David W. Sanders M.D., FRCSC
Assistant Professor, Orthopaedic Surgery
London Health Sciences Centre
London, ON

2001 Fellows:
David W. Sanders M.D., MSc, FRCSC
Peter A. Cole, M.D.
Steven Frick M.D.
Khaled Saleh M.D., MSc, FRCSC
Alexander Shin M.D.  

The fellowship began in Montreal, QC, gliding in from diffuse parts to a landing enveloped in the brilliant colours of a fading St. Lawrence autumn day. We left the comforts of home and family, unsure of what the next five weeks would hold, and filled with some foreboding regarding the travel to follow. Certainly, the tour began in the fresh penumbra of the most terrible tragedy of our recollection. Yet within scant hours of our twilight arrival in Montreal, the soaring potential of our fellowship became clear, as the charm of Crescent Street fueled instant friendship and bold toasts. The 2001 North American Travelling Fellowship had begun!  

The North American Travelling Fellowship (NATF) is a unique opportunity in which five orthopaedic surgeons of varying backgrounds are brought together for a five-week tour. The word "fellowship" is an accurate descriptor, for it implies the development and evolution of true friendships, combined with the underlying singleness of purpose of an educational mission. Founded in 1970, this biennial occasion recruits surgeons within three years of the completion of their training for a tour of medical centres within Canada and the United States. The fellowship is organized under the auspices of the Canadian and American Orthopaedic Associations. Four U.S. and one Canadian surgeon are selected. For this edition, the surgeons selected included Dr. Peter Cole, trauma, formerly from the University of Mississippi Medical Center and in transition to the University of Minnesota; Dr. Steve Frick, paediatrics, from Carolinas Medical Center in Charlotte; Dr. Khaled Saleh, arthroplasty, trained in Toronto and now working at the University of Minnesota; and Dr. Alex Shin, hand surgery, from the United States Navy Medical Center in San Diego and in transition to the Mayo Clinic in Rochester; and Dr. David Sanders, traumatologist, from the University of Western Ontario.

It is a formidable challenge to fully describe our experiences in a brief summary. In total, we visited 15 cities and 18 orthopaedic programmes in a whirlwind 35-day tour, beginning October 12 and concluding on November 16. The highlights were protean, diverse, and at times, surprising; from kayaking in the Atlantic south of Halifax, to F1 go-kart racing with the residents at Boston University. Perhaps the most overwhelming experience was the visit to the site of the September 11 tragedy. The personal experiences of the medical personnel in New York - "I was watching from this window when the second plane hit" - brought the staggering magnitude of the disaster home like a slap in the face. Without question, however, the formation and development of friendships of the five travelling colleagues will highlight our legacy in years to come.

The tour began in Montreal, at the Programme d'orthopédie Édouard Samson. We toured the impressive research facilities at the Hôpital de Notre-Dame with Dr. Julio Fernandes and Jacques de Guise. An afternoon of talks followed at the Hôpital du Sacré-Coeur. The evening brought a delicious Italian dinner with Dr. Alain Jodoin. Gorging on rich food and drink stimulated our first gut-burning workout scaling Mount Royal the following morning.

Next we were treated to a visit with the McGill faculty, again with a tour of the clinical and research facilities hosted by Drs. John Antoniou, Gamal Baroud, Mark Burman, Ed Harvey and Jan Krygier. In the evening we enjoyed dinner with Dr. Max Aebi and the McGill faculty and superb talks by Jean Ouellette and John Antoniou. The following day we visited the Shriners' Hospital where we witnessed the treatment of Osteogenesis Imperfecta using percutaneous osteoclasis and Dr. Fassier's telescoping nail. A visit with Dr. Robin Poole introduced us to the work of the Joint Diseases Laboratory. We then visited the Osler Library of the History of Medicine, and were given a personal tour of the facility as well as the history of the Canadian medical icon. A true taste of Montreal followed as we feasted on smoked meat at Schwartz's Deli. With full stomachs and stimulated minds, we left La Belle Province en route to Canada's Ocean Playground.

Halifax was the second host city and the Bluenosers welcome and hospitality was second to none on the tour. Dr. Gerald Reardon acted as our host and led us on a true whirlwind tour of the many Halifax sights. On the first day we were treated to a first rate academic programme including some cutting edge faculty lectures. Later we were treated to a Halifax dinner cruise, sailing the harbour and down the arm. Our visit coincided with the deployment of Canadian soldiers to Afghanistan and the same famed harbour that we cruised was the site of many tearful farewells earlier the same day. Of course no visit to Halifax is complete without an evening at the pub and we subsequently hoisted the foam to the Celtic strains of an authentic Bluenose pub.

Alex Shin and Peter Cole paddle the waters of the North Atlantic near Halifax.

The following day brought an opportunity to visit the clinical realm. We were hosted in the OR by Drs. Gerry Reardon, Mark Glazebrook, and David Petrie (one of the original North American Travelling Fellows); and in the clinic with the paediatric faculty. Over lunch, Dr. Mike Dunbar shared his insights on outcomes research and career development with us. Informal talks such as this were one of the true fellowship highlights and the visit with Mike was invaluable in this regard.

October 20th held many surprises for us all. Dr. Lorne Leahy hosted us in one of the social highlights of the entire visit. The day began cold and early with a tour of the countryside south of Halifax. We visited the postcard town of Lunenburg and passed by the schooner Bluenose II en route to Mahone Bay where Ellie Leahy greeted us with famous Nova Scotia hospitality. The adventure was still to come, however, as next we were introduced to the homebuilt kayaks Lorne assured us were seaworthy. What followed was an 18-mile ocean trek through the icy salt of the Atlantic. We spotted countless treasures, including bald eagle, great blue heron, and some friendly seals. Lorne certainly made us work for Ellie's seafood chowder. Invigorated but exhausted, we eventually stumbled into the home of Dr. Chris Cook for a true gastronomic orgy featuring an endless stream of fresh Lobster, shared with the finest hosts in Canada.

The fellowship next shifted countries to the United States. Tragic events held the nation transfixed but united with a singular resolve. Nonetheless, we were welcomed with open arms to our many stops. Providence was first, hosted by Michael Ehrlich and Arnold-Peter C. Weiss. The social highlight was a dinner at Pot-au-Feu, one of the country's finest restaurants, culminating in a dessert of Iles Flottante, which can be loosely translated as "Instant Obesity". Next we traveled to Boston, hosted by Dr. Harry Rubash at Harvard. Each fellow spent a day with one of the renowned masters in his area of interest. The following day was spent enjoying the Annual Research Grand Rounds of the Mass General, where Dr. Bill Harris surveyed the past year's progress. James Heckman then held an informal meeting with us in his role as editor of the JBJS, discussing how to publish as well as the role of the Journal.

Our second stop in Boston was at Boston University, hosted by Dr. Thomas Einhorn. Again, informal talks with Drs. Einhorn and Paul Tornetta were a true academic highlight, but the social highlight was again without parallel as we visited a Formula 1 Racetrack. The track was rented out for the fellows and residents for an afternoon of spine rattling pandemonium. Steve Frick, from the home of NASCAR, managed to eke out a slim victory over his rival fellows in the race to the checkered flag.

Paul Tornetta hosted one of the traveling fellows' favourite fracture conferences with a rapid-fire exchange with the Boston University residents.

We next headed to upstate New York where we were hosted in Rochester and Syracuse. Both programmes have strong and accelerating research production. Rochester is led by Randy Rosier and Regis O'Keefe, the two friendliest titans of academic orthopaedics. At Upstate University in Syracuse, the welcoming confines of the Human Performance Institute are fostering research in every realm of orthopaedics. Something in the Hallowe'en air possessed Cole and Sanders to test the cold of the Finger Lakes with a polar dip at the lakeside home of Andy Palmer.

The Big Apple was next, and the experience was one to savour. The Yankees were charging, the City was afire with zeal and the New York Marathon was running. We spent two days at HSS hosted by Scott Wolfe, including visits with Russ Warren and David Helfet followed by a visit to Bellevue and the Hospital for Joint Diseases with Dr. Zuckerman. This brought us to the doorstep of the site of the September 11 tragedy and the personal accounts of the day were unforgettable. We toured the site, our hearts filled with disbelief even as our lungs were filled with the still-acrid scent of disaster. The magnitude of the event and its ripple effect on all of our lives were foremost in our minds, shared with pride in the humanity that prevailed through the challenges.

Baltimore was next, hosted at Johns Hopkins by Dr. Frank Frassica and at the University of Maryland and Shock Trauma by Dr. Andy Pollack. This is a city rife with academic medicine and again, our visit was highlighted by an opportunity to chat with the Orthopaedic Titans. In the trauma field, the experience was particularly rich as we visited with Andrew Burgess, Allen Jones, Pollack and the entire Shock Trauma team. In keeping with the spirit of the visit, the Fellows donned the famed "pink scrubs" for a picture on the Helipad.

North Carolina was next with a whirlwind tour of four sites; Carolinas Medical Center, with Jim Kellam, Ed Hanley (and the Frick clan); Duke, with Jim Urbaniak; University of North Carolina, and Wake Forest. The state was filled with highlights, including dinner with the Frick family, and watching Dr. Urbaniak perform a free fibular transfer. Alex Shin (not a sports fan) induced apoplexy at Duke during a tour of Camden Indoor Stadium when he congenially inquired, "Who is Coach K?" We were treated to extravagant and elegant dining but perhaps the most memorable repast involved polishing off two-dozen Krispy Kreme donuts in rapid succession as we pulled into the airport. I didn't think we could do it, but Khal and the rest of the boys proved me wrong!

Emory University in Atlanta hosted us, with Dr. Scott Boden at the helm. Scott was without question one of the most impressive academics we met on the tour, and one of the most accomplished. Peter Cole, as a former Emory undergrad, experienced a homecoming of sorts as we toured the University grounds. One of the highlights was a talk by John Scheuerholz, general manager of the Atlanta Braves, who outlined the secrets of the Braves' worst-to-first transformation with his motto, "Winners make commitments, losers make excuses".

Vanderbilt was the final stop on the tour; a fitting bastion of academic medicine combined with Southern hospitality to bring the events to a conclusion. Drs. Dan Spengler, Herb Schwarz, Neil Green and Kurt Spindler shared the hosting duties, beginning with an evening at the Spengler's home perched high on a bluff enjoying the warm breeze of a Nashville night. Dr. Schwarz hosted the academic session, including an inspiring conference on medical training in the new millennium which brought our own academic mission to our minds. The social side was similarly engaging, ranging from tossing a football around Belle Meade with Dr. Mark McAndrew to kicking up our heels with the high charging Vanderbilt residents.

The fellows at the gates of Vanderbilt University: Khaled Saleh, Dave Sanders, Alex Shin, Peter Cole, and Steve Frick.

From Vanderbilt to our homes, the 2001 North American Travelling Fellows then parted ways. Joyful reunions with our incredible families were to follow. Somewhere in the total of 25,385 miles traveled, or perhaps in the 172 dinners, 685 cups of coffee, 144 academic sessions or 288 miles jogged, our lives have been permanently enriched. I returned home 12 pounds heavier, but also sporting untold new opinions founded in the considerable academic wisdom obtained on tour. Encouraging trends in orthopaedics were in evidence at every centre we visited, including an improved emphasis on education in training programmes; inclusion of a new generation of orthopaedists in meaningful academic leadership positions; and genuine concern for ethics in patient care, education and research. Equally important, however, are the new friendships developed along the way; founded in common academic interests and aspirations, and grown in the course of many shared experiences. The 2001 North American Travelling Fellowship has concluded, but the value of the lessons learned and friendships enjoyed will linger.