As the year draws to a close, many of us are wrapping up medical school placements, moving through different hospital rotations as junior doctors, or even taking some well-deserved time off before the new year begins. Whatever stage you are in, the last few weeks of December are usually used for reflecting on the current year and preparing for the year that's to come. One way I will be doing this is by resting and recharging in preparation for the exciting year ahead!  I think it's important that we all take this time to rest and recharge, but also ensure that we have a clear understanding of the definition of resting and recharging and what that means for us specifically. What does resting and recharging mean to you? Take a moment to reflect on your personal needs! Resting is done usually when we are tired. Rest becomes necessity when we have completed actions that have depleted us physically, emotionally, mentally and more. I see rest as something that should be regularly done in your routine, meaning at least once a day (hopefully more!) you are intentionally taking the time to cease from work and the business of the day in order to relax. Rest isn’t just about recovering from tiredness; it’s about building resilience and preventing burnout. Regular rest is shown to improve focus, boost creativity, and even strengthen the immune system. Think about how you feel after a good night’s sleep or a peaceful moment of quiet - hopefully your mind feels clearer, your energy is renewed, and you’re better equipped to tackle challenges. So, I would say that whilst rest can seem like a luxury; it’s a necessity for sustainable success. For me, the best way I love to rest is: sleep!  A nap hates to see me coming! Sleeping is a vital part of human nature therefore for me, ensuring that I sleep for the correct amount of hours in a day, or even take a nap when my body calls for it, means that I tackle each day being as rested as I can possibly be. As well as resting, it is important to recharge! Especially as we are reaching the end of the year and have worked so hard this quarter, it is important to refill our batteries and regain the strength and energy needed to continue again. Most of us have phones, and, as we know, the best way to recharge a battery is to plug it in and leave it alone! Therefore, I see the best way for me to recharge is to take some time off!  If this means for you scheduling some annual leave at the end of the year, booking a holiday, or even turning off your phone, refusing to check emails, and shutting off for some time—go ahead and do it!  Recharging looks different for everyone. If you find joy and gain energy from meeting up with loved ones, or perhaps you recharge by going to the gym or spending time in nature, everyone has an activity that restores their energy and passion for life.  Take some time to experiment with different approaches and find what works best for you.  It is so important to take the time to refuel ourselves before stepping into the new year, remembering that we are not machines but human beings naturally built to rest and recharge. Whether you need to rest, recharge, or both this winter break, be sure to set aside some dedicated time for yourself! Think about ways in which you personally enjoy resting and fit it into your schedule before beginning the work on the great plans and goals set for 2025. Take a moment to schedule your rest and recharge time today—your 2025 self will thank you!

This year our theme for Black History Month (BHM) is Reclaiming the Narrative - an opportunity for every member of the Black community to take part in shaping how our stories are told and ensuring that the complexity of our experiences is fully represented. In this blog, we aim to understand the root of the current narratives surrounding Black medical professionals and patients, and advocate for a new, empowering narrative that truly reflects our contributions and challenges in the NHS and wider healthcare organisations. It's essential to recognise that the experiences of Black patients and doctors are not monolithic; individual narratives vary widely based on factors like socio-economic status, geography, and personal circumstances. By incorporating diverse stories and testimonials, we can paint a more accurate and nuanced picture of the challenges and triumphs within our community. Reclaiming my Health: The Narrative on Black Patients Black patients have historically been subjected to systemic biases that have distorted their healthcare experiences and compromised the quality of care they receive. These deep-rooted issues have created barriers to equitable treatment, highlighting the urgent need to reclaim and reshape narratives around Black health and well-being. As someone invested in this field, it's painful to witness how these deep-rooted issues continue to create barriers to equitable treatment. Historically, black patients have had to endure a challenging healthcare experience due to silence, mistreatment and unmet needs. Biassed diagnostics, disparities in treatment, dismissed concerns and minimised pain has shattered the patient-provider trust leading to hesitance in seeking care. There must be a shift in narrative, a focus on movements that empower black patients to advocate for their health and mental well-being. We applaud the initiatives that are aimed at increasing awareness of conditions that are rampant within black communities. These initiatives, such as Black Minds Matter UK, give all black patients the ability to tell their stories, to illuminate the disparities in their perception of pain and health outcomes - to truly be heard in a system that systematically ignores their needs. If this silence within healthcare is not addressed, it leads to unwanted outcomes, greater risk of misdiagnosis or inappropriate treatments. The challenges Black individuals face in accessing mental health services are rooted deeply in systemic barriers and cultural stigmas, as shown in a qualitative study from Southeast England. This study detailed two major themes that influenced access to mental health services. The first was the inability to recognise and accept mental health problems, and the negative perception and social stigma against mental health. Moreover, the inadequate response to mental health needs as well as the lack of understanding and sensitivity to cultural differences towards black services users and the lack of awareness of the different services was highlighted. There is a dire need for improving information about services and access pathways, with healthcare providers being provided relevant training and support in developing effective communication strategies. This can be done by developing resources in multiple languages and training being provided specifically on cultural sensitivity. The information on access pathways should be given in a format that explains the process simply and step-by-step. Moreover, regular opportunities to give feedback should be introduced so that patients have the opportunity to have their opinions heard and acted on by providers refining their communication approaches accordingly.  This study highlighted to me the need to reshape the narratives around mental health, to encourage open discussions about the topic in black homes, communities and in the hospital to destigmatize seeking help. Moreover, I find it essential to promote culturally relevant mental health resources to ensure Black communities are aware of where to seek support, allowing them to navigate the healthcare system more effectively. By reclaiming narratives around mental health, we can create a more inclusive dialogue that de-stigmatises seeking help and addresses the specific needs of Black individuals. I believe that us as black medics have a crucial role to play in this by leading these conversations, advocating for mental health awareness, and being visible examples of the importance of seeking support. This shift is critical for encouraging greater engagement with mental health services and empowering communities to take control of their mental well-being. Overall, I believe there is a need to reclaim the negative narratives that form the experience of black patients in healthcare. The empowerment of black patients and an increase in education and awareness of their rights and services available is essential to address their needs and how they are viewed. Moreover, culturally relevant training for healthcare providers is crucial for improving communication and trust between patients and their doctors. To address the disparities in healthcare outcomes, all black patients should be encouraged to share our stories and challenge existing biases, in this way we can advocate for our own health which can lead to systemic improvement in healthcare practices and policies. As we explore the barriers that Black patients encounter in the healthcare system, it's crucial to recognise that these challenges extend to Black medical professionals as well. Reclaiming My Profession: The Narrative on Black Doctors We will also take a deep dive into the narratives that have been placed on black doctors in the professional environment. We will look at challenging the negative historical perceptions to promote equity within the medical field. As a Black medic, I've seen firsthand how deeply ingrained stereotypes can affect not just my career but my daily interactions with colleagues and patients. Throughout time, black doctors have been perceived as less competent or qualified than their white counterparts. These harmful stereotypes persist within medical institutions such as the NHS, undermining the confidence and credibility of black professionals. Moreover, as a black medical professionals, we often experience mistrust and scepticism from our patients solely based on the colour of their skin. This can lead to a breakdown in the patient-doctor relationship further complicating our ability to, as black doctors and medical students, provide effective care. From microaggressions to overt racism, these experiences of racial discrimination faced by black doctors can create a hostile work environment leading to stress and burnout which can ultimately impact career progression. It was reported that black surgeons were 27% less likely to be promoted than their white colleagues between 2016 to 2020, with black women being 42% less likely. As someone navigating this field, these numbers hit close to home. It’s disheartening to know that even with hard work and dedication, many Black doctors may likely face significant barriers to career advancement. For me, and for many of my peers, the lack of Black representation in senior roles is more than simply a statistic but impacts the way we see ourselves and our future in medicine. Initiatives such as the Melanin Medics SurgIn: The Lewin Programme have been pivotal in supporting black medics reach these career milestones. A lack of black representation in higher roles within medicine can cause a suffering in treatment of patients, when those in charge don’t reflect the diversity of the population, important perspectives are often left out of the conversation.   In this case, it is thus crucial that we, as black healthcare professionals and students, share our personal narratives to highlight the experiences of racism and discrimination within this system but also flip the script and showcase the stories of black doctors who have successfully navigated their careers despite barriers, serving as role models for future generations. It is also crucial that representation of black doctors in leadership positions is increased, with increased efforts to create a more inclusive environment where diverse voices are heard and valued. While it's crucial to address systemic issues and challenges faced by Black patients and doctors, highlighting success stories is equally important to inspire hope and resilience. In my own journey, seeing Black professionals make strides in medicine and witnessing the impact of community-driven health initiatives has been a constant source of motivation.  Celebrating achievements within the community, such as advancements in health initiatives or notable contributions by Black professionals, can motivate others to engage and advocate for positive change. Sources Black surgeons ‘promoted far less than white colleagues in England’ | NHS | The Guardian NHS risks losing black and Asian doctors over ‘intolerable’ racism levels – report | NHS | The Guardian ‘I know what racism is’: Black doctors detail their experiences of discrimination in the NHS | ITV News Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England | BMJ Open Breaking the Silence: Black Women’s Healthcare Struggles | Psychology Today United Kingdom Most black people in UK face discrimination from healthcare staff, survey finds | The BMJ   https://www.blackhistorymonth.org.uk

This month is Movember, a time dedicated to celebrating men’s health. During this month, it is common for men to shave their facial hair at the beginning and let it grow throughout the month. One thing I love about this movement is learning that the moustache symbolises a healthier man - a symbol for advocating for healthier men across the globe. By letting their facial hair grow, it sparks conversations about Movember, which should then lead to discussions about the charity's cause. Movember also shines a spotlight on critical issues like mental health and suicide prevention. By sparking conversations, the movement encourages men to open up about struggles they might otherwise keep hidden, creating a culture of support and understanding. I believe that it's important that we all understand the reason and the need for Movember as we must all advocate for the health of men globally. The life expectancy for males across the globe is 5.9 years less than for females. This is due to a number of factors, from our genetic and hormonal differences, to increased likelihood of chronic illnesses and less beneficial health-related behaviours. For example, men are more likely to suffer from cardiovascular diseases, be obese or have a poor diet. Additionally, some men are less likely to seek prompt medical attention which can lead to delayed diagnosis of their conditions and even worsen their outcomes. For me, I question why these statistics are true. One aspect I believe plays a part are the societal norms around masculinity which may discourage men from discussing physical and mental health concerns. From hearing statements such as ‘men don’t cry’ and being told to be ‘tough’ in hard situations, some men may experience barriers in reaching out concerning things that may be affecting them. This is why I see it as important that Movember is in place as the script must be flipped and the health challenges that men go through must be addressed. We must also play a part in breaking apart these stigmas and creating spaces within homes, healthcare, relationships, workplaces and more for men to be more open about their healthcare concerns.  So, here are three actionable steps to support all men facing physical or mental health challenges: Create a safe space for open communication Normalise seeking help by sharing information about therapists, support groups, or health professionals. Share and suggest healthy lifestyle habits ; activities like exercising together, eating healthy, or engaging in hobbies - all activities that support wellbeing. This should not only be addressed in November but at all times and in all situations. So, as healthcare professionals, siblings, friends, parents and more to all men across the world, I urge you to take part in being an advocate for men’s health, making it a priority every day. Together, we can create a lasting impact that promotes healthier lives for men everywhere. Here are some opportunities and groups that focus on bettering men’s health and wellbeing! Mental Health Foundation: Our work on men’s mental health   Movember HeadsUpGuys Movember isn’t just for those growing moustaches—it’s an opportunity for everyone to get involved. From organising fundraising events to simply checking in on the men in our lives, there are countless ways to contribute to this vital cause and help create a lasting impact on men’s health worldwide. ​ Sources used: Provisional Life Expectancy Estimates for 2021. Movember

This year’s theme for Mental Health Awareness week is ‘Movement: Moving more for our mental health so this blog’s focus will be looking at movement at work, which particularly will be poignant to those of you who work in hospitals. Have you ever looked at your step count when you’re at work? I went back to look at my step count when I was on my general surgery rotation - I was doing between 10 - 15,000 steps per day on my on-call block! In medicine, we often talk about this golden phrase “work-life balance” which, don't get me wrong, is incredibly important, but I found my experience, particularly when transitioning to F1, really difficult to balance exercise with work. To be honest, I felt really guilty that I was not putting aside the time to go to the gym as frequently as I would have liked. Now, I try to go at least once a week and give myself bonus points if I feel like doing more or instead go for a short run when the weather is behaving. I was always inspired and jealous of  gym influencers waking up at 5am to slip in a workout before work, but honestly I found myself to be too exhausted needing a longer sleep before work but then too tired to do anything else after work.  So thinking back on this theme helped me reframe my thinking behind moving for mental health because automatically we can assume that means intense exercise but actually that is not the only way to move our bodies. “We know that even the thought of starting “exercise” can be off-putting to many people and that’s why we’re focusing on movement to make you feel good. At a very basic level, physical activity means any movement of your body that uses your muscles and expends energy. One of the great things about moving more is that there are possibilities to suit almost everyone.” - Mental Health Foundation There are many ways which we can move more at work - here are five simple tips: However, the point is any movement is great and as Mental Health Foundation have noted this is not an exercise campaign as this can be a triggering message for people with experience of disordered eating/ exercise addiction. If you are worried that you or someone you care about is exercising excessively or causing harm, please visit BEAT for further information and support. You may find that you do this automatically anyway without realising and that’s great! I hope this blog helps you realise even the small steps in your day counts as movement. Working in the NHS is no mean feat so these little snippets of energisers can make all the difference for your mood and energy. #MomentsForMovement Written by, Dr Ellen Nelson-Rowe, Melanin Medics Blog Lead Further resources: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/be-active-for-your-mental-health/ Why not check out our previous wellbeing blogs? https://www.melaninmedics.com/post/nurture-your-wellbeing-maintaining-a-work-life-balance https://www.melaninmedics.com/post/balance-~-hitting-the-gym-vs-hitting-the-books https://www.melaninmedics.com/post/burnout

All things UKFPO Before we tackle the focus of this blog with some tips and tools for ranking foundation programme jobs, it is apt to address the key changes to the UK Foundation Programme this year, including the allocation process move to Preference Informed Allocation (PIA), where applicants are assigned a random computer based generated ranking. This compares to previous years whereby ranking scores were comprised from academic performance (EPM) and the situational judgement test (SJT). A key aim of PIA should theoretically result in more applicants being allocated in their top 5 choices. However, despite UKFPO involving stakeholder engagement before implementation, this new system has come under criticism with removal of security for applicants and reports of deanery allocations in unwanted bottom choices. Furthermore, from 2025, it should be noted that the PIA system will also apply to the Specialised Foundation Programme and may have considerable impact on the future of clinical academia. We will be writing an up-to-date application guide for 2025 entry as further information is released so do look out for this! So how does preferencing work after deanery allocations? The preferencing process either occurs as a one-stage or two-stage process: One-stage process = rank all of the foundation jobs in that deanery Two-stage process = firstly rank groups within the deanery (usually divided by trusts or further breakdown of regions); secondly after being assigned a group (with the same computer generated ranking) then rank all of the foundation jobs within that group Many of the larger deaneries have moved to the two-stage process which significantly cuts down the workload for applicants and technically should allow for more specific location preferencing. Then by mid-April, all applicants will find out the exact job they have been matched to; and the registration and employment checking process begins! So where to start with ranking your jobs? Firstly, it is well worth downloading the list of jobs in a spreadsheet so you can scroll through them easily rather than navigating individual details for each job manually on Oriel. You can do this by selecting “Click here to download preferences in an Excel compatible file (.csv)” under the programmes preferencing area on Oriel. Alternatively, lists of jobs can usually be found on the individual deanery websites but Oriel will have the most up to date job information. Note that most jobs will be listed 3 times due to different rotation orders (e.g. 1a- Cardiology, General Surgery, Paediatrics; 1b -  General Surgery, Paediatrics, Cardiology; 1c - Paediatrics, Cardiology, General Surgery) so make sure you start by organising in terms of the overall rotations in each job, THEN look more closely at your preferred order in what rotation you would like to start on - we will tackle a bit more on rotation order later on! Next, you need to think about your priorities! Everyone has different priorities and there are multiple factors you may want to consider when ranking jobs. Click each dropdown to read more: So does the rotation order of foundation jobs really matter? There are different opinions on this. Technically no, because at the end of the day you will get to do all 3 of those rotations in one year no matter what, but there are some factors you might want to consider. Click each dropdown to find out more: Tools to help you with ranking Whatever method you use to rank, make sure to give yourself time to review a couple of times before you add them in on Oriel - sometimes a fresh night’s sleep can give you a different perspective! It is wise to rank ALL of the jobs in the deanery group you have been allocated to increase your chance of preferred choices. We hope you find this advice useful and all the best for your future job allocations! We will be updating our application guides across aspiring medics, medical students and doctors content this year - do not hesitate to reach out for blog requests! Written by, Dr Ellen Nelson-Rowe, Melanin Medics Blog Lead

As we are coming into the end of the first month of 2024, we thought we would take the opportunity to introduce our new team members who have recently joined our organisation. Melanin Medics would not be able to continue to uphold our various streams of work without the dedication and generosity of our volunteers so we are incredibly grateful to them!  We proposed to them a challenge of describing themselves in 3 words and have shared some of their responses below! New Members: Communications Team From left to right, Emma Brew - FY1 (Secretary), Faith Lambo - 3rd year medical student (Social Media Officer), Funmi Asekun - 5th year medical student (Social Media Officer), Ellen Nelson-Rowe - FY1 (Blog Lead) We are delighted to have 4 new members to our Communications Team. They are looking forward to seeing Melanin Medics continue to extend their reach and create new events adapted to current demand, and continue to foster an even greater and more connected community of young black medics through nationwide events and our social media presence. Emma has a career interest in dermatology and medical education. She describes herself as “introspective, reliable and sensitive”, also astutely recognised by 16personalities test!  Funmi has interests in ENT, Paediatrics and OBGYN. She describes herself as “curious, caring and diligent” as she loves exploring new things especially through travelling and hobbies and her determination: “once I set my mind to doing something, I want to do it and do it well! (or at least, learn how to do it better!)”.  Ellen is an aspiring ENT surgeon who describes herself as “empathetic, efficient and extroverted” - alliteration intended! Ellen says that her outgoing, eager nature has helped her to network widely and meet people from all streams of life which has nurtured her ability to relate to others and adapt to working with others effectively. New Members: Academic Team We are delighted to have 2 new academia officers: Kwaku Duah-Asante (FY1) and Michael Atife (3rd Year Medical Student). They are excited to see they can support the research network to help students and doctors alike through webinars and blog posts. They are both passionate about diversity and “hope to do their part in making the lecture halls of tomorrow more diverse by helping the next generation get a foothold. No black talent should be lost for lack of guidance” Michael describes himself as “outgoing, enthusiastic, cheerful. I like to seize the day with a smile on my face!” New Members: Programmes Team We are delighted to have 2 new members to our programmes team: Giulia Olayemi - Outreach Officer (Final Year Medical Student) and Patricia Ogunmakin - Education and Training Officer (Enrichment Programme) (Core Anaesthetics Trainee). They joined Melanin Medics to provide others in a similar position with the help and support they wished they had received, and to be part of a network of incredible Black Medics! Trish describes herself as “motivated, passionate, resilient. All three are needed to overcome adversity and I strongly believe with these skills, you can achieve anything you wish to!” New Member: Events Team We are delighted to have Ginika Okaka  join our events team. She is a 4th year medical student with interests in Obstetrics and Gynaecology, Paediatrics and Global Health, who joined Melanin Medics to help promote diversity in medicine. Representation in healthcare matters and factors such as socioeconomic background or race should not be an obstacle to becoming a doctor. She describes herself as “curious, open and kind” - “I love asking questions and researching things that pique my interest.I'm open-minded and outgoing. I like to try new things and get out of my comfort zone often. My favourite quote is that people may forget what you said or did but will never forget how you made them feel!” New Member: Advocacy Team And last but not least, we are delighted to have Naomi Ehigie join us as an advocacy officer who has previously supported our enrichment programmes events. She is a current FY2 and has interests  in medical education and widening participation. She is excited to channel her skills into bridging gaps and nurturing future medical leaders with such a talented team. We are incredibly excited to see what they will participate and achieve with us in 2024, under the direction of our chief executive Olamide Oguntimehin and Directors who have recently undergone a new structure you can read more about here. I look forward to writing and hosting guests on our blogs for the rest of 2024! Dr Ellen Nelson-Rowe, Melanin Medics Blog Lead

Annually in November, we see men compete to grow impressive moustaches to fund raise for Movember - the leading global charity for men’s mental and physical health, particularly for prostate and testicular cancer. We thought we would contribute to raising awareness by interviewing Mr Jonathan Noël - consultant urological surgeon, based at Guy's and St Thomas' NHS Foundation Trust. He also leads in prostate cancer diagnosis at Lewisham and Greenwich NHS Trust for the South East London Cancer Network. He is a double robotic surgical fellowship trained urologist and performed an excess of 100 robotic procedures in his first twelve months as a consultant (which is impressive compared to the average UK surgeon performing 46 per year!). He was born in the UK, then raised and attended medical school in the Caribbean. He is also a third generation surgeon, his father practices in the island of Grenada! You can find more about his work on his website. Health awareness: prostate cancer 1. What is one thing you wish everyone knew about prostate cancer? I wish people knew it has no symptoms at an early stage. It is important for families to talk to each other and understand their own risk, as a lot of people seek this out after their diagnosis. We need to see more openness and vulnerability around men and break down the “strong, mighty and never sick” stereotype - we are all human. It is also useful to know about the genetic relationship to breast cancer in families, which can also increase prostate cancer risk. 2. What are typically the most common first symptoms patients report? Most patients that present with symptoms can do so when the disease is advanced, such as urinary symptoms = haematuria (blood in urine), back pain at night and flank pain. It is important to note that it is not an old man's disease! We can see people present as early as in their fourth decade. 3. Once a patient is diagnosed, what is the typical journey to go through to get treatment? So most patients are referred by their GP following an elevated PSA above age specific normal range (blood test used primarily in clinical suspicion of prostate cancer) or a hard prostate discovered on examination. In a clinic, we go through a patient’s history, risk profile & perform an examination which is part of a clinical assessment. Next, we usually request a MRI scan which can avoid a prostate biopsy if it is normal. However, if there is an area of suspicion on the MRI, we perform a biopsy with precision to pick up clinically significant cancer, as opposed to without an MRI. If it is low risk or clinically insignificant cancer, we put these patients on active surveillance, which usually involves monitoring the PSA every 6 months and an MRI every 2 years. If it is intermediate or high risk prostate cancer, they tend to proceed to treatment which is discussed in a MDT (multidisciplinary team meeting where other specialists are present such as oncology and radiology) to recommend the best course of action such as radical surgery, radiotherapy or chemotherapy, or a combination! 4. How would you recommend men reduce their risk of developing prostate cancer? Men can get check their risk with this tool created by Prostate Cancer UK: https://prostatecanceruk.org/risk-checker Like all cancers, maintaining a healthy lifestyle is important - exercise, avoid excess smoking and alcohol consumption. These will improve a patient’s cardiovascular health as well. Actively being aware of your family history is important too, as you may be informed to enquire about PSA testing! 5. Do you think a national screening programme will come to fruition soon? At present, the UK does not have a national prostate cancer screening programme due to concerns about overdiagnosis and overtreatment. However, we should consider this carefully, as we know that “Black men are disproportionately affected two times more likely than white men and three times more likely than Asian men”. Additionally, the National Prostate Cancer Audit (NPCA), led by the Royal College of Surgeons, have discovered that black, elderly and deprived men were all less likely to receive radical treatment for their high risk disease. Important evidence we have for screening from the US is from 2012, the US preventive services task force downgraded PSA screening. However, following a surge in advanced prostate cancer presentations, in 2018 the task force recommended PSA screening discussions for men aged 55-69. 6. Tell us more about the community health initiatives you have been involved with to raise awareness Since 2019, I have been involved with an annual event hosted at a London barbershop owned by Kevin De La Rosa. It is converted into a mini auditorium and health fair complimented by cook-ups and music. It is a non-intimidating, relaxed environment to have discussions and learn a lot from patients. You can hear more about our initiative here: https://www.youtube.com/watch?v=p94UkqpyOzE This has received great support from prominent figures including Errol McKellar, MBE (60 year old football coach, former garage owner and prostate cancer survivor). Furthermore, local faith leaders such as Bishop Lennox Hamilton from Lewisham Greater Faith Ministry also hosted prostate cancer seminars in his community of south east london. I join these gatherings to speak about secondary care of prostate cancer diagnosis and treatment. I am honoured to receive perspectives on varied journeys from patients, which help us improve our service. Career Insights 1. Why did you choose urology as a career and why should aspiring surgeons choose your specialty? I’ve always wanted to do surgery and was particularly inspired by the technology used in urology. My mentor in Barbados, who I observed using a laser surgical system to treat prostate enlargement, is what sparked my decision to specialise in this field. In 2023, living in a digitalized world - technology in surgery is essential. This specialty lends itself well to balance between elective and emergency work. There are unknowns in prostate cancer, which makes it an interesting space to help build new knowledge in, particularly in respect to health inequalities. Also, you do not have to only do high risk surgery to make a difference in the field - it has everything for every career ambition. Urology offers the opportunity to make an impact with medical therapies in addition to surgical procedures. 2. What’s your favourite thing about your job? It has to be the consultation at the beginning - I really enjoy speaking to people and learning about their decision and journey to a diagnostic clinic. I also enjoy the challenges of robotic prostate surgery - no single operation is the same, yet the outcomes are so important to get right. 3. Where do you see the future advancement of robotics in urology in the next 10 years? Seeing additional specialties getting involved to improve on our robotic surgery further (we already see advances in colorectal, thoracic and ENT outcomes). It will be advantageous to see multiple specialty collaboration; when all surgeons in a hospital can use the system. For example, an iatrogenic bowel injury during prostate cancer removal and general colorectal surgeon performing robotic repair. I would like to see robot systems being more affordable, not only for developing countries, but for smaller NHS hospitals to use for the benefit of their patients. Additionally, it would be great to see smaller sized robots - at present they can take up a fairly large footprint in theatre! 4. Do you have any other final words for our readers? → We need to keep questioning the role of prostate cancer screening in the UK, particularly for groups of patients at higher risk than others. → Encourage your patients to know their risk! Use the risk checker and talk to their GP about PSA testing → I would not change my career. I encourage surgical trainees to find mentors and learn from their experiences. It gives fulfilment to mentors to support you and see you progress. → Robotic surgery is the future - everyone needs to get involved during training! We hope you have found this interview insightful! We can all play our part in raising awareness and supporting men to be open about their health. Dr Ellen Nelson-Rowe, Melanin Medics Blog Lead

In Part 1, we highlighted some changemakers of the past, who had an impact in history serving as inspirations to this very day. In Part 2, we are celebrating 'changemakers of the present and future' who are bringing fresh perspectives to what the world of medicine and surgery can offer. We are going to spotlight four esteemed varied individuals who have broken the mould of expectations within clinical medicine to pursue their passions. Let’s begin with two incredible women, seeing as the national theme for Black History Month this year is “Saluting our Sisters”. Dr Uyiosa Ogunbor Dr Ogunbor is an award-winning, multifaceted medical doctor, TV personality and entrepreneur. Her excellence shone even from medical school where she founded an organisation Medsimple - working with schools to raise aspirations and mentor students pursuing a career in healthcare. She is actively involved in healthcare leadership and management, having shadowed the CEO of a £600M NHS trust and is also a member of the NHS Clinical Entrepreneurship programme. She has also used her medical experience to educate on health topics on Channel 4 health series. Some of her other interests lie in finance and property investment where she writes a successful newsletter to provide advice. You can find out more about her in this fantastic podcast - listen here Dr Rochelle Pierre Dr. Pierre is an anaesthetic trainee following the ACCS route. She is the Founder of the British Caribbean Doctors and Dentists Association, a supportive community for fellow Caribbean doctors, dentists, and students, aiming to support each other, be involved in outreach programmes, advocate for health inequalities, and host health promotion events. Recently, she received two Caribbean Global Awards for her excellence in community health service and best healthcare staff organisation. Additionally, she serves as a trustee for StreetDoctors, empowering young people to save lives. Dr. Pierre also has a passion for music and works as a DJ at various festivals and events. Now onto the men! Mr Carlon Fitzpatrick Mr Fitzpatrick, an orthopaedic surgeon by background, is the co-founder and Business Development Director for Encode Health - a company that works by setting the standards for tracking and tracing of medical devices. Encode Health won international awards for their innovation in COVID-19. He is also the director of ‘Bee Sting Cosmetics’, a luxury natural skincare brand. He is also actively involved in the British Caribbean Doctors and Dentists Association. Dr Ivan Beckley Dr. Beckley is the CEO of Suvera, a healthcare company that enables virtual care for people with long-term conditions in the UK. His entrepreneurial background began during medical school, where he completed internships at companies, including Google's DeepMind, which sponsored and funded his MSc in Health Data Science. He was also part of the first group of UK medical students appointed as NHS Clinical Entrepreneurs. He is an esteemed public speaker on international stages and has also hosted a successful podcast: The Bias Diagnosis, where he explores health inequalities in modern medicine. We hope you have found these four spotlights inspiring, as they have and continue to make a national and global impact. It is important, however, to mention that there is often a misconception that if an achievement isn't publicly shared on social media, it is not important. We are all changemakers, perhaps in ways we don't even realise, and it does not have to fit within the constraints of clinical and academic achievements to count. A possible definition of being a 'changemaker' could be a person who strives to have an impact, no matter how big or small, in order to bring sustainable solutions, often in pursuit of their passions. What's your definition?" Happy Black History Month! (though we should all be celebrating it all year round!). Dr Ellen Nelson-Rowe, Melanin Medics Blog Lead

This year, our theme for Black History Month (BHM) is black Changemakers in medicine of yesterday, today and tomorrow. This blog factfiles esteemed doctors of the past born in the 19th century, serving as a bitesize Black British history lesson! Dr James “Africanus” Beale Horton (1835-1883) Dr Horton graduated from Edinburgh University in 1859, attributed as the second person of Nigerian descent to qualify as a doctor. He served in the British Army as a Staff Assistant Surgeon in West Africa (predominantly Sierra Leone and Ghana). This experience inspired multiple acclaimed medical publications based on tropical medicine - notably, “The Diseases of Tropical Climates and Their Treatment” is accredited for describing key symptoms of sickle cell disease contributing to its discovery. He also lobbied for higher education and medical training for West Africans. Dr John Alcindor (1873 - 1921) Dr Alcindor, of Trinidad descent, also graduated from Edinburgh University in 1899 and established his own general practice in London, becoming known locally as the celebrated ‘black doctor of Paddington’. He was rejected by the British Army to serve during World War 1 but despite this prejudice, he went on to be awarded a Red Cross Medal for his work helping soldiers at railway stations through signing up as a Red Cross Volunteer. He is also known for his research particularly in cancer and correlating poverty and diet with poor health. Additionally, he was a great advocate for racial equity and became president of the African Progress Union. Dr Cecil Belfield Clarke (1894-1970) Dr Clarke was born in Barbados after winning an island scholarship, he graduated from Cambridge University in 1918, also certified as a surgeon. He similarly opened his own practice in south London and later on in the 1950s, Clarke was elected to the BMA Council as representative for the West Indies, as well as Senior Medical Advisor to Ghana. He is renowned for being the inventor of Clark’s rule - still used globally to calculate pediatric drug dosages based on weight. He is also known for his civil rights activism working alongside Dr Harold Moody founding the League of Coloured People. Seeing as the national theme for this year’s Black History Month is “Saluting our Sisters”, it is important we pay homage to black women as well. Whilst there has been recognition of Black pioneering nurses in Britain such as Mary Seacole (1805-1881) and Annie Brewster “Nurse Ophthalmic” (1858-1902), there is little known about black female doctors during this era, if any. This is most likely due to the compounded barriers for women in the UK gaining a medical qualification. It was only in 1865 the first (white) female doctor Elizabeth Garett Anderson was openly qualified after private education with professors. However, we recognise that in 1864, Dr Rebecca Davis Lee Crumpler (1831-1895) became the first Black woman in the United States to earn a medical degree after serving as a nurse - an inspiration for us all across the globe. Unfortunately no photo of her has survived (she is often mistakenly adjoined to a portrait of Mary Eliza Mahoney - the first African-American nurse). We hope you have found these historical insights informative. What stood out to you about their profiles? What does being a Changemaker mean to you? We will explore this further in part 2 where we will celebrate Changemakers of the present and future who are bringing fresh perspectives to what the world of medicine and surgery can offer. Happy Black History Month! (though we should all be celebrating it all year round!). Dr Ellen Nelson-Rowe, Melanin Medics Blog Lead Sources: https://zodml.org/discover-nigeria/people/industry/james-beale-africanus-horton https://news.band/from-the-archives-meet-james-horton-the-1st-man-who-proposed-modern-independent-nation-for-igbos-1865/ https://www.forcesemployment.org.uk/news/black-history-month-dr-john-alcindor/ https://spartacus-educational.com/SLAalcindor.htm https://theblackcurriculum.com/blog/blackhealthcareworkers https://www.bma.org.uk/news-and-opinion/a-forgotten-hero https://www.caths.cam.ac.uk/about-us/history/black-history/c-b-clarke https://www.womenshistory.org/education-resources/biographies/dr-rebecca-lee-crumpler (All photos used - taken from public domain with unknown authors)

Sickle cell disease, an inherited genetic mutation, holds a significant place in the health narrative of Black communities. Its genetic footprint is deeply intertwined with people of African ancestry, influencing not only the prevalence of the condition but also the unique challenges faced by those living with it. This blog piece will delve into some of the challenges people with sickle cell face when accessing healthcare. Understanding the Prevalence Globally, sickle cell disease stands as the world's most prevalent genetic blood disorder, casting a profound shadow in England, where it affects 1 in every 2,000 live births, and affects 15,000 individuals living with the condition (1,2).While this genetic anomaly is not exclusive to Black individuals, it is undeniably more common within this community. This concentration is largely attributed to its historical origins in malaria-endemic regions, where a genetic mutation providing resistance against severe malaria contributed to its propagation over generations (2). The prevalence in Black populations is further shaped by complex dynamics, including heterozygote advantage, intricate inheritance patterns, and historical migration routes, particularly among African Americans and Afro-Caribbean communities (2,3). Healthcare Disparities for Individuals with Sickle Cell Disease The path for Black individuals living with sickle cell disease is fraught with intricacies and disparities within the healthcare system (4). They frequently encounter delayed diagnoses, inadequate pain management, and limited access to specialised care (4,5). These challenges are exacerbated by some healthcare providers who may grapple with fully comprehending the nuances of the disease and the unique needs of Black patients (4,5). In 2019, a global survey conducted by Novartis brought this issue to the forefront. Shockingly, nearly a quarter of painful sickle cell crises were managed at home, with 39% choosing to avoid hospitals due to previous negative experiences (6). Common reasons for this avoidance included a lack of understanding among healthcare providers (26%) and the intensity of pain (19%) (6). Unfortunately, stigma and misconceptions about sickle cell disease persist within the UK. The "No One's Listening", a All Party Parliamentary Group (APPG) inquiry report in 2021 revealed inadequate care within the UK's general hospital wards and emergency departments (4). Healthcare professionals were believed to often lack awareness, training, and positive attitudes toward sickle cell patients (4). Investment in care was insufficient, and communication among professionals faltered (4). Furthermore, racism was thought to compound these issues, with patients unfairly labelled as 'drug-seekers,' leading to dismissive attitudes and a lack of empathy (4).Disparities in care and geographical variations were also evident, particularly between specialist departments and general wards (4). The Call for Change In 2022, a national audit further exposed the alarming variations in pain management for sickle cell disease across England (5).Despite recommendations from the APPG, subsequent research by Public Digital in 2023, commissioned by the National Race and Health Observatory, continued to reveal unmet needs during acute crises, inconsistent care plans, and a reliance on family members for medication management (5). Hence, individuals in crisis were described to often be hesitant to seek help, citing a lack of trust in the care they would receive due to deficient knowledge and delayed access to pain relief (5).The lack of communication and collaboration among some healthcare professionals in hospitals perpetuated these challenges (5). However, direct access to specialist sickle cell nurses or teams was identified as a significant improvement (5). The Emotional Burden However, this battle extends beyond physical health. Living with a chronic illness like sickle cell disease exacts a profound emotional toll, leaving a lasting impact on mental well-being on individuals and families. This psychosocial aspect is intricately intertwined with cultural factors, including the prevailing perceptions of illness and healthcare within the black community, presenting a multifaceted challenge. The Sickle Cell World Assessment Survey (SWAY) in 2023 revealed that 41% of respondents experienced significant impacts on family life. Additionally, 44% reported feelings of anxiety, and a disheartening 45% grappled with depression, underscoring the emotional burden (6). The Path Forward In the face of these challenges, a resounding call for advocacy and research specific to sickle cell disease within the Black community emerges. Charities such as the Sickle Cell Society continue to advocate, support, and represent people affected by sickle cell disease (4). NHS England recently launched the campaign "Can you tell it's sickle cell?" to raise awareness in emergency care of the signs of a sickle cell crisis as part of a broader effort to improve care for patients with sickle cell disease across the UK (8).In addition to this, NHS England is also investing in a new blood group genotyping program, in partnership with NHS Blood and Transplant, aimed at improving the transfusion process for patients with inherited anemias like sickle cell disease and thalassemia (9). Conclusion This blog post has aimed to shine a spotlight on the profound impact of sickle cell disease within the Black community in the UK and the significant challenges that persist in ensuring consistent, high-quality care, highlighting disparities in healthcare access that demand our attention. It is clear that individuals living with sickle cell disease bear a substantial emotional and physical burden. However, in the face of these challenges, there is a call to action for advocacy, awareness, and dedicated research to tackle this pressing issue. Organisations such as Sickle Cell Society, along with NHS England initiatives, are making efforts to raise awareness, improve care, and provide essential support to those affected. As we look to the future, we hope that continued efforts, increased understanding, and unwavering support will lead to a more equitable healthcare landscape for individuals living with sickle cell disease in the UK, ultimately enhancing their quality of life and well-being. Written by Dr Oby Otu Enwo (Public Health Academic Clinical Fellow in East of England) References https://www.hematology.org/education/patients/anemia/sickle-cell-disease#:~:text=Approximately%2070%2C000%20to%20100%2C000%20Americans,the%20production%20of%20abnormal%20hemoglobin. https://cks.nice.org.uk/topics/sickle-cell-disease/background-information/prevalence/ https://www.hematology.org/education/patients/anemia/sickle-cell-trait https://www.sicklecellsociety.org/no-ones-listening/ Lugthart, S., Kotsiopoulou, S., Lumani, A., Eleftheriou, P., Drasar, E., Brown, R., Webster, A., Chakravorty, S., Stuart-Smith, S., Velangi M., Atoyebi, W., Howard, J., and Telfar P. Acute and chronic pain management in sickle cell disease: Outcomes of an Englis national audit. Hemasphere. 2022 https://www.novartis.com/news/media-library/sickle-cell-world-assessment-survey-sway-results Hemasphere 2022. Black sickle cell patients’ lives matter: healthcare, long-term shielding and psychological distress during a racialised pandemic in England – a mixed-methods study https://www.england.nhs.uk/blog/can-you-tell-its-sickle-cell/ https://www.england.nhs.uk/long-read/new-project-to-blood-group-genotype-all-patients-living-with-sickle-cell-disorder-and-thalassemia-launched-by-nhs-england-and-nhs-blood-and-transplant/

Oyindamola Adeniyi, a 4th year Medical student, and a recipient of the Diana Award 2023 shares her tried and tested tips on how she masterfully balances the many hats she wears. "How do you balance everything?" is a question frequently asked, and for good reason! As a medical student, social entrepreneur, mentor, and volunteer, I have embarked on the journey of honing the skill of managing multiple projects simultaneously—a journey that is still ongoing. Within the realm of medicine, where the workload is demanding and stress levels run high, it can often feel like there is little room for anything beyond the confines of the profession. Over time, I have discovered that by diligently applying specific strategies, we can empower ourselves to assume various roles and develop layers of identity that go beyond the stethoscope. Oyindamola Adeniyi is a 4th year medical student, mentor, strategic communications officer at MelaninMedics, co-founder of the Black Excellence Network and a worthy recipient of the Diana Award this year. With all things considered, we must ensure that we look after ourselves and put our mental well-being above all things – remember that by investing time to rejuvenate your spirit, you enable yourself to give generously from a place of abundance. Ultimately, wearing multiple different hats alongside medicine is no easy feat – it requires discipline, structure, and a clear understanding of your 'personal why'. According to James Clear, the author of Atomic Habits, "...the person who builds better habits gets better results. It's not the outcomes. It's the inputs." A practical framework and consistent effort will enable you to diligently manage your work, studies, and projects while avoiding excessive stress and burnout. With these elements, alongside the guidance provided above, one can embark on the journey of mastering the balance between external projects or side hustles and a thriving medical career.

We spoke to Dr Robyn Anderson about her experience as part of the first cohort of participants to join SurgIn: The Lewin programme. Dr Robyn Anderson is currently an F3. She will be a CT1 come August, having secured a general surgery theme post. She will start in cardiothoracics, moving to plastics surgery, and then general surgery for the rest of her time as a core surgical trainee. Why did you join the SurgIn programme? So I'd always known about MelaninMedics, and I saw it on the Instagram and I thought, It sounds really weird - but I'd actually had a similar idea earlier in the year before I saw the application. It was because I thought that there's not really like an official mentoring or support system for black medics, especially in surgery. I knew that a lot of what MelaninMedics had done was with medicine, but I hadn't seen anything like it for surgery. So initially I was just like, I'll give it a go and do the application and see. But actually I think it was almost craving to be around other black people with my same goal because everyone else that I knew bar like one of my friends - either didn't want to do surgery or was white. So just to have a place where I could air those frustrations, learn from people who have probably been through and thought through the same processes that I was going through at the time - I thought was really good. And I think it was also appealing because it wasn't a massive commitment, but I felt like what they advertised I could get quite a lot out of because it was only like 4 or five sessions throughout the year, which isn't a lot to make. But I thought that if it was what it said it was going to be, then I would get a lot out of it. What sort of things do you feel black doctors who want to go into surgery miss out on? I think it's that element of somebody very plainly telling you this is what you need to do. I think at the leadership session that we had, I think it was Christine was talking about how we don't have an old boys club. And it's people saying to you this is what they're saying. But this is what you actually need to do. Which in surgery, I feel more so than medicine is more prevalent. I just found that people were very unwilling to - I guess I found a few registrars - but people were very unwilling to share that. I think sometimes in order to get ahead in surgery, and to plan through your path in surgery, you need to know what you actually need to do. How do you feel the SurgIn programme has prepared you for your future surgical career? I think the practical sessions that we had, like the interview sessions and the initial session to do with applications, that was quite helpful for me. Also just that inspiration of seeing people who have done it, I think for me it was a lot, especially in the East Midlands, there aren't very many black surgeons, male or female. But one thing that SurgIn has shown me is senior female surgeons in all specialties. Which is something that I don't think without that, I would have been able to see and also to have the opportunity to ask them questions and interact on like a more, not informal level, but a more comfortable level. So I'd say the practical sessions that we had were really helpful. And in those sessions, I feel like everybody was very honest, which then helped when I was doing other sessions and preparing for interviews. I didn't go on any official courses - I just did block practice with you obviously. And then, some things that my Deanery put on for free. I found in the deanery ones, they just gave positive feedback, which is great, but it's not actually helpful. I liked that in the MelaninMedics one there was obviously the positive stuff, but they gave you those little hints and tips of "You're not quite doing this right," which was more helpful I felt. On the kind of, I suppose, less hard evidence side, just having those opportunities, inspirations and people who I feel like going forward, if I had any issues or I wanted to talk to someone about it, I wouldn't feel, I wouldn't feel worried to contact people in the future. And I think it's that network that I was missing before. What is one thing you will take forward from your experience in the SurgIn programme? I would say, it's kind of a combination of two things. Always go for the opportunities that you think will fit for you, even if you don't necessarily believe that you'll get them - go for them and within that, don't think that you can't because of x, y and z. I think a lot of the people I've spoken to and the people who have done talks at the sessions, they've kind of had a 2 common themes. One is "I just did what I enjoyed and what was my passion and it worked out". So like why not go for it? Like why not You? And also that, if you work hard in whatever you're doing, people will see that and you will work hard if you've got a passion for something. I think I found it quite difficult, in probably the last like 18 months, to know what to go for, what to say no to, what to pursue. A lot of the times when I've asked in the programme, people said if it's something that you're passionate about and you feel like you can take it forward, don't let other people’s doubts about you stop you from going for something. I guess as black people, as black surgeons, as black women, we won't always have people on our side. So if you don't advocate for yourself, then who's going to? What was the most memorable event that you attended? I would have to say it's probably the last one that I went to, the leadership one. It was a really nice variety of speakers - so there was a T&O Reg, Miss Christine Mitoko, who's in Neurosurgery and then a consultant who's a respiratory consultant who's spoke to us about types of leadership and management. And he just went through a lot of things - he went through the 16 personalities. And I think I've always thought of myself as quite not an introvert, but I'm not really the person who's going to stand at the front. Because of that, I think I've always subconsciously thought that I wasn't maybe best suited to lead. And that day kind of showed me that there are different ways to lead, and even if you're not the loudest, there are still ways to put yourself forward and to be assertive and authoritative for people to listen to you, in an arena or a space where people might not want to. I think that's something that I will remember - just because it was so different and it changed my perspective completely on me being a leader and how I can impact the space that I'm in and other people. What would you advise black female doctors who are considering applying for SurgIn? This is really like corny, but do it. Just go for it. The experience that I've had in surgeon I've not seen or experienced anywhere else. I'm part of the British Society of Black Surgeons. I'm part of lots of other societies and organisations that are for upcoming black surgeons. But I think it's that in-person, like having the sessions, being there, having those conversations even just like the conversations you have in the tea breaks like those are things that you don't, I haven't seen, that you get in any other programme. I think sometimes those are the most valuable things - making those in-person connections and seeing where you can fit in. Any final words? I would just encourage everyone to do it. And I think it's about taking those opportunities when they come, but the SurgIn is a very, very unique thing to be a part of. And even when I tell my friends about it and what I'm doing, they're all like that must be really good. Because literally every time I come back, I'm driving home on the phone to my mom. Like, "Mom, you will never guess what, I'm so excited, I'm so inspired, I really want to do this." I feel like sometimes, when you're not surrounded all the time by people who are like pushing you to go for things and putting you forward for things, you need that little boost stuff so often to be like, "yes, I can do it. I've made the right decision." There are people doing it, enjoying it. It's a space where the people who come to talk to us are very honest, none of them have been like "ohh yeah, it'll be easy, it'll be fine." They've been very honest about their experience, but also been very practical in that,"Yes, it was hard. But I did this, this and this to make it a bit easier. So like if you try this way - maybe it will be better for you." Do you know what I mean? And learning from the experience of others who have been through it and also looking at surgeons who didn't take the straightforward path that everyone talks to you about, I've found really good because, I'm intent on enjoying my life. So I feel like the linear pathway that they try and shove everyone down is just not for me, and I've not, until SurgIn, I've not seen anyone who hadn't done that path, so that's also an encouragement for me. Surgery can work for everyone, because I feel like, it's portrayed as a career where you have to be like, "surgery is life" - you can't do anything else. We've seen people who have made it work for them, which is really encouraging for me.