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general cold nights? No, nothing last. Thank you so much. Thank you. Katie. That was really, really useful talk. Thank you. And so, um, moving or now Teo Mission Attache case. It's s O Natasha, or touch is a PMT training, and she's going to do it all at the moment about taking enough three s, so I'll hand over Thank you. Um, thank you very much. And I was, um, hiding behind my camera with comments Katie's comments about, say, here your annual even I was actually applauding the screens that yes, he needs to take her on your leave. Take your time. So it was a long time your time off. You're going to be a better person to take care of yourself. Eso Thank you very much of the introduction. I hope you're having a very excellent day. My name is task. It's Simon Ent s t five. I'm also an average are a CF On day I am into regimen acid Vice president and I'm his talk to you about time between or out of training. What I did everyone does something different but also going through some of the key questions I always get asked people have asked me and then hopefully l will be time that the entropy towards question clinic people have any specific questions. You want to ask about these things? So thank you so much for having me. And we'll move on on then. Just on a theme off, Uh, also promoting my region. I'm down and Peninsular. This is currently the view One minute from where I'm staying and call Well, I recently moved to calm also. Like what? Surgical trains. Amazing it a little bit for places on. Do have wonderful time doing the job, So enjoy the time away from hospital as well as the time they're so it's quite so. There we go. So how many people are taking time out? Quite a few, it seems so This, uh, very pretty chart here shows that as time has gone on, more and more people are going on to have time out. Now, the evidence to show that most people come back over time that lots of people are taking time out. So you can see in 2018 decreasing rounds of people, um, who were taking planes outside of the UK or not currently practicing medicine that yellow box is getting bigger and bigger. I'm somewhat still speaking implement that weren't quite in. If you could see them. Short amount of people going into court training and run through training. I've recently been some meeting, so we have talked about tracking training's Onda like the missing cobalt, and the evidence is that most people do you come back within 3 to 5 years, but they're enjoying taking time out between, and so it may feel like you're the only one planning this. But I guarantee there's about five other people wishing they were planned, where she would have a break not to do what we're planning to do. So you're in good company. Um, taking regularly after foundation is increasing, gone from 30% of over half in 2016. I don't have recent data for that, but I imagine it's higher. But as I alluded to, nearly 90% of people do eventually come back. And what are they all doing? So this is from your oncologist, a website on um so about half that are working some sort of non training job about 35% of the work, or wanting to overseas somewhere doing extra qualifications. 50% of traveling, which is what I, which is what? One of the ones I did start taking out to talk about that. Some decide to work in medical education, drink teaching fellows and things, pursuing other interests. So I know people would have gone off the settle up some charity to do that military stuff, volunteering in the UK sitting exams and then some other little things with the bottom now. But there's lots of things today. My particular journey am sorry, but I I got a cold, so I don't know. We sound like this. No problem chance. But I'm managing to get the words that's that's gonna be going. Okay, so I'm I did F one f two, um, in the sunny today. Done. Then I then decided that I wanted a break. So I did. They were bandings back then. So a lot of my jobs to 52. That band and I was really quite tired by the end of it. And so, for my f three, I had great kinds to go to Australia. My husband didn't agree because he had a job here, so I went to trust of it except when I lived on, I did any anti nausea, Felix, because I was interested in those I didn't know which one was going to inspired me the most. I started my masters, and that year I also did my basic surgical skills. Girls looking after have a fellow job. They had a study budget attached to it with was excellent. So much to get that done without having to empty my pockets. I was very lucky enough to get any antihistamine job back in Sunny Today, which had one year the auntie's in plastics. Um, it's more in t A t end of it and I went on to my second job, my masters on. I went on to the Clomid year of my medical education quantification, which I had started in F one on. I tried to do the MMR siestas. Well, that was a very challenging year. I would not recommend trying to do that many things in one year on. As a result, I decided to drop my hours in on CT two, which is very positive for me because I finished out of synch in May and I was very lucky enough to, uh, get a nasty three number, Any anti And they said, Oh, you could start one almost October until, like October, please. And so my husband took a sabbatical. We went traveling for six months, so I'm sorry with everyone who has had that scuppered Mike over. This is luckily before cave in on, um, I had a great time, absolutely no medicine, which is great. And then I came back in October to start my a cf on STT on I'm currently ST five. Within their holding along planning hopefully stop another year or two. Some point and people talk about taking time out between training programs. Now, with some people having run through Jane program, that's a very long time. But you can now with the Gold Guide, which is like the the textbook, how to of any training program you can Google find a copy of it. There are now several options were taking time out of training with in training so you can have an out of program for training, which is, for example, in my region of my specialty. Some we don't have a cocker implants down here, so people take time out within their training to go to other places to learn skills that their region can provide. And usually that would count towards your training. Not always that you want to do something very different. So Edie trainings might go off and do, um, like a PT experience. Yet something like that. Um, so you can also do a new B, which is not a program for experience that would be something similar, but generally wouldn't get counted toward your training. And it isn't allowed and foundation training. The fortunately, little still found to be getting generic training back one. Very commonly. It would be hard on some of these electricity people have gone out to do now to program for research, and then that will depend on how long that is. Four. Um, whether you're doing our commercial and your PhD and then the new one that came out most year, um, is the out of program for a career broke? People realize that that is something people need, but they don't want to leave their training programs to get the time away. And some people who need a bit of time to decompress and think about what they want. Um, the the pilot unless it'll time training. I know it's not my lecture, but also means, if you can also take, reduce their hours within training for reasons other than child carol health concerns. So there's always that you can swap the balance for training if required. All these need to be agreed of the TPP. You need a reasonable amount of notice. That guy's gold glasses, not much. It tends to be a and also they can say no. But they have to have a very good reason. There was Provisionally Goes against should not be a reason that so And if you're if it's applying But again, not going to have some regional variation. What do people ask me? Well, she would get very worried about what will happen into Do you have all those gaps in your CV? No one's said anything on when you do it. Online application. It's like to list every employment job I let you just put a cap on. I just said at three non training or traveling because when I was applying Prestige three, you have to give all the time, too. The time up to appointment. I was like I will not be here on down wasn't mentioned. Not negatively, Mark. No one thinks they're not dedicated. Honestly, Not a problem. Um, been any negative comments or some people that probably similar people who are, like, you should come in all you're off days and do all these things like we should also have lives on. I think any negative comments, almost certainly. Juicer. Jealousy. Do you regret it? Know I know it. Um, I like to my f three. Um, it was 3. 50%. Band of jobs will talk about the pros and cons of all those things I really enjoyed being able to sample. My job's going into a themed role. I don't think would replied for ent thing role. And I hadn't had done the extra year. So on that seemed course. Surgical training process was the making of my career and getting the nasty three number Almost all my points case in that job. So I wouldn't have got the energy. No training scheme. So I think think you use it. Two advantages. Bridge also men. I then had the time to collect the other qualifications that I wanted to do. So I now have a diploma, a medical education. I also have a masters of surgical science, is which has helped me get my a cf Post made me competitive as well. I know things I enjoyed and I had the time to do that. Whereas if you did that straight from an F once the end of CT to, I probably would have melted under the stress of trying to do a little bit. Also, they're just physically isn't enough time to, um, when I do another one. Hopefully, I've always had a hankering to do a PhD quite challenging at the moment with opposite numbers, the way they are might stick around with clinical training a bit longer for taking another timer. I definitely love to, and even now, my husband, I like looking forwards a fellowship, things like, you know, really nice to go traveling around there like that. Very nice as well, so you can pull these gaps in. You plan ahead. Then this is a photo of us that magic, which you just one reading my six months traveling, That's my husband. And it was just beautiful, highly recommend it on all my consultants when I told them I'm kind of with my sister and same place and my CT, too. And they were like, we're due for your six months. Most because they were, like, could give you a job if you like. And I was like, I think I want to go traveling on my consult was like, Absolutely. Go do it. Don't ask anyone that ask permission. Just go on. I'm really got it. Made me feel really comfortable over. All right, going Now that I come back, the same concern to, like, you know, I think I'm going to get here is well on, um, it's you're you're gonna look back on your whole life, and I love my surgical training, but I also love these using these memories as well. Advice A tips do well you want If you want to use your gap to go do it. And Ian, the cleft center of the world Do that if you want to go scuba diving in the middle of nowhere, that definitely go do active. That's what you want. Just do what makes you happy? Because everybody doesn't impact on things Negative Commons. Almost always jealousy, But try and make life easier. So I made my life particularly hard by and my three years like I want a break. I didn't do it. Hold it. I didn't do my own RCs. It took me. Several goes to pass. My Marcia's partly very happened to admit that the best of us some take more than one. Sometimes I think the driving test, um, the other. It's up, you can see almost yes, a much earlier. You do the earlier in training, so I would just recommend that if he can get it done early, I just fight it by saying, Well, doing surgical training that surgical training is four. But in course surgical trading you're suddenly really 18 months. You have to get along this stuff and then you might want to try and do publications and other things. You take a lot of time, and so I just made my life very difficult. Also, with the other qualifications are doing a little bit city, not the practical parties and stuff. That's my relevant doing your course surgical training and people are more ate parts that if they're in a surgical job, but there's no limit to the gap you can have between those two. I don't think so no enough. Within 2 to 5 years on actual looking, this special specifications for applications audits. They want you to have a real order, which is much easier to do the same departments around and just being me and doing a one order to year. And no, we ordered eating it because you've moved hospital. What, really silly? Because when I turned up to my closet, to them, To you, I haven't even done a reorder it, which was very silly. I still need to get my job, which is a small miracle, but I just made my life really quite hard. So if you're going to move jobs that you do in order, reorder it it If you're got a geeky placement in my joint, gonna do all this time, my friend, who's now don't have any anti red with me in the same region. Um, did her Marcia's party a GP. She's like in the three hour lunch breaks we had, or if I had a teaching day, she just did. Revision cracked through that first time takes a lot more money than I did pretty faster. First time made her life much easier. I really should have done that. I highly recommend that you just think ahead. So when these things man my feasible not all trust jobs have studied budgets and fortunately, but this is a little ago, she able special. You're feeling a much needed gap. Some of them will go towards for a pain for a PG certain, which is great, and I'll get you pulled later. So points me money if you can try. If you got dropped pounds between a couple of jobs and one gives you something else to go with it, that's something to think about on when to take causes. So if you take a very long time, if I had done my 80 less enough to have expired by the time I applied to rest, the three actually even would have had to do it again. So I purposely left that nature where his basic surgical skills doesn't expire. So I did that, um, much. Where do you find all these roles? You could get the money, just jobs, but actually word of mouth people know you're hanging around them or like to try and scramble some money together and put together a job. There are some formal fellow rolls. The fellow job I did in there a role in job that happens every year. But if your key and you have a knife, find a nice apartment, just go Say, Is there anything coming up? What can we do to help with this? Some people have grants or research might need a research million, which is great. So I only do that part of the time and you can look in the rest of you Are things to consider are the financial implications. Um, I know people who just local. Um although child to health and walkers, you know, parental leave if you So, for example, my six months away traveling broke my, uh, nature service cause it was over three months, which meant that my sickly on my eligibility from attorney leave went down to zero. So if you're going to plan a family, just take that into account and make sure your weight your time when you come back for those in essentially, there are pension implications. If you go away again, I ran them up. They're very helpful when they said it isn't a big deal. If you're going to come back. If It's going to be a very long time. Fine. If you're going to go looking through an agency, there are ways that you can go about making your own contributions to make sure your pension progresses. The support services. I didn't do this, and I went away for six months, thinking I will be absolutely fine when I come back and it's not straight back into work. But actually, I went straight into a tonsil. I couldn't get the guy again. It was a very friendly. I was very stressed out, very sweaty. And I'm like, Why can't I do the simplest things? And you just need a little bit of support getting back in there on calls six months out, I looked there, was in the same hospital it was in a new hospital thing would have been really quite stressful. The support services liaised your department. They provide funding for you to be super new, me for a reasonable amount of time. I think it's about today, a month for the time. You're way like we were going to leave Career gap, sickly aloes things. Every hospital has one will do. You know you're upset. She had a champion for it and so should have done it on now. I spent the last year emailing all my colleagues coming back off a parent Aleve being like, You need to do this. It is brilliant for yourself. It's very useful. Um, and you always have to think about your time and specialty if you're going to do with these other fella Rolls. This came was that this will change with Covic on, Dave increased lost the numbers, and as time goes on and the imagine that Kobe is having less of an impact, they will be reducing them. So you have to check the buying toothpaste with self test with each time. And unfortunately, it's very difficult to plan for years ahead because it might change. But this is what we have for the moment. So, for example, for me ideas, Four months of ent and my three job I then it had 18 months in my plan cause surgical training job for ent. At the time, over 18 months, I would have lost five points for each six months over. That was quite a lot, and so I petitioned my training program to swap in. Ironically, I ended up having to be more plastic surgery and do less of the specialty. I wanted just to make sure he definitely got that number. Not all crazy training programs will do that, but you should think about that one applying for theme jobs as well. If you have too much experience, you will be penalized for it at the moment, cause of covert and people being deployed again stuck in Georgia's grants 27 months. None of these include the experience of foundation trainings to my colleague Claire, who's always something better than me. No. Did I have to do any anti enough to know if she got that extra full wants experience of it, but they didn't penalize her time. So when she did a similar there's the same job is never talked to me. It had no issue for House, and she just carried all fine. That was quite stressful. I was taking that out. So for CST, you do more than 18 months of surgery. Then you have to apply up too Rusty three. But you're considered to have too much experience if you're taking too much time between F two and replying to call searchable training the higher surgical training, your your certificate foundation expires, and so you need to get the equivalent form signed while see if I sing consults just very difficult to do with your local me are not in a department and work with, and I need to be within a certain timeframe to applying. I think has to be within the same year you apply. But that changes there, so you need to quit the rules for that. She need to think about. Also. They have a complex system where they divide your total number of points by the number of time you have over 42 months. Oh, and we'll surgery. If you have more than substance experience, you have to apply. Address the three The same vascular these dates. I looked up last night, so you should be accurate for this year. Neurosurgery again. We have lots of new stones from tree and see because the council's have add alive complimentary specialty. We didn't take time out of then your surgical time. So if you have more than 24 months of that, they have to find to ST three much. Not many numbers or you have to carry on season later. Cardiothoracic surgeon. Since you just got to think about these things, it doesn't mean you have to stop what you're gonna do. You just have to plan. Think ahead. Yeah. Yes. More. Focus is when we were Australian from my time away. These are a couple of times right now is that my husband is rather obsessed with Oh, so they're quite a fun comparison of the two different slices just to break things up for you. So you have to listen to me and micro. Okay, What can you do? These are all examples of people that I know. So I owe someone, you know, works. MSF I think he tried to apply for and it says it's a couple of times that has kept finding other, more interesting traveling opportunities with medicine. So he traveled. Also, space is he went to a very possible It's on a prick. Your and singlehandedly ran it. It's with a couple of nurses. You know what's from the South? You could do it after three. And your local colleague of mine dropped out of course, surgical training and did that for taking a radiology training. I think he paid off most of his mortgage company makes life much. Um, you could do research. You can set up a charity and sees I have a colleague who's very dissolution of medicine. She left it in a degree and marine biology and then decided that actually is very few employment or changes. And that came back to medicine on Found a trust job that makes that happens. And she's now a geriatric staff. It's, I know 80. Any doctors have gone off the the bridge. Fantastic. So every doctor in job, that's Ah, several months year. Very beautiful photo she sent that you can go off and do expedition medic with things like One a steer, which is a problem with mine is done. We did a nonmedical roles. A lot of people have gone off to do, um, innovation rules, and she and the GMC just prioritize your family. Michiko Couple, please monitor. We could just look up, travel, local and travel, local and travel. Make us feel very jealous. Well, like me, I went and did enough three and did some things, and I also just went to travel girls for a bit and did a very good job trying to empty my bank balance to the information? Uh, yeah. So small voters. Ah, I think this is on by bird part of the boat there. And then this is in the Galapagos where this is our hotel on dial. Clearly the local residents important. That's which is correct. Which was looking back for me. Advice to learn from how I turned Using the wrong is take your exams early. Make your life things work smart. Not harder, because I'm not nearly my fellow job Was wonderful, was very tiring. I wish I had someone that had actually a few hours or more learning, studying time. They might have done more with it. Do not try and take too many qualifications. One go looks lovely on my CD now, but I was a horrific couple of years and I would recommend it to anyone if you want a great take it. Surgical training is so long and a copay disorders anything. You just gotta take the time to do it. You want time? That allowed me to continue with my other studies, which was great. And I should have used the support senses on by think people. Look on this mostly in a very positive light, and you'll be a much happier person. My college fairs, I've said, has gone straight through from med school to now, and she is actually very jealous of all the time out I've taken. She's much younger than me, which my wrinkles get upset about it. But she it's different stuff, different things to different people. So I'm very happy that I have done. And although she has been with the benefits from that, um, she wishes that she takes, um so thank you very much. Um, I hope we have some time to questions. Um, this is my email. It won't ask me anything. That's my twitter handle. If you want to, please follow me my own ending battle to please try to have more followers than my father in law, which I'm failing at dismally. Some photos from Japan, the normal gated by famous, and there's a QR code for feedback for me. I'm sure Emily and so if you're gonna send you different. But if you find you're getting any feedback, there's the code to do that. Thank you so much. Preston's right over. No, no, no. You don't thank you Thanks so much That what? That was really good. And it's so nice to have, like, a normal perspective on surgery, because I think, you know, you go through Medical Needle If you want to do surgery, you've gotta do this and this and give up your life and give up. Give up everything you know on. It's nice that that's no actually the case. And so, yes, I I think there's been a few questions on the chat. But a few of them were talking about ent, which may be more relevant in your talk later. I'm doing the ent talk later, so hold on to your questions. I'll definitely focus on that later, because I know if you work five balance ent is the place to be a I'm afraid, but I'm very biased. But I think if you will work life balance, you can still have it with surgery. Just pick the right kind of surgery, but, uh, any questions about time out? And if I'm I've seen a question and it's quite specific, but so for those do it So it's from Regina. So for those doing a purely teaching job in medical education with no clinical world but want to look him. Do you have any advice on how to go about sorting a designated body with prescribed erection and appraisal price s. So that's difficult if you're doing it for a locum agency. If you work enough hours with them, I believe some of them will do that for you. You feel on, I think, even if you're just low coming every now and again, I think there are agencies that will allow you to pay them a handsome fee for them to do your appraisals. There are ways around it. I don't have any personal experience in that. But most people I know how done that, either by working enough from one department because most people never favorite department and finding a nice consultant to do that. That especially for doing it for a local and hs bank, not usually okay. Otherwise, the bigger agencies, I think, do you tend to offer this service on so it might be worth it, especially if you're going to do it for a long time. I'm afraid I didn't do the long term locally, so I can't help. But there are lots of people in knots. Hospitals. Who built onto that for you story sometimes the gene. See how runny nose Very helpful as well. So ask what needs to be done that. But people have always got around it. So there is a way I just don't want to be on. The answer is Yeah, And so one was about portfolio scoring criteria releasing, I think, the answer that we don't know when it's coming up, hopefully soon, so I wouldn't give you that one. But the next question I think we'll finish on this point is on the hands. But do you think it's becoming more acceptable to be less than full time training as a surgical trainee on This is something that they might consider if they decide to have Children. So I'll let you want. Yeah, so I surgery is difficult, always difficult personalities. I think it's very specialty and department we based so in ent In my region, I think almost every single female trainee and ent and against the resistance full time, because, on incidentally, ones just have a dry transfer from London. She was like no one ever goes back nest Little time, Even if you do have Children. That's just their culture. I don't think that's a great culture. And I think that's a reason she's moved down to business. Um, but it is definitely becoming more frequent in the pellets. Is specifically, were quite favorable to it. So there are two or three male trainings down here. Also doing it care reasons to help their partners get through training quicker. I know a male general surgical training you unless it's called time to allow his wife to go up to full time so she could see CT Kashima's further along than him on that. Men that they could still provide Good child can be a home machine. They want to do that on with the pilot for lesson full time. Now extending to surgery, it's going to become commonplace. So I think people will moan and they'll route. But the fact is that we need to keep good people in the specialty, and this is the way to do it flexibilities the way forward. I firmly believe that if they can't cope with it, that is their problem, not yours. Um, if you want to do it, do it. Um, you may be the blail tracer to do it in your hospital, in your place. But that's when I think knowing your rights and what you should get and advocating you're in training is important, which is exhausting. It's not easy, but I think it definitely is becoming more frequent. I certainly have had no problems. I don't know Children, but I would lessen fulltime ct too. And I'm lesson full time now because I I want to live a life on most people down here understand that. That's why we all live by the sea. You know, as for the self assessment, Yes, I think they tend to release that very near to the time off applications. Which is why we don't always managed to capture in time for this course. But just keep checking websites lovely. Thank you so much. That was really that was a really, really good talk. And, um yeah, as I said, nice to see that sort of normal approach to turn into surgery and, yes, season when he has a lot going outside of work, so good in inspiring. And so thank you so much cash for that. I think now we're going to move on and