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BOA Chatterjee travelling fellowship report
Sabina Barbur
I secured a Major Trauma fellowship at Auckland City Hospital (ACH) under Bruce Twaddle. With the support of the BOA Chatterjee Travelling fellowship, I could make this a reality, bringing my family. I had two aims for fellowship: increase my surgical exposure to trauma, gaining skills and concepts that I could not at home, and to work in an environment comparable to the NHS, to identify solutions to our common problems.
My first words for anyone contemplating an international fellowship is that the orthopaedic surgery will be the easier aspect of your year. Do not underestimate the amount of paper work, medical council interviews, visa applications and of course if you have children, the challenge of getting them to sit quietly on a 30-hour flight!
Within my first month, New Zealand and Auckland had endured catastrophic flooding, over a thousand landslides and a tropical cyclone. My first on-call patients were from the aftermath of Cyclone Gabriella and required emergency surgery. The lack of national orthoplastics or open fracture management guidance made me appreciate the resources and guidelines from the BOA and MTN!
I then undertook a mixed public / private fellowship at the Tauranga and Grace Hospital for a further six months to pursue my subspeciality trauma interests. It was an opportunity to be educated in complex upper limb trauma and lead in a senior role within an orthopaedic department.
The first obvious difference in NZ is the ‘No-fault compensation’ system, allowing freedom for training and independent operating at a more junior level. This independence creates a more effective trauma service. Secondly, Accident Compensation Corporation (ACC), additional to state-funded health care, provides rapid investigations and treatment options for patients as the entire patient pathway can be conducted privately at a pre-agreed ACC price.
My final insight and change which I have taken from 15 months abroad was the need to make medical care more sustainable and the environmental impact the medical industry has on the local land, the loss of biodiversity surrounding hospitals, pollution and the cumulative effect on the climate. This fellowship experience has been worth every effort required to make it happen.
