HIGIO – James Shelton – “Inspired by Time in The Developing World”

I strongly believe that it is the inspirational people in our lives and careers that dictate our career paths. I am not the kind of person who was ‘born to be a orthopod’ or had any real perception of what it was like, before my elective at the end of fourth year of medical school. I could have chosen from a variety of elective companies, but instead I organised my own. My mum (a volunteer with a lower limb charity) had the email address of a consultant (Steve Mannion), she met whilst presenting at a conference, on whom she had pulled the ‘my son is a medical student’ routine on. She told me he was doing some pretty inspirational stuff in Africa, with clubfoot.


A couple of emails later I was set for my elective at Rumphi District Hospital in Malawi. This experience really showed me the magic of orthopaedics. In Malawi there is no social welfare system – If you cant walk you can’t work, if you can’t work you can’t eat. Simple as that. By correcting these children’s deformities, we were able to give them a real shot at life, instead of condemning them to becoming beggars on street corners.


After this experience, I took my career into my own hands, organising special study modules in orthopaedics, ensuring my foundation track had orthopaedics as my first FY2 job, so I could have first hand experience of the profession, before applications to core surgical training. I loved it. My consultant was a hand surgeon that also looked after paediatrics for Tayside and when he realised I had an interest and a little experience from Malawi, he started taking me across to Ninewells for his paediatric lists on Friday mornings. It was great for someone to take an interest in my career; it gave me the motivation to pursue my career in orthopaedics.


I moved to Merseyside for my themed core surgical training, with, (after a little negotiation), 18 months orthopaedics and 6 months general surgery. During these jobs I was lucky to be exposed to both trauma and elective orthopaedics, which I think gave me an additional depth of knowledge for my interviews; certainly 6 months at Alder Hey Children’s Hospital gave me something different from most other candidates. I think it is important to be aware that going into a CST programme does not necessarily mean more operating, as many hospitals like to team up senior SHO’s and junior Registrars to make the transition a little easier. There were many frustrating times as a senior SHO, but also many great times, mostly that feeling of ‘I can’t believe I’m doing this ‘insert operation’.


This year, I was appointed to ST3, after the gruelling national selection process, which I can only liken to the Hunger Games. It’s tough, but the rewards are great and I have a job in something I love doing. I’m not sure many people can say the same.


My advice to you, if you have the slightest interest in orthopaedics, would be to organise some time in orthopaedics; it’s not often a huge part of the undergraduate curriculum and it is one of the few medical specialties where you genuinely fix people. If you think you like it, ask your seniors, get a feel for it as a career. Engage in every job you do, even if it’s not orthopaedics; you want a reputation (and references), that say you’re motivated and a good doctor. Get involved with some audits and research – application forms don’t care what specialty, only that you finish what you start and research in particular takes ages to come to fruition. Take some courses, such as basic surgical skills or core skills in orthopaedics – it shows you are keen and willing to spend your own time and money on your career.


Lastly, sharpen your elbows and get into theatre!