By Ignatius Liew
Trauma and Orthopaedic Registrar, The Queen Elizabeth Hospital, Kings Lynn

Published 10 April 2020

‘What a month! Soon it will be Christmas day’.

23rd March 2020: The day the earth stood still and changed everything here in the United Kingdom. What a difference a few weeks have made since the start of lockdown. A few months ago, we as trainees were more than hopeful that the ‘winter crisis’ would soon end, returning elective beds for elective surgery. Little did we know how December 2019 would unfold, and now, in March 2020, what is clearer than ever, in these unprecedented times, is that the only things that spreads faster than a virus are the anxiety, rumours and politics.

It has saddened me to see that, in a time of crisis for the NHS, we can be tempted to put our emotions and fears before our Hippocratic oath. It is a matter of fact that, even as orthopaedic surgeons, we all have feelings. We should, however,  acknowledge them and never lose focus on our patients. Throughout all this, we must remember as we experience the first pandemic that most of us have witnessed during our professional lives, that we are doctors first and orthopaedic surgeons second.

As of 1st April 2020, 1,756 COVID-19 related, peer-reviewed publications have been published. With  this and frequent emails from JCST, SAC, PHE, HEE, TPD, AES and every three-letter acronym you can think of, we are constantly bombarded with new information at an ever-increasing rate and the only constant is change.

With guidance, updates and support from various stakeholders, it is reassuring to see we are in this boat together. We may not know what the best PPE to wear, whether to turn the laminar flow off, if we can get tested for IgM/IgG or antigen or whether the quarantine for mild symptoms has made any difference. Crucially, whatever the answer is and whatever our strategies are, the only constant is change and we should adapt.

As trainees, we should feel supported and clinical practice should not be an act of heroism. We should ‘Hammer it out’ and stop any resistance to being able to protect ourselves, our colleagues and our loved ones. We should also shut-out the keyboard warriors and self-acclaimed COVID-19 experts and prepare to appraise and follow the latest guidance, evidence and updates from government, (, Joint Committee on Surgical Training ( and British Orthopaedic Association ( There will be variation and it is crucial we are ‘Getting it Right First Time’.

Some of us will be re-deployed to specialties in which we find ourselves uncomfortable. Some of us will fall sick. Some of us will be anxious, worried for ourselves and our loved ones. It is, however, very reassuring as a trainee to hear voices that are active on our behalf.

There will be uncertainties about fellowships, training progression, ARCP outcomes, exams and ST3 interviews for those currently within higher surgical training. There will also be uncertainty for our foundation doctors and medical students who want to pursue a career in orthopaedics with MRCS exams, recruitment and clinical experience in orthopaedics up in the air.

It is not all bad news. There has been great support for the National Health Service (NHS).  The country joined together to clap for the NHS on 26th March 2020 ( #clapforourcarers providing us with great pride and this has become a weekly affair.

We have had free food and countless items from various people to support us. Local communities have come together to support their local hospitals, NHS volunteers and health care workers returning from retirement. We have found new ways to keep in touch with our friends and family and perhaps, a new found appreciation for how it feels to be isolated, and to be in the shoes of our patients.

It is important that, in these anxious times, we provide support to each other and work as a team. After all, if we fall, who will look after our patients, so instead of spreading the virus, spread the love and support.