ISKSAA MIDLANDS UK TRAVELLING FELLOWSHIP

First of all we are grateful to the Whole ISKSAA team for extending their support for guidance and completion of ISKSAA Midland fellowship-2014-15. We are thankful to Dr. Lalit Maini and Dr. Pushpinder Bajaj who are guiding us in every step so also encouraging both of us throughout.

Myself Dr. Sambit Kumar Panda ad my colleague Dr. Darsh Goyal have a very good experience regarding our ISKSAA Midland fellowship. This started from the last interview itself where we all had offered a very friendly environment. We were excited and nervous regarding our interaction with Dr. Ved Goswami over the first interaction but he himself greeted all with an wonderful HELLO and made us relaxed by offering a very casual and friendly interaction. He asked our expectations regarding the fellowship and also at the same time made everything clear regarding his work schedule, so also the type of help we could get from this fellowship. We did clarify our doubts and enquiries everything regarding the fellowship so also the kind of accommodation, weather and work culture at his workplace. Really that was a great interaction as everybody felt good following that interview. Ofcourse I and Dr.Darsh were announced to have that at the end of ISKSAA - 2014.

After that we got the congratulation mail by Prof. Lalit Maini and Dr. Pushpinder Bajaj. From this we got know each other and also started interaction together with Dr. Goswami by e-mail regarding our further plans. Basically it was planned for the month of February but due to some unknown factors delayed up to June 2015 when we got our confirmation letter and fellowship schedule for the month of September 2015. In the meantime we were constantly in touch with Dr. Lalit and Dr.Bajaj regarding our progress with Dr. Goswami.

To start with this was a two weeks visiting fellowship, but both of us requested Dr. Ved Goswami to convert this into six weeks fellowship and it was accepted with an offer letter of schedule from 7^th September to 6^th October 2015. After all formal paperwork's and VISA clearance both of us were ready to fly on 4^th of September from New Delhi to Birmingham. By this time we were good friends over telephonic conversations but really we did interact each other by face at IGI T3 airport only with a warm hug to each other.

We reached at Birmingham airport in the night 5^th of September. Actually our accommodation was assured from 7^th September onwards and thus we took a taxi for our hotel booked before. We spend three days there. The next day was a shining Sunday and we did arrange our SIM cards, had a visit to the local super-market and a country side walk together. We telephoned Dr. Goswami to inform our arrival at Birmingham and had a good conversation. He enquired about our comfort at our arrival and also guided regarding our schedule for next day so also confirmation of accommodation at the best suited place.

We were to work with him in three hospitals, The Heartland hospital, The Solihull hospital both of which come under NHS trust and a third Spireparkway hospital which is a private one. Our accommodation was planned before at Heartland hospital but since most of our schedules were at Solihull hospital and Spireparkway hospital which was nearer to Solihull Hospital thus we were advised and offered accommodation in the Solihull hospital itself. We got shifted there on 7^th September. It was very good with all facilities like fully furnished kitchen, a separate lobby and spacious individual bedrooms. Most important was it was in the hospital premises itself and adjacent to the library so also to the Orthopaedics OPD and OT. There was a shuttle service running to and fro from Solihull hospital to Heartland hospital every hourly and Spireparkway hospital was at a walking distance of one mile from Solihull hospital.

We first met Dr. Goswami in his Fracture clinic in the Heartland hospital in the afternoon on 7^th of September. He greeted us with a warm welcome and introduced both of us to his Department. He involved his one of the staff named Mr. Rehman to find it ease regarding our paperwork to get hospital identity badge, detailed schedule etc. Mr. Rehman is a nice person who did his best to guide us and made our first day very easy. By this time we were happy persons to get settled well, we had our identity badges, Work schedule and after all a very good accommodation. In the evening we had a walk to the side by big shopping mall TOUCHWOODand the SAINSBURY'S store, purchased some essential food and vegetables. Since we were exhausted eating the British food and frozen readymade Indian food we brought along with from India, we together cooked Basmati rice, Dal Tadka and Gobi Alu fry. Along with Curd and salad we enjoyed the food very much. Since the next day schedule was very busy in Spireparkway OT with a long OT list we decided to reach there early.

Dr. Goswami was having on an average of ten cases in his OT list at Spireparkway OT and worked hard from 8 AM to 10 PM every Tuesday and Saturday to finish them with ease and accuracy. There we met Dr. Su Shilling, the Anaesthetist, hats off to her how she was managing all the cases one by one smoothly and continuosly. The transit time between every case was hardly 15 minutes, by this time Dr. Goswami was ready with scalpel for another case. The OT staffs were very punctual and dynamic in coordinating each and every case. Very often Dr.Goswami's OT list had 3-4 TKRs, 1-2 THRs, 3-4 Knee and shoulder scopys and 1-2 Carpel Tunnel Syndrome or Morton's neuroma. Dr. Goswami convienced the OT management to allow us to scrub and assist without much interference to their OT sterility to make easy the process of learning and teaching for both of us. So for each and every case both of us got scrubbed with him to understand the work culture, OT protocol and most importantly each and every step and tricks performed and taught by him. Dr. Goswami was very careful and alert in teaching and demonstrating each and every step and clues to the operative steps and repeatedly asking for questions and queries for our better understanding, and believe friends this stands true for each and every Case we did assist him through out this fellowship period. He was such a perfect surgeon that in every operation he recreated the similar steps and in each case we were taught all the steps again and again with increased perception of fundamentals all the time. We were very brave enough to fire tonnes of questions and doubts every time and Dr. Goswami never ever hesitated to explain those before us. Really we did admire his patience, dynamism and surgical skill that made the difficult things very easy. We also learnt his attitude and soberness towards OT staff which made everything run smoothly in the OT itself. Meanwhile we were served Indian food in lunch and dinner with a special reference as Guests to Dr. Goswami throughout the period.

Dr. Shilling was very much friendly as well as caring to both of inside the OT. After every OT she offered lift to both of us to drop in the hostel. This was a routine schedule for us to attend the OT early, to assist Dr. Goswami in every case, enjoyed food with special attention as guests and lastly had lift in the Land rover with Dr. Shilling up to the hostel. Really we enjoyed the Spireparkway OT very much.

Dr. Goswami was operating in the Solihull hospital on Monday afternoon, the whole day on Wednesday and often on Friday also. Therefore we did attend the OT there most of the time. He had his OPD in Solihull as well as Heartland hospital in rest of the time and we together got a chance to observe his attitude and dealing towards the patients from a close distance as Dr. Goswami made us sitting near to him while interacting with patients with the necessary formalities and permission from their side. Dr. Goswami was very kind enough to introduce us to some of the other consultants, pioneer in their fields and even we did scrub with them to learn and assist in their OT. We assisted Dr. Soumitra Bhattacharya many a times and learnt from him the tips and tricks regarding THR and TKR. We have assisted around a dozden of TKR and around 15 - 20 THR with Dr. Bhattacharya. We learnt the art of Total Shoulder Arthroplasty and also assisted a couple of Reverse shoulders with Dr. Salama, the famous shoulder surgeon. We came to know that Dr. Salama was a good friend of Dr. Pushpinder Bajaj and he was very happy to know our association with ISKSAA and Dr. Bajaj. We have got a chance to scrub in a couple of Revision Hip Arthroplasty with Dr. Trevor Laurence, around 5-7 THR with Dr. Madhur Srivastava and even a couple of Microscopic Discectomy with Dr. Holland, the famous spine surgeon. Truly speaking each and every consultant took all care to teach their skill and tricks in a simple way that we did admire a lot. However this was possible because of Dr.Shishir Nagware who guided us a lot in each day to best utilise our most valuable time in the OTs. Even we were taught the art of studying MRI of each knee and shoulder before scrubbing into each case in the OTs by Dr. Goswami and Dr. Shishir. We always asked Dr. Goswami the plan of operation and what he was thinking to act for that case before each and every case and he was always explaining his mind thought before us.

We got a chance to be registered free of cost in the conference "Upper Limb Regional Study Day" under BOA on 25^th September 2015 due to recommendation of Dr. Goswami. There we got a chance to interact with a famous shoulder surgeon.

Dr. Goswami was having a one week on call consultant duty in trauma at Heartland hospital in the meantime. Thus we have got a chance to observe various trauma cases like Bipolar HA, PFN, Interlocking Femur and Tibia so also Plating of Humerus and Forearm Fractures and many a number of trauma cases. Dr. Shishir also helped us to have a word round, to attend trauma review meetings and to observe some of the post operative rounds along with him.

We have got an opportunity to attend the journal club in the Solihull hospital, of course followed by a grand dinner. Each and every day we made it a habit to visit the 24 hour open - library at least for one hour to recollect the daylong teaching and operation skills which helped us a lot in raising many a more doubts and questions for next day to be clarified by Dr. Goswami.

After all we had a very busy weekdays schedule followed by the only free and sunny weekend Sunday that we reserved for refreshment and visit to places nearby Birmingham and Solihull. We visited London, Stratford –Upon-Avon, famous for Shakespeare's birthplace, local sightseeing in Birmingham so also the city centre and marketplaces in Birmingham and Solihull in Sundays. Many a times we were offered a warm hospitality and dinner by different consultants in different famous Indian restaurants.

Before coming back Dr. Goswami arranged a formal farewell for us two fellows along with some of his Indian Colleagues and registrars in his own house. We have had a great time there enjoying drink and food with his family. Really it was memorable.

Lastly at the end of our fellowship we were very sad to comeback as we enjoyed each and every moment there in a friendly and homely environment. Even oneday in the Solihull OT the Patient upon whom Dr. Goswami was operating was an Indian so also the Anaesthetist, the Assistant, both of we fellows, the Sister and the OT brother were.

The last day was also very hectic with a list of ten cases in the Spireparkway OT. As usual we reached there early, assisted one THR ,Two TKR and One knee and one shoulder scopy. Dr. Goswami took a great care again that day in teaching every step and really it was a revision for both of us. Then Dr. Goswami and Dr. Shilling arranged a group photo session in the OT to make our last day memorable. Lastly we said Good- Bye to everyone, took permission and blessings from our true mentor and a couple of advice and take home message and returned back to hostel. Dr. Shishir was waiting for both of us and we spent a good time before leaving the hostel. Lastly we were accompanied by Dr. Bhattacharya to the airport and we said Good-bye to him before leaving for India.