ISKSAA Lancashire Fellowship 2014 Report
I, Dr. Jaswinder Singh, along with Dr. Prateek Behera was selected in the interviews conducted in September 2014 at New Delhi for a travelling fellowship at of three weeks duration at the East Lancashire Hospitals, UK. Mr. Makaram Srinivasan, primarily an upper limb surgeon, and our fellowship guide to invite us, advised us to book flight tickets to Manchester. We arrived on 25th October, 2015, and were received by Mr. Alan at Manchester airport, who drove us to Blackburn. Mr. Srinivasan had arranged for our accommodation at Croasdale Street, Whitingdale cresent, close to the Royal Blackburn hospital. He came down to meet us and discussed plans for the next day.
Our fellowship started officially from the next dayin Orthopaedics and traumatology department at the Royal Blackburn Hospital (RBH). We were introduced to Mr. Q Choudry, the director of orthopaedics and we were followed to trauma meet.
After occupational health checkup and medical staffing clearance, we were issued our temporary identity cards for the hospital by Ms. Kathrine. We then attended theatres with Mr. Choudhry to observe an uncemented THR. The day ended with a trip to local supermarket ASDA, to get some daily supplies for home.
Next day we accompanied Mr. Srinivasan to Burnley General Hospital (BGH). We met Mr. Mohan, Mr. Rajesh Sarin, Mr. Saikia other consultants for the ELHT. We observed revision THR being performed by Mr. Mohan. Thereafter, we went to Grisburne Park Hospital (BMI Group) with Mr. Sarin to observe a TKR. The following day, we attended the outpatient clinic of Mr. Srinivasan, which we found was an altogether different experience for us. Use of Dictaphone to record the observations and the coordination by the staff was amazing. I was really amazed by the way Mr. Srinivasan was managing the outpatient fracture clinic. His clarity of the conditions and way of explaining the condition to the patient was noteworthy. Quick decision making was also appreciable. He same afternoon, we went to BGH and observed an "all in technique" of ACL reconstruction by Mr. Goyal, who is primarily a knee arthroscopy surgeon. In the next two days we observed surgeries by Mr Srinivasan and Mr. Mohan along with few by Mr. Shah.
Weekends being free in England, we travelled to Blackpool and Windermere for local sightseeing, assuggested by Mr. Mohan and My Ahmed (our accommodation owner). We enjoyed the trip.
For next three working days, Mr. Srinivasan and Mr. Mohan were both in Irelend for FRCS exams. We were guided and looked after by Mr. Shiv Aithal, a foot and ankle surgeon, and we are really grateful to him for organising everything to the smallest details. The plantar plate repair performed by him for a degenerative tear was amazing. He also performed few image guided injections into the ankle and subtalar joints. The technique which was simple, effective and easily reproducible. These techniques would help me in my clinical practice a lot. Next day, we observed the surgeries by Prof. Robin Paton, a paediatric orthopaedic surgeon. He revised a failed DDH surgery, with addition of femoral shortening and derotation osteotomy. In another case of subluxated hip in a CP child, he performed VDO. The following day, we attended the theatres of Mr. Shah and Mr. Saikia to observe hip and knee arthroplasties, with each surgeon having their unique way.
The coming day we attended the audit meeting of orthopaedics department.Following the presentation till noon, we headed to the OT complex, where Mr. Srinivasan had arranged for a delicious Indian lunch for us. We observed few trauma surgeries. On Friday we went to the Beardwood hospital with Mr. Srinivasan to observean arthroscopic Bankart's repair and a rotator cuff repair. He performed both the procedures with dexterity and ease and also kept on describing the steps. We asked our questions and clarified the doubts freely and he was kind enough to explain all the points raised by us.
Next day, Mr. Srinivasan drove us all the way to Wrightington, the famous centre for Hip Surgery developed by Mr. John Charnley. We had the opportunity to attend one of the teaching sessions being conducted for the MCh students by Mr. Videsh Raut. We discussed the details of the MCh programme. We also had a healthy discussion with the MCh students, majoritybeing Indians and got a genuine idea about the course, the job profile, its pros and cons and the fee involved. The weekend ended up with travel to Manchester for a sightseeing.
The last week started with an amazing shoulder surgery in the form of a reverse shoulder arthroplasty performed by Mr. Srinivasan. The procedure was described step by step and was performed fluidly. This was followed by arthroscopy of ankle and a hallux valgus correction in the afternoon session by Mr. Aithal.
The coming day was fruitful again with Mr. Srinivasan to observe arthroscopic surgery on shoulder for rotator cuff injury, impingement and a of clavicle malunion. The following day was spent with observing surgeries performed with Mr. Shah and Mr. Kevin Sharpe. The same evening, we were invited by Mr. Srinivasan at his home for dinner. I generously thank for Mr. and Mrs. Srinivasans's hospitality. We had a sumptuous homemade dinner and good and frank conversations which lasted till late in the night.
Next day we observed ulnar shortening osteotomy performed with a Synthes jig and a PHILOSby Mr. Srinivasan. The same evening, we were again invited for dinner in an Indian restaurant with Mr. & Mrs. Srinivasan, Mr. & Mrs. Mohan and Dr Kiran. We enjoyed the conversations along with excellent words of advice regarding our careers. The last day was spent observing an arthroscopic Bankart's repair by Mr. Srinivasan followed by a THR and a TKR by Mr. Choudhry.
I left for London the same evening for a week, where I joined my family, who had come from India the same evening.
Overall, it was a nice experience. The love, affection and support received from Mr Srinivasan and all other consultants was exemplary and the cooperation received from the OT staff in each of the four hospitals we visited was praise worthy. I was able to see the work culture in the field of medicine way different than what I'm used to. I believe my trip would be helpful in my day to day practice. I am also thankful to Dr. Pushpinder Bajaj and Dr. Lalit Maini and other ISKSAA organisers for taking all the pains to arrange this fellowship for us. I would also like to thank my co-fellow, Dr. Prateek Behera with whom I spent these academic three weeks. He is wonderful human and a curious surgeon. Overall, I would describe the whole experience as Another feather to my 'Turban'. Thanks ISKSAA and thanks everyone unnamed.
Regards,
Jaswinder Singh.
