Teaching the registrars
Dr Kenneth Cutbush presented a shoulder surgery session to the Australian Orthopaedic Registrar Association in Cairns in October 2016. Around 120 orthopaedic registrars attended the AORA conference.
The Australian Orthopaedic Registrar Association
The Australian Orthopaedic Registrar Association is the representative body for orthopaedic surgical trainees in Australia. Its annual conference is organised for registrars and brings trainees from every state together with invited faculty. A meeting run for trainees rather than for consultants can cover the fundamentals openly, and trainees are far more willing to ask a straightforward question in that setting than in front of their own department.
The topics
- Prosthetic joint infection.
- Examining rotator cuff problems.
- Assessing glenoid bone loss in unstable shoulders.
- Managing osteoarthritis with a B2 glenoid.
All four are subjects where a trainee's approach is formed early and is difficult to change later, which is why they are worth covering at registrar level.
Two of them are about measurement before any decision is made. The glenoid is the socket of the shoulder. In a shoulder that has dislocated repeatedly, bone is often lost from the front rim of the glenoid, and how much has been lost influences which stabilising operation is appropriate. A B2 glenoid describes a pattern of wear seen in shoulder arthritis in which the back of the socket is worn away unevenly, which affects how a replacement component can be seated. Individual results vary.
Why teaching registrars matters
Registrars are in training for a limited number of years and then practise for decades. The habits formed during training, in how a shoulder is examined, in how a scan is read, and in when an operation is or is not offered, tend to persist. Teaching at this stage reaches the point where it has the most effect.
It also exposes the teacher to the questions a trainee asks about steps that have become automatic, which is a useful discipline for anyone who has been doing the same operations for a long time.
Related information
See our pages on rotator cuff tear, shoulder instability and shoulder arthritis, and our shoulder fellowship page.