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Pioneer: Jorge O. Galante, MD, DMedSci
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How did you decide on a career in orthopedics?
Jorge O. Galante, MD, DMedSci: I made the decision to become an orthopedic surgeon late in my internship. Unfortunately that set of circumstances is not always feasible today when medical students are required to choose a field of medicine much too early in the process.
I knew I wanted to be a surgeon I knew I wanted to pursue a career in academic medicine that combined surgery with a research opportunity. I enjoyed my orthopedic rotations more than any other fields of surgery. I enjoyed addressing issues related to the musculoskeletal system, not only the surgical procedures, but also the rehabilitation needed to allow patients a full functional recovery.
Jorge O. Galante
While participating in patient care I soon realized there were too many questions for which there were no good answers. I understood this was a fertile opportunity for a surgeon with an interest in research.
Orthopedic surgery in the late 1950s was a sleeping giant. There were serious problems affecting millions of people and few valuable solutions. From my viewpoint, the allure of tackling unresolved issues of that magnitude was irresistible.
What valuable lessons did you learn from your mentors?
Galante: The three individuals that had the most profound influence in my professional life were Fred Shapiro, MD, Robert D. Ray, MD, and Prof. Carl Hirsch.
Dr. Shapiro was a superb clinician and a stout disciplinarian. He taught his students how to think in clinical terms and to never stray away from the human and ethical principles that should guide a surgeon’s life. Dr. Ray was the chairman at the University of Illinois where I completed my residency and Prof. Hirsh was the chair at the University of Gothenburg under whom I took a post residency fellowship. I learned from them that research is the basis for any development that will benefit patients and advance our knowledge. I learned the education of an academic surgeon requires a thorough understanding of the basic sciences and skills that he or she will address and need in the future. I learned that any research undertaking is not the product of a single individual but rather that the partnership between a basic scientist and a clinician is the key to success. I also learned that the pursuit of excellence within strong ethical constraints is a goal from which one should never deviate.
What do you believe was your most important contribution to orthopedics?
Galante: My contributions to orthopedics were the result of many years of laboratory and clinical research done in collaboration with a group of dedicated investigators. Our work in the areas of biomaterials, porous materials and biomechanics related to prosthetic design was important. Within that framework, I believe our input in the development of cementless acetabular fixation had the most widespread influence in the field.
However, the most important contribution from my viewpoint was the opportunity to create and foster in my own institution an environment where gifted physicians and scientists could interact to address patient-oriented research issues. That led to contributions in many areas of orthopedics. It allowed for the development of a strong educational program in which graduates continue to influence the future of the specialty. It led to the establishment of a superior patient care environment where the pursuit of excellence and the delivery of cutting edge orthopedics is the norm.
How do you envision the future of orthopedics?
Galante: Technology reigns in orthopedic surgery and will continue to do so. There will be new developments in electronics and robotics that will allow further advances in minimally invasive approaches to most surgical procedures.
Major progress will relate to a better understanding of the biology of disease and especially the biology of repair. The orthopedics of the future will be less mechanical and more biological in its approach to the solution of musculoskeletal problems.
The funding of research — an essential basis for innovation — will be closely linked to the dynamics of the future. Regulatory issues and the influence of health care legislation on orthopedic industry will also have a major impact on the nature of future developments. The key to progress will continue to be the orthopedic surgeon who provides in addition to the basic scientific knowledge, the relevance and an understanding of the clinical factors. It is essential that we strive to maintain a cadre of qualified surgeon-scientists capable of guiding the specialty to the next level.
From a health care delivery viewpoint, we will continue to see further growth in the subspecialties, consolidation of orthopedic groups and a major trend towards hospital-based practices.
What advice do you have for young orthopedic surgeons who want to learn from your experiences?
Galante: There is a patient at the end of the tunnel and thus all we do should be for the benefit of our patients. Their welfare is number one.
Young orthopedic surgeons should get the best and most complete training they can without worrying about the additional time they may need to accomplish that goal. More is better. Take a fellowship. Learn a subspecialty and learn it well. Some personal sacrifices may be needed but the eventual benefits will make it all worthwhile in the end. Keep at it. Keep improving one’s knowledge and skills.
The American Academy of Orthopaedic Surgeons has marvelous resources for continuing education. Young orthopedic surgeons should take full advantage of them. Technology is changing our practice and one cannot afford to stay behind. Don’t be influenced by the “swan song” of others to adopt new developments without first undertaking a thorough analysis of the benefits and disadvantages. Be up-to-date on current knowledge to make an appropriate decision that will truly benefit patients.
The same principles apply if one is set on an academic career. It is essential to acquire the tools to be creative in research efforts. Establish strong interactions with a team of basic scientists, in my own experience the key to a successful and productive research operation.
Keep a moral compass always in sight. And finally, remember that your family needs all the love and attention that only you can provide.
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Disclosure: Galante is a consultant for Biomet Inc.