Raghib Ali OBE, CEO @ Our Future Health UK

Hey everyone, welcome back to The Graduate Guide. Today I'm joined by Rohit. Rohit is the CEO of Our Future Health UK. Welcome to the show, Rohit.

Good morning.

Thanks so much for coming on. I guess the perfect place to start would be to tell the listeners a bit more about the work you're doing at Our Future Health.

Sure, thanks for inviting me on firstly. So Our Future Health is a new research programme, but it's going to be the world's largest research programme quite soon. And what we're really focused on is how to better prevent common chronic diseases like diabetes, heart disease, cancer, dementia, mental health disorders, obesity, etc. So The way we've really developed medicine, delivered medicine for most of the history of the NHS, is to treat people when they've already developed disease, when they've already got symptoms and signs. What we're trying to do through Our Future Health is really to see how we can identify people at higher risk earlier, intervene earlier, and thereby prevent those diseases.

Amazing. That's a great cause. I can't say anything more than that. How did you come to join the organisation?

So do you want the long version?

Whichever is best for the listeners.

Or the short version. I mean, it's an area I've been working in. By background, I'm a medical doctor. Yeah. And so I'm a consultant in acute medicine. That means I work mainly in A&E, seeing patients with things like heart attacks, strokes, infections, kidney failure. So that's really seeing people at the end stage of a disease, you know, when they've already had this disease probably for decades, and then they end up with a heart attack or stroke, something like that, or cancer that's already spread. But in parallel, I've been interested in what causes disease. So I'm also an epidemiologist. Which means that we're focused on disease in the population, not just in the individual. So I've spent much of my career in research trying to understand what causes disease, and particularly in trying to understand cause in populations that haven't been studied before. So in the UK, that's mainly ethnic minorities and more deprived populations, and then globally, lots of populations haven't been studied. So I've worked in India, I've worked in the Middle East. In terms of Our Future Health, so the project was launched or announced in 2019, And Professor Sir John Bell, who was the Regius Professor of Medicine at Oxford, was the life sciences champion, or is the life sciences champion. He launched it back in 2019. It started around 2020. He asked me to join the programme early on, but the reason I couldn't join actually is because of COVID So I think my first meeting was December 2019, and then obviously the pandemic struck.

Yeah.

So I spent 2 years, kind of 2020, 2021, mainly working on COVID. So partly on the frontline, working in A&E, seeing patients with COVID Also as an epidemiologist, trying to understand why COVID is affecting some groups, particularly some ethnic minorities, more than others. And thirdly, on the vaccine programme, trying to ensure that we had good uptake across the whole population. So it was finally in January 2022 that I joined RPH Health as Chief Medical Officer. So that's based on my background both as a researcher but also clinically, and I'd run similar studies before on a smaller scale. I mean, this is, this is on a scale that we've never seen before. We're trying to recruit 5 million people.

Wow, wow.

The previous studies I'd worked on for the last 8 years, we were trying to recruit 20,000 people. Well, I did work on UK Biobank briefly, which is 500,000 people, and that was the previous largest study. So I started as Chief Medical Officer in January 2022, and then in September 2023 is when I was appointed CEO.

Amazing. And what was that like transitioning from Chief Medical Officer to CEO? The reason I ask is that prior to that, right, you had never been, you you've never been a CEO anywhere else. I assume you'd manage teams and manage people, but how was that transition going into being the CEO of, like you said, a massively fast-growing organisation?

So it was a big change and in some ways a big challenge, but also a big opportunity. Yeah, generally in my life I've always seen challenges as opportunities, and I've had a slightly unconventional kind of career path, which maybe we'll come back to. Um, but I had run a university department before, so I had some experience of of running, you know, a department not on the same scale, that was about 40 people, with a relatively small budget, so a few million pounds a year. Our Future of Health is on a different scale, although when I joined we were 40 people, it's now 250 people. Annual budget is in, you know, 3-figure million, like over £100 million a year. So, and it's a big project, as I said, it's the biggest health research project in the world. So, but so far so good. I'm enjoying it, The main change, I guess, is there's no one really above you that you can ask for, or to delegate things upwards, you know, you can delegate things downwards, but the buck kind of does, you know, to use the expression, the buck does stop with you. So that puts some pressure on, but I think partly because of my background, I don't feel that pressure that much, because it's not as much pressure as, for example, dealing with patients in A&E or even during COVID That was probably the highest pressure situation I've been in, the first wave particularly.

I was actually going to come back to that, because I think for students especially, or young people listening, there will be a lot of times throughout their journey so far where they've experienced high-pressure situations. Nothing to that extent, but for them, I'm sure exams, assessments feel like they are as high-pressure as it could get at those points in their career. What would— do you have any tips for how students can, and people in general, can actually deal with that pressure? How they can still kind of, I guess, execute effectively under that pressure?

So I've got a lot of experience in exams.

I can imagine.

I think I've got 8 degrees now, so I've done a lot of exams over the years. So I very much can identify with, you know, what you say. I was a student for a long time as well. Yeah, a student from 1994, full-time until 2000 as an undergraduate studying medicine at Cambridge, and then postgraduate degrees carried on until 2020 actually. So my final, well, 2019, my final Viva I think was in 2019.

You can definitely relate to the students out there.

So I've been a lifelong student, and I think in some ways we're always of course learning. In terms of pressure situations, even at school, university, I think what was always helpful for me was, I guess, partly by nature, I don't panic particularly, I've always been fairly calm, and it's always putting things in context, you know, what's the worst that can happen if things go wrong. I mean, certainly over the course of my career, that's become an even bigger thing, you know, when I'm in the hospital, the worst that can happen is someone can die, and everything else in the context, putting that context, is less pressurised. I mean, you're right, for the average student, your exams, assignments, getting a job, etc., are high pressure. Now, it's not that I didn't feel that, particularly when I was doing my finals for medicine. Actually, one of the reasons I felt more pressure at that time was because I hadn't got a job. So normally you have a job before you graduate as a medical student because that's the way the system works. But for various reasons, maybe slight overconfidence, I didn't apply for enough jobs. And so the job that I'd applied for in Cambridge I didn't get. And, but that in fact turned out to be a great blessing in disguise because because the job I did get was at Oxford, and moving to Oxford in many ways led to the rest of my research and the career that I pursued, because Oxford was much stronger in epidemiology than Cambridge, which tended to be stronger in kind of basic science. So yes, I think overall my advice— and in fact my two sons at the moment are doing exams, my son's doing A-levels— the advice I always give in terms of exams is not to panic, you know. If you have a bad first part of the paper, If you panic, that makes the second part of the paper worse. If you have a bad day, that makes the next day worse. So it's always thinking positively as much as possible. And if you found the paper hard, then almost certainly everyone else has found it hard as well. And that's something you don't realize at the time, and you can't always take what other people say about how they found a paper. I certainly found that in my— particularly when I moved to Cambridge, which is a very different experience for me, having come from a very different background to most of the other students. And I always felt I'd be towards the bottom of the class. And I probably was until we actually got our first-year exam results in our college, and then I saw, okay, maybe I'm not at the bottom of the class, and that really gave me confidence for the rest of my time there.

Yeah, no, I think that actually is great advice and carries over to any really situation where you're under a lot of pressure. Like you said earlier, changing and reframing that challenge and opportunity, having that positive thinking, I think it's a great way to deal with those situations. So thank you for that. I'm sure that the listeners will take a lot of value out of that. In terms of, as you mentioned, you've had a bit of a unconventional career path. Could you maybe expand on that? What have been the, I guess, the biggest challenges along the way?

Sure. So I mean, as I said, I graduated in 2000, and at that time the system was slightly different for medical students. So you either— you did a house, what's called a house job, your first year, which was compulsory. You do kind of 6 months medicine, 6 months surgery. So I did that as expected. I said, not in Cambridge as I planned to, but half in Oxford for medicine, maybe the half was in Walsall, which was again a different experience. I've lived in the South most of my life, and moving to the Midlands was— and quite a deprived part of the country— was quite an interesting experience, very different to Cambridge, Oxford, certainly. And then the first decision you make as a medical student, or as a junior doctor rather now, is whether you go into medicine or surgery generally. So I decided I was more interested in medicine, so I applied initially to do A&E because I had a 6-month kind of gap between starting a medical rotation. So I did that in Nottingham, which at that time was the busiest kind of A&E department in the country, and we used to have very long waits for patients, like 8, 9 hours. That was a good experience, again relatively high pressure. I think the main thing that which is unusual, so I did actually follow for the first 3 years a fairly conventional path, so house jobs and then 2 years what's called a senior house officer rotation in various medical specialties. But during that time I'd already realised I was more interested in kind of public health, what causes disease, And I wasn't ready to give up clinical medicine. I asked advice from my consultant at that time. He said, 'If you go to public health now, you can never come back to clinical medicine, whereas if you carry on doing clinical medicine, you can come back to public health later.' And that's really what actually did transpire. So I carried on doing my clinical medicine consultant training, and that carried on until 2009. But in parallel, what I did, which was slightly unusual, is I started taking degrees in epidemiology and public health, and then my doctoral degree as well. I started at that time, I started working on projects, not really in my spare time because I didn't really have spare time as a junior doctor. I took a couple of, or a few months out to work on UK Biobank in 2004. That was my first introduction to kind of large-scale epidemiological research. And then I became a consultant in 2009. And I guess even the other thing I did, which was kind of in my spare time during that, was to set up a clinical research network in India, which hadn't really done clinical research at scale before. So that was a new experience and a new experience for me as well as researchers in India. So that was unusual, doing that in parallel while working. But yeah, the next 10 years were slightly unconventional. So from 2010 to 2020, I actually spent most of that time abroad. So I was looking to set up what are called cohort studies, large studies where we study populations to try and understand what causes disease in the Middle East. And the reason I got that idea was not actually from me, it was someone called Sir Richard Doll, who's a very famous epidemiologist, really the father of kind epidemiology in the UK. He set up the first study called the British Doctor Study, which established the link between smoking and lung cancer. So he's very famous because of the finding, but not everyone's heard of him. So obviously it's kind of, everyone knows that now, and it's kind of, of course smoking causes lung cancer, but back in the 1940s and '50s it wasn't known. And he did the study that really established that. But he said to me, we've got no studies like this in the Arab world, so you should go and try and set up a study. I'm not sure why he asked me, but anyway, he gave me the idea. So yeah, 2011 I moved out to the UAE. So I lived in Dubai, I mean Abu Dhabi, for 7 years. And I set up a study there, it was called UAE Healthy Future Study. That was the first cohort study of its type in the UAE and one of the first in that whole region. And so yeah, that took me like 2011 to 2019. I was mainly out there, and then as I said, I came back for the pandemic and then I decided to transition.

And then I've transitioned into our future.

Yeah, working abroad is not It's not that no one does that, but it's not that common. And also kind of taking in some ways quite a big risk, because when you go out to live in a different country and work outside of the conventional career path, there's no guarantee you can come back. So although I carried on doing some clinical work, like a month every summer when I came back from the UAE, it was, it wouldn't have been necessarily that easy to get back into an NHS career. Yeah. Also from a research perspective, because I had taken, you know, this time out, it may not have been that easy. As it happened, you know, thank God it was relatively straightforward, but it may not have been.

Yeah, everything worked out in the end though, right?

It did, but I guess the main point is I was willing to take risks because I saw the opportunities, and for me it's worked out. I know that, you know, who dares wins, I guess.

Always, always. But one thing that really stood out to me about your journey is the fact that you mentioned earlier being your belief and how much you advocate for being a lifelong learner. Um, something I find really interesting is I think a lot of people learn up until when they get their degree, they then go into their full-time role and they find themselves too busy to find time to then learn on the side. How did you manage to balance that between being a junior doctor and still studying degrees? Is there any tips you could give to students on how they can still find the time to kind of still develop skills on the side alongside that graduate role or whatever they may be working on at that point in time?

So time management is obviously kind of the key here. Yeah. And you're right, junior doctors are busy, you know, we do work long hours. But actually the role I had for those 5 years from 2004 to 2009 was a kind of split research and clinical role, so half the time was in research and that did give me more time to devote to the degrees. The other thing, I did all my degrees by distance learning, so, and I've got a good memory which helps, so I was able to kind of do 2 master's degrees with relatively less work than maybe other people would require, just because I've got a good memory, so I could kind of cram. And in fact, that's always been my— I'm not advising this, by the way, but different things work for different people. But for me personally, I've always been able to learn quite a lot of material in a short period of time. So I'd kind of take a week off before the exams, you know, read all the books, and that works for most things. I mean, there were assignments I had to do during the year as well, but yeah, because I was doing a combined clinical research role, it certainly made it easier. If you're a full-time clinician, that's much harder. If you're a full-time doing any job, of course, you know, finding time in evenings, weekends, etc. is not easy, but it's easier now. Yeah, because there's so much opportunity for distance learning. In fact, when I started, it was still kind of pre-internet. Of course, existed, but the courses was delivered by book and paper, and now it's all online, which has made it even easier. No, 100%.

I think that makes complete sense. In terms of your work then at Our Future Health, is there anything so far? And I mean, if you can't share, Martin, that's completely fine. Is there anything so far that you found that you'd recommend to students right now out there that they can do to live healthier lives? Obviously, when you're early on in your life, one thing you are aware of is kind of that prevention and not wanting to get to a later stage and regret stuff. What would you recommend to students to do so?

So you're right, the study is in its early stages.

Yeah.

Although we have got 1.5 million people have already joined. Okay. So we've made a good start in the first kind of 1.5 years. I mean, there are certain conditions which affect young people more. So mental health disorder has been a big issue, you know, anxiety, depression. Obesity also is a big issue, even in younger people. So there are things which in some ways are very obvious. So in relation to many diseases, physical activity and a healthy diet are really important, and most people don't exercise enough, most people don't eat a healthy enough diet. I know it's easier said than done, but it does come back to some of these basic things. And often it's very small decisions. So if you ask people to go to the gym, for example, or to go for a run every weekend, they may not do it because we're all busy and it's taking time out. But there's fairly good evidence now that even small decisions, like for example, in this building we're in now, you can take the lift or you can take the stairs. When you go to buy lunch, you can buy a sandwich or you can buy a chocolate bar. These small decisions actually make a big difference. If we're in London now, you can take the tube or you can walk. So these kind of small decisions that you make every day actually make a big difference. Doing housework, doing small small tasks, standing up every hour, etc. But these things do help. So it's not that you need to completely change your routine. It's those small decisions that accumulate over time and really do reduce your risk of disease like diabetes, heart disease, cancer. For mental health disorders, it's a slightly different challenge. Obviously, having supportive friends, family, etc., helps. Being able to talk to people when times are difficult is certainly helpful. But yeah, that's a slightly different challenge.

So I guess part of it is just being more, more conscious of your decisions.

Certainly for physical activity. Yeah, that's certainly true. It will make a difference.

And how important is sleep? Because I know that's a big, a big issue, and I'm sure one that you've experienced in your time.

No, you're right.

Having been a junior doctor, how important is sleep?

I should have mentioned sleep. Sleep is really important. So there's very good evidence now that people that sleep less than 7 hours a night, you know, have worse health outcomes. So somewhere between 7 and 8 hours seems to be ideal.

That makes me feel really bad about last night.

I mean, as a student, actually, I was quite good at making sure I had a good night's sleep before exams. Yeah. So I knew at that stage, I remember my first year at university, my neighbour, she used to kind of stay up the whole night and cram, you know, before the exams, and I used to kind of get asleep fairly early and get a good night's sleep. And this is only a small trial of two people, but unfortunately she failed her exams and I managed to do quite well. So that was a kind of lesson for me that that, because people do do that as students, you know, that they do try to stay up all night. But my advice generally, not just for exams, but in life in general, is to kind of prioritise sleep over most other things, because it's really important for health. And there's a lot of evidence for that now.

And would the amount of sleep that's needed vary from student to student or person to person?

It does vary. And we're getting better data now. And in fact, physical activity, diet, sleep, all of these things, you can make general population recommendations. But it's true, that what is best for an individual does vary. The problem is it's quite hard to know what is best for you as an individual now. I mean, if you ask me in 10 years' time, I suspect we'll have much better data and Our Future Health will actually help to show how we can track individual people. Because at the moment, mainly what we do is to look at the whole population and then look at averages and then say— but you're right, there will be people within that and the technology has moved on now so we can see based on your kind of genetic makeup, other things that we can measure in your blood, and measuring physical activity, diet, etc., for you as an individual over a number of years, and whether that— what that leads to. And you're right, you'll find people like Donald Trump, for example, or Margaret Thatcher, for some of our older listeners, who used to sleep very short time but in some ways have been very successful. So there's always these kind of exceptions, but at population level, it's certainly true that a good night's sleep is very important.

And so something you mentioned there is that kind of that personalised healthcare. Is that where you're looking to move towards in the next 5 to 10 years of our future health, is being able to actually provide that personalised insight into how you can live a healthier life, how you can prevent these diseases.

Exactly. So yeah, currently we're mainly based on population-level advice, but we need to develop interventions that are tailored to the individual. So we talk about precision medicine, some of your listeners will be familiar with that, and that's really about getting the right treatment to the right person at the right time. What we're trying to do through our future stuff is something like cancer, you know, there are— each tumour is different and you can now tailor your treatment to that particular tumour. For prevention, that really hasn't been tried yet. And we're looking at this, what we call precision public health or precision prevention, where we're trying to understand how to prevent disease in individuals. And that's really what Future Health will have a transformational effect on this field because it's never been possible before. Yeah. Yeah.

And I think it will have a big impact, like you said, with sleep. There always is the— and I think you can often lie to yourself when it is population data that you're given. You can always lie to yourself and say, oh no, but I'm one of those people. Doesn't need, doesn't need 7 to 8 hours sleep, even though you don't, you're not aware of the effects it's having on your body yet.

And there's lots of things going forward we'll be able to measure, as I said, in the bloodstream, wearables, etc., that will give us much better data on this.

And what are the biggest challenges to getting to that future, would you say?

So the first challenge is collecting the data. Our Future Health will certainly help with that. So having data on 5 million people. The other thing we're trying to do through our Future Health, which hasn't really happened before, is to get people from every type of background. So different ethnic groups, different socioeconomic groups, every part of the country, all ages. So it's the first the first study that's open to kind of 18-year-olds plus. So we've got a very large number of young people that have joined already, but we're very keen to get more younger people. So the group least likely to join are 18 to 29-year-olds, so which is very much your listenership. And the group most likely to join are 60, 69, as you might expect, because— but if you want to live a long, healthy life, which is what we're aiming to do through Our Future Health, it's best to start as early as possible. So collecting the data is the first step, but then researchers being able to analyse that data is the next step. And what we're doing at Our Future Health is to make the data available to everybody. So anyone can apply, you know, researchers from the NHS, from universities, etc. And UK Biobank did the same thing. That was actually very helpful because it meant that you can maximise the opportunities from that research. And the third thing is to test interventions on people to see, does this intervention lead to better outcomes and is it cost-effective? And again, we'll be able to do that through our future health.

Amazing, I can't wait for that. In terms of, you mentioned a lot there about kind of the physical activity, the sleep. In terms of mental health, is there anything that students can do to help improve their mental health? I think that's something that a lot of listeners will be able to relate to, is that everyone throughout their journey, especially at university or going into their graduate role, will go through periods where maybe their mental health suffers. What advice would you have for them at that stage of their life?

So mental health is harder in terms of tackling it, partly because we don't understand all of the risk factors as well, and there are lots of things which are outside of healthcare which obviously impact on people's mental health. So I think for the first time, as I said, we've got a large enough study to really understand those risk factors better. So if you ask me again, if you come back in a few years, I'll be able to give a better answer. For now, what evidence we do have is that, you know, being able to— so-called talking therapies, so being able to talk to people about the problems you're having, anxiety, depression, stress, etc., there's good evidence that that leads to improved mental health. Some of these mindfulness techniques, etc. What I don't think we should be doing is overmedicalising anxiety and depression in particular. This is It has increased, and that's partly, you know, COVID didn't help, of course, economic situation, cost of living crisis, etc., hasn't helped with all of these things. And that's what's led to some of these increases. But yeah, some of these techniques there is evidence for. I think we'll have better evidence in the coming years, and ideally without having people to take, you know, medicines, because all medicines have side effects as well. And if there are things that we can do that lead to better health outcomes, whether it's obesity or mental health disorders or any other disorders which are non- involve medicines, I think that's preferable.

And ideally get into a future where we can prevent the, the suffering in its entirety, right, rather than having to go through it and then treat them.

Exactly.

Ideally we'd like to prevent it beforehand.

Most of the causes of disease lies outside of medicine.

Yeah.

You know, a lot of it, I mean, I mentioned briefly earlier in terms of my own background, you know, growing up in relative poverty, if you like, difficult childhood circumstances, that's given me an insight into the challenges that people face, and that doesn't help, you know. Most outcomes are much worse for people from the poorest backgrounds, you know, whether it's mental health disorders, whether it's obesity, diabetes, cancer, heart disease, etc. I mean, on average, and it's shocking in some ways, but people from the most deprived backgrounds live 10 years less than the least deprived, and that's in England, you know, or across the UK, and they have 20 years lower healthy life expectancy. So they live in good health for 20 years less. You know, if you live in Blackpool compared to Westminster, there's a 20-year gap, and that shouldn't be the case. You know, so that's something which, as I said, does lie outside of medicine in many ways. It relies on not just government, but certainly government has an important role, but government and society seeing how we can reduce those inequalities, how we can provide better opportunities for young people. And that starts from a very young age, really at primary school or even before that, you know. So children have— I mean, I was lucky, I had very supportive parents, you know, they provided, although they didn't have money to support us, they provided a stable kind of home environment that we could study. And take those opportunities to get a good education, and that's really where it starts.

I think it really is an amazing mission that you're on. I definitely would love to be able to speak again in a couple of years and see how much more insight you have for the listeners. I'm sure there's already a lot they can take away. Two final questions for you. The first is, now being a CEO and as you mentioned having led kind of departments or led teams in the past, what have you learned about what makes a good and effective leader?

So for me personally, it's The most important thing, I mean, there's a few things which have been helpful for me, and this doesn't apply to every situation. Yeah. But certainly for leading Our Future Health, having a background as a medical doctor, having seen patients and being able to explain to people why this is so important has helped for my team as well. Because although, you know, it's a great mission, you know, our mission is to enable everyone to live longer, healthier lives. No one's going to disagree with that. And people that join the company, they're very much committed to that mission. But being able to explain to them how it's really going to help, enable them to maintain that motivation. So that's certainly been important for me at Our Future Health. Secondly is kind of the people skills, so that actually again being a doctor has helped with that, so dealing with not just your executive team but anyone across the whole organisation. And very much I try to lead by example, so I don't ask people to do something usually that I wouldn't, you know, be able to do. If I can do it myself, I would do it myself. Yeah. And also I always stress this is an opportunity, you know, I don't see Although I am leading the project, it's a privilege, you know, to be able to lead a project like this. It's something I could never have expected, not just because of the circumstance I grew up in, but just in terms of my career. It's not something I would ever have thought would be possible for someone like me to do, so I'm very grateful for the opportunity. And I think the rest of the team, they can see that, you know, we are a mission-led organisation. But I also always say, you know, a good mission or an amazing mission is not enough. I mean, even in the NHS, We see junior doctors going on strike and struggling even though they've got, you know, they are literally saving lives. But you also have to make the work environment as good and as productive and as pleasant as possible for the team. And that's what I've also tried to do at Our Future Health.

I think that's some amazing advice there. I think especially I love the fact that you've said about leading by example, the fact that you have this background in medicine. I think it's something I always preach, I've always believed myself is that when you're a younger person, when you're less experienced in your career, don't be afraid to do the tasks that maybe don't seem like something a CEO should do, because actually if you do reach the point of CEO, it may feel uncomfortable to be able to say to someone, hey, can you do this, if even if you've never ever experienced yourself. So doing that kind of groundwork yourself at some stage in your career is then, I assume, makes it easier to lead when it comes to that point.

No, it certainly does. And people, you know, I do tell them about my background because I think it helps them to see, you know, if someone like me can get to this position, yeah, um, then they should also. I want people to be ambitious. I want young people you know, students who may think they couldn't achieve what I'm doing now, that it is possible. Of course, you have to work hard and you have to have an element of luck as well, and opportunities that have to arise over time. But certainly, you know, in the UK, we're very fortunate that we have really good opportunities to get almost anywhere if you're willing to work hard and take the opportunities that arise.

No, I love that. And the final question, what is your final piece of advice for students listening?

So the first piece of advice is please join Our Future Health. So you can join online, you go to our website, which is ourfuturehealth.org.uk. You just to sign up online. But no, the most important thing I say, whatever your background, you know, ethnically, socioeconomically, geographically, don't feel that you can't achieve something because of that. I'm one example, but there are many others, you know, across all fields, not just in medicine. And in fact, medicine used to be dominated by people from private school backgrounds, but now it's changed a lot. You know, there are people from every background that are becoming doctors. There are people from every background becoming lawyers, becoming managers, teachers, etc., all walks of life. So don't limit your ambition because of that. Secondly, of course you have to work hard, you know, there's no shortcuts. Although I said I was good at cramming and good at, you know, I had good exam technique, I mean, of course I've worked extremely hard to get to this position. So there really are not shortcuts. But thirdly, don't be afraid to take risks, and actually it's easier now in the way that the world of work is, you know, you don't have to be in the same job or the same career forever, and I've changed careers in some ways, You know, what I do now is very, in some ways, quite far from being a doctor, running a company, you know, being involved in all the financial, legal, administrative aspects of running a company. But it ultimately will lead to what I want, which is to help people to live longer, healthier lives. So yeah, don't be afraid to take risks and to do something slightly different, and to even to do it for a short time and then come back. So, you know, the opportunities are massive out there. Sometimes people are a bit negative about the UK. I certainly don't see that. They're thinking, you know, I hear about these, I'm going to move abroad, or I'm going to go and work in Australia, or the Middle East, wherever. I really think the UK is one of the best places in the world to achieve whatever you want in any career.

Yeah, no, I love that. I think that's a great way to wrap it up, and thanks again so much for coming on, Raheb. I'm sure there's a lot of value there for our students. Thank you.