This Resident Roundup post comes from Dr. Anton Lambers, MBBS, an orthopaedic surgeon from Australia who, upon completing fellowships, will return to work in regional Victoria at Northeast Health Wangaratta.
Designing a Fellowship on 4 Wheels
Traditional fellowships can be wonderfully structured, but they’re rarely flexible. I wanted the opposite. By emailing ahead, leaning on colleagues’ networks, and keeping our route clockwise along the coast, I pieced together a bespoke curriculum—12 informal mini-placements that stretched from Melbourne to the Top End. The (sometimes enormous) gaps between visits were just as valuable, giving me time to reflect on what I’d seen and spend precious time with the family, towing the van through gum-studded hills, sandy beaches, or empty desert.
What the Clinics Taught Me
- Ice in the Tropics
In humid Far North Queensland, a surgeon running a high-volume arthroplasty service swore by aggressive cryotherapy protocols. Watching his team send all patients with joint replacement home after 1 night—pain controlled, knees cool, flexion excellent—upended my assumptions about heat, swelling, and discharge timelines. - Rural Reality Checks
Spending time with 2 surgeons in a remote hospital in South Australia showed the razor-thin line between independence and isolation, with our discussions including the difficulties of attracting new surgeons. - Coastal Generalists
In another coastal Queensland town, I witnessed some talented rural generalist orthopaedic surgeons. One surgeon’s list included an MCL reconstruction, a pelvic ORIF, and a revision hip replacement followed by some hand surgery—all performed by the same surgeon and done very well!
What the Road Taught Us
Why a DIY Fellowship Works
- Flexibility: By picking dates and destinations ourselves, we balanced professional goals with family priorities.
- Cost-Neutral Living: Caravan parks and national-park campsites are cheaper than city rentals. Meanwhile, a couple of locum weekends covered diesel and groceries.
- Targeted Learning: Instead of a single super-specialist environment, I cherry-picked surgeons whose strengths filled gaps in my own practice—from revision hip strategies to sports injuries.
- Network Expansion: Arriving with a unique request made introductions easy and memorable. The various hosts are now colleagues I can ring for help anytime.
- Family Enrichment: A year together, 24/7, isn’t always bliss. But the shared hardships—flat tires, cane-toad and crab invasions, an unexpected caravan accident—built resilience and a bank of family legends that no theme park could top.
Tips for Would-Be Traveling Fellows
- Plan Light, Communicate Early: Send introductory emails a few months ahead, but leave room to adjust as weather, road conditions and other plans shift.
- Respect Local Workflows: You’re a guest; absorb first, contribute second. Bring fresh research or techniques to share so it’s a 2-way exchange.
- Build Downtime into the Syllabus: Reflection turns observation into practice change. Take some notes, and leave plenty of days (or months!) between visits to focus on family.
Coming Home
If you’re nearing the end of training and the call of the open road—or rail, river, or sky—won’t leave you alone, lean into it. As much as my colleague and I feared the consequences of a year off, the opportunities will still be there when you return, and you might just arrive back sharper, saner, and closer to the people you love. A caravan isn’t the only vessel for a DIY fellowship and there are lots of ways to get creative with visitations. But it’s proof that, with curiosity and a satellite Wi-Fi set-up, a fellowship can have wheels—and the commute can be paradise.
Interested in other OrthoBuzz content for residents and trainees? Check out the posts below from the Resident Roundup section. Or if you have an idea for a post, we’d like to hear from you. Find out more here. Questions and submissions can be sent to orthobuzz@jbjs.org.
A Year in Review: The 2024-25 JBJS Robert Bucholz Resident Journal Club Support Program
Turning the Flywheel: Building Balance Through Consistency in Residency
Reach Out to Your Fellows and Short-Term Trainees Early and Often!