Dr. Myeroff’s International Traveling Shoulder Fellowship
Shoulder & Elbow UPenn-Princess Grace Traveling Fellowship
The relationship between Monaco and Philadelphia dates back to the marriage of our own Grace Kelly to Rainier, Prince of Monaco. She was revered by the citizens of Monaco. After her traumatic death, there was a re-prioritization of resources in Monaco. While climate change remains the prime initiative, healthcare was boosted to a close second. Starting in cardiology, and now orthopaedic surgery, The University of Pennsylvania became a natural partner in the pursuit of excellent care for the citizens of Monaco.
Relationships then forged among our orthopaedic chairman (Dr. Scott Levin), our shoulder and elbow service (Dr. David Glaser and Dr. Russell Huffman) and Tristan Lascar, Chief of Orthopaedics at Princess Grace Hospital. In an effort to increase academic collaboration, a traveling fellowship was spawned. As the shoulder and elbow fellow at Penn, and with the support by our department, I was given the opportunity to be the first UPenn-Princess Grace Traveling Fellow.
Dr. Lascar was gracious enough to host me and my family for these 2-weeks. Each day started with team rounds which included consult presentations by the orthopaedic resident as well as indications conference. Here, a multidisciplinary team included subspecialists in trauma, joint reconstruction, shoulder and elbow, spine, and arthroplasty. The team was diverse with members hailing from Portugal, Russia, Monaco, Italy, and France. Debate and planning mirrored that of American academic subspecialty teams. There were regional differences in treatment strategies and patient care which made for phenomenal debate and learning for all parties. This experience included time in the fracture clinic, shoulder clinic and operative theatre where I was able to learn and teach in a dynamic environment alongside Dr. Lascar and his resident. Cases focused on upper extremity trauma and elective shoulder and elbow surgery.
Regional differences in treatment algorithms were consistent throughout the traveling fellowship. Monaco sits in a geographical hotbed of shoulder excellence with regional thought leaders scattered in its vicinity, including Lorent Lafosse (Annecy, France), Giles Walsh (Lyon, France) and Pascal Boileau (Nice, France). Leveraging these opportunities, Dr. Lascar and I traveled to Nice where we joined Dr. Boileau for a day of complex shoulder reconstructions, including a bio-reverse shoulder arthroplasty which Dr. Boileau has developed and championed in the literature. Following a day of learning, Dr. Lascar hosted a debriefing dinner at his favorite restaurant overlooking the Mediterranean coastline.
After a brief respite, I traveled to the small town of Montbrison, where I visited a small rural hospital. Here, I teamed up with Dr. Grista, a master surgeon. I scrubbed alongside him for several unique cases including an endoscopic ulnar nerve decompression and stemless reverse shoulder arthroplasty, both of which are cutting edge techniques. Following a day in a rural French OR, I joined our industry partners (Fx Solutions) for an evening of French faire, followed by a day of didactics and a cadaver lab focused on stemless reverse shoulder and hemiarthroplasty for proximal humerus fractures.
After re-establishing roots in Monaco at Princess Grace Hospital, it was time to say goodbye to Dr. Lascar, his team and his gracious family. From there we traversed the the French alps on our way to beautiful Annecy, France. Here I joined hundreds of shoulder surgeons for a 3 days course lead by Dr. Lafosse, which was the perfect conclusion to my traveling fellowship and the capstone to my training at Penn. I am forever grateful for this educational opportunity and am privileged to wave the our flag high as we continue to build relationships and affect patient care worldwide.
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