Portal de Periódicos da CAPES

What is the point of the American-British-Canadian (ABC) fellowship?

2008; British Editorial Society of Bone & Joint Surgery; Volume: 91-B; Issue: 1 Linguagem: Inglês

10.1302/0301-620x.91b1.21820

2044-5377

Alasdair Sutherland, A. Barrow, Kevin Mulhall, R.M. Dominic Meek, Rob Pollock, P Y Poon, Richard Williams,

Diversity and Career in Medicine

The Journal of Bone and Joint Surgery. British volumeVol. 91-B, No. 1 Personal ViewFree AccessWhat is the point of the American-British-Canadian (ABC) fellowship?A. G. Sutherland, A. Barrow, K. Mulhall, R. M. D. Meek, R. Pollock, P. Poon, R. WilliamsA. G. SutherlandSenior Lecturer, Hon. Consultant in Orthopaedic Division of Applied MedicineUniversity of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK.Search for more papers by this author, A. BarrowConsultant Orthopaedic SurgeonSunninghill Hospital, Corner Witkoppen and Nanyuki, Westmead, South Africa.Search for more papers by this author, K. MulhallConsultant Orthopaedic SurgeonDepartment of Orthopaedic Surgery, Mater University Hospital, Eccles Street, Dublin 7, Ireland.Search for more papers by this author, R. M. D. MeekConsultant Orthopaedic SurgeonSouthern General Hospital, 1345 Govan Rod, Glasgow G51 4TF, UK.Search for more papers by this author, R. PollockConsultant Orthopaedic SurgeonRoyal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.Search for more papers by this author, P. PoonOrthopaedic SurgeonDepartment of Orthopaedics, North Shore Hospital Private Bag 93503, Takapuna, Auckland, New Zealand.Search for more papers by this author, R. WilliamsConsultant Orthopaedic SurgeonPrincess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland, Australia.Search for more papers by this authorPublished Online:1 Jan 2009https://doi.org/10.1302/0301-620X.91B1.21820AboutSectionsPDF/EPUB ToolsDownload CitationsTrack CitationsPermissionsAdd to Favourites ShareShare onFacebookTwitterLinked InRedditEmail To be asked “Do you think that the ABC Fellowship has a future?” at the interview was something of a surprise. The initial response was “Well, I hope so, given that we are looking at giving it six weeks away from home.” You wouldn’t want to waste your effort on something that has had it’s time, now would you? There was, of course, serious intent in the question. Participation in the ABC is not something centred only in the present but is wrapped in the history of the fellowship and the experiences of those former fellows. The experience gained for the future and the responsibilities which fellows owe to the ABC are what it stands for.The first ABC Fellowship was the innovation of Professor R. I. Harris, Chief of Orthopaedics in Toronto and President of the American Orthopaedic Association in 1948. The Second World War had created great destruction, but it was a time of innovation in orthopaedics. There had been a great exchange of ideas between surgeons brought together to treat the casualties, but in the period of economic re-building and austerity that followed, that contact was lost. The stated aim of the fellowship was to give a group of promising young surgeons the opportunity to travel to North America and visit major orthopaedic centres, which the economics of the time would have rendered impossible without the significant financial support which Prof. Harris brought together. At this point it was not called the ABC, but it was clear to the initial group of fellows that they were involved in something important. When, in 1949, a group of North American surgeons made the reverse trip it was agreed by those involved that the ABC should be formed. No further exchange took place until after the 1952 Combined Meeting of the Orthopaedic Associations of the English-speaking World in London. At that meeting, members of the 1948 ABC group, led by Phillip Newman and Derrick Strange, successfully lobbied the British Orthopaedic Association (BOA) to establish the ABC in its current form; on even years a group of British and Commonwealth surgeons would visit North America, and on odd years a Canadian-American group would make the reverse trip. The exact structure of the groups has evolved over the intervening years. Their experiences and the history of the Fellowships are described eloquently in Derrick Strange’s book, available from the BOA.1In 2008 the ABC Fellowship marked the 60th anniversary of the first trip. Looking back at the picture of the Fellows that sailed on the Queen Elizabeth in 1948, it is clear that the group comprised promising young surgeons, many of whom went on to make a significant mark on orthopaedics: Adams, Charnley, Durbin, Ellis, Fairbank, Langton, Newman, Patrick, Pearson, Smillie, Sommerville, Strange and Wishart. Members of this and subsequent groups have been very clear in recognising the boost given to their ideas, techniques and careers by the trip. For the 2008 group the BOA selected four fellows: Dominic Meek from Glasgow, Kevin Mulhall from Dublin, Rob Pollock from London and Alasdair Sutherland from Aberdeen. In addition, Richard Williams from Brisbane, Peter Poon from Auckland and Andrew Barrow from Johannesburg were all nominated by their respective National Associations. The special interests and practices of the fellows were diverse and varied, creating a group that was exceptionally well balanced, and suited to the variety of experiences on offer in the 13 North American cities visited.The full travel diary is available online at http://journals.jbjs.org.uk/education/TravellersIndex.dtl (date last accessed 23 September 2008).LondonThe British and Irish Fellows met at the offices of the Journal of Bone and Joint Surgery, principle sponsor of the Fellowship. There, James Scott and Frank Horan led a history lesson on the Journal, the ABC and the structures of orthopaedics in North America. Dinner at the Athenaeum Club involved former Fellows and BOA President Steve Cannon, and served to outline some of what lay ahead, further raising levels of anxiety. However, we need not have worried.VancouverThe visit to Vancouver revolved around the Annual Orthopaedic Update conference, which centred upon management of hip disease. There, we were hosted by Bas Masri (ABC 2001), and heard research presentations by local trainees, as well as state of the art talks, before giving the first of our own presentations. Dr Masri organised for one of his patients to take us out sailing on the final day, which was a real highlight.EdmontonIn Edmonton, our host was Dave Otto, the head of a Unit engaged actively with politicians and funders in the design of musculoskeletal services. There are extensive research facilities yielding interesting work in spinal surgery, the shoulder, basic science and trauma. We were honoured by having a Pacing race (horses pulling a light-weight buggy on which the ‘jockey’ rides) at Northlands Park entitled ‘The ABC Travelling Fellows Feature’, although none managed to penetrate the intricacies of the form book to any great degree.CalgaryOn arrival in Calgary, we were whisked up to Banff and Lake Louise by local host Kevin Hildebrand (ABC 2003), providing an excellent opportunity to discuss the differences in health care systems and service provision. We were invited to attend clinical sessions with local faculty, who were carefully selected to reflect the specific interests of the Fellows. This was combined with an excellent and wide-ranging scientific session, from which we gained enormously.San FranciscoGetting into the United States was far from easy. The aircraft doors were about to be closed as we finally arrived at the gate after struggling through immigration and security. Once in San Francisco, host Ted Miclau (ABC 2001) looked after us exceptionally well. The visit coincided with the local Annual Scientific Meeting, where talks ranged from philosophical concerns about surgical orthodoxy and loss of conservative orthopaedics to the economic costing of new innovations such as navigation in surgery. The Fellows were once again greatly impressed by the facilities for research and training that are available. San Francisco is a beautiful city, and we enjoyed great hospitality, as well as a visit to the famous Napa Valley wine area.San DiegoThis was the first time the ABC Fellowship had visited the city of San Diego, and the organisation was expertly handled by local host Matt Provencher of the US Navy Orthopaedic Centre. A wide range of surgical cases and research projects were show-cased, and the enthusiasm of the whole Unit was really infectious. The Fellows had the opportunity to test their co-ordination skills on the F-18 simulator, under instruction of a Navy fighter pilot, as well as the sort of close inspection of the real thing that is not normally possible for civilians. Nothing seemed too much trouble in Top Gun town.Los AngelesIt seems that Beverley Hills is not just a film set but a real place. It was home to local host Jerry Finerman (ABC 1977), who entertained us to a dinner at his home, once we had unfolded ourselves from the cramped mini-bus transfer from San Diego. After a session of basic research the next morning, we enjoyed a hike in the Santa Monica hills, which really cleared the cobwebs. A clinical research session included a presentation on tumour surgery from Dr Eckhardt, a true tour-de-force. He later entertained us with more Scotch than was really appropriate.DenverBennie Lindeque (ABC 1992) and Evelina Burger (ABC 2000) had visited the United States as ABC Fellows from South Africa. They hosted us at their new base in Denver, where they provided one of the best barbecues that any of us had been to. Denver boasts some superb clinical and research facilities, and we had the opportunity of interesting clinical sessions and social discussions. We also visited the Garden of the Gods National Park, a place of outstanding beauty.San AntonioFor the first time on the trip, we were to be billeted with our local hosts, which provided an opportunity to see the American way of life close-up. Our local chairmen, Daniel Carlisle introduced the Fellows to Drs Rockwood (ABC 1967), Green (ABC 1975), DeLee (ABC 1983) and Wirth (ABC 1997), who all contributed to a fascinating scientific session drawn from a huge collective experience and to a most enjoyable social session at Dr Carlisle’s home. It was a very short stop, but visits to the Alamo and a Western outfitter completed the experience.DallasFamous for the assassination of JFK, Dallas is also host to two world class orthopaedic units at the Texas Scottish Rite Hospital (paediatrics) and University of Texas Southwestern. Bob Bucholz (ABC 1985) led the fellows sight-seeing to Dealy Plaza and hosted a dinner at his home. A varied selection of clinical sessions and research presentations highlighted the wide range of work undertaken.St LouisBill Ricci travelled on the most recent ABC Fellowship (2007), and was supremely well placed to look after us in St Louis. He provided a guided tour of the sights of this attractive city, as well some free time to unwind. A tele-conference meeting linked us with local faculty, residents and alternative sites to great effect, allowing the Fellows to present and hear talks on a wide variety of topics before embarking on tours and clinical sessions in superb facilities. The temperature plummeted for the visit to the baseball stadium, but this did not reduce the enjoyment.Iowa CityThe fellows were given a warm and relaxed welcome to Iowa City by Dr Buckwalter (ABC 1987) and his faculty. There are not many centres that can present 50-year follow-up studies, but Stu Weinstein (ABC 1985) continues to question the best management of scoliosis, while Professor Ponsetti, at the age of 94, is still actively treating club feet with his eponymous method. In addition, this vigorous and active faculty was not content to rest on these laurels, and we heard much of interest in clinical conferences, clinics and scientific sessions.MemphisBack in the heat of the South, host Jim Beaty (ABC 1999) welcomed us to the famous Campbell Clinic. It is clear that the Campbell Clinic does not rest on its textbook. It is expanding its research opportunities and enjoys superb clinical facilities. Great interest was shown in the Fellows’ contributions. There was also the opportunity to enjoy Memphis, a fascinating city, from the base of one of the best hotels in the world.Quebec CityDue to the length of the trip from Memphis, we arrived in Quebec City in the evening, which contributed to an odd feeling that we were nearing the end of a long trip. It also tied the whole experience together, as many of our hosts over the preceding six weeks were in Quebec City for the Combined American Orthopaedic Association/Canadian Orthopaedic Association Meeting. The Fellows were presented to the opening ceremony of the meeting and had the opportunity to catch up with old friends in a relaxed setting. However, the clock was ticking and finally the group went their separate ways, rounding off the trip with a farewell dinner.Previous groups of ABC Fellows have claimed various records. In contrast to previous years, the diligent exercise regimes of the 2008 Fellows led to an average weight loss of 2 kg, despite the excellent hospitality received everywhere. We also claim a new record for photographs taken, with the final total of 4950 contained in a computer file in excess of 10 Gb.We clearly had an excellent time socially, being treated like rock-stars everywhere we visited. What is the advantage of the ABC over other Fellowships? Specialist Fellowships offer a different experience, where the knowledge gained is concentrated within a narrow field. Longer visits to single centres allow a more detailed view of specific units and their work. All of these are useful, but the ABC is unique in its scope. It promotes the idea that the best sort of experience is broad based, with particular expertise in a specific area. It exposes Fellows to experts in the other areas and demonstrates the overlap in clinical and scientific approach across the sub-specialties of orthopaedics. It places specialist practice within the general scope of orthopaedics, reminding us that there may be several ways of doing things and that we can all learn from others, even in different sub-specialist areas. Orthopaedics in general benefits from the relationships made, and from what the individual Fellows bring to the centres that they visit, as much as the Fellows benefit personally from these contacts. The ABC has been the proving ground and launch pad for previous generations of orthopaedic surgeons, as witnessed by the achievements of past Fellows, who have become leaders in all areas of orthopaedics.The 2008 group of ABC Fellows are beneficiaries of the legacy of their predecessors as Fellows and have gained enormously from the experience. The survival of the Fellowship depends upon the realisation of their potential and their support of future Fellows. With the continued financial support of the Journal of Bone and Joint Surgery, the BOA and the AOA, the ABC Fellowship remains as relevant today as it was in 1948.AddendumThe Journal of Bone and Joint Surgery has been very pleased to make a significant contribution to the cost of the ABC Travelling Fellowship since its inception in 1948. We have continued to encourage and nurture the exchange of Fellows. We endeavour each year to entertain the Fellows, both the British and the American, at the Journal offices here in London for half a day. During this time we merely wish to emphasise our views on how research papers should be prepared and presented and how the reviewing process can be fashioned and monitored to the mutual advantage of reviewers, authors and readers of the Journal. Both processes need to be continually updated, particularly in the electronic world. We also, of course, learn much about particular areas of research endeavour and general current concerns in our specialty. As a charity we simply see this as further investment in education within orthopaedic surgery.So long as the Fellowship continues to flourish as it has clearly done so for the last 60 years and produces the benefits outlined by A. Sutherland we will continue to support it.James ScottReferences1 The History of the ABC Club of Travelling Fellows. FG St Clair Strange. British Editorial Board of Bone and Joint Surgery, London, 1998. Google ScholarFiguresReferencesRelatedDetails Vol. 91-B, No. 1 Metrics History Published online 1 January 2009 Published in print 1 January 2009 InformationCopyright © 2009, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download