Leaving Brisbane
Noel Peter is leaving Brisbane for a post with the Buckinghamshire Healthcare NHS Foundation Trust in Oxford.
He completed a shoulder fellowship here, an AOA-accredited programme in shoulder arthroscopy and arthroplasty based at Princess Alexandra Hospital and Brisbane Private Hospital.
The team gave him a farewell gift of RM Williams boots. I have never seen such a turnout to send off one of my fellows.
With thanks to everyone who helped set up the fellowship.
What an accredited shoulder fellowship involves
A fellowship is undertaken after a surgeon has completed general orthopaedic training and is qualified to practise, and before entering independent consultant practice. Accreditation by the Australian Orthopaedic Association means the position has been assessed against standards covering the volume and variety of cases, the supervision provided, and the teaching and research opportunity attached to it.
Basing a fellowship across a large public hospital and a private hospital is deliberate, because the two provide different case mixes. A public trauma hospital brings fractures and the acute presentations, while a private list tends to carry more elective reconstruction and joint replacement. A fellow working across both over twelve months sees the range of shoulder problems in a way that one site alone would not provide, and follows patients through clinic and rehabilitation rather than only seeing them in theatre. Treatment for any individual patient is decided on their own examination and imaging. Individual results vary.
Arthroscopy and arthroplasty
The two halves named in the programme describe the two broad kinds of shoulder operation. Arthroscopy is surgery done through small portals using a camera and fine instruments, which allows work inside the joint without opening it widely. It is how most rotator cuff repairs and most stabilisation procedures for a shoulder that keeps dislocating are performed.
Arthroplasty means joint replacement, where the worn surfaces of the ball and socket are replaced with artificial components. It is considered for arthritis or joint surface damage causing pain and loss of movement that has not responded to non-operative treatment. The two require different skills, different instrumentation and different judgement, and a fellowship that covers both prepares a surgeon for the full range of a shoulder practice. Posts of this kind are frequently taken by surgeons who then return to practise in another country, which is one of the ways techniques move between health systems.
Related information
- Our post on the 2016 Cutbush Research Prize
- Our post on all-arthroscopic latissimus dorsi transfer
- Shoulder fellowship
- Shoulder surgery