A past fellow returns
Dr Rishi Narasimhan, a past fellow who is now an orthopaedic surgeon at Ipswich Hospital, visited the operating theatre.
He took part in discussions on shoulder arthroplasty alongside current fellows Mirek Karel, from the Netherlands, and Ryosuke Iio, from Osaka University in Japan.
Past fellows returning is one of the more useful features of a long-running programme: they bring back what they have found works in their own practice, which is a different perspective from that of a fellow still in training.
What shoulder arthroplasty involves
Shoulder arthroplasty is the replacement of worn joint surfaces in the shoulder with implant components. The two main forms are the anatomic replacement, which reproduces the normal layout of the joint and depends on the rotator cuff tendons still working, and the reverse replacement, which inverts that layout so the deltoid muscle can raise the arm when the cuff cannot. Choosing between them, and deciding how to deal with a socket that has worn unevenly, is where most of the discussion in shoulder arthroplasty sits. Individual results vary, and the choice is made for an individual patient after examination and imaging.
Why a fellowship network is useful
A fellowship programme that has run for a number of years accumulates a group of surgeons now practising in different hospitals and different countries, and that group is worth more than the sum of the individual training years.
Fellows currently in the programme gain from meeting people who have been through it and are now making the same decisions without supervision. Past fellows gain a set of colleagues to put a difficult case to, drawn from people trained the same way, so a description of a problem needs far less preamble. The unit itself gains feedback it would not otherwise receive, since a past fellow reporting that something has not translated well to a different hospital is more useful than any conference abstract.
Fellows from different countries
Fellows come from a range of countries, and that is deliberate rather than incidental. A surgeon who trained in the Netherlands and one who trained in Japan arrive with different default assumptions about the same problem, and the discussions in theatre and clinic are more productive for it. Having to explain why something is done a particular way, to someone who has seen it done otherwise, is a reliable test of whether there is a reason for it.
Affiliations and acknowledgements: QUT, The University of Queensland, St Andrew's War Memorial Hospital, Tornier USA and Stryker.
Related information
See our anatomic total shoulder replacement and shoulder fellowship pages, and our posts on Dr Mirek Karel and Dr Ryosuke Iio.