By Morgan Bailey
ST8 Trauma and Orthopaedics, University Hospital Southampton

Published 11th November 2021

Fellowships are a fantastic way to expand your experience outside of your training job. Whether they be clinical or research based, there are opportunities to develop your specialty interest with the support of those who share your passion and who can share their experience in the field.

Besides keeping a look on websites such as NHS Jobs, social media is a really good way of keeping abreast of these opportunities. Reading to the end of the monthly BOTA Bulletin email is also worthwhile. On identifying these positions, discussions with previous fellows is usually a valuable tool in ascertaining whether it is the right post and how to put yourself in the best position to be appointed. 

The British Association for Surgery of the Knee (BASK) Research Fellowship provides trainees at registrar level with the opportunity to develop their research interests within the field of knee surgery under the supervision and mentorship of one of the BASK consultants. They often work alongside one of the British Orthopaedic Association’s specialty working groups, focusing their research efforts within a particular area of knee surgery.

I commenced my fellowship role following completion of my FRCS as an ST7 Trainee. With an interest in soft tissue knee surgery, I was assigned Miss Caroline Hing as a supervisor, and linked to the Patellofemoral Working Group. My first project was to utilise the Freedom of Information Act to identify codes used to describe the diagnosis and treatment of patellofemoral instability. I began by familiarising myself with the principles of the Freedom of Information Act and then created a database of contact points for all acute trusts in the country. I then emailed each unit with a list of diagnoses and surgical options for the manage-ment of patellofemoral instability, asking which codes they would assign to each one. This process and the outcome has been written up and accepted for publication. 

I was also asked to write up the consensus process for the new specialty BOAST guidelines for the surgical management of patellofemoral instability. This involved sitting in on meetings of the Patellofemoral Working Group, and reviewing previous meeting minutes. I collated information about the process itself, the literature review that was performed and the results of the consultation that went out to the wider membership. This was subsequently published in The Knee and hopefully will highlight the existence of these new guidelines, and explain how they were developed.

Finally, I was tasked with creating the BASK Trainee Collaborative, in collaboration with Khalid Al-Hourani, BASK research fellow for 2021-2022, and Varun Dewan, a senior trainee who was keen for the knee society to have their own trainee collaborative group. This was successfully launched with the project EPPIC (Evaluation of Practice Patellofemoral Instability Collaborative). We used the newly published guidelines on surgical management for patellofemoral instability as a standard against which departmental practice was audited across the country. The trainee network was used to collect data from around a third of UK trusts. The results of this was presented at the BASK Spring Meeting, and we are in the process of writing it up for publication.

The BASK Research Fellowship will be recruiting for 2022 and 2023 fellows this winter. The selection process involves submitting a CV with an additional one page covering letter outlining the applicant’s research enthusiasm and a short appraisal of the two most pressing research needs in knee surgery. This is an opportunity to reflect on which elements of research appeal to the trainee and which elements of knee surgery they feel passionate about. My experience in running a regional collaborative project within my deanery leant itself well to the role of creating the BASK Trainee Research Collaborative.

The fellowship appealed to me because it did not involve taking time out of training, and I have always been reluctant to step away from clinical practice for a prolonged period of time. Having said this, some previous fellows have chosen to take on the fellowship during a period of Out of Program Research. I never saw myself as an 'academic' surgeon, but this fellowship gave me the opportunity to involve myself in a range of research methods within a speciality I am passionate about. On top of the experience gained and contacts made, I was able to achieve a few publications and a presentation at the BASK annual meeting.

My time as the fellow fell during the COVID pandemic and then maternity leave, and my projects leant themselves well to remote work, providing me with something hold my interest during some very strange times! My supervisors were very supportive, and although we were not given the opportunity to meet in person, we had regular zoom meetings to touch base and plenty of email communication. I made an effort to tie up all my loose ends prior to starting my maternity leave, and there was certainly no pressure to be involved in projects during that time, however I found myself keen to keep a hand in for my own interest. Having never really appreciated the patellofemoral aspect of knee surgery, my involvement in these projects sparked my interest and lead me to apply for and be awarded a future post CCT fellowship relating to the subject.

The research fellowship offers a broad range of opportunities. Some of the fellows before me have been involved in projects such as using James Lind Alliances to develop Priority Setting Partnerships, and developing guidelines within other areas of knee surgery. There is the potential to be involved in a range of topics within knee surgery itself. With the increased opportunities for remote working that have been born out of the pandemic, trainees are not limited by their location with respect to which consultants they can work with. For more information about this year’s application, visit the Twitter handle. Overall, I can highly recommend the experience!