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January 16, 2019
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International education goes beyond learning new techniques

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Education continues to evolve. New ideas on how adults comprehend information combined with innovative technology has led to a greater understanding of the complexity and individuality of learning, which has had a significant effect on the education of orthopedic surgeons. Changes in training curriculum and CME have improved the ability of surgeons and surgeons-in-training to understand musculoskeletal diseases and provide care resulting in the best possible outcomes.

New methods for education present practicing orthopedic surgeons with many opportunities. Some of the most valuable experiences for education occur internationally, however few American surgeons take the opportunity to experience the views, surgical skills and teaching of overseas colleagues. Some may develop a hubris that all valuable ideas come from the United States, but this is clearly false. There is variation among states and institutions, and not all U.S. surgeons practice the same way. Many techniques are similar. International education offers other avenues to analyze problems, evaluate patients and develop new techniques. Distinct variations in culture, patient expectations and socioeconomic factors necessitate creative thinking and the innovation can be distinctly different from that developed in the U.S.

Anthony A. Romeo, MD
Anthony A. Romeo

International education opportunities

International education opportunities are available to orthopedic surgeons of all levels. They include traveling fellowships, international rotations as a resident/fellow, meetings, including cadaver labs and visiting international colleagues to observe how they practice. Traveling fellowships offer the opportunity to learn from international thought leaders at prestigious institutions worldwide. Some residency and fellowship programs also offer rotations outside the U.S.

The international educational opportunity available to every orthopedic surgeon is attendance at international meetings. These are an undervalued source of education for orthopedic surgeons trained in the U.S. Some international meetings offer live surgery, with highly interactive moderators and the highest level of educational content. To see an international thought-leader address challenges that orthopedic surgeons experience in their own practices, but with different trainings and socioeconomic backgrounds, is a unique and innovative approach to education and can positively affect patient care.

Brandon J. Erickson

International meetings are also networking opportunities for collaboration with surgeons around the world. This includes innovations developed overseas before their availability in the U.S. International health care systems have led to advances in outcomes research. International registries that have helped identify problems with innovation, such as metal-on-metal arthroplasty of the hip, metal-backed glenoids or certain spine instrumentation, were first discussed at international educational programs.

The value of international education surpasses learning a new technique for the OR. It can affect every aspect of patient care, including learning unique physical examination tests developed by surgeons who lack technology found in the U.S., but better understand the use of simple technology, such as plain radiographs. Also, some of the most advanced technology in orthopedics was developed outside of the U.S. and was first available to our overseas colleagues, such as cartilage restoration and the resurgence of managing bone deficits of the shoulder with bone-based reconstructions. There are many other examples. Each has been a catalyst for extensive growth and development of new innovations for patient care.

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Challenge our minds

We should be proud of the innovations and advances that originated in the U.S. However, orthopedics is global. We should expect, evaluate and embrace innovation from around the world. Today, the claim of “being an expert” should include healthy exposure to education in the U.S. and abroad.

Our ability to remain competitive in thought and innovation is dependent on our ability to challenge our minds and status quo, as well as to refuse to accept anything less than return to normal as the expected outcome. To continue to be leaders in education, we must continually educate ourselves, which includes exposure to the incredibly talented international contributors of orthopedics.

Disclosures: Romeo reports he receives royalties, is on the speakers bureau, is a consultant and does contracted research for Arthrex; receives institutional grants from MLB; and receives institutional research support from Arthrex, Ossur, Smith & Nephew, ConMed Linvatec, Athletico and Wright Medical. Erickson reports he is a committee member for AOSSM and on the editorial board of PLOS One.