Journal of Trauma & Orthopaedics – Vol 5 / Issue 1

From the Editor

The concentrated and rapid acquisition of skills and knowledge at the start of a career is not a new concept.  Commencing higher surgical training remains a daunting prospect for most trainees.  The article on “Boot Camps” [cover image] explores how they get new registrars up and running, able to cope with the sudden increase in responsibility and support their incorporation into the orthopaedic community within the training programme.  The BOA and BOTA are supporting their rollout across the UK (page 30).

People learn in different ways and new technology makes the learning environment richer and more accessible.  The BOA podcast project that was championed by the late Andy Sprowson has come to fruition with regular updates on fascinating and controversial topics (page 6).

Commissioning of elective orthopaedic services is a subject that is reaching white heat.  As finances get ever tighter, the criteria for referral for surgery begin to look more like overt rationing.  Balanced and transparent evidence-based commissioning would protect patients who risk unnecessary suffering, progressive immobility and dependency and worse outcomes.  Ian Winson argues that enlightened shared decision-making should support both patients and surgeons in his Presidential piece on page 2.

The fall in the number of Medical Students and Foundation Doctors exposed to our specialty is having a negative impact on patient care and limiting career options for those who may never consider a future in surgery.  The development of “physician associates” in the extended surgical team is now gaining momentum and suitable graduates will be able to enter a specific post-graduate degree course.  We will need to play a part in curriculum development and regulation, but also embrace them and see them as a positive influence on training for the whole team (page 18).

Another hot topic is audit data.  Some excellent advice is given on what to do if your practice is singled out at being at variance.  The robust systems in place around the NJR data and the limitation of publication to unit level outcomes should support confidence in the newer registries that will cover other sub-specialties (page 22).

Finally, I would like to give thanks to our Guest Editor, Duncan Tennent, who has commissioned some excellent articles on various aspects of shoulder surgery that should appeal to both the specialist and generalist.

Phil Turner – BOA Vice President Elect