All right, let's give it up for Abro. So hi, my name is Abro. So a little bit about me. I'm going to be a senior in high school when the summer ends. And I go to high school in San Jose, California. Yeah, that's my github and my Twitter in case you guys want to know. Okay, so I've been interested in chess for a long time. And I really wanted to create a chess engine. And since I knew Python, I figured, you know, why not? So there are a couple of ways to do this. First of all, you can theoretically brute force chess. So like just calculate every single move and every single position on the board until victory. But I hear some of you guys laughing. Yeah, there's like 10 to the power of 43 moves out there. So you're going to have a bad time with that. So conventional chess engines, therefore, they kind of quote unquote hard-coded. In terms of like a lot of there's, when a chess engine looks at a position, it'll look for certain tells like double ponds, king safety, or things like that in order to determine if the position is beneficial or harmful to a certain side. And so the problem with this, though, is that if you like strategies evolve and obviously different people have different ideas of what means what. And so this becomes really hard to maintain now because you have to keep changing this code in order to look for different tells on board in order to look for different signs of how a position is. And on top of that, these two don't work particularly well on Python because Python isn't the best language out there. So you'll see most chess engines nowadays do C++. So yeah, I'm not learning C++. So I figured, you know, why not use machine learning? So let's back up a bit. So essentially at a core chess engine is a function that converts a position into a move. So in order, the way it does that is it looks at all the possible moves a player can play and then it selects what it thinks is the best move and chooses that. But there's a problem and let me show you what I mean. So first of all, the way it does that is it uses something called an evaluation function. An evaluation function looks at the board and determines how good that position is for a certain player. So then chess engine can look at all the positions that will result from someone playing a move and then look at which is the best one and play that move. So the very simplest one is using piece weight. So I don't know if you guys know, but like a pawn is worth the 1, knight is worth 3, bishop 3.5, so on.  But let's play a game for a while. Okay, so imagine that it's me versus all you guys. So you guys are trying to get the highest number and I'm trying to get the lowest number out there. And how this works is I start at 1 and then I either go left or right to level, I start at level 0 and I go left or right to level 1. And after that you guys go left or right to level 2 and then I go left or right to level 3 and so on and so forth. So I'm trying to reach the lowest, you're trying to reach the highest. So initially it might look like the best position to play is go towards that negative 10 right there because that's a lower number than negative 7. But then if you look even further you'll see that that doesn't lead to any good results because on that side of the tree all the numbers are higher than on the other side. So if you are smart you go to the other side of negative 7 because even though it looks like that position is worse, if you look further down the line you'll see that that position is actually better. So that's the, it's something really really similar in chess because chess works in a similar way. So in order to accomplish the same feat we have an algorithm called minimax. So minimax, this is a code example, but minimax essentially recursively goes through the move tree and looks farther, a couple moves ahead and then decides like, hey is this position, which is the best position for me? Assuming my opponent plays well. So this is like, I'm not going to explain that code word line for line, but yeah that's the code if you want to like see it. Okay so back to evaluation functions, right? Because minimax still needs an evaluation function, right? Because you still have to evaluate the board even if it's 10 positions in the future. So the problem is again, as I mentioned earlier, a lot of us like handcrafted because chess didn't look for certain tells of what's a good or bad position. And that's sort of a hard coded way to do it. And as well as that you need like chess experts on your side in order to determine those tells. So if you're a normal programmer like it's kind of hard to do that. So enter TensorFlow, Google's library for deep learning. And TensorFlow is obviously a very amazing library because you can do deep learning really easily in it and it's also pretty fast. So basically I built a neural network and this is like a basic description about what it does, but essentially it'll take an input, in this case the board, and feed it through a series of layers which consist of neurons which kind of fire depending on what the input is. So then the output will be like if the position is good for you or good for the opponent. And now a neural network, essentially it requires a lot of data. You have to like give it a bunch of data of position that are good for you, good for the opponent. And then it'll tweak itself in order to match that and create a sort of a model. So yeah, to basically solve the problem. So training data. Obviously I mentioned you need a lot of training data. Luckily chess training data is really, really easy to get. So there's a file from that called PGN which let me just show you an example of. This is like a very basic example of a PGN. Oh wait, oops. Okay, whatever. Let me do this there. Can you see that now? Wait, okay, whatever. So essentially what a PGN is is, so essentially what I wanted to show you guys is that a PGN is essentially a text file. And it contains all the moves written in algebraic notation one by one. So like E4, E5, and so on and so forth for a bunch of different games. So the nice thing is since it's a text file we can open it in Python and really easily convert it into like a move that the computer knows and then feed that.  So after the grandmaster, like after somebody moves I'm assuming that that position that that results in is better for that player. So like if white moves then I'm gonna assume that that position is better for white and then if black moves then I'm gonna assume that that position is better for black and so on and so forth. There are exceptions like I look for extreme material deficits meaning if somebody's obviously doing worse depending on material I'm not gonna count it for better just because that player moved. So that results in like a really, really big training set that I can use which is really nice. So here to get into a bit more detail these are the features and labels. So the input is an 8x8 array representing the chess board and I'm storing the pieces as their words.  So essentially what that means now is that like I have an 8x8 array of a bunch, mostly 0s because most of the position on chess board are unoccupied but with a few negative numbers and positive numbers and then the output will be a one hot vector meaning like a vector in which either the consisting of two elements in which either the first one is one or the second one is one. So if the first one is one then that means it's black. If the second one is one it means white as you can see up there.  So that's the output of my whole neural network. So now I have to construct a neural network that converts that to that. So I decided to use a convolutional neural network because a chess board in some ways is a lot like an image. So convolutional neural networks do really well with analyzing images and what they do is they kind of look at different parts of the image and run convolutions on them and like kind of simplify them to look for distinct features that can be used to determine whatever is trying to determine. So specifically my neural network consisted of two convolutional layers and one fully connected layer which is just a normal standard layer in a neural network. So here's kind of the graph of it. It looks a lot prettier. So you can see that there's con 1, con 2 and then the fully connected layer as well as some other things that I generated this using tensorboard. So yeah, here's the code. I wanted to show a snippet of it. So I also use dropout and what dropout does is it tries to prevent overfitting of the model so it'll like randomly drop some neurons in order to make the thing a little more randomized so that way the model will try to fit to, will kind of generalize the situation and try to fit to what's important and not look at little bit of like the noise in every model because there's going to be a certain amount of noise and you don't want to fit to that noise. You want to fit to the essential relationship. So dropout kind of helps with that issue. Okay, so a couple of future improvements I'm going to make is number one, like right now, the thing is pretty slow which I want to show demo. I don't know if I'm going to get that to work. But basically, so I want to make it faster and hopefully I'm going to write some things in Cython later because Python is still slow with some of the computational stuff and I also want more training data. So the issue is like right now, I'm not using that much data in a PGN so like you know there's loads and loads of chess data out there so I have to like curate each one and make sure it's like actually like good games and there's a wide variety. And I also want to build features to let the chess engine play itself. So the problem with playing chess engine and playing itself initially is that it can get if it doesn't know anything initially, it can't do much. So I want to kind of get it off on a good footing with data that already exists and then have it train itself from there. Okay, yeah, that worked. So I want to show the demo. I'm not sure how to exactly. Let's try this. Oh, here it is. Okay, awesome. Okay. How do I... Let me see if I can mirror this. Oh, here. There. That's better. Okay. Now I can show you guys what I wanted to show you guys. Okay. So here's what a PGN looks like. So as you can see, it's just a bunch of like moves written in algebraic notation with some metadata with like some ones and two tunes first. So kind of have to parse this out and get rid of all the numbers and the metadata and like just purely feed the moves into the engine. So now I want to show you guys a demo. So here it is like running right here. So like if I... I don't know what move do you guys want to play? Which one? Queen. Queen? Queen pawn, D4. Okay. Take a while. Okay. So I decided that was the best move, probably because everything is like the same like initially. E4? Okay. Yeah, yeah. But the issue right now is the fact that to it since the data is not like... it's having a hard time with openings as you can see obviously with this current moves because with openings it's harder to tell whether position is good for you or good for the opponent because there's less material loss. Like for instance you wouldn't want to move an edge pawn like that like if you were a human usually but you know the computer it's all the same because you're not losing anything by doing that. For two or more moves. Yeah, exactly. Exactly, that's the thing. It still looks good like a couple moves down the road. Now if I were to play like B4 then it would probably capture it. Let's see. No. Not yet. Yeah, got it. So yeah, that works. And like if I were to play C3 I think it would still capture it but let's see. Yeah, I did. So yeah, I guess it's very aggressive. So you guys have any questions? Yeah. So first of all, thanks a lot. This is really cool stuff. When you said high school you meant grad school, right? No, I actually meant high school. Second question. Can it beat you creation and is it defeating its master yet? So I haven't actually played a game. I probably should but the thing is me now is a lot worse than like me before because I used to play chess a lot in middle school like competitively but now I just code I guess I don't. Third question. Machine learning. Like in chess it solves chess but like in the problems that we face like where are the limits for machine learning? So he's asking where the limits to machine learning? For me personally I think it's the fact that machine learning right now it still like requires a lot of effort meaning you still have to go get a bunch of data curated by hand most of the times and like still mess around with the model like for instance I had a model that legitimately was not working and I had to mess around with it and realize that the learning rate wasn't going to do it. So things like that right? I mean you're not going to make you know SkyNet happen if the learning rate isn't right right? Yeah exactly. So it still requires a lot of like human and manual effort so I would like to see in the future machine learning become smarter and more able to tune itself and more able to not maybe not select its own data but like better at getting data. So that's kind of where I would like to see it go. So that's the current limits yeah. Any more questions? Yeah. Can you get like the chess engine playing itself and beat that? Oh yeah. So you would have to make it much better that way? Yeah. So yeah it's theoretically possible. I'm probably going to try to tackle it next. So the thing is like obviously you need it to be a little good before doing that. So but yeah it is definitely possible which I'm probably going to tackle next. Any more questions? That one in the back I think. If you tried to compare this approach to old school kind of mini-max how far ahead do you think your approach thinks? Can you follow me? Yeah. So he's asking how far ahead my approach would reach compared to traditional chess engines I think? Yeah. So traditional ones would obviously beat mine right now because they're you know written in like C++ they're written in like extremely handcrafted code and whatnot but like this has the potential to do a lot better because it you know it's machine learning but as of so I do think it has the potential to beat any chess engine but as of right now obviously not. Any other questions? Oh yeah that one right there. So you're asking if, sorry what? Self training. Yeah okay. So can it update its own database that way you're asking? Oh okay. That would be interesting you'd have to write rules for that. Probably something along the lines of if I lose added to my database but there's obviously a lot of trouble with that too because some moves might still be bad. So that would be an interesting problem to tackle but as of now the database is pretty constant. Any other questions? Oh okay one over there. Oh so it does have some like in one I remember playing it and I tried to get it into a fork and it got out of that. Even though like the way I was playing like if you had taken a pawn say it would have been a fork but it didn't choose to do that. So it can do basic things because like it could look ahead and see that hey it's queen and Rook is going to get forked and that's bad news. So it can do basic things like that but as far as like sacrifices and stuff I'm not quite sure because there's some pretty advanced like queen sacks out there and stuff that you know you don't see coming in so yeah it can handle some basic strategy but I don't know about that. Theoretically there's no limit. Yeah theoretically I guess there's none.  Either if the material deficit was high then I kind of knew who to give it to like better for white or better for black meaning if white had way more pieces than black it was obviously better and if black had way more pieces than white it was obviously better but in terms of things in the middle since the grandmaster games if it's even then I chose to give it to whoever last moved because I assumed they're going to you know they're planning something tactical and they're in a good place so I'd like if white had just moved I'd give it to white even if it's even if black had just moved I'd give it to black so this approach kind of worked but it kind of didn't also so I guess the only real way to do it would be like to go by hand and decide yourself again going back to one of the limits I've discussed and where I see like machine learning has anyone else? I have a question I'm sorry okay


Let me just provide you with the context. When you look at the World Economic Forum, which was created in 1979, it was first created more or less as a convener of leaders to join for a dialogue at big conferences. But then we decided that it's not enough to have conferences. Actually what we need is to integrate people on a continuous basis into communities. And for this reason we became a membership organization and we integrated many other communities, particularly in the scientific world. For example, I see here some of our tech pioneers into the interaction of the World Economic Forum. We finally became very active in terms of shaping global thinking and we are at the origin of some basic concepts in the world.  Why is it the forced industrial revolution? Some people say, no, it's the third. Let me just recapitulate. The first one, of course, we all know, was the steam engine. The second one was the invention of mass production, electricity, the Ford T-model. The third one was the computer and the beginning of the internet. And now people ask, but isn't the forced industrial revolution just a continuation of the third? And my answer is definitely no. Why? There are four reasons. The first one is that the speed of the forced industrial revolution is mind-boggling. I started to write the book a year ago and I have to say a year ago I just remember I had to explain to a banker what fintech is. All those new blockchain, self-driving cars and so on which were considered to be futuristic became reality just over the last 12 months. And you have been at the forefront of this fast implementation of the new, innovative drive. The second difference of the forced industrial revolution is that it is not just one technology. People say, sometimes, yes, it's a digital revolution. No, it's not just a digital revolution. It is many other areas. It's brain research, nanotechnology, and I could go on and on, life sciences and so on. It's a fusion of the physical, the digital and the biological world. That's really the essence of the forced industrial revolution. Now the third change is the fact that it is a systems revolution. It is not so much a product revolution where you bring out new products or create new services. It is changing existing systems. Just think of Uber or Airbnb or of shared economy. It is not a new product, I repeat, but it's a system as such which is changed. It doesn't just change what we are doing. If you look at the first three revolutions, it made us more productive. It helped us to communicate faster, to communicate with more people, to help us in our consumption patterns and so on. But the forced industrial revolution is actually changing ourselves. It's changing not only what we are doing, it's changing who we are. Just look at the pattern today of young people. That's why I became so interested in this whole domain and I tried not to write a book which describes robots or which describes a specific technology but I wanted, in a very small book, I wanted to explain to everybody, also ordinary people who are not very much familiar with technology, I wanted to explain what does it really mean for us. I also wanted to show that this revolution at the end offers so many opportunities for humankind. It offers us to create a much greener economy. It offers us to create much more opportunities to develop our potential. Just think of the ubiquitous access to knowledge which we have and I could go on and on. But I think we have to explain to everybody that this revolution, there are some risks which we have to get under control but there are many more opportunities. And at the end, if I look very far ahead, I feel that we are at a threshold of human society. I think it gives us the opportunity at the end with the help of robots, with the help of those technologies to find a new sophistication for humanity which means a kind of renaissance to become more creative, to become more society-oriented, to show more a feeling of solidarity because it freezes from the traditional production and consumption cycles.


Okay, so I think that that's what we all want for family doctors and primary care and family medicine. So I mean, I think when I'm by no means the best person to explain about this but I think when you see this kind of diagram everyone relates, you know we do all this we're in the center of this we see this every day. Family health, community services, long term care, hospital services specialists and community resources and social services, but of course a person itself and it's and their family and all their support so you know we're in this kind of loop and it triggers us every day about what we're doing and we're trying to increase the quality of what we do on a daily basis. So that's where I think looking into all that and looking into I mean the education effort of one car. We go into education and the family doctors and I mean, I think we do this everybody does this on a daily basis educating the patients on anything this is just this is not an exhaustive list is what is close to me I guess I what I see every day based on my experience in this is all this non communicable diseases, children and education, and the underprivileged, and as a lecturer myself I do see students. Some of them become our doctors students doing their porch graduates, and some of them are actually patients as well. And I think knowledge just doesn't go one way it goes both ways as well as something very fluid and very dynamic and I learn from everyone every single day. So I mean I think a lot of us do this as well we actually educate the public on on different forms and I think since COVID happened. We've been very active online. For example, something that I wrote in when I was a trainee lecturer training family medicine in family medicine and a lot of patients were worried about their kidneys because they were thinking in other countries but it is in Malaysia. And we do talk a lot about hypertension because I think we see the majority of types of cases, and we actually get referred to cases, even from a tertiary level, most of the time. So the another just another initiative that we do as well in. This is one of my NGO health care efforts and it's called the teddy bear hospital. I'm not sure if anyone is familiar with it, but we do this in Malaysia there's a QR code you probably scan that and just save it for later to have a look. But basically what we do is we hold a pattern play where children will bring in the teddy bears and medical students are doctors, and we use that as kind of like a platform to educate children in that. And of course, we do teach our patients but in order to be able to give quality kind of education or quality information, we have to have research because it's always very, you know, changing it's evolutionizing that's the word, and information changes and the way we presented change as well.  And among the things that we, apart from teaching the patients we do support each other in terms of management, as I mentioned earlier on in terms of our patients. We also social media is a big thing here in Malaysia I don't know about the rest of the world but I think they are. It is, I've been looking through that social media for patients social media for doctors themselves acute illnesses. And I think that I think that should be looked more into this doctor's health and well being because I think that good doctors bring out better education, education and also health care to the public, and also looking after the junior doctors or the ones that are doing our steps as well. And this includes students as well and students are really big in social media as well and I do teach them my specialty which is my interest which is hypertension. I was trying. I was asking my colleagues in education department what kind of things do they think resonates with what we do in primary care and what we do as healthcare professionals. And I said well maybe it's because we don't really learn this formally, but we actually do it without recognizing it that if it makes sense. So one of the things to the story that she suggested was interest driven creativity so if you saw that I, I listed out a list of things that I was involved in and I'm sure that you guys are also involved in it. It's something that what we do what we educate and what we look into or do research perhaps is what interests us. And the theory goes is something that triggers you first so something that makes you more curious and likes it. And when you like something or you're curious about it you learn better. And the next step is immersing yourself into it and, you know, learning the activities that gives that person full attention or we teach and we try and make that person to be immersed in the activities, and of course extending it, you know, doing more activities and extending it and then it goes in a full circle. So I don't know about anyone else but when I became a postgraduate student I think I learned better. I think it interested me more than when I was a medical student because we're actually doing it on a day to day to day basis and we want to improve ourselves constantly. So another thing that she might probably kind of help me with, she showed this thing called the cone of learning. And you can see at the very bottom 90% after two weeks we tend to remember things that are 90% of what we say and do. I think a lot of things that we do is because we are actually immersed in it as I mentioned earlier. So, so when we learn from that chance to stick to us. And we remember this when we actually teach into other people, our juniors, and also our patients. I think that's all about the theory that I'll go into bore you more on the details of that. But I'm just going through my personal experience and what I've been doing and hopefully get some dialogue later on. As I mentioned, I'm a family medicine specialist so I do actually do some in GPs and also public government health centers. We also have a hospital and our hospitals like enough to have primary care there. Medical lecturer I do teach undergraduates, masters in family medicine as well and a parallel pathway which is like an examination, which is called the FRC GP in Malaysia I help with the research module there. And I'm also a health NGO activists. Some of the associations that I'm with here and have been associated with this as well. I'm also advisor to projects which is a training program for junior doctors as well. The research that I've done is obviously type two diabetes and hypertension as I mentioned early on. So for, for example type two diabetes. I look into social support and self efficacy, but I think that's what we as doctors in primary care a lot of that we do whereby social support is really important in terms of things in behavior as well I think we do a lot with behavior so self efficacy is the confidence of somebody doing or the confidence of them carrying themselves in the disease that's if that makes sense. So I, when I looked into these factors and they do their interconnected social support and self efficacy in type two so when we deal with the patients, we think about that more or look into that more. And that interested me as a young mother in a junior doctor was breastfeeding practice. And of course we found that support, and we looked into the support that they were given in the workplace, and how their self efficacy was in terms of breastfeeding, and of course that that had a very positive relation, and that was one of the things that we found out. So the project that we did in terms of, you know, looking into our practice, there was, when I was a junior doctor, we talked a lot about, you know, your ti symptoms and how when do we do here with antibiotics and things like that. And one of the scoring that we use was center scoring, or the stroke score, and we noticed it's been used in countries outside of Asia. So we did it in Malaysia and we found that it was it was quite a good tool to be used in Malaysia so we had it for that as well. Another one that we did, or my group did was making an app. And ever since COVID happened, people are more tech savvy now. We interviewed patients, we interviewed healthcare professionals, but what they thought was a good app to screen. And I found, we found really interesting things to look into when developing an app. Working with underprivileged, we did open clinics with refugees, and this was one on diabetes and how the doctors, if the doctors stuck to the guidelines. And of course this wasn't just to kind of audit the doctors, but actually to raise awareness. And this was one of the ways that we did. And of course we found that those were who stuck, those that were managed stick with by sticking to the guidelines had better HPC levels. But of course we had a lot of limitations, for example, we didn't have enough medications and things like that. But since then we've had great support and we have already have a refugee clinic going on. So that's one of the things, I think that's one of the things that helps in terms of where we do research and we look into things like this. Another one was antimicrobial with children of refugees as well. And we found that age and BMI were associated with infections and the most antimicrobial that we gave were actually deworming which were albendazol. So that I think that was no surprise there. As I mentioned earlier, social media and primary care we try and educate each other and share experiences. It's something that I think everyone struggles with. And we've tried to you know bring out awareness out there on how to do that and what what we can do as doctors. So we've written a few articles this is by this Malaysian family physician by the AFPM. They've published our article in terms of social media and primary care. Another one that we did was, as I mentioned earlier the the Tally Bear Hospital so we wanted to look into if Tally Bear Hospital was a good way of course we knew personally it was a good way. So we thought we looked into all different articles and we did a systematic review of different Tally Bear hospitals and their outcomes, and we found that it did help with health outcomes of our being. And when we do this we learn from different ways of people doing it and also we're more confident in what we do and when we promote it. We have, you know, like science and evidence. Okay, thank you so much. So, and then the other step that we did was we thought that this was a very good kind of platform to teach on prevention of sexual abuse and we did studies on that. So we did get our new doctors. We did a research on how house offices from medical students can actually be more prepared to be doctors. We found that there was a loophole and although I'm in education in the universities, you know, things don't change so quickly so we did a separate training program by NGO and training programs, and we did an intervention, especially those that traveled overseas, were studying overseas. And we found this, we did a study because people were asking us, what was the evidence and of course, we found that it was effective. Last but not least is the prevalence, lots of road pressure with doctors so we looked into it and we found significant results. There was a lot of road pressure, especially if you're a single junior and working overtime, and we found that if you nap, you're two times more less likely to be involved in a road crash injury. So these are just ideas that I want to put out there that that what I've been doing so far. And I hope to get some dialogue from from this group. Hopefully, here are my is my email and my contacts and I hope I did okay with the presentation. Thank you very much. Thank you. I am so thankful for you for this. Thank you, Dr. Anisa. I am so thankful for you for this wonderful session and this wonderful information. Can we start now with the second speaker, Dr. Helen. Dr. Helen John, a scientific assistant at the Department of Family Medicine, Sirlan University, Hamburg, Germany. Dr. Helen, are you ready? Can you see my slides now? Yes. Okay, then we can get going. Thank you for inviting me to speak here. I want to present to you a little study that we did that also has to do with education and primary care. And we focused on specialty training and how young general practitioners want their specialty training to be. And some other colleagues that unfortunately cannot be here today but I will present to you everything that we did. So, at first I will give you some information on what the trainers and institutions think about how specialty training for GPS or young GPS should look like. And as you all know, Wonka is the world organization of family medicine doctors and in Europe there's also something called URAC and that's the European Academy of Teachers in general practice. So they focus on guidelines on how GPS should go through their training and what they should learn. So we focused on a paper that was published in 2018 by the researchers, Michels, Magad and others, and they kind of summarized all information that was out there published by URAC and Wonka on how GP specialty training should look like. So they kind of summarized the trainer's perspective on this topic. So we're wondering, yeah, what do GPS so the people that are in training think about this. This is the Wonka tree you probably saw seen this before, and it just focuses on the qualities that a GP should acquire during the training so we have person centered care for example or specific problem solving skills so these are all things that you should be able to do when you finish your GP training, and they all based on these three roots you can see in the bottom, attitude, science and context. So this is basically what was already out there when we started doing our study. We used a method called the Delphi method. So it's a, yeah, qualitative research method where a small group of experts is asked on a topic multiple times and by this, you try to get a consensus on a certain topic. So at first we were starting out on the conference of the European young family doctors movement so that's the YFDM. And they usually do pre conferences for the Wonka conferences in Europe so this one was in Edinburgh. And here we do the discussion among 30 experts and the experts were young GPS or GPS that were in specialty training so they had to be in specialty training or within five years after that. So we did an online word cloud, where we asked them what do you think are the most important competencies that you want to acquire in your training and we sorted them by categories, namely psychomotor though this is everything that you do with your hands. Cognitive, this is what you do with your head or what you learn and then effective is more like the emotional side or empathy understanding others. This was the first round of our study. The second round online with the online tool Qualtrics one month later. And here we send a summary of the workshop results to our participants and ask them to rank the competencies by their importance. So they should put the most important thing first and then least important thing last. Yeah, we try to keep the same group of experts, as it is recommended in this Delphi method. And then the last stop was in last summer. Again at a pre conference for a Wonka conference, Wonka Europe in London in July. And here we had a presentation of the previous results and then we had an open discussion again with the experts and then the re ranking on site using the tool Slido. So that's an online voting tool where people can roll with their mobile phones in real time. And the hope is that we can publish these results. So the voices of young GPs are actually heard and implemented into the specialty training design. Here's a little map of where the participants came from so as all the conferences were in Western Europe. You can see it's a bit Europe centered and this is also one of the limitations of our study. We had some participants from like Eastern European countries but most of them were from Western European countries. So the numbers are the numbers of participants in the different rounds so you can see for example France and the UK are countries that are very strongly represented, whereas some other other countries in Eastern Europe are not represented at all. So that's a limitation. Now to the interesting part the results. At first I present to you the psychomotor competencies that the European GP trainees that we asked thought were most important in training. So at first we have the general physical elimination of course this is very basic without the physical examination we cannot do anything. And then we have specific examination so techniques from E&T or orthopedics. For example, then we have diagnostic tools so that would be ECG or spirometry or stuff like that. Then we have interventional skills that could be something like wound care or joint injection. So, yeah very hands on skills. Interestingly, documentation and digital skills. So how to deal with the computer since computer and digital documentation are becoming more and more important in Europe. This is also something that GP trainees wanted to learn about. And last but not least we have on site diagnostics for example ultrasound. So the results for the cognitive competencies. So the first point is maybe not that clear individualized care means that people want to learn how to take guidelines and then use them on an individual patient with different pre existing conditions. So it's really about how to apply this to like my patient. I think medication and prescribing is pretty clear so we want to learn about medication side effects and so on. The third point is basically everything that you learn in the textbook so for example what blood pressure should someone have or how much should someone weigh like numbers and that kind of stuff. Then we have mental health skills how to deal with someone that has mental health issues, how to discover them, how to treat them. Then we have imaging interpretation, especially on the countryside can be useful to interpret x ray or something like that without having to ask a radiologist. We have health systems in finance. How does the health system work in my country where can I send my patient, what will it cost to the patient for example, and this last point is, I think, also calls caused by a covert that people want to learn about infectious diseases. Now we come to the last category, which are effective competencies. And of course the most important thing is communication skills. So, for example also breaking bad news or motivational interview with me this topic. Then we have establishing a good doctor patient relationship. It's also really important to learn. Then we have interestingly managing once own well being so good like work life balance how to not burn out basically by being a GP. And the last ones are for example, with clinical quality improvement how do I provide better care in my practice. When I have someone that I don't get along with for example, teamwork and time management also very important in a GP practice and the last one is sensitivity to what differences for example, being sensitive with topics like gender or patients from different cultural backgrounds. So we found basically that some of these topics are also represented in the publications by Wonka. So, the things that GP trainees want aren't that far away from what Wonka suggests. We felt like or the data show that especially the area of effective competencies so communication skills and also taking care of oneself, not very much covered in GP training in Europe yet. So it would be nice to have this covered a little bit more. And we also want to keep the study going and have some follow up research, especially on effective competencies planned for Wonka conferences in Brussels and also in Sydney and the last thing in here would be especially interesting because we could include other areas of the world as well, because right now we're still very Europe centered but would be interesting to see what young GPs from other countries or areas of the world to think. Yes, some references and thanks very much for your attention. Thank you, Dr. Many thanks for this wonderful information. Thank you, Dr. Helen. Many thanks to you. And then we can start with Dr. Fajdan Bola-Titubiti. Dr. Bola, are you ready? Yes, I am. Yes, here you are. Can I share my screen? How will it be projected from there? Yes, please, Dr. Aiden. Dr. Bola, you can just share it. You have the share from. Thank you. Can everyone see my screen now? Yes, you can proceed. Just put it in presentation mode and go on. Okay. Greetings, everyone. I want to appreciate the guide. Dr. Bola, if you can just put the presentation mode on. The F5 one. All right. Okay, is it better now? Yes, that's a great. Thank you. Greetings, everyone from Nigeria. And I want to appreciate the previous speakers or giving the perspectives about family medicine, postgraduate training in their countries. So I'll be speaking on behalf of Sub-Saharan Africa. And knowing fully well that Africa is a continent of about 54 countries. And presently we have a family medicine training going on in about 13 to 14 countries presently. So I will be presenting the challenges of the training across countries. And some way forward that was suggested by trainers and trainees alike. So family medicine is making significant progress across Africa. It's no longer a new specialty. But the growth has not been in leaps and bounds, but the growth has been significant. And as common to every evolving a new program, family medicine program in Sub-Saharan Africa have recognized friends and challenges we can be across countries and training centers. So I would like to start by making reference to these reports from Wonka Africa conference in Uganda in 2019. Then there was a mini study conducted with the conference attendees. The status of family medicine postgraduate training is like in their present countries. So from the reports of that 2019, we could see that South Africa, Nigeria and Ghana, these three countries have well established postgraduate programs. And in fact, Nigeria alone has above 500 family medicine fellows with above 50 training centers. And Kenya too has two established training institutions and three that are still upcoming. And the Rwanda started training in 2000, trained residents between 2008 and 2012 after which this was stopped. So they are still back to drawing board to see when they can recommence family medicine program in the country. And likewise, in Syria, Leon, as a present, there are residents, but there are having challenges with a stable family medicine trainer as at last year, hoping that by this year things would have improved. And so other countries like Niger, Guinea-Bizou, they are still contemplating of having family medicine training. In Tanzania, family medicine training is offered in private sector in a network of health facilities attached to Aga Khan University. But yet the government doesn't support family medicine in public sector yet. Simba way in the early stage of implementing the postgraduate family medicine program. South Sea is a French-speaking African country and so they have like two challenges. The first is like to blend with other countries who are English-speaking and do maybe collaborative work and research and all that has not been easy for them. Do some of them try to learn English language too. So but this challenge, they have one university training family medicine residents in postgraduate and one big challenge they have as at 2019 was with retention of family physicians because the family physicians trained in DRC move out of the country to South Africa. So that's a big challenge. I feel like a week or two prior to this presentation, I did a mini survey among young doctors across South African. To know the present challenges that are ongoing in different countries and their training centers. And we could see here the respondents from six southern African countries, Nigeria, Simba ways, Zambia, Ghana, Botswana and Sierra Leone were represented. And among the respondents we have people who have already finished their postgraduate training and are still within the first five years. We have those who are still on the going training as senior residents as junior residents and in some countries instead of running residency program. We are running masters in family medicine so we have such people also among the respondents, and we have a few people who are already doing their PhD family medicine. So I try to know what's the current status of the challenges of postgraduate training across Sub-Saharan Africa is and this is the result I got from the mini study, the mini survey I did. So I grouped this into two. The challenges seems to be like countries have like almost identical challenges, though some problems are more prominent in some countries than the others. So the problems were like grouped into two, the health system challenges and the challenges from the individual training institutions. Among the challenges identified under health system in Ghana, respondents reported that family medicine is being underrated by non-family medicine physicians, like when the trainees are undergoing clinical rotations under the linear specialist. They look down on them, they feel like their specialty is not really a specialty and all that. So that is one challenge the residents are facing in that country. Across country, there is increased cost of training because family physicians are poorly renumerated in most African countries. The pay is very low and with the inflation, the global economy melts down, which affected countries also across Africa. The cost of training has increased and likewise the risk of training because taking for example Nigeria, there is a lot of insecurity and that equally affects training of family physicians. Due to some peculiar challenges in some countries like Nigeria, residents are experiencing longer duration of training. The average year for training a family physician in Nigeria is usually around like around four to six years. But some other factors which could range from like strike actions and all that tends to extend the duration of training of residents and it's making people really lose interest. Likewise, there is the challenge of co-funding across most of the countries that responded and most of some health systems don't really understand the importance of family medicine yet. That could explain why some countries are still hesitant in adopting family medicine as a postgraduate program. And a big challenge that I want to emphasize a little is what's in Nigeria is being referred to as JAQA syndrome and that's a coinage for brain drain which is really, really intensive. Presently people just want to go out just want to get out of the country. So in my training center, for example, the senior residents we have recently who we are hoping that we could train and become family physicians about 50% of them are already writing foreign medical exams to move out maybe the next few months or within the next year. So that is really a big challenge threatening the sustenance of family medicine in the country because if this is not carved, it's going to really lead to a death of family physicians across the country. And that's what's seen the health outcome, especially at primary care level. And from training institutions in Ghana, they have the challenge of not really having a well-structured learning resources. Sorry, the hoping that will soon be over. That problem will soon be over because as of now. Not too much remaining for you. I'm sorry. Okay, so let me let me quickly just run through. These are the challenges. Limited and so on experience from Nigeria born outs from access clinical workload for mentoring and inadequate number of train trainers, change in policy for communication between trainees and trainers. So we could see the other challenges highlighted. And among these challenges of balancing clinical workload with academic workload is something that is happening across countries. Some reported lack of clarity on what the scope of family practices and inadequate surgical exposure. These are some quotes from the respondents. Some respondents from Nigeria reported that they are exposed to multiple heroes at once and they are being overestimated beyond what other specialists would normally be asked to do just because is a family medicine residence. And some some body some a respondent from Zambia said some vertical specialist poorly understand the program and does the assessment may not include the formats for family meeting. So those are the challenges. Now way forward. For it system. I think advocacy about the role and importance of family medicine to policy makers will help. Trainers of faculties in different countries could step up the advocacy role to and not give up keep pushing for family medicine until it is well accepted by policy maker. Another challenge if there is meta renumeration for physicians that could have the problem of poor renumeration. If more doctors employed from the private sector that could also help. If some general hospitals in most African countries, we have what we call general hospitals that's like a three care level. If such hospitals are converted to family medicine training institutions could make training or family postgraduate training to be solely on the family physicians are not necessarily pushing them out to solve specialist to train and another thing that's good help is when trainees are involved in planning training programs. It's good help restructure the program because if decisions were made without the trainees imputes that could not favor the trainees in a way so and if there are some specialties in all the disciplines which are on the family medicine. If trainers have some specialties in all those disciplines like surgery, go and gene, dermatology, no medicine that could equip them to better train more postgraduate students. So other suggestions is to have stipulated both monitor research days. Presently from my experience here, there is no day dedicated to research in most training institutions in Africa. So the clinic workload is quite much. Your time is running out, I'm sorry. All right, so those are the the highlighted way forward. So I quickly just want to say that the working party on education actually is ready to support any training institution or country that is having all those challenges. So faculties in those countries can work and in and would be working party on education and try to collaborate and overcome all the challenges that have been listed. So I think that you can hear all the links for the resource for the Wonka working party on education for anyone that's think this could be helpful for them. So I'd like to conclude by saying that though family medicine is growing in Sub-Saharan Africa countries for their several challenges threatening the quality of the postgraduate training and if there is any to improve the quality of training, so that's the quality of care in the region can improve. So step orders should work together to identify these challenges. So these are few as resources, studies that form the basis for this presentation. Thank you. Thank you, Dr. Bola. Thank you very much. Anyone have any question? Many thanks, Dr. Bola, for this valuable information. Dr. Moran, are you ready? Yes, of course. I need to share my screen if it's possible. Yes, just start sharing. The camera, you can just share. I have another device. Hello, everyone. Greetings from Jordan. I'm Dr. Moran, family medicine president. And thank you for having me today on this webinar. So I will start talking about some challenges that we face, especially in Jordan and in the Middle East. region. And I think it's the same that everybody face with the family medicine speciality around the world. So in my slides, you won't say any sentences or words. I just share some samples and I will let you think what everyone and each of them means to you and your country. And your region. So the challenges we face and we were facing since we were medical students and now as a resident and a specialist. I think it's the same. The main challenges or the lack of resources at the first place, especially as the family medicine specialist is a comprehensive. Specialty. So we need to know more every time we need to read more we need to expand our knowledge and many fields as it's a general speciality and that's what makes it distinguished and that's what makes it unique, but at the same time that would make it challenging and. difficult for all of us, I think. And being a family medicine physician. You need to build up more of your skills in community communication skills in your counseling. And how to build your doctor patient relationship more that you will be the person your patients will return to every single time he needs to see a physician and after he sees other specialties. As well, so you need to be there and you need to be always ready to respond with your knowledge and your skills to your patients, regardless how old are they. Regardless what gender are they and how many and which medical conditions they have. So these are some of the challenges that we need to be aware of. As a family medicine specialist and physicians. So other thing that we. We need to always think and see the patient as a whole. And we need to be aware of that. So other thing that we. We need to always think and see the patient as a whole, not like other specialties who like think in some systems and some organs and some diseases but being a family medicine. puts pressure on you that to always see your patients as a whole and to treat it as a whole so in Jordan here family medicine specialty is somehow still a growing specialty and in your field. We are still discovering the best way to practice it here in their community. And we still don't have an enough number of family physicians, but it's still growing and many in growing in this field in the recent years and hopefully in the upcoming years. One of the challenges as well as that it's not really a well known specialty for the community. Many of them still they misunderstand or they understand in lack of understanding the importance of family medicine and its role in the community. So we see many patients still don't know what we really do and what we really provide as a family medicine doctors in the society and in the community so we still need to do more awareness and campaigns to make this more clear and more understandable for the community and for the society. So, and the family medicine is looking at the person as individualized so this makes stress on the family doctors to see each patient from another perspective to treat it as. And as it is another from any other patients who might have the same complaint or the same diseases that he might have. So, these are some of the challenges that we might face and in any region around the world. Now let's come to the solutions and the price part of the family medicine is like, although it's comprehensive individualized speciality but that's one of its distinguished features as we always read we always search for new information we always update our knowledge. That might reach us to a point that burned out for the physicians but it's still encouraging them to know more and to practice more to improve their skills and their knowledge. And one of the solutions I might suggest that to always search always there is something new to learn or was there is something new to know. So these are some of the suggestions I might get for the residents are seeing this webinar or watching this webinar and for the medical students who are interested in family medicine so always search always read always updates your knowledge and always search for the new guidelines and approaches. And you will see amazing things each time. So the other solution is to always ask always ask for help always ask for if you have any question you don't know we are all learning in this process from your colleagues from the same specialty or other specialities from your seniors from your trainees and don't hesitate to ask and to learn more. And I would encourage everyone to do it how to improve your skills. The secret is by believing in yourself and to do it and family medicine we have many procedures and many skills we can do, but it is depending on you on how and in any level you want to learn. To improve yourself and in any level you want to practice family medicine. Some might just see the most common things diabetes hypertension and others might want to practice more, and I will encourage you to do it, encourage you to believe in yourself. And this is the way that we will improve the family medicine as a whole in the community, and you will help your colleagues to make the community understand that we can do more every time. So do it and practice it. And now I want to share with you some of the solutions that and the ways we did before as already young doctor movements in Jordan to improve the family family medicine specialty and the region. So we did many scientific days to discuss and to present a new articles in your journals and new topics and family medicine for the medical students and for the family medicine resident to improve their knowledge and to emphasize on the importance of family medicine. And here are a webinar that we did for the Jordanian board. It is an exam after finishing the family medicine residency. We did a workshop to help the residents in their way and doing the family medicine for Jordanian examination. So it's made every effort from each one of us in the community and in this field to build to a ground for the future. And we did many workshops and campaigns for the community so that they will know what we do and they will know that family medicine doctor can do much many more that we might think or know and to understand the importance of seeing and refaring for their family physicians at the first place before seeing any other specialist and we can help them. Throughout their medical conditions, whatever they were seeking helpful. And we routinely do like meetings with other specialties and attendings from the older generation and the new generation of family doctors. So we can share our perspective and our ideas on improving family medicine and we can share our knowledge and we will get many informations and useful ways to improve this family medicine speciality in Jordan and in the region by the guidance of our attendees and specialists as well. So the last but not the least I want to emphasize on this quote that the good physician treats the disease, but the great physician treats the patient who has the disease and this is our role as a family physicians. Thank you. Thank you. Thank you very much. Thank you. Anyone have any questions? I'd like to thank all our speakers and all our attendees and Dr. Sankar. Are you here? Yes. Keep Sankar to you Dr. Sankar do you want to give in to us? My audible. No. No we can't hear you Dr. Sankar. Sankar you can close the mic and open again. Because we used to hear. What about now? I think that's great. That's great. I think there's some internet issue. However, I thank you all especially Al-Razi moment for handling this webinar organizing everything on behalf of the young doctors moment as well as the Wonka working party on education. We have two years since young Dr. Liason's now in the working working party on education so I'm really grateful to them, Bola and Brune and also to the to all the resource persons for this excellent webinar. Thank you very much and have a great day. Thank you. Thank you very much Dr. Jihad, all of our panelists today for this nice webinar about perspectives on education. It was an interesting talks from all of you and sharing these experiences all over the globe. It's really interesting and useful. Thank you for joining us and helping us in collaboration with education working party to excel or to have this successful webinar. Thanks Sankar also. I'd like to thank you all our speakers, our translators, Dr. Chen Dem, family medicine specialist, Hong Kong with a Chinese translator and Dr. Nelka Benemas, a Spanish translator. Thank you for all our attendee. I hope you have a nice time with us and waiting for the next webinar. Thank you everyone. If you can just take a moment for a group photo. If you want to participate, please open your camera. Thank you everyone for participating. Ideally you have to open your camera please. Yeah, my cameras are not connected. Thank you everyone. Thank you Dr. Ai. Thank you very much. Okay, so bye bye. Bye. Thank you very much.