Dr Ali Haghnegahdar was the winner of the 2016 German Ochoa Traveling Fellowship Award. His plan was to attend Queens Medical Center (QMC) in Nottingham to work alongside Michael Grevitt (Chairperson of AOSpine Education Commission) and bring with him one of his young Fellows from Iran.

 

Dr Haghnegahdar recently returned from the UK and was very grateful for the experience.

 

Why did you choose QMC in Nottingham for your trip?

QMC is a well-known spine center world-wide. There are spine surgeons from both ortho and neuro schools. They are working in all fields of spine surgery, from minimally-invasive to advanced deformities. They are leading educators in spine fellowship programs. There are two Iranian-British senior surgeons, Mr Mahdian and Mr Shaffafi. They are working on state of the art spine surgery and are also experienced in fellow's education. This is very helpful for Iranian fellows to become adapted with their new situation at QMC much more easily. There are fellows from many countries. A real multinational, multicultural environment is present at QMC. Almost 20 fellows are involved in research and clinical activities. This is an indicator of the high level of acceptance of this center. There are 3 operating rooms available every day and a vast variety of spine pathologies are treated each week. This provides a chance for short term fellows to observe a wide range of pathologies from deformities, degeneration, traumas, to tumors. Language is a barrier for overseas trainees. English is the most popular and easiest for Iranian surgeons. This is another advantage of QMC. And last but not least, the role of Mr Michael Grevitt is very important. He has outstanding ability in teamwork and leadership. He encouraged me to apply and accepted that QMC be my host very generously. When I arrived at QMC and observed his excellence in surgical management, skills, and education, I never regretted my selection of QMC.

 

​"The organization has already given me so much during my entire professional life. Thus, I do not expect to get something back in addition. As the current president, I am continuing to serve the organization. The opportunity to contribute to shaping the future of the AO is what motivates me to donate my time and my energy."

 

Do you feel it was useful for your fellow, Dr Hamid Rezaee, to also attend the hospital?

Yes definitely. This was a great opportunity for him to touch a different fellowship program. I am sure his short stay at QMC opened a new vision in spine surgery for him. Comparing the Shiraz and Nottingham fellowship programs started a kind of motivation for improvement inside him. I would like to have 2 more fellows with me but unfortunately it remains a wish at this stage.

 

I understand you got the opportunity to visit St Thomas's Hospital in London. Do you feel the hospitals vary from city to city?

Yes. I recognize the same sorts of differences when I travel between Shiraz and Tehran. Living, traveling and teaching in bigger cities is more complicated. For every step more time and energy is utilized in metropolitan cities. It took time to get permission for access  to the OR at St Thomas. I appreciate Mr Lucas's support for helping me achieve this goal. In Nottingham life is more smooth and friendly. In London you enjoy life at a more expensive price.

 

I know you planned this trip to create cross cultural relationships. Do you feel you have been successful in this endeavor?

Yes. This trip provided an environment of exchange between two centers. I firstly received a request to have an observer fellowship at QMC a few days ago. I will send it to Professor Grevitt soon. I hope we can exchange fellows and invite consultants from QMC to visit our center. It may be attendance in a course or symposium or a short stay to share their experience with Iranian colleagues.

 

​

 

Working in Iran must be very different to working in the UK. What barriers are there for you in Iran that do not affect spinal surgeons in the UK?

No; there is not a significant difference between spine surgery in Iran and UK. Nowadays we are living in a global village. All improvements in science and changes in skills and instruments are well addressed and available in Iran. Let me say, AOSpine provides a unique utility that helps all spine surgeons world-wide to become up to date. In some aspects, we have some limitations in Iran. Regarding the economic situation and long term sanctions, we had a shortage of some kinds of instruments for short periods of time. This did not have a huge impact on treating patients. There are some limitations in hospital budgets over recent years. However, overall, they will be improved after elimination of the sanctions. These types of problems are unimaginable in UK.

 

Finally how has AOSpine influenced and supported you in your professional career and why would you recommend becoming an AOSpine Member?

Put simply, AOSpine opened a door to an international community of spine surgeons for me. There is no other comprehensive organization that allows all spine related specialists to join so simply and engage in its programs. Furthermore, each region has its own AOSpine, founded by local surgeons creating a sense of community.

This democratic organization provided me a chance to gain knowledge, improve my skills, and act as a faculty and tutor. Its courses are designed from basic to master level. There are vast opportunities for fellowships, being a faculty, and doing research. All of these make an environment for growing over time. As a dynamic process, there is constant change in responsibilities and positions. This provides the chance to meet new faces and to be involved and fostering scientific dimensions of AOSpine. My final point in answering this question is that internal relationships within AOSpine are based on respect, friendship, and rule of law. This makes AOSpine as a big family. You feel yourself at home when you are working at or attending an AOSpine event, even when you encounter challenging situations. All of these have helped me greatly during my career.

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It's been 6 months since the election of the the first Member Representative in the history of AOSpine at the Global Spine Congress in Dubai. Alaa Ahmad joined the AOSpine International Board (AOSIB) as Member Representative Elect on the first Trustees meeting after the election in early July 2016. In July 2017, he will start his official term as Member Representative with voting rights in the AOSIB for one year.

In this interview, the representative of over 6,200 AOSpine Members shares what he's been up to since the election, and the projects he is currently working on.

 

How was your experience so far as an AOSpineMember Representative, and what projects have you been involved in so far?

The past months have already been an incredibly rewarding experience. I have had the pleasure of meeting and engaging with wonderful doctors from my region, the Middle East, whom I didn’t have a chance to get to know before. I have also met doctors from North America, Latin America, Southeast Asia, Europe, and Africa. For me, listening to the experiences of these surgeons from around the globe underlies how much we can learn from one other, and how many common challenges and concerns we face, despite our rich cultural and institutional diversity.

Within AOSpine, I have been working with Klaus Schnake, the AOSpine Community Development Chair, and Ginesa Aviles and her team.  I am also participating in the AOSpine Community Development interregional meetings and their regular calls.

 

With the support of the Global Spine Congress (GSC) 2017 organization team, and in particular Jeff Wang, I am trying to arrange an interregional symposium as part of the GSC 2017 activities.

 

 

​"For me, listening to the experiences of these surgeons from around the globe underlies how much we can learn from one other, and how many common challenges and concerns we face, despite our rich cultural and institutional diversity. "

Another great experience has been meeting new people at AOSpine, who are not surgeons, but who are experienced, very skilled, and highly professional in other fields. These people are specialists in areas like business administration and marketing. It's great to work with them and to get to know their way of thinking. I have always had interactions with AOSpine staff, but now that I am more embedded in the organization, I realize that there are a lot of things that one doesn't realize from the outside. These include the challenges with translations, and operational challenges, including difficulties with payments for countries where people can't have credit cards. I never thought about this before and there is a lot of work behind the scenes that one never gets to see unless you are really working in the organization.

 

You are representing over 6,000 members worldwide. What are the most important topics that you would like to discuss during your term as the AOSpine Member Representative?

At the international board meeting, I will bring up and discuss topics that are important at the level of individual membership and also from a broader perspective. My role is a two-way function: to promote the feedback and ideas of the members to the AOSIB, and also to communicate and explain the AOSIB decisions to members and to promote them across the regions.

 

At the level of the individual AOSpine Members, I will relay to the AOSIB the necessity of improving the networking activities in education and research between the regions and at interregional levels. This would involve research projects, symposiums, increased use of live surgeries, virtual surgery programs, the implementation of translation software programs to help involve non-English speaking members, and greater involvement in social media.

 

More broadly, I will emphasize to further the engagement of our members internationally in educational and research activities. It is important for AOSpine Members to feel that they are part of a family. It is also imperative that they feel exposed to and able to interact with other surgeons, educators, and researchers from around the world.

 

​"More broadly, I will emphasize to further the engagement of our members internationally in educational and research activities. It is important for AOSpine Members to feel that they are part of a family. It is also imperative that they feel exposed to and able to interact with other surgeons, educators, and researchers from around the world."

 

I would also like foster interregional discussions to exchange experiences. One idea is to host a symposium on a designated topic that brings forth the different views from each region. These could consider: “How can we treat patients in countries with limited infrastructure and very little resources for surgeries that are very demanding in terms of surgery skills and financial resources?” or “How can we deal with such cases, what are the different perspectives and what are the experiences and challenges in the regions?”

 

Another topic that I am very interested in is virtual surgery. More and more, people rely on other sources of knowledge than journals, and the future definitely lies in distance learning with the ongoing revolution in the digital world. Especially in countries with limited resources, virtual learning, and therefore virtual surgery, will become an increasingly interesting topic. Sometimes, there is no experienced senior surgeon around who can teach young surgeons, so they need to teach themselves. I believe that this will revolutionize the educational system and the teaching of surgery.

 

​"Especially in countries with limited resources, virtual learning, and therefore virtual surgery, will become an increasingly interesting topic. Sometimes, there is no experienced senior surgeon around who can teach young surgeons, so they need to teach themselves. I believe that this will revolutionize the educational system and the teaching of surgery. "

 

As an AOSpine Member, what does an AOSpine membership mean to you and why would you recommend someone to become a member of the organization?

To me, being an AOSpine Member means simply that you are never alone. You are with a group of people who are sharing knowledge and thoughts, and sometimes you even become friends.

 

As a doctor or surgeon, we are sometimes very isolated. We work a lot and are very busy. If you are a member of this community, you can share your challenges with highly skilled, excellent people from around the globe. You are part of something bigger, without any geographical borders, or other limits. Around the world, we often witness the unfortunate discourse that stereotypes people from different parts of the world. We enclose ourselves within our own communities and become less understanding and more self-centered. AOSpine is the opposite of that. As AOSpine Members, we champion openness, understanding, and a humanitarian vision for our patients and for our world. It makes me very proud to be a part of this organization and its membership community.

 

​"As AOSpine Members, we champion openness, understanding, and a humanitarian vision for our patients and for our world. It makes me very proud to be a part of this organization and its membership community."

Looking forward, how do you wish to contribute to AOSpine’s vision?

Besides the points already mentioned, I want to work with doctors from all over the world on advancing the methods for spinal deformity management in children, which is my specialty. I think it is also important that the AOSpine vision incorporates not only the challenges facing children and their spinal surgeons, but also the gap between advanced and developing countries in this topic. I will always make sure that the challenges that our colleagues face in developing countries are at the front and center of our mission here at AOSpine.

 

In your first interview after the election, you mentioned that you want to more generally improve access to pediatric orthopedic services. Can you tell us more about that?

Improving access to pediatric orthopedic services is something that I am very passionate about. This lies close to my heart. The experience that I have should not stay in Palestine. I would like to make sure that is also of use in other places. I have treated more than 1,000 patients in my professional career so far, and I am moving more and more into research. I am currently working on my biggest dream—to improve pediatric spine services in sub-Saharan Africa and in other areas of need. I am also involved in a committee that is trying to establish an educational curriculum in pediatric orthopedics for residents.

 

 

I would like to invite all AOSpine members to get in touch with me. Also, I am keen to get answers to the following questions:

 

1. What attracted you most about AOSpine to become a member and what does the membership mean to you personally?
2. Why would you recommend to become AOSpine member as a surgeon?
3. What is your best AOSpine experience?

 

Please send your answers to membership@aospine.org.
Thank you for your continuous support!

 

Alaa Azmi Ahmad, a citizen from Palestine living in Ramallah, works as a pediatric orthopedic surgeon, and is specialized in spinal deformity. He currently chairs orthopedic surgery at the only medical teaching hospital in Palestine, the An-Najah National University Hospital in Nablus. In parallel, he also serves as associate professor of medicine at the An-Najah National University. Additionally, he holds an adjunct assistant professor of medicine appointment at the University of South Carolina in Charleston, USA.

 

The majority of Ahmad's work is in spinal deformities, with a special interest in early onset scoliosis, especially with rib construct and vertebral modulation. Ahmad is married, and has two grown-up children.

Follow Alaa Ahmad on Twitter @alaaortho, connect with him on LinkedIn, or contact him at: alaaahmad@hotmail.com