A visit from New Zealand
A few days with visiting New Zealand orthopaedic surgeon Dr Marc Hirner, with a productive time in the operating theatre.
Also pictured is Dr Kristine Italia, fellow.
Why surgeons visit one another
A visitation, sometimes called an observership, is an arrangement under which one surgeon spends a period of time in another surgeon's theatre watching operating lists. It is a long established part of how surgical technique moves between hospitals and between countries, and it continues well past the end of formal training.
The reason it persists is that a written paper or an edited video conveys the steps of an operation but very little else. Being in the room conveys how the patient is positioned, how the theatre and the instrument trays are set up, the order in which things are done, how much tension is put on a repair, and what the operating surgeon does when the anatomy does not look the way the imaging suggested. It also allows the whole day to be seen, including the decisions made before the first incision and the instructions given afterwards. Surgeons travel in both directions over a career, and arrangements like this one are usually reciprocal.
What a fellow does
A fellow is a surgeon who has finished general orthopaedic training and is spending a further period working in one subspecialty area before entering independent practice. In a shoulder unit the fellow assists and operates under supervision across the full range of cases, runs clinics, follows patients through their recovery, and usually carries a research project alongside the clinical work. Having a fellow in the unit also means a visiting surgeon has someone to talk to through a list without interrupting the operating.
The conditions seen on a typical list include rotator cuff tears, shoulder instability, stiffness and arthritis, and the treatment chosen depends on the individual patient's examination and imaging. Individual results vary.
Related information
- Our shoulder surgery page
- Shoulder fellowship programme
- Rotator cuff repair
- Consultation