Being a spine
surgeon trainee
IN JAPAN
By Kyaw Linn Linn
Yangon General Hospital and NayPyiTaw TatKone Hospital, Myanmar
AOSpine Center:
Okayama Rosai Hospital
Spine Director:
Masato Tanaka
I started my AOSAP fellowship training in OUH on 6th Feb 2017 as already planned. To be able to start my fellowship on time, several document have to be prepared for acceptance to OUH for advanced surgical training. It really aids me to learn how to prepare to work in a hospital in a developed country and make me understand how much the system there in OUH, is given attention to details. I left Yangon Airport on 4.2.17, by ANA Airline and arrived at Okayama Airport on 5.2.17, where I was warmly greeted by one of the subordinates of my spine center director, and helped to be allocated in my apartment. My spine center director and his staff have prepared almost everything that I may need during my stay in Okayama and Japan, including internet and some food and beverages & sightseeing plan. I felt surprised by their helpfulness and well planning.
Next day when I reached OUH, I cannot be more than fascinated by my sight. The hospital itself was more splendid than I have expected. There were several departments and infrastructures, facilitated for all the doctors, staff, patients, attendants and visitors. The government, the administrators, the doctors and the people are all in harmony to achieve the welfare of patients. By the same time, I felt sorry for the difference between the health facilities and situation in Okayama and those of my country. That made me get heartache for my colleagues and patients in my own country. Actually during my stay in Okayama, I had been treated with meals for several times and on the day of my arrival, they made a welcome dinner for me. My director and team brought me to a restaurant where I got my very first experience of trying authentic sushi and sashimi, which is the most favorite and expensive dish in Japanese society. I tried various kinds of Japanese traditional cuisines, and found very delicious, i.e., in Japanese words, O-ishi ! I could feel not only the various dish but also their culture, including how to eat sashimi, how to drink Odon soup, how to taste ramen and how to enjoy green tea. It was really worthy to learn their culture.
My academic clinical and surgical training in OUH was really rewarding. Basically, the routine working hours in the center was much more than ours, starting from about 7:20 AM through 9:00 PM, although there were some variations. The schedule was well and all the doctors and staff are strictly punctual. The operation and conference started on exact minute without any delay. On the other hand, there was recognized place, time and facilities like computer, internet, intranet, library for academic studies. Thus, I could get not only advanced surgical training but also their good life style: punctuality, discipline, hospitality, helpfulness, respect, and care, that really exceed my former expectation before coming here.
The surgical techniques were fascinating. Not only my spine center director but also his subordinates could carry out sophisticated techniques. They allowed me to actively participate in surgical procedures that included spine exposure, navigation assisted pedicle screwing, occipital, cervical, thoracic, lumber, sacral and iliac screwing, TLIF, OLIF, MIS, scoliosis and various advanced operations. And I felt much delighted when I myself could do these procedures under their supervision. The facilities available were really helpful and O-arm, navigation, neuro-monitoring, cell saver, arterial monitoring, intermittent pneumonic compression device, ultrasonic tumor surgery device, endoscopes and microscopes were widely and routinely used, with resultant very few risk of complications. Radiation hazards to spine surgeon was dramatically reduced because navigation is used instead of C-arm in almost all every case let alone accuracy in spinal procedures. During my stay, neurological, hemodynamic and infective complication incidence was very few and there was not any case of mortality noted. Because of the help of facilities and team’s technical experience, the surgeons seemed to be comfortable in their surgeries. I am envious of their talents, skills and facilities.
During my fellowship period, I could discuss on several spine problems including scoliosis and ASD through conference, workshop, seminar, journal club, conversation and even on online frequently with my director and his subordinates. I could get learnt a lot and my opinions were also appreciated during discussion. The mutual respect an every occasion is their culture. The relationship among surgeons, junior doctors, anesthetists, staff and patients were very smooth with respect and care to each other. There is culture to use the word su-mi-masen, that means ‘ I am sorry or excuse me’ on every occasion that may make embarrassment to others, to show their respect, both postural and verbally.
Before my departure, I was treated farewell party by the spine team as well as by the orthopedic department. I felt sorry when I heard their words expressing our relationship, my good points and funny points, their wish for my coming back again, and I understood that we had very strong attachment between us. At last, I could have completed my fellowship training in OUH successfully and I had made up my mind to share my knowledge and skills to my colleagues, juniors and society. Besides, I would like to improve my standard of care, my culture, my habit, my attitude as well as to help others to adopt the good culture of hospitality and punctuality and mutual respect. I strongly believe that 8 weeks of spine training fellowship directed me to a positive track in my life indeed.
Being a spine
surgeon trainee
IN KOREA
By Ji-Hoon Shin
Yeungnam University Hospital, Korea
AOSpine Center:
Sanggye Paik Hospital
Spine Director:
Jin-Hyok Kim
As participating several AOSpine symposiums, I have heard of how to apply for AO fellowship. Since, I have always wanted to see how other experts do the surgery, I thought that It was a great opportunity. Sure, I think it would be nice to have fellowship abroad. But, there are so many great spine surgeon in Korea, I applied domestic fellowship. Domestic fellowship also has advantage that there are no barriers such as conversations or distance. When I first arrived designated sanggye-paik hospital, I was puzzled because the hospital size was not bigger than I thought. There was also the burden of thinking about working in new environments with new people. But the director was warmly welcomed from the start, I was easily able to relax because all the residents were kind to me. On the first day, I observed director’s outpatient. I learned the method of physical examination that I usually missed, I learned a lot about degenerative lumbar disease or osteoporosis treatment.
Almost everyday form that afternoon, I participated in many spine surgery. (Discectomy and decompression, PLIF, OLIF, fracture surgery, etc) I was allowed to scrub, able to see the director 's surgery nearby. In addition to director, I was able to participate Dr. Jang and Dr. Im’s operation. Director used a different surgical technique than the one I usually worked with, so that was very helpful to junior surgeon like me. Since I am a spine surgeon who lacks experience, I think it is very important to experience various methods of surgical techniques. And almost every evening, after the surgery, director and other supervisor treated me some delicious food. I ate too well during the fellowship and my weight has increased. To summarize, it was an unforgettable experience, and I was inspired by the enthusiastic view of the director. I would like to encourage many AOspine members to apply for AOSpine fellowship. I am grateful to AOSpine and the director for giving me good chance. Thank you very much.
Being a spine
surgeon trainee
IN SWITZERLAND
By Lin Han
Tongji Hospital, Tongji Medical College, China
AOSpine Center:
Bern University Hospital
Spine Director:
Lorin Michael Benneker
Time always flies away. It has been about one week since my return from Inselspital, Bern University Hospital. I was so lucky that AOspine provided me a chance to contact the spine center of university of Bern. I really appreciated AOspine for providing the fellowship. I would like to appreciate Ms Adele Chan for helping me to choose the spine center and preparing all the documents needed for visa application. And I also would like to appreciate Ms Karin Haueter for helping me to find a suitable accommodation and preparing all the documents needs for working badge application. For sure, I would like to appreciate Prof. Benneker, Dr. Deml and Dr. Hoppe for explaining the detailed information and operation plan of each patient. And I really appreciated them for the step by step teaching. Also, I would like to appreciate my colleagues for undertaking my work in hospital. Finally, I should appreciate anybody whom i met or not met having giving me a hand or Spiritual comfort. Inselspital is a large university hospital. The spine center belongs to the department of orthopedics and traumatology. There are five doctors in the spine group, including one professor, one associate professor and three attending doctors. Each Tuesday, Wednesday and Friday is the operation day. And each Monday and Thursday is outpatient date. Each week, they complete about ten to fifteen operations. The therapy includes the entire spectrum of spine diseases and injury. They take care of all the problems of the spine, from children to old people of the deformity to serious injury, from head to sacrum.
Most of the cases suffered from degenerative pain or deformities and instability. Most of the operations are decompression, fixation and fusion, percutaneous vertebroplasty, and revision. The affair that moved me most is not only the doctors and nurses treat guest doctors friendly and warmly, but also that they would like to help you from the bottom of their hearts. For example, they would like to talk to me in English, although there is only one foreigner. And during the operation, they would like to communicate with you and would like to explain the aim of every manipulation. Through this four weeks fellowship, i have learned a lot of knowledge of spine surgery, especially the concept and idea of fixation and fusion. And also i became more familiar with the surgical instruments and consumables. Furthermore, I got new comprehension and confidence of how to do extreme lateral interbody fusion and anterior interbody fusion. Through this fellowship, I enlarged my vision and broadened my scope of spine surgery. I really appreciate AOSpine for providing this kind of fellowship. But, if anyone would like to ask me whether there has been any deficiency, I think the amount of the stipend should be adjusted according to the level of local consumption and also the cost of airline tickets should be covered.

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