Undertaking the ABC Travelling Fellowship

Michael McAuliffe

Michael McAuliffe undertook the ABC Travelling Fellowship in 2016, gaining experience at a range of hospitals, universities and scientific meetings on a month-long tour through North America. Here he writes on the places he visited, the philosophies and cultures he encountered and the incredible value of the opportunity.

Michael and Co At Campbell Clinic

Michael and the other Fellows at the Campbell Clinic in Memphis

The first ABC Fellowship was the innovation of Professor R. I. Harris, chief of orthopaedics in Toronto and president of the American Orthopaedic Association (AmOA) in 1948. He established the Fellowship in response to the destruction of the Second World War, to allow the exchange of ideas and to foster innovation in both North America and Europe. Australia first joined the Fellowship program in 1954. 27 Australians have had the honour and opportunity to complete the Fellowship.

We began in London and were hosted by the Bone and Joint Journal team and the British Orthopaedic Association executive. In the USA and Canada, visitations were to large academic orthopaedic centres rather than private, Veterans Administration or county hospitals. The units that we visited all shared common themes: patient care, education and research were integral to each centre. There was a local variation as to what received primary emphasis. For example, in Memphis education via the almost constant production of Campbell’s Operative Orthopedics was prominent, and teaching of orthopaedic residents was clearly a dynamic process in Chicago and St Louis. The value of teamwork and a common unit function were on display in The Cleveland Clinic. Research featured heavily at The Mayo Clinic and the value of a lifetime of dedication to fundamental research questions was embodied by The Iowa University Department, whilst the trauma section of the Canadian Orthopedic Association (COA) meeting was exemplary in the conduct of large multi-centred trials. It was clear that no matter the local variations, each of the three common themes underpinned each department.


Michael and the other ABC Fellows with the staff at the Cleveland Clinic

The camaraderie and sense of identity of each centre was also clear. This carried a sense of common purpose, close supervision and understanding of trainees’ progress, and the ability to institute research and longer-term planning processes. The weakness of this structure was the relative insularity of training and potential for less challenges to the ‘way’ of each unit.

...patient care, education and research were integral to each centre.

It was fascinating to see a little of the role of the carousel presidents and understand the enormous amount of work they undertake for the betterment of all our orthopaedic associations. These individuals and the many outstanding people we met at each centre also gave us insight into our shared responsibility to conduct ourselves constantly for the betterment of our patients and to learn from those around us. This overarching view of orthopaedics is often absent from the daily maelstrom.

The ABC Fellowship is an incredibly valuable opportunity. The chance to travel with six other surgeons with such diversity of expertise and life experiences gives a broad perspective on orthopaedics that is perhaps fast diminishing as subspecialisation becomes the norm. The time to step away from daily practice allows clarity as to the value of activities that consume the working  week. The real challenge is how to incorporate the lessons learnt into daily patient care, research, education and personal life. This remains an ongoing process.

For any member of AOA considering applying for the ABC Fellowship, do so...

I would like to acknowledge the hospitality and generosity of all our hosts – it was impressive. The unflagging efforts of the fellowship co-ordinators from the AmOA (Kathy Sinnen) and COA (Cynthia Vezina) ensured a seamless tour. The Fellowship would not be possible without the support of the carousel nations and the Bone and Joint Journal – as a group we would acknowledge the importance of this. I would thank my wife, Sally, and my family for their unflagging love and support, without which I would achieve little. For any member of AOA considering applying for the ABC Fellowship, do so – it will be a truly valuable experience on so many levels that will return many times over the investment of time away from work and family.