BOA Soli Lam Travelling Fellowship

Euan Stirling

The three-week BOA Soli Lam Travelling Fellowship in August and September 2024 provided invaluable insights into the management of spinal oncology across three leading US institutions: New York University Hospital, North Shore University Hospital, and Memorial Sloan Kettering Cancer Centre. With a focus on primary and metastatic spinal tumours, the fellowship offered a chance to compare approaches in both healthcare systems and clinical management, enhancing knowledge just before beginning my own consultant practice.

At NYU, under Dr Ilya Laufer, I observed a collaborative, multidisciplinary model involving specialists from surgery, oncology, and palliative care, which streamlined patient management and minimised clinic visits. This model demonstrated the potential benefits of incorporating similar practices into the NHS to improve patient outcomes and optimise resources. Dr Laufer’s team also showcased the effective use of allied health professionals, allowing physicians to focus on specialist care – a concept worth exploring within the NHS context.

A brief visit to North Shore University Hospital, led by Dr Daniel Sciubba and Dr Larry Lo, highlighted advances in surgical navigation, robotics, and pre-operative planning, particularly for complex spinal tumour resections. I also attended a spinal deformity course and gained insights into more aggressive surgical strategies practiced in the US compared to the UK, sparking reflections on surgical risk tolerance and patient management.

Lastly, at Memorial Sloan Kettering, I observed the prioritisation of swift systemic therapy alongside minimised surgical interventions. Techniques like stereotactic radiosurgery (SBRT), intraoperative ultrasound, and postoperative CT myelograms were used to optimise patient outcomes.

The experience underscored the benefits of multidisciplinary and systematised care, alternative therapeutic approaches, and the potential to adapt these learnings within the NHS. I would like to thank both the BOA and the family and estate of Soli Lam for providing me with this opportunity, and the generous financial support accorded to me.