01 Jun 2018

Changing the T&O image for undergraduates - Orthopaedic experience week

by Mariea Brady

At the University of Oxford the undergraduate T&O teaching has recently been restructured in response to the recognised need to attract students to the specialty.  Under the direction of Professor Chris Lavy, the T&O ’Experience Week’ was introduced. Fundamentally, this initiative involves integrating medical students as part of the T&O teams for a week (rather than students randomly dipping in and out of clinics and theatre during an eight week rotation).  I was amongst the first intake of students under this new initiative and detail my experience below.

The Orthopaedic Experience Week

Students were able to choose an orthopaedic subspecialty for the Orthopaedic Experience Week; I selected paediatric orthopaedics.  Oxford is lucky to have an exceptional team of paediatric orthopaedic consultants who are enthusiastic about what they do and keen to engage students with their specialty.  I spent my first day in theatre with Mr Andy Wainwright, who, from the very first procedure allowed me to scrub in and assist.  The list was nicely varied beginning with a trigger thumb release, followed by an achilles tenotomy and tibialis anterior transfer, then a more complex femoral neck lengthening osteotomy.  Mr Wainwright was very encouraging both in theatre and subsequently in clinics (cases included: perthes disease, leg-length discrepancy, bowed-legs, achondroplasia) where he guided me through relevant clinical examinations with patients (let’s face it, students need to pass the OSCE!).  Further, his advice with respect to career development: becoming a student member of the British Society for Children’s Orthopaedic Surgery, building a portfolio and carrying out audit and research projects was most helpful.

I was also able to spend a couple of days with Mrs Rachel Buckingham, an inspiring female role model, who specialises in the upper limb as well as having expertise with cerebral palsy (CP) patients (Figure 4).  In clinic I was struck by the challenge of determining and managing musculoskeletal pain in CP patients, some of whom can only communicate through eye movements.  It was interesting to attend the gait analysis meeting which demonstrated the combination of clinical acumen and engineering technology for managing a range of joint contractures.  From the gait lab to the plaster room, I was able to observe various stages (in different patients) of the Ponseti serial casting method for club foot.  Finally, a day in surgery with Mrs Buckingham performing a bilateral femoral osteotomy (’proper surgery’) dispelled all myths that orthopaedic surgery is for the strong and stupid; it is for the precise and sharp.

Excerpt from 'Re-branding T&O: The undergraduate Experience', published in JTO Volume 6, Issue 2, June 2018.