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Welcome back, everyone. It's my honor today to introduce on stage Ms Victoria Ban. Well, who is an STD? A trainee in transplant surgery. And Victoria's going to speak to you on a career in transplant surgery. I hope you enjoy. Thank you. Thank you, Ryan. Thank you very much for asking me to talk to today on behalf of the Headache Society who are transported training representatives. Um, so, firstly, just for the chat can anyone guess where I work based on this photo country or center? Um, but just have a look and have a think about where I could be working in the UK based on that and answers in the chat. And I will answer right or wrongly. No, no, very close. Not quite. Glasgow. Right country. Um and that's because Iron Bru is in the photo. And Iron Bru is the most popular drink in Scotland, and it's the only drinks company that sells Pepsi and Coke in the world. So there you go. Fun facts about Scotland. Um, they for anybody who's interested. So, um, what about transplant surgery? You hopefully have heard from everybody here today that their specialty is the best specialty um, I'm trying to convince anyone that has any ideas about transplant surgery or wants to inspire anybody who wants to go into it to think about it. The good thing about everyone thinking they have the best specialty is that they are in the right specialty. Not everyone's specialty is right for everybody else. So, uh, the good thing about surgery is that we have this huge umbrella of different specialties, and with in general surgery, you can even sub specialize even further. So this is just a taste about what transplant surgery offers. I'm very happy to take any questions throughout the Portsmouth. No, not Portsmouth. Very, very far away from Portsmouth. Any questions about transplant surgery as we go feel free to ask, and I'll try my best to answer them. Um so transplant encompasses, uh, the abdominal transplant, kidney, pancreas, liver, islet, um, and retrieval surgery. Um, that's the kind of core surgical skills in transplant, multi visceral and small bowel are very, very, very subspecialists that only offered in a couple of centers across the UK. The other thing is that we do pediatric and adult practice as well. So real spectrum across, uh, the age range. We are very small, though, uh, and you do have to do general surgery part of it. So there's only seven liver transplant units in the UK There are 20 kidney units, and there are nine retrieval teams on any one time across the United Kingdom, and that's abdominal retrieval teams. And it's a slightly different system for cardio thoracics. There is an excellent potential to mix clinical work with a host of different specialties, so that's academia, research or management roles. Not everyone wants to do academia or research, but they're good managers, and not every everyone wants to be a manager. But they could pursue academia, whether that's bench side, academia or wet lab stuff, for example, or clinical research. And there's a huge potential to get involved in any one of those areas. Um, my favorite thing is that you really get to transform people's lives, and I know that sounds very, very corny. But when I speak to patients about what really matters to them, um, and what I try and teach young people and and medical students is that we really do change a life. You get someone off dialysis. That means they can actually go on holiday. They can do a full time work. They get a great quality of life, and that's very, very rewarding. And as I said, they're getting transplant. Surgery is the best specialty. Um, although I am open to negotiation from my colleagues, but I think we all think we're in the right job, which is which is the right thing. Um, so you went to the next slide? Um, So, as I said, transport surgery is a subspecialty of general surgery. From the abdominal side, you can do run through ST 18. Or it can be decoupled with course Surgical training followed by higher surgical train number at S T three. Um, when I joined a general surgery many, many years ago, uh, it was all decoupled. A following run through and now run through has then been reintroduced. The new curriculum has a modular component. So the three core modules you don't have to do all of them to do the transplant surgery. Uh, and this reflects that kidney transplant is much more accessible than, say, liver, pancreas and retrieval surgery. So kidney with vascular access, and then his liver and pancreas surgery together and then retrieval surgery. You do have to fulfill the general surgery syllabus elective an emergency surgery to the level of ST eight, and that is an essential requirement. Uh, some of the syllabus for liver and pancreas transplant and certainly for things like small bowel and multi visceral, is considered post e. C. T. Training. So you don't have to be fully fledged in liver and pancreas surgery to see CT. But if you want to do that, you would have to fulfill fellowships either in the UK or abroad to do that. Pros. Um, as I said before, you really do get to transform people's lives, and you do make a real difference to people. Um, I really enjoy working closely with other specialties, so I mainly a kidney pancreas person. I work very closely, Um, with my renal colleagues and hepatologists on the liver side, you work very closely with DIABETOLOGISTS. Um, and all of these people really bring a unique perspective to the patient management. Um, and also they educate you, and very occasionally you get to educate them, which makes you feel pretty smug when you get to tell a physician something they didn't already know, Um, it is an excellent mix of medicine and surgery for so for slightly noted people like me, it has a great mix of both of those things. Um, you also can mix and match other bits of general surgery. If you want to carry on doing general surgery Hernia school, that is, um then you can still do that. Or if you want to step aside, um, and do HPB and liver transplant, you can do that. Um, there is a real opportunity to do different things, and some of my colleagues do endocrine surgery as well as transplant surgery, and you can also develop non clinical rolls again within management. Academic we are a small specialty is a central governance process through NHS bladder transplant. So there's a huge data mining a data field of the data that you can mine and get excellent results from very easily. They even have their own statisticians, so there is really huge scope to do clinical research, and and that can actually make a difference pretty quickly because we are a small specialty. So someone asked me when you apply for run through, is that a separate application of oil Or do you apply for CST three oil? I'm afraid I don't know that. I would suggest that you, um, speak to probably whoever runs whichever Dina re runs your, um The subspecialty. Sorry. The course surgical training. Um, I'm a bit too far out to actually know that process, I'm afraid. Sorry, but the other thing is, I can ask one of my colleagues, um, to give me some advice, and I will hopefully be able to put in the chat a bit later on, if that's helpful. Um, so more pros. So we get sometimes get to go on fancy planes around the country. This is US retrieval team. So in Edinburgh, we do liver retrieval, surgery, kidney, pancreas and island. So we really do a broad breadth of transplant surgery. We are one of the retrieval teams from the UK We cover Scotland and Northern Ireland, and this is us going to Belfast on a very windy day. Um, but we've got to go in a Learjet. Oh, I think it was legit. If anybody knows what type of pain that is, let me know. But it was very, very fancy, and it was very, very quick so Edinburgh to Belfast in 20 minutes was pretty swish. Um, so cons. It's not 95. It's pretty much the only specialty, apart from live donor kidney transplant, that that's the only elective activity you can predict. The rest of it is all emergency work, so a lot of it will be out of ours. A retrieval often involves if you're going on a plane or on a bus down to somewhere else, it can. It can be a 12 to 20 hour retrieval that you're away from base. So there are long hours and it is unpredictable. As they say, training opportunities mean that sometimes you just have to, um, you just have to go in and do a kidney transplant at two in the morning, although you have a war drowned at eight, and sometimes you have to just be very collegiate with your colleagues, a little bit of give and take about those training opportunities and usually most people. Um, if you give and take as I say, I have a good working relationship with your colleagues, you can get a lot out of the job. Training can continue beyond CCT, so even though you get the magic? Yes. The Ercp outcome six. I think it is. You still have, uh, significant training to do if you want to do a liver and pancreas surgery. Um, so someone has had how does it compare with HPV? Can you do both? Can you do one without the other? Absolutely. So HPB is also a standalone specialty. But if you want to do a liver transplant, often they work well together. If you want to do that. And there are many units who have consultants in HPV and liver transplant. We have several in Edinburgh. You can do one without the other if you want to. So again, I work with liver transplant surgeons who don't know HPB and I work with HPV surgeons who do no transplant. Um, so again, you can combine both if you wish to, um, to do that. Um, So societies and associations plugged for the Headache society. We are absolutely free. We have an education event. It used to be in November, but it's now changed to May next year, a little bit beyond the scope of the audience here. But we also offer FRC is preparation courses. You don't have to be at the level of FSGS to join in. You can still just be part of it. You don't under any, um, you don't have to answer any of the survivor's. They are usually set up for people who are coming towards the exam. All that. You can still take part as an educational event if you wish to. So, asset, um, is a great resource. They have education events like this throughout the year and a meeting in March 2023. We have a wet lab, and we're certainly setting up a wet lab kind of experience. So how to bench a kidney? And I think we're hopefully going to get pigs kidneys so that you can, um, get an idea of how you prepare an organ before it is ready for transplantation. So come along to that if you're interested. Um, the British Transplantation Society is the biggest transplant society in the UK, and even though it's the biggest one is still quite small. Everyone knows each other. Uh, we have a congress every year in March 2023 the big plug it's in Edinburgh this year, so if you want to come up and see the city, Um, I will certainly be there, and others will be there, and it's very friendly. Um, and it does offer education bursaries as well for travel. Um, 22 places if you want to go and have a look at certain units, but you have to be a member to do that. And there's also the European Society of Organ Transplant. They have a biannual Congress, so it's in September next year, and I think it's in Athens and they also offer education events. They can be online or in person. Um, and that is a much more as you can imagine, global kind of audience. And it's really interesting to go to the socks that Congress is and and share ideas, because no, no. Two countries do the same thing when it comes to organ transplant, and it's very interesting. Um, so what can you do at your stage to think about transplant and to get involved so I would speak to your t P D and any clinical director for your local transplant units, and that might be a regional center that you're not working at, but often people are very keen for you. to come along and to consider things like tasting weeks. You get a real flavor of what we do. Um, you'd be able to come along, meet the patients. Come on. More rounds comes to the surgery, which is the cool bit. And maybe go on retrieval. If you go to a treatment center, you're more than welcome to come. If there's space headache society, it's free. We have our education again in May, not November. Apologies for that, Um so check out the website, um, and come and join in. And when we go to events like BTS, Congress or Congress, we often have headache society, um, socials, which are good fun. And three. So another plug for the asset transplant weight training session and then a more local level. Join your surgical skills club or even get on a basic surgical skills course through one of the colleges. Um, they are really good at giving you kind of generic skills. Okay, research opportunities. Find a friendly transplant surgeon. Um, they are there. I promise you. We're all very friendly. If you're keen, Um, you can also find any renal physician or a hepatologist anywhere that has any renal liver patient will have a transplant patient amongst them. Um, so they will have data to look at if you wish to. You don't necessarily have to have it in the kidney or liver transplant. Associated specialties around transplant like vascular access infections in lines you call calculation for consideration of liver transplant, etcetera, and try and present those at your local meetings, either in house or regional meeting, for example, submit any project abstracts to any of the Congress is if you can, UM, you'll get a poster, I suspect, and it's really great to go along, present your work and meet fellow people. Get a flavor of off use around. We also have the headache Society Transplant Research Collaborative. Um, and we do, um, we get together, and we think about projects and ideas, and often they will get translated into proper research. And we across the UK so that's really exciting. There's also the Dragon's then. So if you've got an idea for a clinical trial, um, and you think it's ago, ER, then you can submit an abstract into the British Transplant Society Dragons Den, where you'll get put forward like dragons den, and you have to picture idea to the dragon's who are all professors of child born surgery. They sound scary, but they're actually very nice. Promise, Um, and then in leadership roles, think about formal informal rolls and they can be general specific. You don't have to have a lot of transplant experience. Just generic skills are really important. An early stage, they think about rotors. Is there a course that you can think of? Can you design one and deliver one locally and then general Kind of rolls rolls with an asset? Um, there's leadership fellowships in the E. There's the national medical directors clinical fellow scheme, their star search. There's rolls within BMA. So none of these, as I say, our transplant specific. But they do have these generics skills, which you could carry forward and then within the Headache society. We do have a lot of committee rolls, one of one or two of which are especially for junior trainees. So F. Y s and core trainees and then for those who are medical students, think about local national medical student associations and again junior doctor associations as well. Uh, right. So final thoughts are that transplant surgery can be very challenging, but it is very enjoyable. Uh, there's a huge potential for networking. And I think we are a great team, not only in Edinburgh, but across the UK as a whole. Um, and you can have a work life balance, and I'm not discussed that very much. But learning to switch off is key. And if that means switching off your phone, then I would recommend that, um, finally, any questions and thank you very much for listening. Yeah. Thank you so much for that really insightful talk, Victoria. And it's really a pleasure to hear from you on about transplant surgery. I really liked that slide on several research and educational opportunities And really key for an event like this. Thank you again for attending. Thank you very much. Ryan, I'm happy to talk about transplant to the end of the day if you want to. Um, but again, open for questions. Um, I know I haven't talked about work life balance much, but it's there. You can do it, you know, um, but I thought I'd just keep things a bit generic. That's great. And we look out for any questions. I think there's one coming Okay, What brought me into transplant surgery in the first place? So, um, I was a medical student, so I also picked early, and I knew I want to do surgery because I did orthopedics, and I really enjoyed it. And then I saw a kidney transplant and I saw, like, a fountain. I'm not joking. A fountain of urine come out of the ureter, and I thought that was pretty cool. And also, I was watching something called Lorna Martin, who was my mentor. Do it and she's She's the first female professor of transplant surgery in the UK, and she was great. She let me kind of watch, and I followed the patient journey, and I fell in love with surgery and then transplant. And then, yeah, that's it. Ever since then, I loved it. Won't do anything else. I think that's I think that's a really important point, Victoria, about mentorship really early on and exposure to surgery and exposure to theater. And I remember personally as well, seeing my first femoral embolectomy as an F one, and I'm thinking, Wow, I want to do that. Yeah, it is really important. So I did. Orthopedics is my first kind of exposure to surgery, and I thought, great. I really want to do that. And then I did a bit of general surgery and I thought Appendix, and I think that's great. I really want to do that. And then I saw a transplant and I thought, No, I really want to do that And I really enjoyed medicine And I really enjoyed the impact on the patient's life. And And Lorna has mental me ever since, Um, and she was my PhD supervisor and she's kind of a friend. So, um, you know, if you can find someone, uh, as a junior trainee who will bring that to you, or if you could find someone that has actually mentoring Sheen to the royal colleges, then I I strongly recommend that, and they can have a look at your portfolio. You know, gently guide, you have conversations. Sometimes those conversations are this isn't right for me. I want to do something else, and that's absolutely fine. You don't have to when you're, you know, uh, if you started a career and something you say it's not right for me, that's fine to get off, and the mentor should see that and and encourage you. If that's right, um, so find one. If you can, uh, do you have any pediatric transplant, or would you need to go down the pediatric surgery specialty Root for that? Um, no. You don't have to do pediatric surgery to do pediatric transplant. It's not offered in every center. So in Edinburgh we do adults, but in Glasgow, so they would do pediatrics leads do pediatrics and several units in London, Birmingham, Cardiff and Bristol. I think so. There's quite a few centers that do it, but you don't have to do pediatrics. I would recommend a stint in pediatric surgery if you can. I did it, Um, I learned how to look after a child, and that is really important in anyone's practice, not just in transplant surgery, but especially in general surgery. Um, and I also learned great tissue handling because if you're a bit rough with a kid, they will not let you get away with it. That your trainer's so it's really good specialty for generic skills. Cool. Thank you, Victoria. Thank you so much. I will. I will let the next person on. Thank you and happy for any further conversation later. Great stuff