Women in Surgery - Plastics
Summary
This on-demand teaching session is an inspirational introduction to medical professionals on the topic of women in surgery. Our inspiring guest registrar, normally working at Queen Mary's in London, will talk about how she has taken less than full time training and have a balanced lifestyle. This open forum allows attendees to ask questions and learn what to consider if they are interested in pursuing a career in surgery, such as work/life balance, overcoming barriers, and pushing forward trends to make the surgical field more accessible to women. Our speaker will be joining at 7:30 PM, so get yourself comfortable and join us for this session soon!
Learning objectives
- Name and describe the anatomy of the most common plastic surgical procedures.
- Describe the various career pathways available to women in plastic surgery.
- Identify barriers to entry for women in surgery and discuss ways to break down those barriers.
- Describe different training and work-life balance options available for plastic surgeons.
- Analyze how the current structure of plastic surgery training can be modified to make it more accessible to women.
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Computer generated transcript
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The following transcript was generated automatically from the content and has not been checked or corrected manually.
mhm. So hello this evening. And welcome to everyone joining us. Um, this evening's start the series really for women in series will be with one of our plastic registrars. Um, she's joining. She normally works over at Queen Mary's in London. She's an S t seven registrar, Um, and she is, uh, inspiration to women. And she's honestly, very, very experienced. And she actually I met her at a conference last year, and so she's kind of really said yes to really starting us off. We also have in the rest of series a core training session on Monday, and I just want to make you aware of the future sessions we've got with general surgery, with head and neck with trauma and orthopedics. And with pediatrics, I'll be putting these sessions live very soon. So what I think is important is just to make you aware of what we're trying to learn. This woman in series in surgery series. So women as we know, uh, highly underrepresented within surgical community, and they really need an uplift. And if you look at current trainees, there's an influx of very junior trainees at the moment, so myself working with some female colleagues. I would say the majority of our group of trainees, um, it's about 90 percent of women, so that's fantastic. But that's not the case when you go higher up. And if you look at the consultant body does tend to be mail. So what can we do to change that? Well, hopefully, um, surgical field is something that becomes more accessible towards women and something that you are going to be more interested in. Um, so how do we do that? You might add. Well, we have to think about how the surgical current structure can be changed and adapted to see women trainees. Um and so that really is something quite bigger than than this platform. But I think what's important is platforms like this. We have to start making that change at our level. So at medical students at foundation, your doctors and going forward, um, so myself. So my name's curious. I think I am a f Y three or junior clinical fellow. Whatever you want to call me working over at guidance and Thomas is at the moment, and my field is general surgery Now, the reason I've asked to do this series with mine. The bleep really is to promote women going into surgery. And the reason that I think this is important at the moment is to kind of get on the back of this trend at the moment, which is pushing women into the field, identifying those barriers and overcoming them. One of the barriers that I'm discussing with my colleagues that's there at the moment is whether or not you know, family work. Life balance is something that is something you can have going forward, especially if you think you're a registrar or a consultant uncle and trying to find that the balance between the two now the registrar, um, he's on this evening is going to talk about how she has taken less than full time training. And that's something that I think a lot of people don't know much about, something I haven't heard a lot of speakers talk about, and I think it's really important that we emphasize looking at that and what options we have. Um, you know, not not every woman who's going to be joining the school is potentially going to want a family, but I think it's important that for those of us that do myself included. We think about what options we have, whether you can have time out and not just for having Children, but also think forward Is that other things we want to do with our careers outside of our medical field? And I think if you look at social media and platforms at the moment, you'll recognize that a lot of people are trying to push forward and take on other things in their careers, whether that be promoting public health, whether that be in research, whether that be with their own business and other things going on separately. So, actually, if you can say doing 80% 20% split balance rotor, perhaps that would actually be more useful for people trying to find what their niche is going forward and how they can make their career path journey actually more exciting, more accessible. Um, so, uh, speaker this evening she's going to join at half seven because, you know, quite familiar like ourselves. She has today been at work. She's been caught with cases and she is trying to get back to do other things, and I think it's important to highlight that because I mean, for instance, I've been at work today. I've had an easier day. I can come back if you've got family. Other commitments. You know often people say, Well, surgery isn't really feel that I want to go into because I'm going to be poor this way and that way, and I'm going to be unable to, you know, do what I want to do in my in my personal life, and I think what's important is she driving people to make that change. So I hope that you will enjoy this going forward, and I hope that you actually want to get involved with us and tell us what you're doing, what questions you have, what's important. This is an open forum. So we are very proactive with, you know, answer your questions and answering those that people perhaps don't want to answer. I think that's also important. I think there's questions that we get worried about. Asking and especially surgical field is quite competitive. Sometimes you don't want to show your concerns and your question because people think that shows that you're you don't have the drive, you don't have the ambition and actually that's not the case. And I think this forum is a perfect way to ask the questions and actually think Okay, it's surgery for me. Okay. So, um, is there any questions at the moment? If you do have them, please do you put them in the forum. Um, and we will try at half seven. Hopefully, for our registered to join and give some more information on plastics. Until then, perhaps would be a good idea to get a cup of tea. Um, you know, get yourself in a comfortable position, and then we'll hear all about less than full time training plastics. As a career, we can get started. All right, I'll let you have a little bit of a moment, and I'm just going to try and see if I can get any questions in the chat. Thank you, but so come off because I'm actually a good question. I am a person. Um, so Hannah's asked. She has a prof. He's my mentor. He always says that I shouldn't share my research ideas with others that I'm too much of a team player and that should become more individualistic. If I want to be a plastic surgeon. I do want to be a plastic surgeon, but I just feel that I don't have that type of personality. Well, this is quite interesting, actually. And, uh um, and actually at work today, I've had a very similar conversation with some of my colleagues in general surgery. Now, I think if your personality is that that you want to share research ideas that you want to work in a collaborative effort, I think, actually, I think you should continue with that. Um, I think if you look at people around you people that drive you people that actually inspire you, those are people who actually you want to work with going forward. And it's quite difficult, actually, when you've got, um, professors and people who are very senior And I mean, I don't know your professor personally, but from my own experience, there's a lot of people who are very senior, who are very respectful, are very well respected and very good at their job, and you enjoy working with them. But I think they're they're slightly from a different era than ourselves. And if you've got people who you trust you want to work with in research, I think actually that's something you should you should do going forward. And actually, I think you're looking at the new consultant in the register. Our body. If they look out for people, if you're a team player and you're someone that they trust, you are more likely When you get to consultant level and you're getting interviews, who are they going to choose? Someone that might have a lot of publications might have a lot of research, but actually, when it comes down to doing the job, working with others, they don't have the communication skills. They don't have the leadership. They don't have the other things you're going to get with working with others. You know, if you compare that, yeah, you can still get the research in one way, actually, So I'm working with a couple of colleagues with this series. Um, and I thought, you know what's what's the point of myself working alone in this series when I can work with a group of women who have the same drive, the same ambition and can actually get more done because we all individually no more female surgeons so we can come together and we can share ideas? Um Anna, does that answer your question at all? And do you have any follow up remarks? Perhaps on that when we put a couple say, Christopher said Hi, Thank you for this one. I'm currently a med student, and I understand that surgery requires you to plant early if you want to go down this route. I don't know any doctors personally to get that insight. If this is the route, I want to go down like, where did you start? So I guess if we go back, I am studying medicine. ST. Georges I was on the graduate course. I had a life before I did medicine. Um, and I was in research. I then decided to do medicine. And then I thought I wanted to be a gastroenterologist, and I was driven to do medicine. And all throughout medical school, everyone that met me said, Okay, Cats doing gastroenterology. And in F one, I thought I wanted to gastroenterology. And it wasn't until I got to the end of F one that I actually started paying more attention to the people around me and actually looked at those who were in the medical field and thought, actually, I'm not sure that suits me, because the things that in the medical field that appealed to me is about being practical being hands on. And I looked at my medical colleagues and thought, Am I going to be excited in 15 years when I'm still doing this as a consultant? If I'm doing ward rounds and and such forth? Yes, there's definitely appeals there for me. But I wanted to be hands on, and one of the things that put me off was thinking, Do I want to be a woman in a surgical field where it's such an uphill battle? It's competitive, There's lots of men and I want to have a family And that's the impression I got from colleagues. Impression I have myself. So I thought, Okay, I don't want to do that. And then I, in the space of a year, change my entire portfolio from medicine to surgical. So I would say Yes, it's a lot easier if you make that decision early. I haven't made my life easy for myself, but I've got a surgical job now. I'm playing applying for core training this year. Um, I work with colleagues. I enjoy working with And actually, I don't feel like if I had made that decision any earlier, the outcome would have been any difference. Um, I'd be interested to know if there's anyone else who's listening tonight that has a different experience. I mean, when we're talking about portfolios, um, as a core trainee, um, there's things you need to take off. So if you know what those things are earlier on, it gives you more time to meet those criteria. However, if you look in the medical field, you look at the surgical field when you're applying to the next level of training after foundation training. Actually, what you need, um, is very similar. So you need quality improvement projects. You need publications you need, uh, research. You need leadership positions, teaching positions. Well, you can get that without making a firm decision. And so you're taking boxes in both categories, and then at the point you make that decision. Your portfolio is already halfway there. Um, so that's what I would say. I mean, I'm slightly different, but I've decided later, and I'm sure there's people that decided straight away that they want to be. I don't know, an orthopedic surgeon and their portfolio would probably look great. But I don't think making a decision later on we'll impact you. Um, right. So here's for international medical graduate, and I'm looking forward to pursue general surgery in UK. What would you recommend for me to do to improve my court surgical training portfolio? Um, so I'm actually, it's so many international trainees that come across and the clinical fellow posts. Um, so the post I'm currently holding often lots of international students will come across because often they will come in, um, an F two level rather than an F one level and because they have a slightly different training pathway than in the UK Um, what I would say is the UK system is very different to abroad. I don't know exactly where you've been studying, but I've worked with lots of lots of students that are trained in in check who have trained in Europe but also in Iran. Iraq, um, Poland's over in Australia, and every system is very different. And even in the UK and the N. H s, each hospital is slightly different, and that can be a little bit difficult, a little bit daunting when you first start. So I would say the best thing to do initially would be to get a clinical fellow job or try to get yourself, um, an F two stands alone job just so that you can get used to the system. Because once you understand in the NHS, for instance, the policies the pathways for, say, someone who comes in with a head injury and you're familiar with that and the medications and prescribing aspect when you apply for core training, it's going to be a lot easier because you understand when you get to interviews, which they ask your leadership management questions and what you're doing. Clinical scenarios. You'll know exactly what they're looking for because you have had that experience personally. Um, if you go into NHS jobs, there's 100 different thousands of clinical fellow jobs. So you have a look. See what takes your interest. If you're looking for general surgery, there's laid out there like my current job and then see how you enjoy it. And there's so many trainees then that can help you build your portfolio. Once you're in that role, um and and it's come back, it really does. I just feel like you really need to find your people to do the collaborative work with It takes time, but I'm sure it's worth it in the end. And I would totally agree. It really does. Depends which team urine and I worked in a surgical team that perhaps didn't have so much for sharing collaborative effort. And now I work in a team that does, and they're really pro research and really pro change. Um, so I think, you know, perhaps a different team with a different dynamic might give you a more positive outlook. Um, equally. You know, I'm sure part of it becomes a problem for a reason. And I'm sure he's done lots of all she has done lots of research. Um, but, you know, I think if that's your personality, I wouldn't shy away from that to become something you're not, um we all we all probably can think of Ms report people we work with, and and then that's not someone that you want to continue working with. So I think be true to yourself and just come back. I've studied in India. Yes. So actually, the last hospital hospital I worked at, um in Ft. We had a significant number of Indian trainees come across, and I think the for those that I've worked with the prescribing, um, and the way we go about assessing patients and the imaging was slightly different. And for them doing a year in one firm. So in one specific hospital, working with one team was really useful because at that point, then they got used to the dynamic. And also, if you're coming across, um, with not too much surgical experience, then it allows you to build your number of hours in theater. Allows you to do the quality improvement projects and audits that you need for applications. Um, okay, Chris Table said, thank you for answering my question. What are your work schedule is like, really? Is it really possible to still build a life without getting above and beyond to gain it? It's a continuous point, I hear when people talk about surgery. Okay, so, um, each hospital does that work slightly differently? Um, so currently, as an s h o. So as a kind of low grade well, middle grade doctor now, um, I have a lot of on call commitments at the moment. So that means I work in a Andy seeing patients in the front door, making assessments that they need to come in or go home. Um, and then when they come in, whether they need surgery and take them to theater or whether or not we can wait and manage them on the world conservatively. So during those shifts, um, it can be quite busy. I don't know if any of you had any experience, but it's definitely varied. Um oh, and my colleague, my plastic registrar colleague, is here, So I'm going to try and get her on books. I think actually getting her, um, experience with a lot more years than me will be very useful for you. So let me just see if I can get her to join. So I'm just I'm just going to invite her to stage. So just to recap for those of you, um, that went here right at the start. So Susan's a lovely senior registrar is currently working at Queen Mary's in London, have plastics, and actually, I think it's really interesting season to pick up because the the girls here that have been currently commenting have had lots of concerns with some international trainees this evening, Um, he perhaps, uh, at my level, or just about to come into my level kind of an F three level, or some of them are students, and they're really worried because they've heard this kind of atmosphere of people not wanting to help each other. And perhaps some of the worries about families going forward and work life balance. Yeah, definitely. Can everyone hear me? Okay, definitely. Can everyone here? Okay, I can definitely hear you. Great. I'm sorry. First of all for being late, and I'm sorry. Second of all for looking a complete mess. It's just been one of those days, and I'm sorry. Third of all for not having any proper slides. Um, and the final apology is that you might see my naked daughter running around. Just say hello. Um, Jesus leading up to that now, um, I have actually a couple of slides together just as a kind of a memoir. Very quickly with a couple of things to talk about with patients. She was a tree. So I'm happy to talk about the work life balance thing first, and then bring those slides up and see if that's parks anymore. Conversation. Is that English? That sounds great. Perfect. I mean, I think the work I'm balancing is hard. Um, and honestly, I think it's hard, Um, in any medical speciality that you're in, Um, partly because, um, in any medical speciality, you have that issue of, um, feeling like you've got the duty of being a doctor and therefore regardless of what your work schedule is, your working hours like today. I mean, I wasn't meant to get home gone seven o'clock, but, you know, that's that's kind of sometimes the way the cookie crumbles. Um, so I think I think it's hard, whatever specialty. And I think the most important thing is that you choose a specialty that you're going to enjoy doing. Um, because that's going to make the hours that you spend and work that are unpaid. Um, not feel quite so much of a hardship if you're, um if you decide to do GP because it's a better work life balance and then you're still they're gone seven o'clock because you're short staffed and your duty doctor. And there's somebody who's phoned, um, that you can't just leave. Um, but you hate being a GP, then you kind of still not not hit the mark there. Um, so I think that's number one. Number two is that, um I think it's important to, um remember, l t f t and less than full time training. And we can talk about that a little bit more detail later. I'm not currently less than full time, but I have been, um, up until recently, and I really, really highly rated as a an option, especially if you have a family, but not not restricted to if you have Children. Um and, um, I guess the last thing to say about it is that, um and I think this is true in any career that you enter. Um, in a way, there will always be people pushing for your time, both in work and out of work, um, in life. And, um, you know, this is a work in progress for me as well. But, um, you kind of have to be your own best advocate and set your own boundaries and say Okay, yes, I am going to work really hard, and I am going to put in the effort, um, in this way, X, Y and z way. But actually, um, I set my boundaries here. You know, some people have a separate. Um, I don't know how to actually do it. I don't have this, but I know people who have, like, a separate business account for their WhatsApp, and they give that number to everybody at work, and they silence it when they're not at work so that they can't receive messages about work outside of work. Um, you know, and that's their boundary. Or people who don't check work emails outside of work. Um, or people who say, You know, um, I'm very happy to stay late on the days that I'm in. But the days that I'm not in our for my family and I'm not going to spend it doing doing anything work related. So it's, um it's sort of finally that balance yourself to say, Okay, I'm gonna push hard and take the extra time in some ways, but not not in every way, because it's not sustainable. And I say there's a lot to, um to my junior colleagues and train and sort of trainees. Um, and I think it's hard. It's easy to forget that especially the more junior you are, but absolutely nobody else in this entire world. Including your mom, your husband, Your, um, best friend. Nobody has your interests. 100% at number one other than you. So you you have to your own back it. And then after your own set those boundaries. You know, um, today I'm literally just too unwell to come to work. Nobody's going to thank you for coming to work and running myself into the ground. Um, you know, and just make sure that you look after number one, um, and have your own best interest at heart. Always. And whatever you do, that's really, really important. Um, I feel like it was a bit like preachy. Sorry. Sorry to be so preachy. Um, shall we move on to, um so an a k R is just saying I did the what business thing as a final medical student. That's been a game changer for me. Oh, that's really interesting to hear. It was one of my female consultants, actually, um, Bristol, who kind of told me about it. It's unreasonable to receive messages about teaching sessions or theater schedules when you're out. Was simply having time off 100% and it's so tempting to get that message. If it's not separate and say or just quickly respond to that or somebody wants some information, quickly, send it to them. And at the end of the day, you know life will go on without you. Um, you are. I'm a sad to say, completely replaceable, completely interchangeable. And when I went off on maternity leave, I thought, Gosh, everyone's going to be, you know, wondering what's happened to me or they're gonna be thinking or what? What's that Susan doing then? If she's not here and you don't realize that, you know, maybe the day before you go, everyone goes, Oh, you're going on that leave. And then the day after you left, people go, um, Susan still here, And then you come back from that leave and I took eight months off. But you know, plenty of people take more or less time off whatever you come back from that leave and people are like, Have you been somewhere? Yeah, I've been off for like a year. I had a baby. Nobody's noticed. Everything's just cracked on. People may do without you, and that is the nature of what we do. So it's important to remember that as well. Um, so I have got some, um, slides. Katrina. Do you know how I share them? I believe if you go to the bottom and there's a little three dots, I think if you press on that, it might allow you to you. And there's a little box with the triangle going up. And I think it's a present now. Oh, yeah. Present, uh, might just share my screen instead. Uh, let me know if that's working. Um, let's see. I haven't actually saved the slides. I just literally let's you save as did anybody have any comments? Um, just while I'm trying to get those slides. Yeah, Let me have a look back. So, um, I know that Chris table you were asking some questions before about work schedules. Um, and I think it's probably a little bit different from a registrar level from an FSH level. Um, and then again, at a consultant level, it changes because your commitment will will start to change to clinics around two more operating time, and you might do the walk around. I don't know, But perhaps once a week or depending on what that schedule is. Um, at a junior level, you are more based on the ward. But depending on where you work, you will get protected theater time. Um, and ultimately in the UK anyway, the b m A. Protect your working hours so your contract should be compliant with that. And you don't normally as far as the contracts can and you shouldn't be working more than, say, 48 hours a week. Um, however, you know, as as Susan said really occasionally, you know, obviously you're going to have days where if someone's ill, you don't leave on time because, you know, you've you've tried to be a doctor, so you look after them. You do what's needed. Um, but that's the case. Regardless, if it's surgery medicine gp, whatever you choose, that's going to be the case. Yeah, let me know if there's any other questions coming through. Um, Susan, any luck with the sharing? Um, I've saved my desktop, but now it's not that any. Uh, let me see if I can just have the slides here. I mean, they're not very exciting. Slide. Let me try one more time and Otherwise I'll just That's right. Um, and I know, perhaps going forward, I don't know if any of you want to put any questions on the chat that are more plastic surgery specific. We've got, um, speakers in the next in the series, really on other areas as well. So this is a good opportunity this evening to pick seasons Brain. If you've got questions about why plastics, why plastics might be good as a female to go into questions, Maybe about as a student, You know what made Susan to go into this field? Um, that's something that I definitely have as a question. Why plastics? It's not something, really. I think it's a student you get a lot of exposure to. And then not many foundation trainees. That's absolutely right. I'm sorry. I don't know why. It's, um it's not letting me share either the slide deck or my screen. If I click share screen entire screen and said, Share you done anything, let me see if I turn off my camera and, uh, speaker, just to see whether or not that works. Any luck. Do you want to? If you have a chance to answer some questions if you send, um I can upload a pedia from my end. I don't know if it's allowing you to do it. You're around either. But I could upload them for you from my computer if that works for you. Um, sure. I'll discuss her. Of course. Yeah, course, they're they're almost not worth the trouble, but to just now and see if you can make any headway. And I can just start talking around them. It was just some literally, like black and white slides with some words on it to kind of spark as a discussion because you asked me to talk about some specific issues that I came across as a woman in surgery. Um, and these are just some literally some thoughts that I had. Um uh, well, I was, uh um I got home this evening, so I'm just sort of off the top of my head. It is something that I'm really interested in. And so I have thought about it quite a lot. Kind of over the years, um, and I think were loaded into a sense of feeling like, um, like there is gender equality in medicine and in the M. H s and even in surgery, because, um, you know, it's national selection. Um, we all are on the same page grade, just dependent on our grade. And so therefore, you know, there isn't any inequality in salary quote unquote, um, like there is, you know, in the BBC, famously or other industries. But I think there's a lot of more subtle, nuanced ways in which there is, um it is hard or is you know, there's a it's a different situation being a woman and surgery, I think, than a man. Um, the first one that I kind of thought about was, um, the relative lack of even our role models consult consultant suppositions, but it is improving. Um, in that the numbers of female consultant surgeons across specialties has gone up over the years across all specialties. I think it's about 15 or 20%. Um, if you look at the lower grades as it goes down and and I wish it would have been so nice to have this on my slides like there's a little, um, uh, diagram that shows this, um, but I I don't have it on the side. Even it's just in my head but the the as you go down, senora in seniority. There's a greater percentage of women now that could say two things. That either says that the newer generation of, um, medical students and trainees coming through, um, are feeling more empowered to join a surgical career. And there are women joining surgery. Or it could mean that there's attrition as the years go on that women start out in the genius surgical rolls and decide. Actually, it's not for them progressively as you climb through the ranks. So there's about 15% of, uh, surgical consultants across all specialties that are women and about 30 30 or 40% of registrars that are women. And then in the more junior year sort of F Y and core training, it's more like 50%. So kind of the future will show us a little bit. What, that which one it is, whether it's that there's attrition as you get up the hierarchy or whether actually things are improving and we're seeing more gender equality. Um, but I way there's definitely women. It's really important. I think when you go through life in general, when you're at school and you look at your teachers. You see, Who do you feel like you have? A Who do you relate to? And who do you feel like I have affinity to and who's sort of mentoring You're looking out for you. And that's often the kind of subjects that you then end up pursuing. And it's exactly the same medicine. How else are you supposed to know what specialty to pursue other than somebody that you back up to and that you enjoy being with and that you feel an affinity to, um says to you, Yeah, go for it. You know what? How how else do you make that decision? So a lack of female role models and surgical specialties is really important. Um, and the way to get around that for me has been things like this. Um, that's not to say that you can't have a mentor. That's male. Um, and absolutely I have done. But, you know, literally, the reason I'm a plastic surgeon is when I was an F three, I worked in a major trauma center where there were two plastic surgeons that wasn't even a proper plastics department, and one of the plastic surgeons said to me. Uh, I cut out, okay. One of the plastic surgeons said to me, Um, yeah, I think plastic surgery is a great career for women. I've got a female friend who's a consultant plastic surgeon. She's got a couple of kids and she has a great work life balance. And I think it's absolutely fantastic. Especially if you want a family. You know, I love my job. It's different every day and varied. And he literally said that to me. And I was like, Okay, that's a big surgery. Um, which, in retrospect, it's like, you know, you should probably do a little bit more looking into it than that, but but yeah, So I mean, it is really important to have those, um, those kinds of conversations with people and see if it's something that you think, uh, suits you, and I'm going to just about all the different things that I had in my head. There's only four of them, and then maybe we can go into a bigger discussion. What I might do is just type here what it was so that we can remember it. So lack of female role models was number one number two was confidence, insecurity. Uh, number three was gender equality at home. And then before it's related with L TFT. Okay, so confidence and insecurity, Um, this has been this is not necessarily across the board a female issue. Um, so I'm going to calculate by saying that, but it is something that I've found. Um, and my husband is also surgical, and it's something that we talk about a lot. He's bless him, He's very emotionally intelligent, and he's very feminist. So I feel like, um, he's always a very good sounding board for this kind of thing. And, um, since we were honestly, um, I met him when? When we were if two's. But absolutely since then, um, we have compared notes about how our days are at work, and I think there is a really a difference between being a male doctor and theater in interactions what's expected of you. And, um, the way people treat you. There's the obvious thing of, you know, walking past the bay and patients saying, you know, hello, love. You know, can you sort this out for me or calling you nurse? Um, and everyone has a different degree of how they feel about that. And that used to really bother me. And I used to kind of spin on my heels and be like, I'm the doctor, actually, um, and it doesn't bother me as much anymore, because I sort of think, you know, a lot of them are kind of like, how are they supposed to know? You know, everyone is walking by wearing a different degree of uniform or whatever. And, uh, there's no flashing light on my forehead that says, Doctor, Um, so, you know, maybe they've come across more male doctors, more female nurses. Um, so if I need to correct them, but otherwise I don't really worry too much about it, but that's the obvious one. And then there's a lot more subtle things. Like, um, my husband and I would compare notes, um, about very simple things. Asking the nurses and award, too, helped you a set of bloods or help do a set of jobs. Um, you know, that is their job. So you're not asking them to do anything outside of the realm of what is absolutely expected of them. And, um, as a woman, I have learned kind of through trial and error and through experience that the way to get glasses to help you is to, um, start by complimenting their hair and asking about the weekend and then saying, Oh, by the way, would it be possible if you're not too terribly busy? Would you mind just saying I'm just I'm really round? And if it would be really helpful if you could explain and see, um and that's all good and well, that takes quite a lot of energy and emotional capacity to have that interaction every time, instead of just saying Please, could you do a set of jobs? That is their job. Is your job to be able to ask them and they should be able to do it. Um, my husband, on the contrary, when I describe these kind of interactions is like, really, I just ask them to do it like, literally just walk up to them and say, Can you state jobs? But if I do that I found nine times out of 10, I met with a bit of it, like, you know why? You know, why do you think you can bust me around? You know you're not the boss of me kind of kind of response. Um, and you can't measure that. I don't think I mean, I'm sure people have tried, Um, but it's It's, um it's difficult to measure that I have seen there are publications that talk about this, about the trials and tribulations of women in surgery and a lot of it's qualitative research based on extensive interviews with women in surgery. A lot of them are US based studies, and this is something that's mentioned. So it's not just my experience, Um, it's, you know, it is in the literature as well, and that's tricky. And that's training. And I've seen also my surgical female surgical consultants, for instance. Um, be assertive about something, um, and be perceived as bitchy or aggressive, um, not taken seriously. And if you compare if a male surgical colleagues say the exact same thing, um, people would respect it and do as asked. So I think that is a big challenge that I've found. And it would be interesting to hear if other people at varying levels in their careers have had similar issues, so I can move swiftly on Sorry. Go ahead and let's say and everything you've said. So far I've experienced even today I would say Yeah, even even as an F three. So I would definitely second that. Yeah, often called Nurse every day. And I have to admit my response somewhat depends on my mood and how my day has been going. Um, often, you know, often I smile if it's an elderly gentleman and I said, Well, actually, I'm a doctor, but I can get you a blanket That's fine. And often I think sometimes if you're a little bit nicer about it, they do feel a little bit ashamed. And I think it is an inherent almost. You know, I think there's a certain generation and it's a little bit sexist, and that's their baseline, and they don't mean anything. But nine times out of 10, it is just literally, um, what's coming to the head and they're assumption and, you know, it's sort of you have to decide for yourself where, at what point you decide to challenge it. Um, I'm on a Facebook group called P M G U K. And one day, if you have Children, you should join. But it's for Doctor Mom's in the UK, and there's like 15,000 people, and they're they're just constantly posts going up about literally everything left, right and center. But it's quite often posts about gender equality and medicine. And somebody posted saying, You know, on the white board and the outpatient department when it says Who's clinic is today and what room there in whatever she came back from that lead to her first clinic and every other doctor on the board was mister So and so mister so and so mister so and so And she was down as Susan, um, and she was posting, saying like I really kicked up a fuss about it And, um, I don't know if I should have done like, What does everyone else think? And, you know, there's very opinions on it. I mean, I introduced myself as Susan Hendricks and one of the plastic surgeons so that it's clear I don't want anybody to call me Miss Hendrickson, to be perfectly honest, I think even once I'm a consultant, I mean, I'm about a year off of being a consultant. Now, um, it's a bit of a mouthful, and it feels a bit, um, I don't know. It doesn't roll off my tongue very nicely. So I don't mind anybody calling me Susan. But I do want people to know that I'm not Susan like that, pal. I'm Susan the doctor and that sergeant. Um, so that's an interesting book, but just that inherent inherent sexism or bias of the nurses Write it on the whiteboard, going Oh, Mr Jones, Mr Thompson, Mr Whatever. And Susan like, it's a bit of I think the person posting felt like it was a bit of lack of respect, And, um and I can see that I've realized that I've actually gone completely off topic. I was meant to be talking about confidence and insecurity, and, um, I haven't talked about that at all. I've talked about other people's treatment of female surgeons, but that was a good other topic. Um, so confidence and insecurity, the thing I was thinking of there is that as a woman in surgery, and this is probably why I got sidetracked, because there's another thing I compare notes with my husband on, um, again, it's not across the board. It's not every woman, but I think societally we are raised as women and we are expected a bit more to, um second dot ourselves. And we are we generally speaking broadly speaking as a agenda or so it's a natural character. Actually, um, we, um, feel like we can't say that we are confident to do something unless we are 150% confident that we absolutely, for sure can do really, really good job of it. And I've done it 1000 times before. We really know what we're doing. And I think men societally are raised from a very young age to, um, take it till they make it and to have a bravado and just say, Oh, yeah, absolutely. That's no problem, even if they have no idea. I think it's very easy as a female surgical trainee as a surgical training in general, but it definitely is a woman to hear everybody else have that bravado and assume that they're much more competent than you and that they really know what they're doing. Because you don't feel that bravado. You feel like you must be less competent. And that, unfortunately still in the surgical world, does not work in your favor. Um, I'm sure you've started experience that already as an f three. But how many times in my career has some somebody said to me, Do you want to do this operation? Um, and I've gone, Um, yes. And they go. Oh. Okay. Um, have you done it before? And I've gone. Well, no, I haven't really done before. I've seen it done. But I have, you know, I'm not really sure. I got 100% and they go. Oh, okay. Well, let me do this one, and you can do the next one, and the next one never happens. And that's you Never progress that way. That's just the fact of it. And so, again, comparing notes with my husband. Um, and even he's, like a bit more like, um, female or feminine, Kind of in his personality than a lot of, um, definitely been a lot of other orthopedic surgeons. He's north. Um, but even then they asked me if I don't know what I was, What have you But you know, I've read the optic and I've seen it done before, and I know the steps. Um, but yeah, the way to do it is to unfortunately still, and I'm not saying it's right, but but unfortunately, is to be a bit more male about it and take it till you make it. And you know there's ways of doing it. You don't necessarily have to lie. Um, but it's remembering to say the positive things first and not the negative things. My instinct is to always go. Oh, I'm not sure I can do it. I'm not sure I know. How can you help me? Whereas James, my husband, he just switches on its head and says, Uh, I know the steps. I know the anatomy, and I probably just need a little bit of help with the approach. Um, or, you know, I'd appreciate it if you if you were scrubbed to give me a hand, But I'm happy doing the case, and, um, it's subtle, but it's an important difference. And, um, maybe one day there'll be more female surgeons, the mail surgeons, and will be achieved the fact that actually, it's, um, much safer to have that female approach of, Well, I'm not really 150% sure. So maybe you should stay and help, but the way that it is currently, um, in the world of surgery, it helps to be a little bit mail about it and to have a little bit more bravado than you feel not saying beyond safe, not saying do things that you have no idea what you're doing. Um, but if you are 80% sure, that's probably good enough. Um, so I think that's something that I really grappled with throughout my career, and it's It's not about it's not about making it up. It's not about lying. It's not about being unsafe. It's about backing yourself that you're, um, well trained and that you are as competent as your peers to do what to do. What what's expected of you. Essentially, um, it's a difficult balance to strike. Um, and it's something I still still work on every day, finding that right balance, Um, so I'm gonna go very quickly on gender equality at home and the reason I put this down and this, um, is very relevant. If you have, um, Children. It's very relevant if you have a medical husband, but I think it's relevant even if you don't, um, have those things. I talked a little bit about societies, expectations of women, and the I think it's a lot better for us than it was for our mothers, Thankfully, and it's much better. It was much better for our mothers than it was for our grandmothers. But I think society still has very much a picture of what a woman should do and should not do at home. Um, and how that balances struck between between partners. I'm gonna caveat that I'm heterosexual and heterosexual relationship and I, you know, identify as a woman and, um, all of those things and I can't speak, um, really, with any experience or kind of knowledge about about other situations, Um, other than to say, um, you know, having maybe I shouldn't call it gender equality, but just, um, equality out of work, um does impact your, um, your career as well. So, for instance, I mentioned my husband is also a surgical, and he is, um, a super involved dad and super keen to pull his weight at home. He's super feminist and really, really supportive of my career and super happy for you, uh, to strive for equality. And I'm lucky enough that when I went back to work after having my baby, I had a lot of consultants and colleagues who were very achieved. The fact that I had a new baby at home and it would come to five o'clock and they would say, Oh, gosh, it's coming up to five o'clock. You need to go and get your baby UK to stay did it, which is fantastic. And that's certainly something that even, you know, 10 years before I wasn't afforded to our colleagues and probably in a lot of places. Still, now isn't afforded to some of our other colleagues, however. Interestingly, my husband and I are the same grade of training, and we took the same amount of print to leave. Um, we do near enough the same job. And, um, not once has any consultant ever said to my husband at five o'clock, Oh, gosh, it's five o'clock. You need to go and even pick up your baby, Um, which is society, you know, It's also a very male dominated specialty orthopedics that might be part of it, But lots of their bosses, um, you know, are married to doctors and have Children, and it literally just does not enter people's heads that a man who's had a baby may also have childcare and duties. It just doesn't go by and large. Um, equally. I went back to work 80% after having my baby and my husband just he did take the same amount of share a parental leave me. Actually, which was fantastic. Got a little bit of raised eyebrows for that in a bit of plaque, but he kind of stood up to it and was just like, you know, this is important to me. And it was, you know, important to my wife. And it was that he didn't feel like he would be supported to to go back to work at less than full time. Um, that would raise too many eyebrows that people feel too much like it was compromising his training or his ability to be a good colleague. Um, any other examples? Um, just the nature that men can't get pregnant and women can. It has a big impact on your training. It slows you down, you know, you know it is biology and and also, you know, it's it's wonderful, and it's it's a beautiful time, and it's very special to to be pregnant and to have maternity even have that time off. You know and and breastfeed if you were able to and you want to. Um But those are things that men can't do, and so naturally that their career doesn't have the same impact from having Children as yours will, um, and, you know, they're always is mitigating that husband, uh, mentally work every day to make sure, uh, they often, um so you know, there are ways of working through that, but it is hard work, and it's not something that comes naturally into the minds of everyone else around you. Um, you know, phrases like daddy daycare still get thrown around plenty. Just, you know, amongst all of our friends, not just the medicine. And, um, you know, we really pressing against it because we think it's not Daddy daycare. Like it's our shared child that we both our parents for and and parents and careful. Um, So, um, anyway, equality at home is, um, is something that will impact on your career. And this is an issue that, um it's difficult to to resolve. And you have to kind of find find your own way with it a bit, but happy to talk more about that Anyone has any thoughts, and the final thing was just about less than full time. Um, and I mentioned I went back to work less than full time at 80% after having my baby. And I just feel so strongly that absolutely everybody should work simple time if it's all humanly possible, we all have things to do that don't involve work work. Life balance is important for everybody, whether you have a child or not, whether you have a partner or not, whether you have ill parents or not, whether you do sports at a high level less than four times now available as Category three and most specialties at least just a pilot. And that's, um, the new kind of initiative that says you're allowed to just apply to work less than full time because you want to really people laugh. My quality of life and my work life balance just improved drastically when I had that kind of impact with my at all. That was partly because we have the financial flexibility to have, uh, uh huh childcare not be able to do that. Also, we had a nanny, and she was flexible enough that she and she had a half day on my day off that she was happy to swap that when I swapped firms, and that meant that whoever I was working for, I could make my day off match. There's surgical consultants, the standard consultant contract. You were in hospital 3.5 days a week. If you work for longer or rotor, it's another thing to think about the long term. So it means that it's a trainee. If you're working for one consultant, there's no, um, you're not missing anything if you have the same day off as your consultant, maybe their private list. Um, some people like to go to their consultant private list on the day off. But if you if you're full time, you're not even able to attend their private list because you'll be working in the NHS, you know, doing a red on the list or doing somebody else's clinic or back feeling for somebody or on call or whatever. So, um, I used that day to, um, do the dry cleaning, get my haircut, but also do all the audit work that you need to do anyway in your spare time to do the research that you need to do anyway in your spare time. Um, and instead of doing that in the evenings, which I would normally do when I was full time the baby or on the weekends, I had the evenings and weekends to be with my family and to relax and to watch Netflix. Um, and I felt like that made a huge impact on my mental health. I'm now doing my fellowship, and it's I think that's another final frontier of less than full time. That hasn't really been reached yet. Um, and every fellowship that I've applied for and been awarded, I've asked about less than full time is a slightly kind of just testing the waters. And they've all it's all been met with, just like a head shake and like, Oh, yeah, uh, so um, so I am full time and I actually am finding it really tough. Um, I think I think it's hard. It's hard to have a toddler sometimes up in the middle of the night and have a surgical husband who's full time and be full time myself. And I think that's tricky. It's tiring. So I highly recommend less than full time I've seen a question that says, How long does that extent training? There's a really nice table, Um, on the h, the website, Um, less than full time. That says exactly how long each percentage extends your training, but it depends what percentage you work. So I worked 80% and that extends each year by three months. And when you say it out loud, that is just such an insignificant amount of time compared to your entire life and career, especially if you do it, you know, only once you have babies or whatever later on in your career. You know, I was ST six by the time I went less than full time. So in total, it's going to extend my training by six months like, give a shit like he's gonna he's gonna worry about those extra six months. And if you reach your competencies, um, you know, before you finish this first city facility and, uh, uh, it's I think it's 90% that doesn't take 80%. Doesn't tend to buy three months. Yeah, um, and that goes up. I think the minimum that you can work is 50% less than that. I think it is basically not allowed. Um, but actually, what I found working 80% is by the time you factored in zero days and bad holidays and study leave and holiday and all the rest of it, you actually aren't even in work four days a week. You're often work less than that. And so, um, for me, I felt like 80% was a good balance. Um, and, um, it just felt really relaxed, baby Caring full time is also really, really for long and hard work and tiring and working full time is really, really hard work and tiring. And having that combination is often working sort of three days a week. Um, you know, by the time you count for the holidays and all the rest of it it was so great. I just I really enjoyed my days with my baby, and I really enjoyed my days at work. Um, see, I can't I can't express enough how much I loved l t l t a t and how sad I am to be full time. Currently, I'm actually, uh you answered that personally because I think when your junior you don't know, even as an F three. I think even when you first get into a rage training, there's not many people who do less than full time. So I think having you're here to talk about it. And then one of our future speakers also took time out with her Children when she first had them. So yeah, definitely promoting that, I think, just perhaps, as you joined, maybe just before we were talking earlier about actually, even if you didn't want Children and lots of people don't or they can't have Children for whatever reason, having less than full time or other business jobs or adventures or traveling or whatever it is that makes you happy. And I think maybe that's the way forward, generally medicine and making us happier in our jobs, Totally. I mean, I think in medicine, out of medicine, any specialty, you know, five days. There's a lot to work. Yeah, plus your ankles and all the rest of it. I I honestly think it's, um, BC'S. I really loved it. The I wrote a paper about it about less than full time and plastic surgery training. If anybody's interested, it was published in the press a couple months ago, Um, we did a qualitative survey and a quantitative survey, looking at how plastic surgery trainees who are currently less than full time, how they feel it has impacted their personal lives. And they're training. And I think it was quite surprising to the results. And most people said that their training was actually improved by it. Because you just have more headspace to consolidate your learning to do some reading outside of work to finish your audit and all the rest of it you're not so exhausted. And if you have the flexibility to change your off day to match your firm as you 88 rounds, then the only thing you're missing is the is the site and you're getting just training, which is so wonderful. Yeah, I definitely recommend looking at that paper as well. If you're interested and you know to your point, not many people do it. And surgery is absolutely true. It's very, very common in other specialties. Pediatrics in, um, anesthetics. You know, it's almost par for the course for men and women, Um, in surgery and especially plastic surgery. It's still very limited. I think at the moment it's something like 7% of plastic surgical training is less than full time and 90% of the women, 90% for childcare. So it's very heavily weighted towards that, and it's it's a real minority at the moment. But my other kind of big, um sort of, um, I don't know that podium point about this, and I wrote on the paper as well as obviously sure, which means it's true and not just my opinion. Um, I'm taking it is just my opinion. But I think I think encouraging less than full time for any reason. Across the board for men and women, whether for child care or anything else, will go a really long way as well to, um, encouraging gender equality because there is an element of stigma to being a, um, less than full time trainee in surgery. Still, there is an element of stigma with being a mom, um, and a woman, and I think the more we say hey, less than full time A is no big deal like you're still a really value team member that can contribute. Actually, nobody really misses you on your day off, as long as the system is set up properly, which, thankfully, where I worked, it was, but in some places that you know it isn't and that that needs to be recognized as a system issue, not a simple time machine. Um, you know, and and to say, it's not a female issue, it's not a woman issue. It's a you know thing, and and the more men that work less than full time, I think the less it would be stigmatized, which is to be seen as normal. In some countries, it's completely normal. So I have a friend who's a general surgery trainee in Holland and in the Netherlands. And they I think 80% of the general surgical trainees work less than full time. And it's completely evenly split between men and women, which is really strong. Maybe we should All right, I said, maybe we should all move to Holland. It sounds, sounds like they've got something that maybe 10 years in the future on us. Um, I know that one of our listeners mentioned earlier that she's training in India, and she was wondering the best kind of room when she comes across for getting the experience for applying to training. I you know, I've seen a lot of international training. I don't know if you had any thoughts on that yourself. Yeah, I think it's always a bit trickier to key into two different system because we're sort of, um, tested and selected at all stages throughout our careers in a very similar way. And so I guess the most important thing, um, I would suggest, is to find a buddy who's about your stage in the UK who's aiming for the same sorts of things, or maybe just one or two years above you can who can coach you and give you some good resources and and kind of talk you through or somebody to practice with who's also applying? Um, at the same time, I think I signed on just as you were talking Katrina, but about building your CV for a surgical career, and, um, I have a separate talk on on that if you if you want at some point. But it will have changed a little bit since I've done it as the unique disclaimer. But, um, it's basically a a tick boxing exercise. Essentially, there's it's pre, you know, you can find out in advance um, freely available information. What the kind of things are that you're marked against in terms of your portfolio. And you just need to fill all the boxes and get as many points as possible. That's what you can control in advance. And if you do, okay, I think my big take. The first time I applied, I did really badly, and my mistake was thinking that it was an interview. It's not an interview, it's an exam. And, um, it's marked subjectively. According to a score sheet, you can practice for it as revision guides. Um, you know, you get given scenarios, similar ones come up here on year on year, and, um, you need to revise for it and practice for it like it's your medical school of ski finals. You know, like it's an exam and have a really slick pattern and have things roll off the tongue. Um, you know, everything that happens in that interview is is expected, quote unquote, and so you can prepare for it. Um, yeah, my best advice, especially if you're coming from abroad because you won't have had Well, I don't know what the training is like in India. I have to say, but, um, you know the system I expect, is a bit different in terms of how you're examined. And here, um in the UK people will be much more used to having that our ski answer prepared roll off their tongue. And so if you can find a buddy who's who's doing it at the same time, practice together over facetime or over Zoom, that's, um, that's going to be really valuable for you. Great. I'm conscious of looking at the time both for yourself after work and for everyone watching, um, or there's one quick, we'll make this the last question. Do you have a Absolutely. So this is true in any, um, specialty. Um, uh, you train, you apply through national selection, and then you rank what degree or region you want to be in and depending on your score at national selection and your rankings, then you get kind of placed into a region. The regions are all different in terms of how big they are geographically and how many hospitals they encompass. And I think that's quite an important thing to look into. If you have the luxury of being able to kind of get your first choice to think About what? Um, what's important to you. So I, um, was desperate to stay in London, and I didn't get a London number. I got a number in the Southwest, and, um, I absolutely love Bristol. And we really made our home there. And I can I can imagine a better place to work long term, um, or to or to train in lots of ways or to live. However. Um, So I'm not sad that I didn't train in London. Um, but the southwest for plastic surgery encompasses Bristol Extra in Plymouth. So you're likely to be two years in each hospital? Not necessarily. It depends a little bit to the program Director is, at the time the A one c, uh, like, and Bristol not familiar with the geography in the Southwest is about 100 miles from, uh, sorry. About 80 miles from Mexico, 120 miles from Plymouth. So it's huge and you can't commute realistically between three. Um so that means moving. And Plymouth is really far away from everything. There's no airport implement. The trains are infrequent down to heaven. Absolutely beautiful, beautiful nature. You're on the coast, just surrounded by areas about standing natural beauty dark, more ex more You're on corn was doorstep. It's gorgeous. But if all of your friends and family are in London or abroad like mine, then being in Plymouth makes it very difficult to, um, to keep in touch with people that are important to you. And that was difficult for me. Um, and the moving around is difficult for me. Um, particularly because you tend to be doing your red training at a time in life when you want to settle down and have some stability and buy a house and get married. And, um, you know, maybe have babies or whatever you know, set down roots in whatever way that you want to do that. Um, so I think that that geography can be difficult. However, it's different in every day. Energy. So, for instance, one C is a plastic surgical unit that is stand alone in Wales, and you would spend your entire six year training program in Swansea if Wales floats your boat and you don't want to move around, so that's a really good one. There are Diener ease that are better than others. Manchester is pretty good for being communicable to everywhere. Um, I think and Oxford is terrible because it includes, um, Salisbury and, uh, another unit, which is escaping me right now. Portsmouth. Um, so, um, that is more difficult. Um, and they tend to I think they tend to have you in your junior year's and Portsmouth for a year. And then they move you back up to Oxford and try not to move you back down again. But I think it is. It can be very disruptive to your life and your training. So it's definitely something worth looking into if you if you do make it as far as the plastic surgery to look at the different sceneries and see what the geography is like. Um, there was another question of data about the average age of people that get into see ST and then ST three. I have a feeling that everyone that's much more experienced than me in two years, let's say, um, they are moving much towards more towards, um, getting people straight into registrar training from core training. Uh, and that's in part shown by they penalize you rub it on your application form for having more this combination training. Um, so I don't have any data about the average age I went straight through, so I, um, had a gap here, Sort of. Not really. But anyway, I started started my undergraduate training age 19. And then, um, I did an f Y three and then went into core, uh, and then went straight from CT to into s t three. Um, and a lot of my colleagues were similar. A lot of my colleagues also were a lot older because they've done PhD s. But I think you shouldn't be put off by that. Um, if you're ready, you're ready. And if you don't fancy doing a PhD for any particular reason, then please don't do one just for the portfolio points. It's a real ton of work to take on just like three points in your CV. Um, and it so it really does, you know, sort of delay, delay your progression. Unless you have a particular interest in an academic career and already know what PhD topic. A lot of research. Yeah, the thing I was going to say. There's definitely varied age group of people that I'm currently working with. So there's people that you know have gone straight into medicine immediately at 18 and have got a core training number straight out of an F two job. Um, and then equally there's people that I know that you know, on the on the registrar rotor haven't done core training but have met the criteria through experience, um, and are now applying for ST three numbers. So there's different ways, as they say, to skin a cat. And I would say, Take the path that suits you. Don't be too bulldozed into doing it the way the textbook shows you equally the same as taking less than full time training. They don't put that in textbooks. But actually, you know, you've got someone here speaking tonight that's got, you know, working on a fellowship job. One of the best places to do plastics in London. Um, so you have to debate things and, you know, look after yourself and do what suits you. Don't don't throw yourself too much into your job at the expense of everything else, is what I would say. Definitely. There's so many different ways of doing doing your career and doing life and Yeah, I think we as medics are kind of get stuck on what the path is and their roots in the bladder that you have to kind of step up, but and there's lots of ways around it. I you know, I wasn't 100% sure what I wanted to do out of f two. I didn't really get any, um, higher training jobs that I really wanted, Um, in the places that I wanted. And so I did an F three, and it was still, I think it was still my favorite year of my career so far. I was, Yeah, just reinvigorated. Inspired, um, and, uh, sort of figured out what I wanted to do and really built up my C b and ended up reapplying. Of course, surgery the next year. And I got my number one, um, Joyce job. So, um, definitely think. What are you doing for your F three Katrina I'm doing to us? A drink at Saint Thomas is, um, and probably similar to yourself. I applied to core training enough to I was telling this group earlier on that I sort of made a decision for surgery quite later on. I think When I met you last year, it was sort of when I decided that surgery was for me and sort of spent my life to applying again. Thought at the interview. It's an interview and it's definitely not an interview. And, you know, you can get in the core training. You can get a point toble, but you're not ranked high enough to really get a job. And that's what happened to myself in the last year. Um, and actually, you know it does. It does not give you confidence like anything in medical school when someone says no. Oh, no. But actually, it's probably worked the best for me because I've got to do a job in a hospital with a team that I love. And actually, you know, I think a lot of us are feeling quite burnt out anyway. Post Cove ID And so I'm actually getting to get, as you said, inspired again, um, and then re applying this year and let's see what happens. And if I don't get it, that's fine. Um, I will get a surgical job way and yeah, I think it's important to to see different people's ways of getting there and and, you know, it's like I'm having a good time for sure. Awesome. That's, um that's what I like to hear. I think three is such a nice opportunity to to do just that. And that was exactly what it was for me. So I had exactly the same thing. I sort of didn't really get the jobs that I wanted. I didn't, you know, didn't, um, wasn't really successful Interview as an F two and, um uh felt like a bit embarrassed, almost like there's medics are so used to never failing everything. And we kind of made it all the way through school and the medical school. Um, you know, many of us, you know, hadn't ever heard that before. And I think I have a light into what I wanted to do but my CD up in a really constructive way and was inspired to follow the path that I've gone down so well, I think we should cut it there for the sake of all of us. And I think this evening has been really useful for myself, selfishly having here as a speaker. And I'm really grateful for you coming, especially after a busy day at work and and seeing your lovely little one. And I thank you everyone who's doing this evening as well. And I really hope you join us for the rest of the series on Monday. We've got a core training. Well, she's now on S t three. He's just finished core training. Who? If you've got more core training, specific questions, she can definitely answer that for you. I'll put the link now in the chat. Um, and then you all get some certificates. At the end of this, they'll get an email to you. And also there's some feedback which hopefully then we can give onto our speaker's that they've got something for their portfolios. Because even when you register on a consultant, you're still collecting feedback. All right, well, thank you so much. Thank you, Susan. And I hope you all have a lovely evening. Okay, Thanks so much for having me. Thanks for coming by.