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Thank You & Farewell from the 2017 NATF Cohort


With the 2017 NATF tour having come to a close, and after having such an incredible experience over the past 4 weeks, there are a number of thank you’s that need to be sent out from our group…..

First of all, to the American Orthopaedic Association NATF selection committee – thank you for taking a chance on us, for believing in our ability to represent our incredible profession and our home institutions, as well as the AOA on this incredible journey. You chose us because of our past accomplishments and potential to become leaders in orthopaedic surgery and our respective subspecialties, and we will continue to work hard to provide exceptional orthopaedic care, train the surgeons of the future, create and disseminate knowledge to advance our profession, and work to change the face of orthopaedic surgery in our dynamic health care environment.

Second, a great big thanks goes to our “godfather” Dr. Brett Owens, Sports Medicine Surgeon at University Orthopedics in Providence, RI, former NATF Fellow and member of the 2017 selection committee, who shared all his pearls of wisdom learned from his own travels and encouraged us to have fun and enjoy each other during the trip. This trip also would not have been possible without the hard work and dedication of Kathy Sinnen and Kristi Halpin, two amazing administrators from the AOA whose organizational abilities surpass all of ours combined, and who got us everywhere we needed to go, working constantly with the host sites to ensure our trip was seamless and smooth. Thank you so much ladies!

That brings us nicely to our host sites – the University of British Columbia, University of Alberta, University of Washington – Seattle, Oregon Health & Science University, University of California – Davis, University of California – San Francisco, Stanford, University of California – Los Angeles, Cedars-Sinai Medical Center, University of Utah and Denver Health Medical Center. You opened your clinics, operating rooms, academic conferences and homes to us and made us feel part of your teams. You took time away from your families, friends and patients to entertain us, educate us and introduce us to your institutions. We thank every single one of you, faculty members, administrators, residents and fellows, OR and clinic staff, nurses and everyone else we interacted with, for helping make our visits so amazing! A special thank you goes out to the department chairs and our incredible site hosts at each of the institutions – your hard work organizing the events for our trip was much appreciated and it was wonderful getting to know each and every one of you!

Of course, none of us would have been able to take part in this incredible opportunity if it had not been for the people we left at home. Thank you to our teams at work – our nurses, PA’s, administrative assistants, and partners – who held down the forts and took care of our patients while we were traveling. We are lucky to have been able to rely on you, traveling comfortably in the knowledge that our patients were in good hands, and we hope to return the favor.

Most importantly, however, the biggest thank you goes out to our families, our parents,  children, and particularly our spouses, without whom none of us would be who we are, or where we are today. Thank you for consenting to having us pursue this dream, for supporting us along the way, believing in our abilities and helping us become who we are. We know it wasn’t easy while we were away, and we will be forever grateful for the sacrifices you made to make this experience possible. We love you and thank you!

And lastly, thank you to all the followers of the blog, who have been watching our travels, sending positive feedback along the way. We hope you have enjoyed our journey as much as we did. For those of you who have had the opportunity to be AOA traveling fellows, hopefully it brought back some great memories. And for those of you who one day might consider going down this path, all we can say is, don’t hesitate to reach out and go for it! You won’t regret it!


– The 2017 NATF Cohort

Christina Goldstein      (

MaCalus Hogan      (

Bheeshma Ravi      (

Scott Tintle      (

Brian Waterman      (


CLG (2017 NATF blog author)




Day #27 – Denver, CO & Home – October 20

Our final day of travel for the 2017 NATF tour saw Scott, Christina and Mac catch an Uber to the airport at 4:15 am, with Christina and Mac heading off just after 6am and Scott flying out at 8am. As we were all traveling on different airlines, we got separated while checking in, and then again at security, preventing us from having another formal goodbye. This was probably for the best, as the kind, sentimental texts that started going back-and-forth the night before continued, and it saved any tears from being shed (at least on Christina’s part!)

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After arriving home safely a few hours early, Christina got to see her friend and assistant Lindsey who picked her up at the airport to surprise her husband. On Saturday, she attended the Mizzou Homecoming Football game against Idaho, where she reunited with her senior partner and other colleagues and friends from Mizzou Orthopaedics, as well as the Mayor of Columbia and his wife who dropped into the suite for a visit. Though the team has had a rough season, they were able to bring home a win for homecoming and it was a beautiful fall day in Columbia!

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Scott took the opportunity to head out for a hike with Haley, Graham and Morgan on Saturday, giving his wife Patti her first moment alone in a month, for which she was grateful. It looked like a great day there as well, and the photo is reminiscent of some of ours from our “hikes” on our tour : )

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Arriving home 6 hours early in Pittsburgh, Mac quickly returned to normal on Friday afternoon while his wife was at work, taking his two daughters to Target for some shopping. On Saturday he spent some more time with the girls, attending a birthday party with them and quickly getting back into the normal routine.

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Brian and Bheesh left later in the day, with Bheesh flying home to his family in Toronto. He spent all day Saturday with his wife Lucy and 2-year old son Raama, with the latter stealing Bheesh’s UCLA hat almost immediately! Guess he’ll have to break down and buy a U of T one at some point!

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Brian was the only one who didn’t immediately head home to Winston-Salem, instead hopping on a plane to Atlanta, GA. Though he usually doesn’t cover away games, his presence was requested for the Wake Forest Demon Deacons game versus the Georgia Tech Yellow Jackets at Bobby Dodd Stadium. Another day, another airport hotel…aahhh, the life of an important sports surgeon and team doc!

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We all agreed it was great to be back “home” and settling into our normal routines, but we have lots of great stories to share from our adventure and will never forget the memories of our amazing trip!

Day #26 – Denver, CO – October 19

Day #26, our last day of scheduled activities on the 2017 NATF tour, saw us getting up at various times to join some of the faculty from our various subspecialties for a day of OR and clinic observation. Scott was picked up the earliest, leaving the hotel at 6am to join Trauma surgeon Dr. Melissa Gorman at the University of Colorado Anschutz Medical Campus main hospital where they began the day attending trauma handover rounds. It had been a busy night, and there were lots of cases to discuss. He then joined Dr. Gorman in the OR for the remainder of the day, learning how the trauma service works and observing several fracture surgeries.
Christina crossed paths with Scott at Anschutz as the trauma service was vacating the conference room and the huge Spine team moved in for weekly indications conference. She had been picked up at 6:15 by Chief of Spine Surgery Dr. Vik Patel who, on the way to the hospital, gave her a rundown of the rapid expansion going on at the medical system. Indications conference was a ton of fun, as the group of surgeons, trainees, industry reps, nurses, PA’s and radiologists discussed the surgeries scheduled for the next week. Christina was “encouraged” by Dr. Patel to join the conversation and felt very much at home among the group, having a ton of laughs and learning lots about the group dynamic. After conference, Dr. Burger gave her a walking tour of the hospital and medical campus, describing all the buildings and history of the expansions. It is a massive and beautiful setting! They then spent the day in the OR, with Christina getting to meet Dr. CJ Kleck, Assistant Professor whom she had engaged in discussion in conference, and she spent the day watching three anterior-posterior cervical, lumbar and thoracolumbar cases. The team approach to surgery and patient care was great, with everyone in the OR clearly enjoying each other’s company and the camaraderie!
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Mac finished his final day with Associate Professor and Chief of the Division of Foot & Ankle Surgery Dr. Kenneth Hunt in the clinic. He got to see how things run in the current clinic and learn all about the new Foot & Ankle Center that will be opened in November. After clinic, he joined Dr. Hunt and several other members of the team at his home for a team dinner, and was very pleased to be included, though he was disappointed he forgot to take any pictures, a very uncharacteristic move for Mac! It didn’t seem to matter though, as Dr. Hunt still invited him to come see the new center once it is opened : )
Brian had a very busy day, linking up with knee and shoulder expert, Dr. Armando Vidal, in the CU Sports Medicine clinic. As an avid fitness enthusiast and head team physician for the Denver Nuggets, he had an incredibly active patient population and shared his experience with the Crossfit Games, hockey athletes, and mountain climbers. He was incredibly affable with patients and colleagues alike, and truly relishes treating the complex revision cases with periarticular osteotomy and cartilage restoration. Brian was able to swing in a quick lunch with his sister, Ilsa, who lives in the Denver area, and then he joined Avalanche team physician, Dr. Eric McCarty, and off duty Denver University sports physician, Dr. Jon Bravman, for the St Louis Blues-Avalanche game at the Pepsi Center. In between tending to a handful of injuries, Eric shared incredible insights on his career as a team physician and academic leader, and they shared some laughs about former Rush colleagues and friends, Drs. Anthony Romeo and Brian Cole, and current Wake Forest partner and ABOS head, Dr. David Martin. The orthopedic sports medicine community is incredibly small and tight knit, so it was great for Brian to have the opportunity to expand his network of professional mentors and friends at University of Colorado!
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Finally, Bheesh had the opportunity to spend time in the clinic with Dr. Michael Dayton, Professor and Adult Reconstruction Surgeon with a special interest in minimally invasive joint replacement. They had the opportunity to discuss a number of very challenging cases as well as identify mutual interests in terms of research. After clinic, Bheesh met up with Scott back at the hotel and the two of them found a great vegetarian restaurant right across the parking lot from the hotel to eat at!
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After going our separate ways for dinner, we reconvened one last time by the patio fire pit to rehash the entire trip, doing multiple round-robins to see what our favorite sites and parts of the trip had been, and what we were going to take home with us, as well as what might be hardest for us returning to our practices and families back home. It was an enjoyable way to finish up the evening, and it was difficult to say goodnight. Fortunately, we did so with the knowledge that we would stay in touch and meet up again soon, already planning research collaborations and meet-ups at the AAOS 2018 Annual Meeting.
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Day #25 – Salt Lake City, UT & Denver, CO – October 18

Our last morning in Salt Lake City with the University of Utah crew, and we were up early for our last series of academic presentations for the 2017 NATF tour. We were met by Dr. Tashjian and Dr. Gililland who kindly transported us to Spencer F. and Cleone P. Eccles Health Sciences Education building where we delivered our talks in the Dr. Claudius Y.  and Catherine B. Gates Lecture Hall. We were met by a large, enthusiastic crowd of medical students, residents, researchers and attendings who had come from several sites to hear us speak and we felt very welcome indeed!
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After a kind introduction of the AOA and NATF tour, Christina led off, one last time, with her talk on her perspective on the American healthcare system. With many surgeons in the audience who have traveled to Canada and have Canadian colleagues, her concise review of the differences between the two health care environments in which orthopaedic surgeons are working was well received!
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Mac followed next with his excellent presentation on creating value beyond the operating room and how, in a very short time, he has led a team at UPMC, to introduce and transform the collection of patient reported outcome measures to improve care and reduce costs. As the Utah Department of Orthopaedics has also been working on this, they were extremely interested in what he had to say and listened with rapt attention!
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Scott was the third presenter, delivering his talk on upper extremity war surgery for the final time. As always, the audience was shocked by the violence of the IED explosion Scott presented to set the stage for his presentation, and his talk was extremely well-liked by the group. It was excellent as always and we continued to be impressed by the outcomes he and his team can achieve for these amazing patients.
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Next up was Brian, as always lamenting the fact that he had to follow Scott’s excellent talk, but nonetheless, doing a great job presenting his approach to treatment of irreparable rotator cuff tears with superior capsular reconstruction. He did a wonderful job summarizing the literature and outlining the results of his research and we all learned something new again! We particularly liked his addition of his photos with his lovely wife skiing in Park City during his residency rotation in Utah!
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Lastly, closing out the academic portion of the 2017 NATF tour was our “keynote speaker” Dr. Ravi! Bheesh did a fantastic job delivering his controversial talk on the impact of overlapping surgery on outcomes of hip fracture surgery and total hip replacement. This segued beautifully into a group Q&A period focusing primarily on outcomes, value and the role that surgeons should be playing in the changing healthcare environment to improve care delivery and surgical outcomes for our patients.
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After finishing the talks and Q&A, we were presented with a lovely parting give by Dr. Brodke and took the opportunity to take our group photo with our great host Dr. Tashjian and the leaders of the Orthopaedics Department Dr. Saltzman and Dr. Brodke. We were then transported back to the hotel, and after saying our final goodbyes, packed up our belongings and boarded an Uber to the SLC airport for our trip to Denver.
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We arrived safely at the airport and after getting through security without difficulty, with Mac stopping at FedEx to ship some gifts home to his ladies, we boarded the plane on-time for the easy 1 hour 20 minute trip to Denver. Despite being warned there might be some turbulence on our final descent, the trip was easy and painless, and the clear sunny skies offered a beautiful view of the eastern foothills of the Rocky Mountains as we arrived!
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After collecting our luggage and boarding our shuttle, we traveled to our hotel and met Department of Orthopaedic Surgery administrator Ellen Bagwell, who had been instrumental in arranging our trip. She presented us with a lovely welcome gift, including CU Orthopaedics sunglasses, a water bottle and earphones! As a result of bad traffic between Denver and Boulder, we decided not to make the drive for lunch, instead walking across the hotel parking lot to a local restaurant, The Kitchen Next Door. The food was great and we had the opportunity to learn about the health system and department structure from Ellen, and Christina took the chance to try out her new sunglasses in the beautiful afternoon sunshine!
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After finishing lunch, we returned to the hotel for some rest, relaxation, work, and Scott and Brian went for a run (with Brian now taking the chance to wear his sunglasses!) At 5:45 we grabbed an Uber to the home of Professor and Department of Orthopaedics Vice Chair Evalina Burger’s home for a casual dinner of some great BBQ with several of the faculty. It was a beautiful evening to sit out on the back patio and we enjoyed each other’s company, as well as her home filled with mementos from her numerous South African hunting trips, immensely. We got to meet Dr. Robert D’Ambrosia, the longest running consecutive Chair in Orthopaedic Surgery. It was a memorable night and we liked getting to know the group in such a relaxed environment.
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After saying our goodbyes, we made our way back to the hotel, and, as it was the last night we would all be together, we took the opportunity to celebrate the success of the tour by sitting on the patio around the fire pit reminiscing over the last four weeks. We discussed everything we had learned, what we are going to take back to our practices and what we hoped to do differently as we continued on our paths moving forward. It was an awesome way to end the evening and highlighted how close we have become over the last four weeks. We had quickly become fast friends and will likely stay that way in the future.
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Day #24 – Salt Lake City, UT – October 17

Day #2 in Utah, and we were at the University of Utah Orthopaedic Clinic by 7 am to have a nice hot breakfast and then divide up again for a morning of clinic with our respective subspecialty providers. Scott spent the morning with Dr. Hutchinson in the operating room where he observed the complicated surgical care of a multiply operated on elbow to improve range of motion. They then moved on to a procedure known as a Swanson arthroplasty for a patient with rheumatoid arthritis. It was an enjoyable morning and he learned a lot!

Mac spent time in clinic with Dr. Charlie Saltzman. It was a great experience for him, and there was great a variety of pathology and symptomatology among the patients they saw. In particular, there were a number of complex cases that Mac had the opportunity to evaluate with Dr. Saltzman, and he also really enjoyed talking with this master Foot & Ankle surgeon about his approach to total ankle replacement design and indications.

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After a observing the difficult revision shoulder replacement yesterday, Brian took the plunge into Dr. Tashjian’s challenging shoulder & elbow clinic. Their discussions covered a wide breadth of topics, including periprosthetic infection, total elbow arthroplasty, and distal biceps reconstruction, and he even extended Brian a courtesy copy of his textbook on the unstable elbow! Brian then to Dr. Burks’ clinic to revisit their earlier discussions regarding high tibial osteotomy and allograft ACL reconstruction with inside out meniscal repair. As the former lead of the Metcalf Conference, Dr. Burks always has an ample supply of pearls and insights that he is more than willing to share!

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Bheesh had the chance to spend the morning in the OR with Adult Reconstruction surgeons Dr. Jeremy Gililland and Dr. Chris Peters. They both had very interesting cases, including a total knee replacement complicated by retained hardware after trauma. Bheesh was particularly impressed by Dr. Gililland’s willingness to show off his fashionable sterile vest that he wears in the OR, though we’re not sure Bheesh will be taking this particular practice back to Toronto until he sees the evidence in support of this practice : )


Finally, Christina had the awesome opportunity to join Dr. Brodke and Dr. Lawrence in the clinic at the UUOC. Before clinic started, she took the opportunity to catch up on the blog and then Dr. Brodke gave her a tour of the beautiful facilities, including the administrative floor, research space, housing both basic science and biomechanical research capabilities, physical therapy space with therapy pool, operating rooms and clinic. She felt very at home given the design similarities between UUOC and her own Missouri Orthopaedic Institute! Clinic was a great experience as she moved between the two providers, getting to see an awesome selection of complex spinal pathology, both preoperative and postoperative, and discuss varying techniques for spinal realignment and reconstruction and complication management!

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After finishing up our clinical time for the day, we reconvened at the hotel and met Dr. Steve Aoki, Sports Surgeon, and Dr. Tashjien for the scenic drive to Park City, a beautiful ski resort town. On the way, we passed the Utah Olympic Park, site of the 2002 Winter Olympic bobsled, skeleton, luge and ski jumping events, where according to Dr. Aoki, people now think it’s a good idea to go down the ski jump in large inner tubes in the winter! Seems our trauma and spine surgery colleagues at UU won’t go out of business any time soon…

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Upon arriving in quaint Park City, we made our way to High West Distillery & Saloon where we partook in some delicious snacks and beverages and got to know Dr. Aoki and Dr. Tashjian better. It was a great place to chill out and chat about the area, and we had a lot of fun!

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Once we finished our late “lunch”, we took a tour of the lovely downtown, stopping intermittently into some shops to peruse the wares, with Christina and Mac making a new, albeit inanimate, friend. The highlight by far was the Burns’ Cowboy Shop, where Mac found some great boots for his adorable 2 and 4 year-old daughters, and Christina resisted dropping some hard-earned spending money on a beautiful pair of goat leather boots which she was sure her residents would have loved : )

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After returning to SLC, we made a quick pit stop at the hotel to change into more dinner-appropriate attire, then headed out to Current restaurant, a great seafood place, to have dinner with Drs. Tashjian, Aoki, Spina, Gililland and Tyser. The food and drinks were fantastic, as was the atmosphere and we enjoyed spending time with each other and the group. Unfortunately Dr. Lawrence was not able to join us, despite chauffeuring us to dinner, because of a scheduling conflict with a conference call. It was the nicest, and cheapest, Uber ride we’ve had the entire trip!!!

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Calling it a night around 9pm, we headed back to the hotel with Drs. Tashjian and Spina, and turned in to start packing and get ready for our last round of academic presentations at the next morning’s Orthopaedic Surgery Grand Rounds.



Day #23 – Salt Lake City, UT – October 16

Our first day in Salt Lake City saw us starting bright and early and dividing up to attend clinics and OR’s at the two sites for Orthopaedic Surgery, the University of Utah Hospital and the University Orthopaedic Center. Christina traveled to the main hospital where she attended the OR with Dr. Brodke as Welland his partners, and her friends from AOSpine North America, Dr. Brandon Lawrence and Dr. Ryan Spiker. While the cases were getting set up Dr. Brodke gave her a tour of some of the hospital, including the beautiful “sky lounge” for attending physicians, complete with sleeping spaces, work rooms and even a treadmill desk, and later they had lunch in the beautiful Point restaurant at the cancer center with almost 360 degree views of the valley! She attended a variety of different surgeries, big and small, cervical and thoracolumbar, and picked up a number of great practice pearls to take back to Missouri!
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MaC spent the day in the OR with Dr. Tim Beals, Associate Professor and Foot & Ankle surgeon, at the Orthopaedic Center. They had a great list of day surgery of cases including a syndesmosis case and lesser toe reconstruction. They also had the chance to have an extensive discussion about the management of syndesmosis injuries in the presence or absence of fracture, particularly that associated with suspensory versus screw fixation. Furthermore, they had discussions regarding efficiencies in the operating room and the evaluation of cost as it ties to clinical outcomes.
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Scott had the opportunity to observe Dr. Doug Hutchinson, Professor of Hand and Microvascular Surgery and Director of the Utah Hand Surgery Fellowship, do three quick elective cases prior to the start of his clinic with wide awake hand surgery. It was a great experience and hopefully something he will be able to implement when he returns home. He then spent time with Dr. Nick Kazmers, another also a Penn fellow and hand and upper extremity surgeon, doing a complex upper extremity procedure involving the bones and nerves. In the afternoon he went for a run in the beautiful neighborhoods around the hotel.
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Brian spent the morning in clinic with Professor and Sports and Upper Extremity Surgery pioneer Dr. Bob Burks discussing AC joint injuries, failed Latarjet procedures, and ACL reconstruction.  He then watched Dr. Pat Greis, also a Professor and Sports surgeon, perform a complex knee ligament surgery on a high level athlete, followed by a complex revision shoulder procedure by Dr. Tashjian. It was a busy, and extremely useful and educational day with all the experiences spawning incredible conversations and extensive Q & A sessions.
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Bheesh spent the morning at the VA hospital with Dr. Jeremy Gilland, a mechanical engineer and adult reconstruction surgeon. They discussed the advantages of gap balancing over measured reduction, as well as the differences between the VA and other hospitals. Bheesh then spent time with Dr. Chris Pelt, tenured Associate Professor and adult reconstruction surgeon, in his clinic and also had a very productive meeting with Dr. Brook Martin, an epidemiologist and Research Associate Professor in Orthopedics with an adjunct appointment to Population Health Sciences. They had an extensive discussion regarding Dr. Martin’s extensive experience with randomized controlled trials and large database studies.
After making our way back to the hotel following our clinical experiences, we met Dr. Tashjian and Dr. Ryan Spiker, from the Spine Surgery service, to travel to a fantastic dinner at Pago, a great little restaurant with awesome menu. We were joined by Dr. Charles Saltzman, Chair if Orthopedic Surgery and Director of the American Board of Orthopaedic Surgery, Dr. Bob Burks, Professor and Sports Medicine and shoulder surgeon, and Dr. Alan Stotts, Associate Clinical Professor and Pediatric Orthopaedic surgeon. We thoroughly enjoyed the atmosphere, food and conversation. After dinner, we walked across the street and enjoyed gelato for dessert at Dr. Saltzman’s recommendation, which was a great one!
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We then returned to the hotel for a brief powwow in the hotel restaurant, discussing our experiences during the day, as well as enjoying a heated conversation between Scott and Bheesh regarding vascularized fibula grafting for avascular necrosis of the hip. We turned in just after 9pm to catch up on some sleep and prepare for another jam packed day.
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Day #22 – Los Angeles, CA & Salt Lake City, UT – October 15

Day #22 of our trip was fairly relaxed compared to most as it was a travel day without any daytime scheduled events. We had the opportunity to sleep in a little bit as our flight did not leave LAX until 11:05 am. Meeting up at the airport, we had breakfast and talked over our visit with the UCLA and Cedars-Sinai groups. We had a brief chuckle over our Southwest boarding positions for the flight as poor Scott was with the C group despite the fact that he had reminded us all to check in at 10 am the day before! After boarding the plane and settling into our respective seats, we took off without event and said goodbye to the beautiful city of L.A.

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The 1 hour and 20 minute flight to Salt Lake City was a pretty painless one and, with no clouds in sight and the sun shining, treated us to some beautiful views of the city nestled in the mountain valley as we descended prior to landing.

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After landing and quickly collecting our bags, our third try at transportation to the Marriott hotel right near the University Orthopaedic Center worked like a charm – the first shuttle company we had been booked with went bankrupt a few weeks prior and failed to inform the department’s administrative staff, and we abandoned the second shuttle we reserved when they attempted to fit all five of us and our luggage, plus an additional passenger, into a minivan and the somewhat unfriendly driver refused to let us assist him with Tetris-ing our luggage into the bag of the van despite the fact that we had done it about a dozen times during the trip! So, Uber it was, and a very comfortable 20-minute extended SUV ride later, filled with lots of laughs over the shuttle issues, we arrived safe and sound at the hotel : )

With some time to kill before dinner, Brian and Scott took the opportunity to go for a run in the hills around the hotel and enjoy the exquisite scenery and the rest of us caught up on some work and blogging. Then, at 5:45 we were met by our local host Dr. Robert Tashjian, Professor of Orthopaedics and Shoulder & Elbow surgeon, as well as third year resident Travis, who transported us to the fantastic restaurant the Copper Onion. We were joined by Dr. Darrel Brodke, Vice Chair of Orthopaedic Surgery and Director of the Division of Spine Surgery, a friend of Christina’s since her first fellowship, spine fellow Dr. Jeremy Shaw and another one of the PGY3 residents. It was a great dinner and we had a great time getting to know one another.

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After returning to the hotel, the five of us visited the hotel restaurant to discuss the day and continue our dinner conversations about work-life balance, and shared with each other our thoughts about hobbies, family and personal time, and the ways we try and make these things a priority with our busy schedules. Again, there were lots of laughs, and there also seemed to be some collective relief as we realized we aren’t alone in our struggles with this important issue! We turned in around 11pm, looking forward to a great day of clinical observation with the Utah faculty.