CORR International-Asia-Pacific: Opportunities and Obstacles of Fellowships Outside of Asia for Graduates of Asian Residencies.

From the column editor, In this month’s CORR International—Asia-Pacific column, Prashant Meshram MS, DNB, a research fellow from Mumbai, India details the obstacles young orthopaedic surgeons from the Asia-Pacific region face when pursuing a fellowship abroad. Dr. Meshram has worked as a resident and junior physician at two of the highest-volume tertiary care centers in the region, and has experience of fellowship at three centers in developed countries including the United States. After a young surgeon in a developing country finishes his or her residency, (s)he must decide whether to pursue subspecialty training or start an independent practice. Traditionally, young surgeons would jump into private practice. But today, we are seeing more surgeons from the AsiaPacific countries pursuing and securing international fellowships. Why are more surgeons taking the road less traveled? And how can young surgeons get the most out of their fellowship abroad? Read this month’s guest column from Dr. Meshram to find out the answers to these questions. — Tae Kyun Kim MD, PhD Orthopaedic surgeons who complete their residency in the Asia-Pacific region often face a difficult question: What’s next? Unlike in the United States, where more than 96% of orthopaedic surgery residents pursue fellowship training [8], many of the orthopaedic graduates in the AsiaPacific region choose private practice or accept a junior physician position at public or private hospitals. Without access to a formal matching process [8], there is a notion, at least in India where I am from, that starting independent clinical practice right after residency will help build one’s reputation among patients and peers. Yet more orthopaedic surgeons in the Asia-Pacific region are choosing international fellowships to practice their chosen subspecialty. Fellowships help build one’s depth of knowledge and skills in a subspecialty, and overseas fellowships offer physicians a chance to learn about different aspects of patient care that they may not see or use in private practice in their home country. But lack of opportunity, a dearth of mentorship or guidance, and financial constraints are just some of the obstacles that may discourage physicians from pursuing their fellowship abroad. After my residency inMumbai, India, I was fortunate to work in clinical fellowships under two leading surgeons in South Korea, and I am currently working as a research fellow at Johns Hopkins University in Baltimore, MD, USA. My experience helped me understand the key aspects that will help young orthopaedic physicians get the most out of their overseas fellowship.