Lifelong Learning in Hand Surgery
By Soumen Das De, MD, FRCS, MPH
“The natural history of science is the study of the unknown. If you fear it, then you’re not going to study it, and you’re not going to make any progress.” – Michael E. DeBakey, Cardiovascular Surgeon
One of the things I really like about Hand Surgery is its diversity and the scope for continuous discovery and lifelong learning. My own practice had evolved into a nice mix of adult & pediatric hand surgery, and the lower extremity soft tissue reconstruction cases gave it an exciting edge. However, I began to see more complex congenital problems, and I found the decision-making daunting. These conditions had always fascinated me, but I did not feel equipped to make the right decisions for these children. So, inspired by Dr. DeBakey and his legacy, I decided to take the plunge and leave my comfort zone. I decided to embark on a mid-career fellowship.
Making this decision was easy. The harder questions were: where, when, and how? Multiple, short observer-ships were the natural choice, but I eventually settled on a formal fellowship because that would provide a more in-depth experience. But it was also a riskier proposition. I would have to close my practice, ensure my patients were taken care of, ask colleagues to take on additional responsibilities, uproot my family and of course, be prepared to make some financial compromises. All this was going through my mind in 2019, when unknown to anyone, a microscopic entity called Covid-19 was preparing to wreak havoc on mankind.
After a lot of research, I found the perfect fit – a dedicated 6-month congenital hand fellowship at Great Ormond Street Hospital (GOSH) in London. Founded in 1852, GOSH is one of the oldest and most renowned children’s hospitals in the world, and the Plastic Surgery unit there focuses exclusively on congenital and developmental conditions. I obtained the position, and after braving quarantine, 5 nasal swabs and armed with plenty of doubt about how much I would “learn during lockdown,” I started my fellowship earlier this year. And it has proved to be one of the best decisions I have made.
Being a clinical fellow at this high-volume center has been a truly immersive experience. It has given me the unique opportunity to participate actively in decision-making with superb mentors and then analyze them in the context of decades of follow-up. I have finally been able to read the papers I had long set aside, and the multidisciplinary vascular anomaly and ortho-plastic limb deformity clinics have been immeasurably enriching. The absence of many other stresses of “normal life” has also given me a chance to spend more time with family, embrace a new culture and make lasting friendships. But above all, it is surreal to be surrounded constantly by surgeons, nurses, therapists, intensivists, anesthesiologists, pediatricians, psychologists, and social workers with a common goal – to provide the best care possible for children. It has made me aspire to be a children’s doctor who happens to also know how to operate!
So, if you are keen to develop a new subspecialty interest, or feel restless in a “comfort zone”, do consider a mid-career fellowship. You can never learn enough.