A visit from Kathmandu
Dr Mani Singh flew in from Kathmandu to collect his fellowship certificate, three years after completing the fellowship. He now practises as a shoulder specialist in Kathmandu, Nepal.
Good to catch up with him, and congratulations.
What a shoulder fellowship is
A fellowship is the period of subspecialty training a surgeon undertakes after completing general orthopaedic training and qualifying as a specialist. The fellow is already a qualified surgeon, so the year is not about learning to operate but about concentrating on one region of the body in sufficient volume to become fluent in it. A shoulder fellow operates with and assists the supervising surgeons, runs clinics, follows patients through recovery, sees how complications are recognised and managed, and takes part in research and in teaching the trainees below them.
Why surgeons travel for fellowship training
Subspecialty shoulder practice is not evenly distributed, and some operations are performed in substantial numbers in only a limited number of centres. A surgeon who intends to offer those operations needs to have seen and assisted at many of them, including the ones that do not go to plan, rather than having read about them. Travelling for a fellowship is the established way of acquiring that exposure, and it is why fellowship posts in Australia, Europe and North America take surgeons from other countries each year. Individual results vary.
What a fellow takes home
The technical skills are the visible part, but the judgement about when not to operate is at least as important, along with the habits that surround an operation: how patients are assessed and selected, how imaging is interpreted, how follow-up is organised and how rehabilitation is directed afterwards. A fellowship also creates a professional relationship that continues after the year ends, which is how surgeons in different countries come to collaborate on research, refer difficult cases and ask one another for advice. Individual results vary.