The South African take on the America–British–Canadian Fellowship

The Journal of bone and joint surgery. American volume, 2016

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Journal of Bone and Joint Surgery - British Volume, 2009

The Journal of bone and joint surgery. American volume, 2015

Focused on young surgeons starting their careers in academic orthopaedics, the John J. Fahey, MD, Memorial North American Traveling Fellowship (NATF) has served to promote clinical, intellectual, and scientific exchange in orthopaedic surgery for the last forty-five years. The 2013 NATF was a tremendous experience for each and every one of us. We quickly developed very tight bonds with each other and friendships that will undoubtedly last throughout our careers and lives. At each site on the fellowship tour, we were made to feel special by our hosts and everyone with whom we came into contact. We each feel that we achieved the goals set out by the AOA (American Orthopaedic Association), making the most of this phenomenal experience through academic exchange, socialization, and networking and developing an appreciation of the various paths to success in orthopaedic surgery.

The American Journal of Sports Medicine, 1987

South African Medical Journal, 2018

Kimberley Provincial Hospital provides the sole public sector orthopaedic surgical service to the entire Northern Cape Province of South Africa (SA). Ankle fractures form part of the trauma burden and pose a challenge owing to high numbers and limited resources. The incidence of ankle fracture is reported to be 169.7/100 000/year. [1] Currently there are no statistics on the incidence in the Northern Cape. An alternative surgical method of treatment was explored in the form of a prospective cohort series, to increase turnaround time of patients needing surgery and thus improve service delivery. Data collection while conducting this prospective trial highlighted loss to follow-up in ankle fracture patients, which prompted this report. Numerous studies have highlighted the challenges in terms of loss to follow-up when conducting trials in musculoskeletal injuries. [2-5] The main factors contributing to this loss to follow-up are reported to be socioeconomic, and include level of education, poverty, male gender, smoking and alcohol abuse. [6] Young individuals as well as the very elderly are prone to be lost to follow-up. Potential reasons for this vary, but are hypothesised to include an increased frequency of substance abuse in younger populations and lack of mobility in older populations. [2,7] In addition, smokers are reported to have an 80% higher risk of loss to follow-up compared with non-smokers. The reason for this is not clear, but it has been postulated that individuals with substance use may lack motivation to change their behaviour for health-related purposes. [2] Several other studies also report smokers to be at risk of not attending for follow-up as expected. [4,5,8] This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

2016

editoR-in-cHieF Arvind von Keudell, MD Resident, Harvard Combined Orthopaedic Residency Program As described in the ongoing Global Burden of Disease Project, musculoskeletal disease accounts for the second most common cause of disability worldwide, with a large proportion of low back pain, neck pain, osteoarthritis, gout, rheumatoid arthritis, low bone mineral density, and other musculoskeletal disorders.1 Injuries and trauma continue to represent an ongoing cause of major disability, disproportionately so in low and middle income countries, with more deaths from trauma worldwide than HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome), malaria, and tuberculosis combined.2-4

The Journal of Bone and Joint Surgery (American), 2009

SA Orthopaedic Journal, 2016

Background: The purpose of this study was to investigate the number of publications and impact of South African surgeons in the 15 highest impact orthopaedic journals over a five-year period Methods: The abstracts between January 2010 and December 2014 were screened and the total number of publications and impact points were collated. Normalisation to population size, GDP and per capita GDP was performed. Results: Of the 23 021 orthopaedic articles from 66 countries, South Africa published 19 articles and ranked 41st overall for the number of publications and 40th for impact. When compared to the other African countries it ranked 2nd. The following ranks were calculated for adjusting population (51st overall, 2nd in Africa), GDP (51st overall, 3rd in Africa), GDP per capita (31st overall, 3rd in Africa). Conclusion: This study demonstrated that South Africa ranked in the lower third of all countries that published in the top 15 highest impact orthopaedic journals. In Africa, Egypt was the leading country for total publications and impact factor maintaining the first rank even when adjusted for population size, GDP, GDP per capita and research funding in percentage of GDP.

World Journal of Surgery, 2018

Background In the era of global surgery, there are limited data regarding the available surgical workforce in South Africa. Methods This aim of this study was to determine the orthopaedic surgeon density in South Africa. This involved a quantitative descriptive analysis of all registered specialist orthopaedic surgeons in South Africa, using data collected from various professional societal national databases. Results The results showed 1.63 orthopaedic surgeons per 100,000 population. The vast majority were male (95%) with under two-thirds (65%) being under the age of 55 years. The majority of the orthopaedic surgeons were found in Gauteng, followed by the Western Cape and Kwa-Zulu Natal. The majority of specialists reportedly worked either full time or part time in the private sector (95%), and the orthopaedic surgeon density per uninsured population (0.36) was far below that of the private sector (8.3). Conclusion Interprovincial differences as well as intersectoral differences were marked indicating geographic and socioeconomic maldistribution of orthopaedic surgeons. This parallels previous studies which looked at other surgical sub-disciplines in South Africa. Addressing this maldistribution requires concerted efforts to expand public sector specialist posts as well as quantifying the burden of orthopaedic disease in both private and public sectors before recommendations can be made regarding workforce allocation in the future.