Friday, July 24, 2015

Dr. James Kigera, 2015 AAOS International Scholarship recipient

It was a great honor to be awarded the 2015 AAOS International Scholarship supported by Dr. Richard Gayle of Palo Alto. The 27-hour trip to Rosemont involved about 16 hours of flying from my home town of Nairobi in Kenya. My first day at the OLC started with a meeting with the staff at the AAOS new headquarters, and I got a chance to put a face to many people whom I had previously only communicated with on email. The staff was very interested to hear about the patients I take care of and the challenges I face. I also got a chance to better understand the workings of the huge organisation that is the AAOS. 
I had a tour around the AAOS new building and visited the 'hall of fame' where I saw the profile of great orthopaedic surgeons whom I had previously only come across in the orthopaedic books I have read. It was a very humbling experience. 
Later that afternoon I participated in the hip surgery course where the course directors Dr. Douglas Padgett and Dr. Scott Sporer made sure I was comfortable during the whole course. The lecturers were delivered by very experienced surgeons many of whom have authored many papers in highly regarded journals. I was extremely humbled to be in the presence of such great minds. The lectures were delivered with a great emphasis on the current evidence while also tapping on the vast experience that the speakers have. The speakers took time to explain the various tricky aspects of each surgery and presented real case examples to drive their point home. They also fielded questions from the audience to ensure that we all left the lectures very clear on how to handle difficult hip surgeries. The audience also came up with appropriate questions and shared their experience and challenges faced.

My highlight of the course was the cadaveric lab sessions. The laboratory is a state of the art facility that could have held triple the number of participants. The student to faculty ratio was one of the best I have seen anywhere at about 3:1 and there were no more than four people in one table. The organizers went to great lengths to make sure that surgeons were as much as is possible exposed to the implant systems they use in their daily practice. The icing on the cake was when we were also grouped according to the approach of the hip we preferred. This saw a few of us who use the lateral approach attended to by a faculty member who also uses that approach. This is very important given the vast majority of surgeons in North America use the posterior approach. I got to try out all the different techniques that I will need for my practice including exposure for primary surgery, cementing techniques, extended trochanteric osteotomies and how to deal with acetabelar defects. I thoroughly enjoyed the laboratory sessions.
At the end of the second day, the course came to an end and I prepared to travel to Palo Alto in California. My stay at the Palo Alto Medical Foundation was hosted by Dr. Richard Gayle a very dexterous sports medicine specialist. The first two days were spent observing at the clinic where I was exposed to a wide variety of patients with hip, knee and shoulder ailments. I got to see the clinical examination of patients with sports injuries and appreciate the process of pre operative planning. I also witnessed various outpatient procedures while also reviewing post operative patients. 

Wednesday and Thursday were spent in the OR. Here I got to witness the gentle hands of Dr. Gayle as he counseled the patients and their relatives before surgery and explained to them the outcome of surgery. I also witnessed the surgical procedures with Dr. Gayle taking me through all the steps from patient positioning, portals and the techniques of the various surgeries. He also guided me through the difficulties that may arise with each surgery and how to avoid this. Though I got a chance to scrub in some cases, this was not possible in some centrers denying one an invaluable exposure. Nevertheless, I am grateful for the experience gained. On Friday I also got a chance to observe Dr. Ecklund another sports medicine specialist who works with Dr. Gayle. It was enlightening to see different ways to approach the same problem. I am eternally grateful to Dr. Gayle and Dr. Ecklund for giving me the opportunity to observe with them and for entertaining all my queries as the surgeries went on.
I am especially grateful to Dr. Gayle for sponsoring my scholarship and for taking the time to pick me up in the morning and drop me to the hotel in the evening.
I would like to thank the staff at Dr. Gayle's Clinic and at the ORs where I observed for extending every courtesy possible to me.
I also would like to appreciate the efforts of the staff at the AAOS International office especially Ms. Anna Gurevich who through her meticulous planning ensured that all aspects of my visit were in sync like a symphony! 
The staff at the skills lab deserves congratulations for ensuring the cadaveric specimens were extremely well prepared so our surgeries were as close as possible to real live surgeries.
I would also like to acknowledge the efforts of the course directors and faculty of the course for their time and for delivering an exemplary course.
In conclusion, I would like to recommend the course to all orthopaedic surgeons in my country and beyond. To paraphrase a popular Swahili saying, 'He who hasn’t traveled thinks that his mother is the best cook!'

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