Mr Paddy (Padmanabhan) Subramanian

Mr Paddy (Padmanabhan) Subramanian

Date of Fellowship: October 2017 to December 2018

Current Appointment(s): Consultant Trauma & Orthopaedic Surgeon

Biography:

Having graduated from Imperial College, my specialist training was in the North East Thames London rotation. Alongside this, I won a scholarship and completed a part time MSc in Musculoskeletal Science at Oxford University amongst winning 10 other prizes during my training. I was successful in getting into one of the UK’s highest volume and prestigious fellowships run by Professor Middleton. This path culminated in being appointed at the leading Royal Free Trust as a consultant lower limb surgeon with special interests in hip and knee surgery as well as complex trauma. A testament to my drive and passion for orthopaedic surgery includes obtaining my CCT with nearly 5000 logged surgical cases (more than double the national requirement). My claim to fame in the orthopaedic world perhaps maybe in authoring one of the most read BMJ articles in the journals history. Outside the world of orthopaedics, I have a keen passion in property renovations including designing custom fish tanks as well as scuba diving. For those that know me well will also note my interests in fine whiskies, coffee and 90s pop music.

Comments on time as Prof Middleton (ORI) Fellow:

Having had a great training voyage in London, I wanted to gain experience from an alternative UK based healthcare model that offered hands on high volume experience in hip surgery. The Bournemouth fellowship certainly offered that. The very staged fellowship had a strict framework in place to allow competency based progression. In approximate times, the first two months were predominantly spent getting used to performing surgeries the ‘Bournemouth fellowship way’ including a number of surgical technique peculiarities which simply work exceptionally. After being ‘signed off’ as competent to perform primary arthroplasty by Professor Middleton, the following 6 months are spent gaining exponential experience in independent surgical operating. Experience is also gained in performing arthroplasties in a consistent and reproducible manner at the Derwent where the fellow has two theatres with two anaesthetists, two assistants and two theatre scrub staff to flip between and utilise the day effectively. During the last 4-6 months of fellowship, you are supervised by Professor Middleton with hip arthroscopy and revision surgery and if and when competent, you are ‘signed off’ for these more complex procedures to do independently. At this point, the experience in independent complex primary and revision arthroplasty and hip arthroscopy increases. In the fellowship, a fellow can certainly achieve more than 250 primary total arthroplasties and 50 revisions including periprosthetic fracture management. One also has the option of doing trauma lists at Poole hospital alongside the weekly ‘periprosthetic fracture’ list.

From an academic point of view, as a fellow you spend one day a week at the Orthopaedic Research Institute Bournemouth University, aptly termed ‘ORIBU’. This research centre far exceeded my own expectations in terms of collaborative colleagues and research tools and facilities including a state-of-the-art gait lab and surgical simulator based training tools. Here we discuss and participate in on-going research such as the TOPHIP Trial or current ODEP studies. The day at Uni was a really helpful way to reflect on the week, catch a breath and in the summer – get a nice drink by the beach (after work).

From a management point of view, the fellows lead the Friday x-ray MDT where Professor Middleton reviews each and every post-operative radiograph of the week and gives helpful feedback. This meeting is also used an educational meeting where recent hot topics are discussed in the world of orthopaedics. There is also the opportunity to get involved in quality improvement projects and regular audit meetings.

Personally, this fellowship really defined the surgeon I am today. The best fellowships not only give the best clinical hands-on experience but equally as important, give insight to how one would run their practice as a consultant.  It has now dawned on me that the least time consuming or worrying part of consultant life is the actual operating.  That being said, I firmly believe that this fellowship had given me an excellent clinical foundation to build upon.

Finally, I have to say Bournemouth certainly does have a lot else to offer, including the New Forrest, the great restaurants and some of the best beaches in the country and as a cocktail fan, I would certainly recommend smoking aces after a busy week at work.