that actually, in terms of A, is capabilities. I want one of my earliest um introductions to A I, I'd say you before the, all the hype about chat GPT. Um And from that I was able to develop other opportunities. And I promised you guys, I am not sponsored by linkedin in any capacity, but I'm a massive fan of linkedin. OK. I think linkedin is absolutely amazing in terms of developing er a surface area to meet like minded individuals. And I've developed such amazing er opportunities networks through linkedin. And this again, similar to this idea of culture. Um This idea of networking has again just um been overused so much that I think it's lost its meaning. Networking to me is just all about making genuine and meaningful connections and you know, being aligned with people. And I think that's what it's really all about. Um And doing so in a, in a genuine way and not in a way that's sort of transactional or superficial, which I think can very easily er be misinterpreted as the other thing is in terms of, again, building a mental er team around you and different sets of mentors for different problems, right? Um It's this whole idea of a toolkit, you're not always, not every problem requires a hammer that you're just gonna hammer a nail with. Sometimes you need a scalp. Sometimes you need a spanner. It's exactly the same thing, different mentors from different experiences. So for me, I've got different mentors, whether it be from an entrepreneurship, charity, researcher, medical education, research background, um whether it be from an NGO background um that I can contact depending on the situation and that's really important and, er, Thurs grant and award application writing. I was quite lucky in the sense that as was shown on um, one of the earlier slides in terms of uh my Google calendar, we were doing lots of essays, er, um medical school. And so this side of writing um made it easier and I think a big thing about sort of grant, an app award application writing, whether that be for your organization to receive funds or um to for you as an individual um in terms of any awards or leadership a or et cetera that you wanna go for programs is that it will definitely get better with time. And what I always do is I've just got a massive word document where I've got all my um previous business plans, all of my award applications that I've submitted. And then a lot of that I can just either drag and drop and change and then, you know, obviously I can see, OK, these ones I was successful with these ones, I weren't and I can adapt accordingly. So you develop a pool that you can utilize so that when you're then writing the next grant application, it becomes much, much easier. One, because you already have a template, but two, you've actually developed a skill set and three, you actually know the information to make writing uh another award or grant application easier as well. Five giving back. Um So really in 2022 we were able to scale the amount of social impact that we were able to do. As was be mentioned, Instagram wasn't working, school visits weren't working. So what did we pivot to? Well, it was towards online video courses. So we then pivoted towards this and we transitioned away um from in person school visits to online asynchronous video courses, basically like youtube videos in the sense that it would be on a course and they could then go through them at their own time. This was an absolute game changer. This was the real inflection point because from this, we were no longer limited by or expenses. And indeed, once we'd have paid the the costs and the one time fixed costs of having a video course on there, it was much, much easier to then scale it in in order to actually email schools and give them free access to give them a a coupon code which I can show you what that looks like. Um We had professionally recorded and animated videos and you can see these here. Um This was all recorded in my bedroom ak a the studio where I've literally got a lightbox and a camera tripod. We also then developed a I powered quizzes as well that you can see here. So these were again ways which we're able to leverage the scale of what we could do. Um very, very quickly indeed, to create very powerful videos and many of these videos are also on our youtube channel where we've received over 500,000 lifetime views as well. And again, we're continuously developing this as well. So as has been mentioned, we can then give these scholarship brochures containing these online courses worth over 100 lbs for free to organizations very, very quickly indeed. And this was an absolute game changer for us. And since then, we've been able to work with over 100 plus schools and charities. And here are just a few that um just to narrow down on whether it be zero gravity. The NHS five NHS Trust received um innovation awards from the UK government working with the Social Mobility Foundation Equal Education Partners, an incredible incredible amount that we've been able to work with. And again, in 2023 it was this society of just adapting and innovating and receiving different awards, whether it be for an organization or individual level as well. And that was a um that was amazing. And all of these why are useful in themselves because you usually either get mentoring or grant applications. Um I was able to receive um a grant from the side business school and from UK innovate, which is a massive change, game changer for us and now being up invest towards our A I capabilities as well. Um And indeed, um about four weeks ago, I was able to meet um Prince William as well and Prince Harry on the same night for the Diner Legacy Award winner. So again, from this, it sort of gives you the rubber stamp and you can sort of see here that things sort of accelerate and because of the impact you've been able to have, they lay themselves onto each other. Ok. So I think that's the key thing to say that I'm gonna pause for a second. I know I've gone through lots of information already. I'm gonna be able to talk about Ava in terms of our A I platform. But are there any questions on the floor? Um before we carry on, there aren't any at the moment? Sure, cool. So what have we been able to do in terms of a, well, what we've been able to develop and I can talk over this is effectively an A I platform in which we've got over 300 plus questions and students can recall themselves answering an interview question right here as you can see. And from that, the er platform is going to be able to transcribe their audio into text and that text then gets fed through our A I engine to be able to give them feedback in real time and you can see this like, so I'll show you another example as well. So basically from this is that we're now developing an educational ecosystem in which we're able to combine an all in one platform, not only with video uh videos that they can go through, but also now with this interactive A I as well. And as mentioned, this, we were able to transcribe their audio into text and effectively run that through our version of chat GPT with our data and prompts. So basically our own GPT to then be able to receive instant personalized feedback upon their answers. Now, as has been mentioned at the start, this is absolute game changer because I mentioned about how in my own lived in experiences, I struggled with the information gap, the inspiration gap and skill gap. This is able to tackle all three particularly information and skill in the sense that they can actually use this in er correspondence with other interview practice if they can get it in person. Now, the thing to stress with this is that this is not a magic ability, this is not something that's going to solve everything. However, if it's between no practice and this, this clearly will be superior to many people that don't, aren't able to either access and access program either because of their geography or just because of their availability, right? 1 to 1 mentoring will always be the gold standard. But that in itself by definition is not one, only very expensive but too limited, just because of the um a number of available medical students and available doctors as well. We already know that the NHS is facing a lot of um strain at the moment and thus being able to create something like this, which can then be scalable and fits nicely into an ecosystem can be very useful indeed. And we can see here another example where you can get a total score what 2012 and even better if now the key difference in terms of um the way we do it is based on data and data is a very valuable tool, particularly in business in general. It's the most valuable tool. It's the fact that we are able to use up to date information, proven strategies and exclusivity of knowledge. That's how we're different to um ch regular chat tty that could be fed into it. And through this, um people's um feedback will actually be shown in real time in terms of progress on different categories and progress over time. And this will become a very, very useful tool very quickly. Indeed. So that is where I'm going to basically finish up. So the fact that using this platform, we're able to give and focus on the you experience, develop a, a research foundation in terms of the different questions that we're able to as well. And effectively 85% of our online users are able to access our courses for free. So the way we're able to do it is actually through our 1 to 12 and paid online courses, able to fund our work on A A, I'm gonna pause here and I'm gonna actually finish here as well. So if there's any questions. Do let me know. All right. Uh There is one question, let me see if I can repeat it. Does that work? Can you see it? Yes. OK. So the question is, how do you see the use of A I evolving and scaling your business in the future? Um There was a talk by um 20 VC and Sam Altman, who's the um founder um of Open A I. And basically, there's like this meme on the internet of like, oh open A I or Chat GPT like killed my business because whenever they wrote a new update them, it kind of sort of nullifies their business. And basically, what he was saying is that you should plan and hope that Chat GPT gets 100 times better because it will, it's only a matter of time and just if you, if you're just putting a layer of paint over chat GPC and like re skinny, but like this is a start up, then that's not gonna work because you're just gonna get steamrolled when the next chat GPC update comes through. I think this technology is very different in terms of A I because of how quickly it's progressing and evolving. So I think that's one thing to bear in mind. So you need to plan for this uh in order and see it from a perspective that chat, you will get 100 times better because it will and thus you need to be thinking about all the other things. So you need to be looking really, really far ahead. And ultimately, with all of this, whether it's A I or not in any business endeavor, the key focus, the key mind is always what does your customer want? How can you provide value? I think that is ultimately where you need to start from and then go from there. What many people do now, especially with this all talk about A I in healthcare or in any business as they see as, oh A I can do this. Let's shoe horn this into an area that doesn't actually belong to it. I think that's the problem. You always have to start from customer user Centricity first and then go from there and A I is one tool, but it's not the only tool. I hope that makes sense. Yeah, that makes perfect sense. Uh I've put on the next question. Yes, great. You have turned a wonderful idea. Thank you into a very successful business. Thank you. How do you navigate all the other organizations in your sector? The Biomedics support a very similar sounding name. Yeah, and into med school. Absolutely. So again, um it's the same idea of, are you actually customer and user centric? And in fact, all those other organizations, I actually don't see them, I actually see them as colleagues because all of those are actually working within the widening participation sector. And there's many, there's a, I'm doing a collaboration with one of them as we speak with one of their founders. Um So I think ultimately, it's a case of actually finding out how you're actually able to work with people, particularly in this space when actually our end goal is writing participation. Um And that's, that's it, you know, so the fact that we can work together with people is great. However, absolutely. Are there competitors in terms of business competitors, in terms of medical portal, for example. And yes, absolutely. There are plenty. Indeed, it's actually a very saturated market. Um And again, it's just about being very customer centric and developing that culture. And ultimately, um it's almost Darwinian Survivor of the fittest. You know, the best idea is the best business is able to come through and that's just the nature of the game, right? So all we do is focus on actually making our product and our service the best and anything else in terms of analysis of the other industry, I think you can just, there's a lot of noise because ultimately, if you are able to focus on your customers, if you're able to grow your business and go from there, that's what matters. And in indeed, in this endeavor, I've learned so much in terms of variety of different skills and organizations. And also you are, there's this thing about, oh, you know, like with um start ups, why is it that like some A I start ups can compete against Google, for example, you're like, whoa, what, you know, how does that happen? Well, the thing to remember is you're not competing against Google, you're competing against a projects manager against a very small team at Google. And there's a massive difference between that and the whole ti and giant of Google. And I think that's the thing to remember and that's the key to start up culture. It's being lean, it's being agile. It's about recognizing your users. That's what it's about. Mm. I think I have a personal question as well because I have like small ideas all the time. But it's a matter of actually making that into reality and that's where I know myself and a lot of other people just get stuck. So how did you actually, even before med school actually just implement construct and actually if like execute your business idea? Yeah, I would say in general, I would recommend I'm also someone that I'm quite almost like a surgeon or engineer's mindset in a sense that I just want to do it. And then see, I think there's a lot of, I think the problem is we can all become like armchair business people where like, oh, this sounds really good and we're sort of debating like theoretical ideas. But I think sometimes you just have to do it and I think i it's really hard but it's just taking the first step of, you know, thinking, OK, let's create a Wix website today. It's gonna be really rubbish and that's exactly what my work I was on the Wix when I started it off, it looks worse than like a Microsoft Word or powerpoint document. It looked terrible. OK? But then you're iterating it and then you get better and better at it and then you develop momentum and then when you see, oh, hang on my user base is increasing. That gives you that dopamine rush and that gives you enough for you to make it work and effectively one, your business will fail or two, you will develop it and it will work. It's just a matter of time. And I think the best thing to do is just get stuck in, develop a network around you as it has been mentioned. And at university there's amazing ideas and then just do it and then just see and experiment and iterate and do that have that iteration cycle as short as possible where you do it, you know, within a week or two weeks and you just see and you react, how's that doing? OK. Good. More. Let's carry on and you just keep on doing that. I think the problem is we can be trapped into um just overthinking and just this paradox of choice that means that we're sort of stifled and paralyzed from actually doing it. But that's why you wanna create that culture within our team where you're not just talking, you're not just writing it, you're doing it and it's al always easier said than done. But that's what it's about. Mm. I think that's something you also highlighted was your time management. Especially during med school. Can you talk a bit more about that? I feel like a lot of, um, as I say, II think easiest way to start off with is just, um, time boxing all the time that you've obviously got lectures, you know, just treat it, especially at clinical school. This is how I treat it. It, it was just, you know, 9 to 5 is um med school. You know, it's either gonna be clinical pace or it's going to be revising on past med and just treating it as that and treat it as a 9 to 5 and then thinking, ok, um from 5 to to 8. So you're gonna be doing this spme stuff or whatever extracurricular stuff you want to be doing from 8 to 10, I'm gonna be at the gym and then eat sleep repeat and then just keep on doing that and iterating it and just having the sort of discipline and just managing your time in that way. Um and also just being aware as an organization um being more comfortable and I'm sure you've seen this as a cycle as uh as a matrix in terms of what's urgent, what's important and then doing it that way and then showing that you're focusing on what's urgent, what's important if there's something that's urgent but not important. Can you delegate that? Can you template that? Can you automate that? And likewise for the other um two quadrants? Well, that's what I think is always key. Just think about the 8020 rule. Um consultants love this in management consulting. It's like 20% of the inputs will dictate 20 80% of their output. And think about OK, how can you mo most maximize that as much as possible? It's always, I've got to say it's always, um, it's always a balance and I definitely think it's always a pendulum, I never think. Right. I got work life balance. Perfect to that point. It's always, it's always something that's gotta give. Right. It's always all sports is too much. Oh, you know, academia is too much. Oh, *** is too much and you're constantly adjusting and that's fine. Um, but I think just being aware of that ultimately as a business to succeed, you just need to make a profit, uh, at levels that you're comfortable with and be able to get growth at the levels that you're comfortable with. You will never, ever, ever be able to do all your to do list and that's fine. But I think if you just recognize that and again, you're just user centric, everything else will come. Um, so I think just having that right mindset and always bringing it back to the user and developing and I work around you so that everybody else knows exactly how to think and how to act and what your culture is and the expectations that's what's important if you can have fun along the way. I genuinely love it. Like, the team I'm able to work with are amazing. It feels like the Avengers, um, like everyone brings their own skill set to the table and that's what makes it work. Mm. And could you also talk about more about collaboration? I saw that you collaborated with quite a few companies, especially in like the NHS and large organizations. How do you make that work? Sure. Uh There are a variety of ways of doing that, whether that be in terms of cold emailing. And I think that's a really effective tactic to linkedin again, incredible promising, I'm not sponsored and that can be done a right of ways or one, whether that be in terms of messaging people on linkedin and, and if you develop a linkedin profile, you know, you've got posts that makes it easier for other people to see and that makes them again, it's just, it's side of like we prescriber some of this authenticity, right? Of just being like, oh, OK, they can see, you know what you're about. Oh, you what, you know, ex person and that can be another way of actually being introduced to someone you've got cold emailing and also again linkedin in terms of liking posts. So when I received the D award last year. Um someone who was a head of NH of an NHS access trust, um just liked it and I was like, ooh, hello, this person's interesting. Let's firstly, um connect with them. Great. They've accepted and then I messaged them and then we were able to get an incredible partnership with the biggest NHS trust in the UK. So it's all about compounding interest in that way and also just developing a network and just going to different events and just meeting people. And it's being really clear, it's that it's been really clearly focused. I think in this world, there's a lot of noise. I think it's about really being able to understand the signal amongst all of that. And I actually, especially from year seven to year 12, I was basically accepting any opportunity as in like, oh yes, drama. I wanna do that public speaking debating. Yes, I wanna do. And you're always pressing yes to things. You can't do that in med school, especially as you go beyond what you find is it becomes more and more important to say no to things or just know what's important and what's not. Who do you actually, then again, you get more selective about who do you want to have as your mentors? Because you've got limited time, you're not gonna be able to have a mentor on call every day. So it's about prioritizing and executing. This is the whole sort of mantra of that. Uh There's another question coming in by Christie by what you were just talking about. Sure. Thank you for sharing. Just out of curiousity. How do you see the business progressing with you starting F one C? Will there be any change in the amount of work you take on? Fantastic question. Absolutely. Um So that's kind of why and we've been doing this already within sort of, I myself have been sort of pivoting as a business. We've been pivoting away from um the Instagram from the in person school visits. We're now focusing more in terms of online video courses and now we're focusing a lot on Ava. Ava really has been my main focus for the last three months and rightly, so because now this opens up new opportunities for us in terms of business to customer as we've always done in terms of users, but also now business to business in terms of schools. NHS Trusts, different organizations that we can also work with. And this has changed my skill sets because from being someone that manages people which I obviously always do within these Biomedics and lead people. But actually, now, in terms of thinking about constructing a research team, now, in terms of as we have done demonstrating the effects of a in terms of improving self efficacy amongst South Trust students. And now with this evidence base, we can now pitch for um different um projects, for example. So in terms of the work. Absolutely. I've also recently had finals and so it's been a natural progression and I'm actually taking more on stuff now because I've got the time. But effectively, again, it goes back to what we were saying about automating, templating, delegating. And those three have becomes really, really important and you become more important in terms of having that long term focus and then recruiting the right teams within house to be able to manage that all. I hope that answers that question. Yup. Thank you so much. I don't think there's any more questions, but thank you so much for taking time out of your Saturday morning to come and present. All right. Thank you very much. Yeah, extremely engaging and beautiful talk. So, thank you so much. Thank you so much. Cheers. All right. Have a wonderful evening. All right. So it's now 1150. And I'm just gonna quickly go through a couple of things before we start the oral presentations later in the afternoon. Um Just to give like a quick summary of everything, we'll be picking one person for an overall prize, but everyone will be receiving a certificate of participation for having the courage to come up and present at a national conference. Uh I'll soon be sending an invitation for all the presenters to join the main stage. Make sure not to present until you've actually been introduced and told to share as we don't wanna create distortions or any unnecessary errors. And each person will have a total of seven minutes to present and one minute for AQ and A, if there's no Q and A, I might come in and ask a question and during the talk itself two minutes before the end, I might interrupt and just say two minutes left, it's gonna be really bizarre and out of nowhere. But trust me, I'm not trying to trip you out. We just need to try and stay up on time and if there's any more questions, please just message me on the group chat. Uh Sorry, the chat and I'll answer anything. I'm now sending a list of all the presenters and the title of the projects. Look, I look forward to hearing all about their roles and the research they did and I hope all of you are too. We'll now be taking a quick five minute break and at 1155 we'll have a prompt start with our first speaker. So grab biscuits peas or whatever and we'll start soon. Yeah. Hey, thank you for joining. Could you just turn off your mic and camera for now? All right. Ok. All right. I hope everyone's well rested. We'll now be starting the oral presentations. So first, I would like to welcome Zhi who will be presenting overcoming barriers to accessing health care for intimate partner, violent survivors in South Africa. Hi. Um, let me try and, oh, that's my slides. Ok. Hi, everyone I'm Ziad. I'm 1/4 year medical student at Leicester and I'm gonna be talking about overcoming barriers to accessing healthcare for IPV survivors in South Africa. So I thought I'd start with the sad story of Uyen. She was a 19 year old student at the University of Cape Town. Uh And when she went to the post office, she was assaulted and murdered. They started a massive awakening across South Africa with the hashtag am my next um movement. Uh They actually went outside the parliament buildings and forced the President Cyril Ramaphosa to come out and address the people. And this was really moving to me, I saw my mother in this population, my grandmother, my cousins, everyone was really affected. So when I had the opportunity to do some research, I thought I had to do about this. So the problem, it's it, it it's a disgusting prevalence in South Africa. To be honest, it's 21%. Uh it's rife and there's different solutions, microfinance edutainment, which is basically, I think uh a soap opera with a message say someone goes through a plot line of having experienced IPV. And the show basically shows how to deal with this. But what I found is that healthcare is overlooked because when someone experiences this, they can often present to the hospital as their first port of call. So what I wanted to find out is why these barriers exist and how we can overcome them. So what I did was I used a critical narrative review it with secondary data from peer reviewed databases. So I used things such as Midline Sinar uh Cabinet Scopus and other databases. I've listed there. Uh I use key words, intimate partner violence, um South Africa barriers and healthcare. And I supplemented the literature I found with uh policy document from the South African government and gray literature from the United Nations. Wh O and South Africa Police. Um I think it's important to conceptualize health care. Um We are, we need to think of it as what providers can do and what seekers can do. So on the top, we have approachability, acceptability, availability and accommodation, affordability, appropriateness. This is what providers have a duty of doing. And on the bottom, we have things that seekers can do and we need, we need to improve both to improve outcomes. So analyzing I use different lenses. And I think it's important to understand that before I get to my results. So structural violence is basically political systems embedded in a country that can have adverse health consequences. Uh This is a social norms framework and this is basically saying we have different norms um that are reinforced in sort of a power dynamic and we allow that to become the status quo. And finally, I've got a theory from Fuko who's a philosopher who basically says um our, our health is basically determined by a lot of other things. And we have the power to resist that. So just to put that in context, in South Africa, structural violence would be the legacy of apartheid. Uh social norms are ingrained norms in the society that's reinforced by a power dynamic. And FCO is basically saying these social norms and apartheid, they've determined health outcomes for a vast majority of the population. And by resisting this sort of burden of history, we can shape new outcomes. So firstly, results, healthcare providers, um prevention is always better than cure. And what I found is that we need to have integrated screening programs. Uh less than 10% of cases are identified in primary care, which is a terrible statistic. What I found was uh when interviewing doctors, a lot of people would find um you know, um it, it takes too long to, to screen for, for, for these problems. And what we can also do is screen for co co comorbidities. So safe arguments say a patient comes in with depression. Is it depression or is it depression from IPV? Someone comes in for argument's sake with bruising. Is it, did they fall or was it IPV? We need to be always asking this question, we need appropriate policy guidelines on how to identify IPV pathways of management. And ultimately, we also need staff to be trained better, to recognize this and to know what to do with these patients. And for IPV survivors. Uh firstly, we can increase health literacy Um We need uh this population to know that the health system is capable of helping, we need to combat social norms. So the social norm of violence and the social norm of fear of men, we need to combat gender dynamics, um improving agency and relationships and enhancing women's economic power. Two minutes left. Cool. Thank you. Um So in conclusion, structural violence of apartheid has created an environment for IPV to thrive social norms are violence and affair of men. Um But this lack of economic power from apartheid is key. We need to improve that. And the health system ultimately neglects how these factors shape IPV, which is evident in poor policy. So we need to re reframe IPV as a disease of poverty. So the way forward, we need to resist what's been imposed on us, resistance can be grassroots like am I next or a policy level? So take home message, we need policymakers to understand that the burden of history is important in formulating policy. And ultimately, a robust health system can tackle sustainable development goal 5.2 which is violence against women and girls. And this can improve the development trajectory of South Africa as a whole. Um Thank you. Uh And I welcome any questions. Are there any questions from the floor? Uh Yes, thank you so much for that very insightful um presentation. Um For you. What were the challenges that you experienced when you were um basically trying to gather your data. I think the main problem was that the data wasn't sort of clear cut about IPV. If that makes sense, I think it's important to realize that there's a massive intersectional approach. So for example, there'd be a paper on microfinance and IPV or, you know, uh edutainment and IPV. And when I sort of conceptualize it with the framework, I mentioned that there's two sort of components you can kind of realize where the gaps are. Um And I think there's a room for a lot more direct research. Um And I think that's important uh to, to, to really move forward. And how long was your research again? Um You mean in sort of the period of time? Yeah. Yeah. Um So I did as a as my dissertation. So it took maybe um a few months, three or four months. OK, perfect. Thank you so much. The, that was a wonderful talk and we'll move on to our next speaker. Thank you. All right. Our next speaker is Synthia Balakumar. I have asked you to join the stage. Would you be able to quickly accept and start sharing? All right. Perfect. Hi. Sorry, no worries. Um I'll just, and she'll be presenting with access to video consultations with GPS in England Equitable during the early COVID lockdown period. Um It's not letting me share at the moment uh should have full access. Uh I think the share button is just um blank at the moment. Not sure why. Ok. What I can do is I can present your and just let me know when to switch the slides. Sure. Thank you. Ok. Are you able to see it? I actually can't. Oh, sure. Oh, yeah, perfect. Thank you so much. All right, thank you. Um, sorry for the delay in starting guys. So, um I'm Cynthia. I'm one of the UCL medical students who did this project along with Atria, who's also um a medical student and Louise and Doctor Jones were our supervisors. Um So we essentially wanted to look at, um as it says, was a, was there a access to video consultations during the initial lockdown period um during COVID-19? Thank you. Um So we all know when the pandemic started, you know, a lot of organizations and individuals were forced to make really rapid changes and GPS and general practices in general had to quickly adjust to these changes because face to face consultations were becoming very risky to both patients and staff. And um essentially video consultations did become a proxy for clinic examination for history, taking diagnosis and sometimes all the way to treatment as well. Everything was done through some sort of telecommunications. But we obviously focused on video consultations. And our objective through this project was to look at whether people from lower socioeconomic backgrounds um had just as equal opportunity to see their GPS through video access. And we really wanted to focus on just that initial lockdown period from March to August 2020. So um there was a lot of um service providers in terms of um video consultations. Um But the one that we realized were used by most clinical um clinical commission groups were was accurate. So we use that um and we access data from their publicly available um data on video consultations within England. Um We then also looked at individual GS socioeconomic data. So we wanted to look at their deprivation value and something that's available on the gov.uk website is this um measurement called indices of multiple deprivations. So I MD, so we looked at that, we looked at individual uh practices and patient numbers and number of GPS within GS as well. And we all collected um into um a massive spreadsheet. So there's an example that I've given for um two of our CCCC CCG S. So barking and Danum and West Hampshire higher, the IMD means more deprived. It is so barking and was um quite high up with 35 in West Hampshire with 11 again population size and number of GPS as well. We had to exclude some C GS that had no I MD data for. So if anyone has previously used the gov.uk website, there's a lot of information that's lacking. Um And obviously with the pandemic, not a lot of information was um actually put into their big data storage. So we had to exclude some GS that we had no individual I MD data for, we then had to ex um extract the number of video consultation invites that were sent. So text messages and then also looked at the number of uh video consults that were actually, you know, ended up happening by the GPS. So this was for two reasons. One to actually we initially wanted to see if um text messages. Um you know, if there was an effort by the general practices to send out these video consults. Uh But then we ended up just focusing on the individual video consults in itself. Uh We then divided the number of video consults done by um completed and then divided that by the number of GP practices within G and then, although we had individual population sizes, we realized it was actually quite hard to use that figure. So then we just divided that by the number of patients in each general practice within England and the number that we came up with was 9007. So in terms of results, so we ended up er including 100 and 17 CCG S. Um In March 2020 alone, there were some um over 77,000 video consultations recorded for England um with a range of 4 to 45 video consultations by GP practices. Um In a given month, there was a negative correlation between the consultation rate and the deprivation. Um There was a 60% difference in um the number of video consultations that happened between like the most deprived and the least deprived CCG S. Um And I guess it's safe to assume that the least affluent CCG S had the fewer uh video consultations. So um we then had to input this into um uh uh you know, we use um a statistics website to look at it in a more mathematical way. Um And we realized that again, it was negatively and significantly associated with uh CCC Jack Prev. Thank you. So again, as um video consultation rate was significantly lower into privacy C GS. And that was statistically significant and this was only seen in the initial lockdown period. So between March to July, interestingly, we also found that by the time um August came about, um there wasn't any significant inequality. Um So actually, video consultation rates sort of evened out um across all general practices within England. Um It's also, I guess like an additional thing that we realized was um overall, the consultation rates did fall by August 2020. Now, we did try and look into why this could have happened. I think the ease of lockdown rules and um as more data on COVID-19 was becoming available to the public, I think people just felt more safe and clinicians also felt safe for um to see patients face to face. So actually, video consultations, the rate overall decreased by August 2020 in terms of limitations. So we didn't cover all English practices. You know, we had to include the ones that didn't have, um I MD data for. Um, we also had to assume obviously that all practices had similar population sizes. And we did come up with a nine, we did come up with that figure 9007. Um, after looking at just, um, you know, how population sizes varied between general practices, but obviously that can, um, that could, you know, that is a significant limitation of our work. Um, unfortunately, we couldn't, actually, I guess another limitation was we had to use CCG S that included Auri. And Auri is one of the biggest service providers in, in 2024. I think they were one of the biggest um still, um, but obviously it would have been better to have some general NH NHS um, er, digital data available, unfortunately, at the beginning of lockdown because it was everything that was going on and how hectic it became. Um We didn't have enough um, data to use NHS digital. And I guess there's also this ecological fallacy that we understand just because A CCG is known as deprived, it doesn't necessarily mean um, er, the patients within that CCG doesn't necessarily mean it's more deprived in terms of conclusions, you know, obviously COVID was unprecedented. Um and UK NHS not to sort of look down on them, but they did have to quickly change. But it's important to note that in the future when another pandemic or another sort of disaster does occur. We are better equipped to help the people that are most vulnerable and shouldn't just be something that we fix with time and we should be ready to combat. Sort of, you know, there shouldn't be any inequity within digital health. Thank you so much. All right, thank you. Are there any questions from the floor? Ok. Uh No, thank you. That was very uh clear. Thank you so much. All right, any questions from any attendees? All right, perfect. Thank you so much. Thank you for coming up and thank you for the tech. Of course, that was a lovely presentation. And next we'll have uh Niddy Re with the role of sage in the UK COVID-19 policy between January and March of 2020. Hello? Hi, I'm just gonna share my screen now. Sorry. Um Give me a moment. Um Yeah. Can you see my screen? Um bec I don't think II can't see it. No. Ok. Let me, do you want me to share again? Ok. Let me just try again. You have to show a full window rather than um sorry, a full screen rather than a window. Yes, we can see it now now. Ok, sorry guys for the delay. Um Hi. Hello. My name is Nitty. I'm a former medical student and I'm just continuing on the um conversation of COVID-19 uh BEF and I'm gonna talk about my citation project which looked at um what form the science that then influence and um inform the U K's initial COVID-19 response. Before I begin, I'd like to thank the Med Aid for organizing the conference and inviting me here to listen to so many other people talk about the incredible work. Um So the United Kingdom had, sorry, I we can't see your slides but I can see um your screen if that makes sense. OK. Um Sorry about that. I think it'd be better. Just, are you sharing full screen? Sorry. Are you sharing your full entire screen rather than a window? Um Yes, that's to share your window. Share your entire screen. Ok. Once. Sure. Ok. Now, no luck. Ok, I'll share the slides. That's ok. Ok. Sorry about that. No worries. All right. Ok. Fantastic. Um Yeah. So, um, if you go into the second slide, please. Um Yes, the United Kingdom had the sixth worst death toll in the world. And a apart as sad as that statistic is, you know, it took jobs, it took education and it stopped people from accessing healthcare. But why was it that we had one of the worst results and outcomes in, in the world? Um, next five, please. Because if you remember the National Hobby of the Daily 5 p.m. briefings, you know, you'd hear Boris Johnson say continuously that we were following the science. But if we were following the science, why were we so wrong? Why did we have the worst results um compared to other people, were they not following the science as well? And the answer to this? And basically what formed my dissertation was that there are sociopolitical factors that affect the construction of science. And it is these sociopolitical factors that I wanted to analyze um during the um early response to the COVID-19 pandemic. So how do I go about doing this? I went about doing this um by analyzing um the meeting minutes of the scient scientific advisory groups that basically form um science advice policy um in the UK and in normal times how it works. So there's a range of actors and they then go um through a whole pathway to then kind of inform the cabinet office and the government Scientific Officer and the Prime Minister. But in emergencies such as COVID and in the case of COVID, the Scientific Advisory group for emergency stage was activated. I remember how I was talking about sociopolitical issues that kind of affect construction of science. Well, even before we get into COVID science, there are issues with the existence of stage in that its membership is exclusive and it is you basically are hired by the government. So there's always issues of whether there are a gender conflicts of interest which affect whether you're getting into this elite club or not. Not that I'm saying that any stage members do have these interests and agenda, but there is always that issue. Um Next slide please. And in the COVID-19 response, there are two main subgroups that kind of came to the forefront that were part of stage. One being spy mo being the influenza group um on modeling and operations and one being the one on behaviors. And um the spy mo group were much, much more kind of powerful and much, much more vocal and used much more than Spy B. And they kind of look at um the infectious disease epidemiology and modeling and kind of working out um statistics that would kind of then inform um the science policy. And um this kind of system has actually been criticized before by um commentators. So if you just press next please, because um there has been um a gap between two epidemic systems where the policy makers just ask, oh, what should we do? But that is very different to scientists who ask what should be achieved. And that's where the miscommunication and mismatch lies between policy making and science advise. Uh science advisory grapes. Um So yeah, so then let's go back to January 2020 which I'm sure everyone wants to do. Um Sage you met twice in this month, one on the 22nd and one on the 28th. And even from the start, you can see how lax they were because the first meeting, they called the prelim meeting just showing that, you know, they weren't really bothered about what was kind of going on. Um in the world really. And even at this point, there were kind of two pieces of data from very prestigious kind of like um well renowned groups. Um One had said don't restrict, don't have restrictions. And one being from the um European Center for healthcare prevention, disease prevention and treatment had actually said in the case of SARS and MERS which is a family of virus and the Coronavirus falls in in in that case, do restrict and they chose to follow the advice of the for former, which was not to follow not to implement restrictions. And on the 28th of January, um S then implemented spy M mode just to kind of get statistical modeling on the virus but not spy B. And this kind of move has been criticized by many commentators because people say that um the United Kingdom government did not want to integrate other social sciences or other disciplines. And therefore it contributed to a kind of echo chamber um of advice which then led to a massive failure on our part. And it has been called part of the failure. Why we did so badly in the pandemic? Um Next five please, if we moved then to February Sage met 11 times in this month. And at the start of the month, there's a big reliance on this 2006 paper that was on in delaying spread um in the case of pandemic influenza. And already you can see kind of what the issues from this. First of all, it's from 2006 and we've had many pandemics, both coronaviruses and influenza epidemics since then. And um the pa the paper actually was based on influenza and we know now and we knew then also that influenza and COVID-19 were very different. Um And the paper itself said that in the case of SARS, you know, you should perhaps modify air travel restrictions. But the government continued and sage continued to have this reliance on influenza. And next I please. And that is because influenza pandemic literature as a whole was advocate against restrictions. And that kind of gives a massive clue why influenza was perhaps used so much in pandemic preparation because if you don't have to restrict, if you don't have to implement restrictions, that is a much more politically feasible option than to implement school closures and um travel restrictions, et cetera. And for a country that has very libertarian government, it would have been easier. And um it said the advice just until three to February was, you know, um don't do restrictions, don't close schools et cetera. And next slide please. And um there's a paper um in, in mid February actually though, um that's when the tone of age kind of changed and that's when people started thinking more and more about school closures and public behavior. And it's only in mid February. So weeks after spy M that spy B was finally established. Um Next slide please. Next slide please. Um And um on school closure, they actually sp o consulted a literature review that used a school closure. And this review must be praised for its holistic approach on such a large intervention. But the problem was that it didn't actually say tell the policymakers what to do. And while from the start, this might be kind of pointless because what is the point? Then it actually is more democratic as Chris Woo himself said that such papers are more useful because scientists don't have policy making skills. And so they shouldn't be made to make the policy decisions. Next slide, please. We weren't following the science but asci because it became very clear that um COVID-19 spread very differently to influenza and um data from British kind of hubs themselves showed that the virus spread much more quicker than influenza, which would have led to policy inflate um implications. But the government chose to continue influenza recommendations for the sake of political um of fe feasibility and for popularity. And um yeah, um I ran out of time but essentially that was the main kind of conclusion of my findings and I opened the stage. Any questions it? Yes. So excuse for my blanket, my room is very cold today. So what were the some of the methodologies you used to kind of gather the information that you found? And it was very um insightful presentation. II definitely did something So um actually the meeting minutes for all the stage, groups, stage meetings throughout the pandemic are available on the gov.uk website, which is very different to what the previous present presentation was saying because actually want to go that UK website was useful. And um so that was my primary source. And then I also did um external discourse analysis from commentators, epidemiologists, what other countries were kind of using to inform their kind of policy to then compare to what we were doing really to see why. And it became more and more apparent that we were using influenza. And then commentators were saying we were using influenza because it's easy to use influenza. Uh kind of a sauce. OK. Thank you so much. Any other questions from the audience? All right, perfect. Thank you so much. Ninth. Thank you. Our, our next speaker will be she energy on why don't they just seek help the bears and facilitators to mental health service utilization for South Asian woman living in Britain. I've sent a request for you to join the main stage. Uh If you accept that you'll be able to present. Hi, sorry, just join. Perfect. OK. Just gonna share my screen. Can you see that? Yes, we can see it. OK. Hi, everyone. My name is Shamrani and today I'm presenting the research I conducted for my dissertation in the integrated BSC in Global Health at U CLI conducted a literature review to find out what the barriers and facilitators are to mental health service utilization for South Asian women living in Britain as a British South Asian women. This is a subject that's really close to my heart and I'm really thankful to be able to share it with you. And this is the poster I created. So in Britain, South Asian women have higher rates of mental illness, but they utilize mental health services less than white women. This forms part of the global mental health treatment gap where unfulfilled demands for treatment are rising. In conjunction with the low global burden of mental disorders. The UK government has formulated plans like delivering race equality to tackling lower access to mental health services for ethnic minorities in general, but this has had limited results. The following research can be used by policymakers and healthcare professionals to design services that meet South Asian women's needs. Contributing to more equal mental health service access worldwide. The aim of this research was to summarize the barriers, current facilitators and future facilitators to South Asian women's mental health services in Britain. What this means is what is stopping them from seeking out mental health support and engaging with it, what is currently helping them utilize it and what will improve their mental health service use in the future? I created a search strategy that resulted in 22 qualitative studies which I reviewed to answer this question. I used a range of sources as you can see and I emulated a systematic review as far as possible. My populations included multigeneration, Indian, Pakistani and Bangladeshi women over 18 as the main subgroups in Britain. While South Asian women are not a homogenous group and they shouldn't be treated as such a limitation. Is there's next to no research that differentiates the factors affecting mental health service utilization between the various groups and across generations. So I use two models to present and analyze my data. Neither of which have previously been used to evaluate South Asian women's mental health service use. The first model is the best of healthcare access where accessing healthcare involves the components of the service such as how approachable and available it is and then how appropriate it is for the population, it serves also the abilities of individual service users. So from their ability, can they perceive the need to seek health care? Um and then can they engage with it once they're in the service, both service aspects and individual abilities are tied together. Then I use a second model to depict how structural discrimination is at the core of issues. So for example, racism, sexism, xenophobia put people at unequal levels in society and they intersect to infiltrate institutions like the NHS communities and individual lives. This is represented in the multiple barriers that were found for South Asian women accessing mental health care from 1990 to 2023. While some barriers are associated with service providers, others stem from the influence of communities and culture on individuals attitude care. And I've presented the main findings in this presentation. So I tied individual and community attitudes together because they individual South Asian women's attitudes to mental health care were based on both assumptions and their lived experiences and mental health services. But they were also heavily influenced by the community. There was a big level of mistrust towards mental health services. For example, South Asian women assumed that especially South Asian healthcare professionals would breach confidentiality, resulting in the community finding out that they were seeking mental health support and this would result in isolation, judgment and being ostracized from the community. Secondly, men in some families had a significant role in discouraging women from seeking mental health care. This was due to protecting the idea of reputation, family honor and stirring that fear that the community would find out and it would bring shame upon them. The third major barrier was that women feared racism and misunderstanding of their sociocultural context from white professionals. And I think this relates to the institutional barriers. As when these women experienced racism and lack of understanding with the mental health care, it encouraged them well, discouraged them from engaging with it further. So the aim of this research was to amplify the voices of many different South Asian women and how they felt when they accessed mental health services. From these quotes, we can see three main themes. Firstly, as you can see, they felt that the therapy was ineffective when they were being misunderstood that involves socially, culturally personally. Secondly, when they experienced racism and being stereotyped, that made them unwilling to engage with white healthcare professionals. And thirdly, the absence of translators or first language speakers meant that women who were not fluent in English were not able to communicate their psychological distress to healthcare professionals rendering the service ineffective. One quote from a health care professional from bur study in 2002 suggested that these women should just go back home as a solution to their problems. And though this study is two decades old, this is an example of direct racism within the NHS. The stereotypes that these women faced included that they are submissive or they just look after themselves in their community. And these stereotypes were used by healthcare professionals in consultations with these women. So I analyze these with my models and these results demonstrate a lack of acceptable, appropriate care for South Asian women contributing to their reduced ability to seek and engage with mental health care, individual community and institutional barriers were all linked together. And this inaction was at the root of this underlying this inaction is structural intersecting racism and sexism so directly stereotyping these women failing to understand them that then created the mistrust in the services for these women. And that meant that they weren't likely to use the mental health services. So fewer facilitators were found than barriers. And that indicates that service uh the services need to engage with users to determine what constitutes suitable c when they were asked, women said that mental health services were helpful when professionals were empathetic and created a secure noncritical space for them in their treatment. Different women expressed the need for 1 to 1 support group based support. Um And secondly, providing same language speakers or translators and demonstrating cultural understanding, encouraged women to engage with the service. They were getting um improving their outcomes for the future. The onus is on health care service provided, provide adequate language support and trained professionals of all backgrounds to provide anti racist, nonstereotypical and sensitive care and sensitive needs to be to the specific cultural, personal and social backgrounds of these women authors recommend affecting culturally sensitive clinical approaches to address the power imbalances in the UK mental health system and remove structurally discriminative biases against South Asian women. So, in conclusion, this research suggests that healthcare professionals and service providers empowering these women and working with them will improve their mental healthcare access if we give these women a voice and we understand the barriers and implement the facilitators that they proposed. We can create a more equitable mental health service access and provide quality care for ethnic minorities worldwide. Thank you so much. All right. Thank you. Any questions from before. Thank you so much for that presentation. Um Just one little question that I had um that I might have missed from the presentation for this um research. What was your, the sample size that you used? So I used, it was a secondary review and I used 22 studies. Um I can share again. Um And I can just show you my methodology and the problem was that a lot, there were a lot more studies that I actually reviewed. So I screened 100 and 61 studies and then I processed them right down. And that's because they weren't focusing specifically on barriers and facilitators or they were too vague or they, they just weren't specific enough to the population that I was identifying. Um I hope that makes sense. And do, do you have any other questions? No, that's, that's, that's OK. Just wanted to get a bit more clarity on that one. Thank you for um when studies included like South Asian woman as the demographic, did they specify for the ethnicities they included? Yeah, they did. So a real limitation I had, I wanted to focus for example, on one population, but there simply weren't enough studies on, for example Indian women or Pakistani women. And then there were some studies that focused on the Punjabi community, but then Punjab has been split across two borders now. So there are Punjabi, Pakistanis, Punjabi Indians. And that made it really difficult to focus on one population. So what I did is I basically correlated it across the South Asian diaspora in Britain. Um And that covered essentially Pakistanis Bangladeshis, Indians. And within that, the main big groups, which is Punjabis Gujarati's and then there was one Kashmiri group as well. All right, perfect. Thank you so much. All right. Next, we'll be having Rosaline Day Koning who will be presenting strategies used to improve vaccine uptake among healthcare workers. I have to send a request for you to join the main stage if you could come and present. I'm so technologically challenged. Can you see me? All right. Yes, I can see. I will now attempt to share. Ah it says a technical error has occurred. So I might ask you to share if that's all right. Brilliant. Thank you very much. I can see those. So I hope everyone can see those now. Um So thank you all so much for having me today. I'm really excited to present the work that I recently did for the World Federation of Public Health Associations. Uh The background of this research is that the wh O recently named vaccine hesitancy, one of the top 10 threats to global health and recent evidence has shown that amongst global declining vaccination rates uptake among healthcare workers specifically is a real problem and it is getting even lower. Now, this is a very important target group because healthcare workers are exposed to a lot more disease and vulnerable patients. But they also have a very significant role in encouraging vaccination amongst their patients So we wanted to tackle healthcare provider vaccination rates in order to help tackle global vaccination rates. And now the research that I did specifically was um trying to take the research that has been done on barriers to vaccination to a more applicable policy level. Um by examining the strategies that have already been used globally to improve vaccination among healthcare workers and then from there to create targeted policy recommendations. Yes, perfect. Thank you for the next slide. So this is the methodology. Um It's a systematic review. So we followed prisma guidelines. Um And with a combination of databases and gray literature, we found a total of 60 primary interventional studies uh in terms of the demographics of those studies. Um I've just wanted to flag this up here because the majority of the studies that we found in the literature were conducted in high income regions, mainly in Europe and North America. And now to make sure that we're able to address specific barriers and recommend specific interventions in regions that weren't represented by the literature, we have also formed with our organization, a task force and an engagement forum that has representative members from all areas of the world. Before we take this research further onto the policy level. Um in terms of the analysis we did from our papers, this is the overview of strategies that we found um across all of the studies that we included. And I created six main categories of strategies and those are education reminders, incentives, access feedback and policy. And I'd like to tell you a little bit more about some of these in detail and some of the really specific quite interesting points we came out um of these and in terms of the frequency, that was one of the main things we looked at a lot of the papers had different ways of measuring the efficacy, but frequency is something that we can really easily analyze across all studies. And we found that across all of those studies, educational and access measures were most frequently used as it says here in lectures. Um and you can read this mobile vaccination units, posters, extended hours and pamphlets, and I'll go into a little bit of detail about these. Um So firstly, in terms of education that took the form, either of lectures or of educational materials, lectures were found to be a lot more effective when they were in person rather than online. And in areas that had fewer resources, it was a lot easier to um conduct those lectures during existing staff meetings rather than having to set up the infrastructure for um completely new lectures and educational series. In terms of the materials, these are really frequently used across all settings and can take different forms depending on what's best for the area. Um But we found that they were most effective when the information contained in those materials were tailored to the concerns that were voiced by healthcare workers in those target institutions. So our recommendation would always be to first conduct a survey of healthcare workers to understand why they're not being vaccinated and tailoring education to those concerns. The next category was reminders. Uh Now this is just to prompt um healthcare workers to be vaccinated. We found that sending reminders as a pre organized appointment which could be modified but was already set was a lot more effective than an opt in appointment where you would then have to schedule one. And for obvious reasons, reminders were better received alongside payslips. Um in terms of access measures, which is our next category. That's not true. Incentives are our next category. You're absolutely right. Um This was um most um kind of the, the most sort of ii in the, the the most powerful intervention I'd say in terms of improving confidence around vaccination in areas where there's concerns with authority and concerns around vaccine um organizations and governments and what ulterior motives might be. Having public figures commit to vaccination and having leadership figures commit was really powerful in increasing um vaccine rates. Similarly, prizes and gifts were very helpful prizes that were given out as group prizes. So for departments awards that had the highest vaccination rates were also really effective both in encouraging friendly competition and accountability amongst colleagues that people were trying to um incentivize each other to get vaccinated. Gifts were also really useful in uh improving vaccination rates and now access measures um which have been described a lot more in the literature. So I don't want to spend too much time on that. But um signposting, extending hours and free vaccination were all really useful. Um But the most important um intervention that we found was the introduction of mobile units, which is the ability to just cart um vaccination onto wards and delivering it directly at the healthcare workers bedside, essentially at their place of work feedback, um could come as publishing vaccination rates on the internet or online forums. Um but also by sending out declination forms to any healthcare worker that hadn't been vaccinated. And that was really good because it both asks people why they're not being vaccinated. So it collects more data, but it also provides us accountability and allows healthcare workers to really think about why they're declining to be vaccinated. And then the final category was policy implementation, which is sometimes a lot more difficult to implement, especially with mandatory vaccination, right? Raising concerns around autonomy um and power over your own body. And so we found where a mandatory vaccination wasn't possible, a mask mandate for anyone who wasn't vaccinated was very effective. Um And that is sort of the the most kind of tangible and important conclusions that we came to. And as I said, we're now working with our task force and engagement forum to bring all of this data and their information together to um create policy recommendations for governments targeted to specific regions for maximum applicability and effect. Uh So thank you for listening and I'd welcome any questions. All right. Thank you so much. Any questions? Thank you so much for that. Ros um One of the questions I have, what was the most interesting finding would you say in, in your research that you were not anticipating? Oh, that's such a good question. Um I think a lot of the, a lot of the things we found were things that we were expecting to find in terms of access measures and educational measures being effective. I think what was so interesting and for me was so exciting about this research was that we're really getting into the nitty gritty of things. And so things like sending out a pre made appointment rather than just a reminder is something that's such a specific recommendation that when we bring this out into global governments for their policy implementation, it's so much easier to actually implement. And I think that's what one of the other presentations today mentioned as well is that there's this real gap between research and applicability and you know, things that we find are actually being implemented in real life. And what we're trying to do is kind of bridge that gap by spoon feeding um governments to create recommendations that are really going to make a difference. And I think that's why we're all very excited about what we've got here. Thank you. All right. Thank you so much. That was a great presentation for our next presenter. We have um apologies Oar Wednesday. Uh He's presenting handheld echocardiography as part of a routine antenatal care in areas with high prevalence of rheumatic heart disease. A narrative review. Yeah. All right. See you. Um Are you able to present? Yes. All right. Oh, you're muted. Oh, thank you. Um Good afternoon, everyone and thank you to everyone who spoke this morning. Um And I've really enjoyed hearing everybody else's research. Um I have everything sorted. Can you see my slides? Uh Yes. OK, perfect. Um So my name's Osas. Um That's my full name. Um And I'm 1/5 year medical student at UCL. Um I also studied um Global Health as an I BSE. Um And to further that research, um I've kind of also done extra research from placements and one such um research project was this one which was about the use of echocardiography um as part of routine antenatal care in areas with high prevalence of rheumatic heart disease. Um And I worked alongside a doctor at the Royal Free um to conduct this research. Um So I hope you guys find this useful both if you're interested in women's health in the future. And also if you want to find out about how you can be involved in, in research. Um So this is kind of an outline of what I'll be talking about. Um rheumatic heart disease was something that we got passionate about because actually cardiovascular disease is a really big cause of um maternal morbidity and mortality. Um And rheumatic heart disease is a very common um heart disease worldwide. Um And then it can cause a lot of complications later on. Um You can see as well from this map here, like showing prevalence that actually it disproportionately affects lower middle income countries. Um And that's because of like several challenges that they might experience um prior um to getting treated. Um And also like, they don't have as much acce access to like the gold standard treatment, which is surgery which could significantly relieve the effects um of their disease um on themselves, their, their quality of life and also their like maternal experience and pregnancy journey. Um So in twen 2018, um wh O actually resolved to like help prevent people from developing I HD and also care for those who are already living with it. Um And they call for like a coordinated global response and I guess this is part of that. Um And service that idea. Um So this was the methodology for the actual narrative review itself. Um These are the search terms that we use and we had like an inclusion criteria. Um Most of the um things were kind of standard and then um some other medical students were also involved with this in terms of screening. Um And they looked at the abstracts and at the end, we had 10 papers in total, um I myself was actually involved in the critical appraisal. Um And this was done using QS two. you can see the form to the side here. Um And actually it stands for a quality of assess quality assessment of diagnostic accuracy. Um And it's used to like critically appraise um different methodologies used within papers. Um So in this case, it was used to assess those 10 papers that we had narrowed it down to um and see if they were actually applicable to subjects of our research, but then also to find out if they were reliable if there was risk of bias. Um So within Q US, um there's four key domains, one is patient selection. Um The others like the index te test, which is the diagnostic test or how they conduct that test within the paper themselves. There's reference standards. So what they've used to actually qualify whether someone has I HD or not and then flow and tim in. So talking about like how many patients were continued throughout. Um what was the drop off rate? Um and how people were assessed. Um So these are the domains we kind of used to talk about um the different papers that we'd seen um and were used for the discussion um when it came to like looking at the results from the critical appraisal, um we found that um eight studies showed they were low risk of bias in terms of their method of patient patient selection. Most of them were actually just done um at randomly selected antenatal clinics. Um And actually, um there was only a couple where there, it wasn't disclosed how they actually um how they actually decided what clinics to use. Um And most of them collected sufficient demographic data as well. Um And in terms of the index index tests, they were seen to be reliable um as well because they were conducted in a, in a very like um acceptable manner. Um They were using healthcare professionals that were trained, they had the like correct equipment and their evaluation methods were also seen to be like good. Um There was some risk of bias in two papers um because there was like nuances and the methods that they used that were not completely explained. So because of that, we had to determine that there was a bit of bias, maybe that could have been introduced there. Um And then in terms of the reference standard, um so most of the reference standards were actually like preset standards. So they were known to the people conducting the test before that could be seen to introduce bias. But actually, um we said that most of them had low bias regardless because um they were also had pre prespecify thresholds. Um And so we felt like that balanced it out. Um One study didn't actually have um the reference standard beforehand, it was created afterwards. So we felt like that was a bit sketchy. And so we determined that there was a bit of a high risk of bias with that study. Um And in terms of flow and timing, um all the patients were mostly judged using the same reference um standard in studies. However, there were a couple where um it wasn't clear what other standards they had to use and not all patients had actually had the same reference standard to use for them. Um So all the results of this were kind of used in terms of discussion and analyzing the results. Um We took some pa some papers, um determinations um to be, I guess more reliable based on these um results and the critical appraisal. Um The results from the actual research papers actually show that R HD accounted for a large number of the cardiovascular disease shown in the studies. Um referring to what I mentioned earlier about the burden of disease. Um and the prevalence prevalence of RSD um was actually found to be 2% but this was as high as like 6% in certain countries. Um cardiovascular complications were actually common in women diagnosed with heart disease. So up to 52% of people, um and over half of those um were seen to require regular medication after this. So, conclusions that could be made um was that actually it could be used to identify a reasonable proportion of undiagnosed rhd. Um because a lot of people weren't actually aware of their heart disease beforehand. Um We saw that there might be a need for active case finding. Um We found this method to actually be useful because you could identify other heart conditions as well. However, we were able to see that some of the rhd that was a large proportion of the rhd that was identified was actually mild, which is not known to always cause complications. So overall, we thought that more research might be needed. Um And in terms of the usefulness of this study, we thought it could be furthered as well if we actually had some papers that compared antenatal care that actually included echo and then had a control group, I guess that had the standard method. Um But we thought there might be some ethical issues to do with this. So, um hoping if everyone, anyone's interested enough, they might take up on this offer. But thank you very much. Um Yeah, here's some key takeaways. All right. Thank you so much. Any questions? Yes. Uh Yes, thank you. Sorry. So what are some of the, um I say for you per personally, when you're going through this research, some of the assumptions that you had made, um what would that be in terms of sorry, in terms of like the outcomes of this, this study? And one of the, some, some of the things that you think um could have been done to address those assumptions that weren't necessarily met. Um So in terms of assumptions, cos I was mostly involved with the critical appraisal. I think I had the assumption that if it's a research paper, it's probably reliable. Um Which is why I think the QOL is really useful in like breaking down what causes something to be reliable, the different aspects that go into actually producing research. Um So, breaking it down like that allowed me to see, OK, actually, this person might have some, you know, unconscious bias or there's there's some guidance here because they have the reference standard already allowed me to think in a multilayer way um in terms of um assumptions to do with the actual like research itself. Um Again, I think I automatically assumed that OK, this is definitely going to be useful um because it, it just seemed intuitive, but I think the discussion and also being able to critically appraise allowed me to see that actually, that a bit more research is needed in order for this to be like concrete um research that we could then take to policy makers and, and implement something from cos right now it shows there are uses, but it doesn't show like the applicability, it doesn't show how that um measures relative to existing um Antenatal clinic care in these um low middle income countries. So, thank you. All right. Thank you. Right. So that was our last talk and last presentation. I just wanna thank everyone for coming. We've ended pretty much right on time. So that's perfect. So you're able to enjoy the rest of your Saturday afternoon. I wanted to quickly just give a brief on student med ad and the work we do. So student med ad also known as small is a community interest company which redistributes medical supplies to underserved areas and addresses access gaps through repurposing unused equipment for low and middle income countries. We try to alleviate immediate healthcare needs and enhance sustainability by minimizing waste. And this entire event was used to fundraise for this redistribution. So I really wanna thank everyone for buying a ticket and contributing to such a wonderful cause. If you wanna get involved with Student Med Aid, we we post regularly on our social media which is at Student Med Aid, London on linkedin Instagram, basically any sort of social media platform. So please engage, we're currently doing blog series posts and having takeovers from the committee covering different global health inequalities, some of which were discussed today. So definitely keep engaged, send recommendations, join and become a member of the actual organization. Volunteer with us. This is an incredibly amazing organization and I'm proud to be part of it. I I totally forgot that I forgot to introduce myself. I'm Sam or so and I'm the Director of Finances student, me and I've had a wonderful time being part. So thank you. So much for coming and have a wonderful Saturday evening.