Dinner in Paris
Dinner with Dr Bart-Jan Veen and his wife. Bart is training as an orthopaedic surgeon in the Netherlands and is completing a PhD on the shoulder.
He will join us as a fellow in 2020, and we discussed the plans for the fellowship year. Fellowship places are arranged well in advance, which gives time to shape the research component around what the fellow is already working on.
What a shoulder fellowship is
A fellowship is a period of training undertaken after a surgeon has completed general orthopaedic training and is qualified to practise, but before entering independent practice in a chosen area. The purpose is concentration. Over twelve months a fellow in a shoulder unit sees a volume and a range of shoulder problems that would take years to accumulate in a general practice, including the uncommon presentations and the revision cases where a previous operation has not achieved what was intended.
The work is clinical and supervised. A fellow assists and operates under supervision, runs clinics, assesses new patients, follows patients through their rehabilitation, and takes part in the teaching of registrars and medical students. Seeing patients at every stage, rather than only in theatre, is a large part of the value, because it is how the relationship between what was done and what followed becomes visible. Treatment for any individual patient is decided on their own examination and imaging. Individual results vary.
Research alongside the clinical year
Most shoulder fellowships carry a research component, and a fellow who arrives already part way through a doctorate changes what that component can be. A PhD in surgery is usually built around a specific question, often a biomechanical or clinical outcome question, pursued over several years with formal supervision. A fellow with that work underway brings methods, a dataset and a defined question with them.
Arranging a fellowship a year or more ahead is what allows the research side to be planned rather than improvised. The question can be aligned with what the unit is already investigating, ethics approval and data collection can be organised before the fellow arrives, and the clinical year can then contribute to work that continues after they leave. International fellowships also create lasting links between units in different countries, which is one of the ways techniques and research collaborations move around.
Related information
- Our post on Bart Jan Veen presenting on shoulder anatomy during his fellowship
- Shoulder fellowship
- Research
- Publications