Why Orthopaedics? Why medicine? Why not ship broking? Private equity? Surely the questions every orthopaedic trainee asks themselves at some point. Especially if they’re based in the capital. Especially when their bosses tell them there aren’t any jobs. Especially when the ST3 cohort doubles.
In Phnom Penh, there is a centre well known to those who ply their trade on the humanitarian orthopaedic circuit. Children’s Surgical Centre is at times a brilliant place, at times a terrifying unit, and at times an unparalleled educational facility. Many orthopaedic trainees have been through it, either as junior trainees interested in limb reconstruction, or as fellows developing frame experience. I went as someone frustrated by two years of foundation programme, and came back with renewed vigour and zeal for training.
Was that what inspired me? I spent a lot of time thinking about this for the interview, and I suppose the answer I gave was one of the more accurate ones on the big day. That the ability to restore function to an injured or disabled person is always impressive. That it is a big attraction to our specialty. The ability to take crude, and often inexpensive materials, (fixators can be manufactured from materials found in a local market), and employ sound engineering principles to return someone to function and therefore to work, is not to be glossed over. If that return to function means a person can feed their family from their earnings, then the outcome is even more rewarding.
So the motivation is there. What is less clear is the world in which we will all work in the future. We hope there will be a health service. We hope there will be jobs. We hope there will be a pension, and a school for our children, and that they may, on some level, be proud of what we do, what we put in, what we sacrifice for the benefit of our patients. But if plan A fails, there will always be a need somewhere in the world for people with the technical know-how to take materials from their local market and make them walk again. Maybe those people will be us?