 go ahead and get started. We don't want to keep you guys here too late. Can you hear me okay? All right, very good. Okay, well, that one doesn't work. We'll just go this way. All right, so first of all, what do you do when you're going to put together a talk? I mean, it sounds silly, but the first thing you've got to do is you've got to know your material. And you don't know how many people sit down to do a talk and realize that they don't really know the material that they're going to talk about. And you got to know that inside and out. So when you're going to talk about a specific topic, you've really got to spend the time it takes to know that topic. And you've got to know it cold if you're going to prepare a talk. You know, I see people all the time that they just don't prepare. And then they start putting together the talk. And then one of the things that's important is if you know your materials, you're going to get questions at the end. And I know a lot of times people will give a talk and then there's a question, well, why did you do this? And then there's that, that panic blank stare, you know, oh, I don't know. That's what my attending told me to do. So really know your material because it's important when you're preparing the talk because if you don't prepare well, you know, the talk's really going to not go well. So you've got to be prepared to read all the background, read the references that are necessary before you're going to go ahead and put it together. Look at all of your data and statistics because that's going to be the meat of your talk. And again, if you don't know exactly what all the results were, then it's not really going to help you when you're putting together the talk. So know your audience. And that's another important thing. And so are you talking among your colleagues? Are you giving talks to other residents? Are you giving talks for, you know, Grand Rounds or something like that? But other times we ended up talking to late people. And so you may be asked to give a talk to potential donors or to give a talk to people who are giving to the iBank or something like that. And so you have to tailor your talk to the group that you're talking to. So you know, late people, I don't mean to talk down to late people, but late people don't know your abbreviations. They don't know exactly what it is. You have to start really simple. You're giving a talk to late people. You say, okay, we're going to talk today about cataracts. What is a cataract? And then you go in and you tell them because people think cataracts are growths on the surface of the eye that you scrape off. And so know your audience and then make your talk aimed toward that particular audience. And that's important. The other thing is what kind of talk are you giving? Is this your scientific presentation where you're giving results of your data? Or is this going to be a review paper? Or is this going to be a different paper? And a lot of it depends. If you're an invited or a guest speaker, you're going to talk for 40 minutes. And so this is going to be a treatise. I mean, this is going to be really a summary of all the work you're doing. Sometimes you may be asked to be a keynote. And that's going to be before a big group. Now, the length of the talk depends. Some talks are the five to seven minute talk that you give at Arvore, that you give at Ascrus or AO. You know, other talks are the 20 minutes you give at Grand Rounds. And then, of course, the 60 minute talk is when it's a keynote. So you have to know how to set your talk up to fit that time limit. And the other thing I find that people run into is that you don't time your talks. And so this is where you get your spouses, you get your friends, you get your other residents, and you make them time you. And you actually practice giving the talk. And so if you've got seven minutes, especially if it's at a major meeting, you get seven minutes. You don't get 10. And what happens is when you go up there, they'll often have a box with a green light that says you could talk. A yellow light means you've got one minute. And the red light means stop. Some meetings, they let you go over. When you go to the academy, if you the red light starts flashing 10 seconds later, the guy goes, please summarize. And then you go, you have 10 seconds to summarize it. So if you're not even through your conclusions yet, you're in trouble. So time it. You know, I said, how are your friends, how are your fellow residents, you know, ask them to sit down with you while you're talking to your talk. Okay, sorry, this has sound effects. So the other thing that you do is talks are boring. People don't like sitting there listening to you drone on. You know, do you ever see Forrest Bueller's Day off? You know, or Benz time goes, I mean, people don't like to hear that. Now, in a seven minute talk, you can't put in joke slides. But in other talks, you can. And you got to play it by ear. You don't want to insult somebody. So every year I have to take out my slides that insulted people. And each year that the bar for insulting comes out this year, I have no idea what I did. I lectured the students and I still got a note saying that my talk is it was very offensive. And please, you know, the administration, look at it. I went. No idea. So so your generation is is is a bunch of winers. I mean, my God. All right, so preparation of your slides, the slides are the backbone of your talk. And so really, most slides use PowerPoint as a basis or some Apple variation of PowerPoint. So what are the order of slides? Really slides are like papers. And so your first slide is going to be your title. The second slide now in all talks is disclosures. Now, you know, you guys probably don't have many disclosures, but you have to specifically say that. If you go to a meeting now, and you do not say I have no disclosures, or here are my disclosures, you are automatically kicked out of any consideration for best paper. So keep that in mind that second slide or your first slide has to say disclosures. And if you've got any funding, if you've got any disclosures, you've got to do that on your second slide. Then you do an introduction, just like a paper. You keep it brief, but you want to let people know what your talk is going to be about and why it's important. Now, the materials and methods are the background of what you actually did. And so a lot of people spend more time than they should on materials and methods. Now, you know, you want to present enough so that people know what you did. But if you spend half your talk saying how you set up the study and how you did it, you don't have anything left to discuss the results. And so materials and methods, you give people what they want, what they need to know so they know what your studies is about, but don't spend half the talk doing that. Results are the guts of your talk. And this is what you're going to present. And so really give the most time to the results. And this is the most important part of your paper. And then you do conclusions and discussion at the end. And this is where you don't just repeat what you said in the results. You summarize them. And you say, okay, why is this important? And this is like a paper. I mean, in essence, this is how you write a paper when you do a paper. So when you actually look at the PowerPoint slides, do bullet points, don't do texts. You don't know how many times people have these full sentences on a slide. The purpose of the slides are to augment your talk. You can say what you want to say, but use bullet points to highlight it. So you don't repeat everything you're going to read on the bullet points, you just give a highlight on there. And then you go ahead and you give your talk. You want to put graphs and tables because again, that people are visual. And when we see things, we can interpret them a lot better. So show pictures, show graphs, that's a really nice way to augment what you're presenting. Don't put too much information on there. And again, people just cram these slides with too much information. So you've heard the phrase, you know, death by PowerPoint. And so, sorry. And again, this is just to illustrate, don't put too much crap in your talks, you know. You can put all kinds of stuff in there. But, you know, if you go ahead and drone on and on, people are just going to fall asleep. And you'll see nowadays, your generation, what do you guys do? You don't fall asleep like we used to. What do you guys do? So you're down there like this, answering emails and sending texts off. And so that's how when I know I've lost you. And you're just doing this. So, all right. So when you do the slides, okay, look at this slide. I mean, these are slides we pulled actually from, you know, from ones that are out there. I mean, how do you get anything out of that slide? I mean, you just can't. So don't put too much on your slides. That's a worthless slide. You can't get any information from that. The other thing is we've now got all kinds of different ways you can do font, you can make a big, you can make them little, pick a font that someone from the room can see. And you want to make sure that you pick a font that you know, good, normal size, don't make it too little, don't make it too big. You know, we now have available all these different special effects. And so we can make things spin, we can make things go around. Don't put too much special effects in because it detracts from your top. If you really want to make a point, you can put something in there to bring it out. But if you put too much junk in there, people are not going to read it. So you want to make sure you don't put too much text on there. You don't put complex charts. Things are going to be simple. You want someone to look at it and get what you're saying right away. And I know we all say, oh my God, I worked on this for a year. This is my project. You don't want to cram in too much because again, you're going to lose people. If you put too much stuff in there, you're going to lose people when you do that. So it's really important. Now, try to keep your fonts similar, try to keep your style similar, try to keep your slides consistent. Don't mix and match too much. Other people is if you go there, you can do all kinds of stuff like this. Okay, what is that saying? I mean, I don't know what that means. And then we all do the same thing. We put a slide like this and we say, well, sorry, this is a busy slide. You know, come on, if it's a busy slide, then you shouldn't have it on there. It's too much on there. Or if you really want to highlight that you work really hard, okay, look at all this stuff we did. And then maybe you can like take this one and blow it up and say, all right, this is what we all did. But here's the one thing in here that's important. And you pull it out and blow it up. But if you can, you put too much stuff on there like that, nobody's going to get anything out of your talk. You know, nowadays, the other thing that we've got is you can do all kinds of different colors and fonts. And so, you know, dark colors on a red background, you can't see those in the back. And if you think about it, you really can't see them. You know, the other thing is these funny fonts. I mean, this is fine if you're writing notes to the person next to you and, you know, in fourth grade, you know, when you put a little heart above the eye and little flowers on there, those are fine, but not for a talk. And so pick a good font, pick a good color, you know, don't use a red background and black stuff on there. People can't read it. And so when you look at your talks, when you're putting them together, step back and say, you know, is this something that people can read? Is it okay? I'm not saying everybody has to be bland and the same. I'm just saying that you have to think about what your audience is going to see when you do it. So when you prepare the slides, keep the talk interesting, keep it light. You know, you can, you can make a joke once in a while. Again, don't offend anybody. You know, funny sides are it, but just be careful. And again, I have no idea how I offended somebody in when I lectured the medical students on pathology. And I guess I don't leave much of an impression because Ashley doesn't even remember the talk I gave when she was a second year med student. So, so much for leaving an impression on you guys. But anybody can be offended by inappropriate humor nowadays. So you really got to be careful. Scenery slides, you can't go wrong. You know, you show pretty mountains, you show places where you were, you know, where you're giving talks, those are okay. So you can show this, you can say, okay, and you can do a little, a little aside, and this is where my fatherland is, you know, these are the slides here. This is where, and then you can say things like, you know, the Greeks invented ophthalmology, you can put that in here, and that's allowed. And you know, you can make, you know, jokes about Delphi and the Oracle and all kinds of things. I think this is the slide that got me in trouble when I talked to the medical students because I actually told them, I said, the rules are when you are a guard at the Tomb of the Unknown Soldier, the Evzon, seriously, these are the rules. You have to be male, you have to be six foot tall, and you have to be handsome. So I said, all you guys who are short, ugly, and not male, you know, are in big trouble. And so that was offensive. And so I got written up by that. No, it's offensive. Read the talk. Okay, so you can't say that. I know, that's offensive. You're not supposed to say ugly, so you can't do that. All right, next time I'm off to change it, I'll say, and people who are high challenged and, you know, have too many, you know, ex chromosomes, I don't know how to say that. But this is what really got me in trouble years ago. So I used to show this, and I thought this was a fun slide. No, no, that's bad. And so I got multiple comments. Does that mean that the faculty thinks they can shit on students? That's what, now I found that offensive. And so, but don't use slides like this. That's offensive. So don't do that, because you can't, I thought that was pretty funny, but you can't. So don't offend anybody nowadays. All right, so when, when you're speaking, prepare, prepare, prepare, prepare. And you could never prepare too much. And I really mean that. Practice. I mean, it's like anything else, you know, you're going to play a piano recital, you practice that damn thing 10,000 hours before you can do it right. So you really got to prepare, you got to know your topic cold. If you're squishy on what you're going to say, you're going to be in trouble, because people will ask you questions. And so know your topic cold, think about it, say, gee, what could people ask me about this? And that way you're prepared to ask questions. Practice, you know, get your family member, get your fellow residents, get your spouses, you know, make them sit down and say, okay, here's a time or time me. And then let me just practice my talk and tell me what you think. And then they could say, well, you kind of fumbled here, I didn't understand that. And then you can refine it. And so, you know, preparation means take the time ahead of time to do this, don't be finishing your residence day talks, Thursday night. That's not a good way to do it. Start now. Make sure you're starting to prepare your talks now, you've got a month. Start now and get them ready to go. Time yourself, that's important. Now, when you're preparing for your talk, most meetings have a speaker ready. And what you do is you take your talk either on a flash drive or on however you want to take it. Some places you even send your talk in ahead of time. It's like if you're going to Askus or the AO, you go to their website, you preload your talk. Don't assume that everything went through. Always carry your talk with you on a flash drive or something. And what you do is before the meeting, you go to the speaker ready room, they'll say, oh, Dr. So-and-so, they'll actually sit down with you at a computer, and they'll go over your talk. And you want to make sure that everything is there, especially if you've got videos, video clips notoriously get screwed up when you send them to a meeting ahead of time. So have it on your flash drive, have your videos there, take your computer, whatever you want to do, and go to the speaker writing room and make sure that the talk works. And that's really important because the worst thing is to get up and say, oh, sorry, my video's not running. And so you always want to make sure that that's going to work. The staff is very helpful. These guys will help you. They're very, very good. A little condescending, but they'll help you. So you just ask them, just like calling Apple, they'll be really condescending, but they will help you. So let the staff do that, especially the video and the clips, as they said. Now, visit the podium prior to your talk. And so when you get there, get there early in the morning and go to the room that you're going to speak in and walk up to the podium and look at them. Podiums are different. Some of them will have the things that you advance here. Some of them will have them there. Some of them will have little clickers. Others will have pointers. And so know the lay of your podium ahead of time. And it's really important that you do that because when you get up there, you don't want to be fumbling around, especially if you've only got six minutes. So look at how they've got the clicker on there. How do you advance your slides, where the pointers are? Now, when you look at the podium, when you're sitting there, you have to develop your own style to know what you're going to talk about. So everybody's different. Some people actually take a script. There's nothing wrong with a script to remind you what you say, but don't read it. That's what's the matter. But we used to do cards before there were computers. You'd have slides. I just use my slides to cue me. But then again, you'll develop your own style. You may want to have a little outline or little points to remind you or something that you can quickly glance at. Most places nowadays, they have your computer right in front of you. So you don't even have to bring stuff. You can look down at the slide and then look at your audience. But if you want to bring cue cards, you can do that. So again, you can put slides in there and give your audience a minute to read it and see if they're alive. And if you get a chuckle, you know they actually read it. Hopefully you guys got a chance to read that. Okay. All right. So when you're speaking, your style is your own personal style. And so everybody's different. Nobody's the same. There's no one way to do it. But what I do find is don't read your slides. You know, talk to the audience, highlight the points, expand upon them. But again, the worst thing is when you see people going, you know, you're not going to respond to your audience, you're not going to click with them. And so you can glance down and you can look at what you want to say, but know it ahead of time. Now you don't have to memorize everything. Use your slides as a cue to what you're going to talk about. And you know, when you've got the bullet points, again, don't put everything in the bullet points, expand on them. The bullet point or reminder what you want to talk about and then expand on that to your audience. Okay. So look at the audience. Don't look at the notes. And some people get nervous looking at the audience. So if you're nervous, looking at the audience, we call it do the 1000 meter stare. You know, usually the audience is dark and so you can't really see them. So stare at the back of the room somewhere where it all blends out. If you like to get positive response, you look at somebody in the audience. And especially if they nod or they smile, then oh, you get that feedback. And so what you can do is if that doesn't bother you, look at particular people. And the other thing is if they make eye contact with you, then that means they're paying attention. And so look at them as you do, but make sure don't stare at just one person, you know, move around the audience and look around. All right. So again, pick out friendly faces. If someone smiles, okay, this guy likes what I'm saying, or maybe he's just being, you know, nice. So you just look at them. You know, again, make the eye contact. Now if you're nervous, do the 1000 meter gaze. Just blur those eyes out and pretend that it's an empty room like this morning, you know, pretend it's an empty room you're talking to. All right, pace yourself. And so when we get nervous, we tend to talk really fast. I do that too. And so you get up there, you start talking fast, you know, and then you got to just just take a breath, calm yourself down, try to pace yourself, you know, not too fast, not too slow. Again, you don't want to do they all are, you know, uncle too slow. But when you get nervous, people tend to talk fast. And so if you find yourself talking fast, just one breath. And it's really a funny thing. I mean, these people all talk about, you know, doing all these exercises and everything, just take a breath. And you just take a breath and it'll calm you down and then slow down. So don't go too fast. You know, again, breathe, relax. Now, we used to talk about using 10 milligrams of Indra. Nowadays, you guys, now I didn't say this, this is off label. That's the other thing you have to say it's off label. Get a little thing of Tim optic, a little drop, you put one drop under your tongue. That's all it takes just enough to block that sympathetic rise for those of you beginning surgery, same thing, one drop under your tongue. Now, don't try it the first time at a meeting. Okay, try it at home first. You know, they said these things, don't do this at home. Do this at home. Try it. Make sure some people have a funny reaction. You take that Indra, and suddenly become a slug, you know, so don't do that at first. But but you know, you may want to even try it just to drop under your tongue and see if that does the trick. Because when your heart starts racing, get that sympathetic fight or flight discharge, you know, nature program this into you. There's a saber tooth tiger chasing you, you know, you're getting ready to run. Well, no, there's no saber tooth tiger. There's just you at the podium. So maybe block that off. And that'll help to make it easier for you to give the talk. Okay, so again, you occasionally put some slides in there. And you can even personalize them and put your little name on the slide. So we never remember when we're in surgery. So I ran into that even yesterday, you know, the nurses are saying, Oh, how's your new baby? Oh, that's wonderful. I mean, yeah, that's wonderful. But when I'm a patient sitting there, I don't want the scrub texts talking about their new babies, or what movie they saw or something. So you know, always remember in surgery, you're under local anesthesia. So people hear everything that you say. Alright, so we talked a little bit about giving talks. It really flows over into how to write a paper. And to be honest, it's the same skills. It really is almost the same thing. So you know, what did we say when you first put together a talk, we said know your material. When you're writing a paper, it's even more important. You've got to know your material before you sit down to write a paper. So just like a talk, know your material, review your data, look at the references, get those all done ahead of time, read your statistics, make sure they're valid. Now, again, papers are like talks, there's different ones. A case report case report is one case, you get five references or three references, you get 500 words. I mean, these are very different. A normal paper is what we think of as a scientific article, but then you may be writing a review paper or a summary paper or now the latest thing, there's people who don't even do anything, but they've made their resumes built on the fact that what do you do? You take all the other papers, everybody writes and you put them all together and you say, is it scientifically valid? And so literally there are people making careers now, looking at other papers. And that's what they do. So I'm nothing wrong with that, but they're not really doing anything. They're just looking at other papers. And so you want to know what it is that you're writing. So the steps to writing a paper, I mean, first of all, you've got to gather all your data. Again, you got to know what you're writing about, go over your data, review the references. I find outlines helpful because initially when you put together an outline, you want to kind of throw together what you want to say and an outline keeps you directed. And so that helps a lot. Now the order of the paper, a paper's just like a talk. You've got a title. You want it to be catchy. You want it to say what your paper's going to say, but you don't want to make it too long. You don't put in four lines of a title because nobody's going to read that again. And so try to make it succinct. Let it know what you want to say. The abstract, of course, is what you're going to do, then you've got an introduction, materials and methods, results, and then conclusions and references. And so just like a talk, it's really the same order. So how do I recommend putting together a paper? I say do it the inside out method. And what I mean by that is when you're looking at writing a paper, it really seems overwhelming. There's all this stuff there. It's like, oh, shit, what am I going to say? And how am I going to say it? So start writing what you know. So you know what you did. So the materials and methods are the easiest way to do that. So write that first. So go, okay, this is what we did. We did this experiment. We did this. We gather all this. This is what we looked at. Write your materials and methods first because that's your study. You know that. Secondly, write the results. So the results, you know what your results are. So write those. Then go ahead and write your discussion, you know, your introduction, your discussion. And then lastly, write the abstract and conclusions because the abstract and the conclusions are the most important things. So start in the middle and work your way out. And then once you've got most of the paper written, then you can say, okay, these are going to be my conclusions. This is going to be my abstract. So write that last. And so people often go from step A to step Z. Don't do that when you're writing a paper. It's like when I teach you guys to do FACO. We don't start with the wound because if you screw up the wound, the rest of the case is screwed up. We don't start with the rexas. We start with something in the inside that gets you used to it. In fact, we save the hardest parts for last. And so again, we do an inside out method when you're doing surgery, same thing. So when you're writing a paper, do the inside out method. It makes it easier. So plan your time. And I call this the rule of adding a zero. It's the logarithmic rule. If you think you can write your paper in 10 hours, it's going to take you 100. And I'm not exaggerating. Those of you who've written a paper, it takes much more time than you think. Oh, yeah, I can write this out this weekend. No, you can't. I mean, add a zero to the time you think it's going to take. And it really does a lot more time. And then you end up not having enough time, then you end up rushing. And that's when you make mistakes or don't do a good job. And so give yourself adequate time. And remember the zero. So if you like it, knock this off 10 hours in a weekend. It's 100 hours. It's a week. So give yourself adequate time when you're writing the paper. All right. So again, you keep people, keep people kind of awake and give them something to look at one's in a while. All right. So the final paper of preparation, read it, read it, read it. And then spell check. I've seen people misspell ophthalmology. I've seen them misspell cataract. I mean, you know, in the old days, you had to actually go through it and look up stuff and read it. Now you just put it in your computer. The computer checks it for you. How hard is that? I mean, you just hit the spell check button. So there's no excuse to misspell words. Proper grammar is something that's really hard, because a lot of us aren't English majors, except Dr. Degrees. So maybe have her read your paper because she was an English major. So, you know, you want to be really careful to check your grammar, make sure what you say makes sense. Have other people review the paper, because a lot of input's very helpful. You don't want to send a paper and then have the reviewer come back and say, this doesn't make sense. And, you know, they might be rejected because of that. So have your peers, have your mentor, especially if you're writing papers a resident, review it and then get their input in it before you send it in. Now, check the quality of figures and graphs. Nowadays, again, with the electronic era, you send in a figure. They will actually check it at the journal and they will say, you know what, this isn't good enough. I mean, it has to be so many, you know, megapixels per whatever. And if your figure is not of that high quality, they'll just reject it outright. So make sure that your figures are of high quality, your graphs are of high quality, anything you put in is going to meet the requirements. And this is the other thing. Follow the journal's instructions for authors. Each journal gives you like a whole set of instructions right there on the website. Follow them. You don't know how many people don't read the damn instructions. And if you put that paper in wrong, it'll just be spit out automatically. And so journals now have a hard time. The journal that I'm editing, we reject 70% of the papers. And so we almost look for reasons to reject papers now because it's so hard now to, you know, pick the best 30%. So we even have journals have prescreeners. And so if you don't follow their instructions and you send in a paper that's not done properly and not following the instructions, it may not even get to an editor review where it may be spit out automatically. So don't give them a chance to reject your work for reasons that aren't legitimate. So follow the instructions. And again, you don't know how many times we get papers in that where people didn't read the instructions. And so if you don't, there's no excuse for that. It's like a spell check. You have to do it. So where do you send the paper? That's often difficult. So talk to your colleagues, talk to your mentors, talk to other people and peers, because you need to know where to send the thing. All right, we all think, yeah, this paper is great. It's going to ophthalmology. Well, the journal ophthalmology, basically, it's almost 10% is your chance of getting in there. So be realistic, at least. You know, if you've got a nice little paper, you know, get a 10% chance of sending it into ophthalmology, you know, archives, same thing, maybe 20%, our journal 30%. It's really tough. So be realistic. If it's an earth shattering paper, fine. But if it's just an average paper, think hard about where you're going to send it, it's going to save you a lot of time. And so I'm not calling journals lesser journals, but maybe lesser known journals are smaller or more subspecialty journals. And they may have so you're doing a piece paper, you know, send it to the PEEDS journal. You know, you're going ahead and you're doing a retina paper, send it to one of the retina journals. And so try to pick a journal that may have particular interest in your paper. So this is my favorite slide. How many times you watch a TV show where there's this auditorium where the characters are up there discussing the case? I mean, I've never seen one of these, at least in the US. The only place I've ever seen an auditorium where the people are up top or they can look through the glasses in Moscow. So I mean, I've never seen one in the US. And yet you watch these movies or these TV shows where the doctors are there, they're always sitting up there discussing the case. There we've got the students doing the wave. All right. So how does the review process work? It's pretty much the similar in most things. The editor or the editorial staff get the paper. And then they choose reviewers. Most papers you try to get at least two reviewers. Now, you know, it's really hard. And my job as an editor is really hard because you have to find non-biased reviewers. And as much as we hate to admit this, there is bias in anything. We're all human beings. We're biased. So the hardest thing for me is finding someone who's not either totally pro this technology or totally against it, trying to find someone who's in the middle or not in favor of antibiotic A versus antibiotic B. And so the editors have a hard time finding non-biased reviewers. And believe it or not, we keep track of reviewers and we rate reviewers. We give reviewers a score on every review and we keep track of those. And when somebody is obviously biased, we just boot them off. We don't use them anymore. Mostly two. I think two is kind of thing. And then if there's... Oh my God, thousands. Oh, really? Yeah. Yeah. Yeah. So I mean, eventually one of you guys, you know, when you guys get out and practice on academics, I may actually ask you to review too. So keep that in mind. And so the way that the review... Boy, when we choose reviewers is we will often have suggestions from other reviewers saying, you know, do you have someone in your lab or someone who's new to your factory that you think is good? And then we try them out. We give them one or two to do. And so I call it the system of punishment. And so if you really do a good job reviewing, then they ask you to be on the editorial board. Then you do a really good job there. Then they ask you to be an editor. And so they punish you every step of the way for doing a good job. So... But you know, you guys maybe ask to be a reviewer too. And so it's really hard to put aside all your biases and say, okay, I'm clearly going to look at this paper, see what's good, see what's bad, and make helpful suggestions. And so some reviewers are just poor reviewers. And we rate them poorly and just don't use them anymore, especially if they're biased. And so again, sadly, if we're rejecting 70% of the papers, I now get one letter a week from someone who says, obviously, the reviewer didn't understand my paper. I'm asking that you send it out to somebody else. Or even worse, I've had people, you know, say that we're biased. And so I rejected a paper from India, which honestly was a crap paper. And they said, well, obviously, you guys are biased against people from our part of the world. That was the direct quote. So I don't let those slide. I just answer them back. And I said, well, if you look at our editorial board, you'll see Dr. So-and-So from Amatavad is on our board. And Dr. So-and-So from, you know, your part of the world is on our board. So we're definitely not biased. And I don't say, and your paper was crap. I say, well, I'm sorry, but our review process, only the top 30% are accepted. And your paper, as good as it was, did not reach that, you know, did not reach that level. So you try to be nice, you can't be snooty. But I take it personally, when someone says we're biased, because we bend over backwards not to be biased. So the two reviewers look at it. Final decisions, though, rest with the editor or the sub editor. Sub big journals have sub editors on each area. Some have just a small amount of editors. But that's where the final decision lies. All right. So revisions are recommended by the reviewer. So if you get something back that says, okay, we looked at your paper, we recommend you revise it. That's great news. It means they didn't reject it. So when you get it back, it doesn't mean it's automatically accepted, but it means it's got a good chance. So the critical thing is, is once you get that back, read the reviewers comments very carefully, because how you answer the reviewers comments is going to decide whether your paper is accepted or not. So when a reviewer has, you know, five or six particular questions or comments, you've got to answer every one of those when you revise that paper. So it's very important that you do that. So just compulsively answer those all. And if you disagree with the reviewer, that's okay, but you have to state why you can't say, oh, this reviewer is biased. You have to say, well, the reviewer raised this point. We respectfully disagree with them. And here's why and you go through your data, your paper and say, this is why you disagree. And it's okay to disagree. You know, so long as you back it up, you've got to back that up so that the editor, you know, agrees with you. So again, it's okay to dispute it, but explain it well. So this is where you want to put in a long explanation. All right. So I know your brains are almost full. We're almost done here. So it's not OCAPs yet. You know, we have to wear earplugs to keep all that information and pouring out your ears after you get that. All right. So publication time. And this is what people will often ask. It's four to six months at best. And so people will often say, oh, I sent my paper in last week. Where is it? Well, come on, the reviewer hasn't even accepted it yet. And so you realistically have to think one, you know, that it's going to be about four to six months, but some journals, it's up to a year. And so don't be impatient. It'll eventually get published, but it does take some time. Don't get anxious. I mean, it's going to come out eventually. So, you know, if it's rejected following the first submission, you know, and that happens. So what are you going to do? Take the reviewer's comments and make it a better paper. So they'll send you the comments when it's rejected and say, okay, these reviewer said this, this, and this. See if you can't make it a better paper and then send it somewhere else. And so, you know, some people talk about the right for first refusal. What I mean by that is you say, okay, it's no harm if I send it to ophthalmology. You know, I've only got a 10% chance. And that's true except for the time. But if you want to send it to ophthalmology, nobody says, oh my God, it's been rejected there and nobody else is going to reject it. That doesn't happen. And so if you send it there and it gets rejected, that's okay. Take the comments the reviewer's made, make it a better paper and then send it somewhere else. And so don't just give up. You know, use those comments and make it a better paper. Now, if the reviewer's comments are such that you say, man, this is fatally flawed, then you can say, okay, how do I make my research better? All right, so this had these problems and man, those are real problems. We can't salvage this paper. Then redesign your study or the research that you're doing or whatever you're looking into to make it better so that you can try next time. And so use those as a learning experience. Now, as they said in The Godfather, when you get it rejected, it's not personal, you know, so don't take it personal as business. And so don't take it personally. Oh, God, these guys hate me. Oh, my God, they hate my work. No, they don't. It's not personal. Learn from it. Now, we're humans. Again, our ego hurts when we're rejected, it hurts. But just again, step back, take a breath and say, okay, why did they not like it? And what can I do to make it better? So practice makes perfect. Your first paper might be rejected. Your first three or four papers might be rejected. But eventually, you'll get better at doing it. You'll get better at writing. You'll get better at designing. You'll get better at sending it to the right place. And so practice. Just keep practicing. Nobody is good the first time out. It's just like anything else. You know, you're trying out for a new sport, you're not going to be an all pro the first time you do it. But eventually, you'll get better. And so just keep working at it. Don't be discouraged. Keep working at it. And eventually, you'll get better and better. And that's, as Forrest Gump says, that's all I got to say about that. So I always leave a couple of minutes. Questions? Specific or broad? Yep. I'm just curious, how long does it take you to review paper early in your career? And now? Early, it takes a long time because you read every line. I mean, it takes, I mean, a couple of hours. I mean, you really do it. Now, I can, you know, review the gist of a paper in five minutes. But if I'm a primary reviewer, I always spend a lot more time than that. But, you know, you can get to the gist of a paper really rapidly. But as a primary reviewer, you know, you put at least a couple of hours into it. It's really important. And I look at it. If you're a reviewer, that's a great responsibility. Because, you know, you got to decide if this is a good paper or not. So you can't just just say, Oh, that's no good. That's crap. No, you have to specifically look at it and say, Okay, why do I dislike this paper? What's wrong with it? And be very constructive in your comments. And I do see negative comments come in. Those I just cut out. So the reviewers, I don't put all the reviewers comments out. And so if someone makes a snide or a negative comment, I just cut it out. And so you just, there's no, there's no purpose for that. So the paper's obviously bad. There's a place when you do reviews, it'll say comments to the authors, comments to the editor. So you can make an offhand comment to the editor, because, because the, you know, the authors don't ever see that you can say, you know, this paper's a mess. These guys didn't know what they were doing. And I wouldn't really spend any more time on it. And that's okay to do that. But when you talk to the authors, you don't say, Oh, this paper's a total mess. What you say is, Well, I have several questions regarding the methodology for this paper. And then you list them. Then you'd be constructive. And you try to help them to learn a little bit again from the process. Especially you younger guys, you may not have had much experience sending in papers. And so it's, it's, it's kind of a scary process when you first do it. One more question. This may be very obvious for you, but how do you, how do you know it's a good reviewer? Like, how do you, what makes a good reviewer? What makes a good reviewer is oftentimes the comments they give, they make to the author to see, did they read the paper? Are the comments constructive? Are the comments on the money? And so when I get a review back, we literally rate them zero to 100, the reviewers. And so when I get a reviewer who says, first thing I like is, is I look through there and they, they really specify, okay, this is the problems with the paper. First of all, when they looked at the design, they didn't do a power calculation initially. And that's important to power calculation. They didn't match the groups together. They didn't, you know, mask it. And then we'll go through and say specific things. So a good reviewer will do specific comments on why they don't think that paper's good. And the worst reviewers to me are the ones that say that, you know, you get the thing that says, excellent paper, well done. Well, what does that do? That doesn't do anything for me. That's like having no reviewers. So then I have to go in and send it out to somebody else again, because that's a worthless review to me. And so even if you think it's a great paper, say why it is or make some comments or do something, there's always something that can make it better. Other questions? All right. Well, thanks for coming in.