June 15, 2026

Traveling Fellowships: Vacation or Learning Experience??

19 minutes

A Surgeon Goes to Europe

The AOSSM/ESCA Traveling Fellowship

Hosts: Dr. Nirav Pandya & Dr. Brian Feeley

Guest: Dr. Drew Lansdown

Episode Summary

Drew Lansdown is back from four weeks abroad — and we have questions. He was selected for the prestigious AOSSM/ESCA Traveling Fellowship, which sent him to six orthopedic centers across Europe before capping the trip at the ESCA annual meeting in Prague. In this episode, Drew tells us what orthopedic sports medicine actually looks like on the other side of the Atlantic — the similarities, the surprises, and what the US could genuinely learn."

"What Is the AOSSM/ESCA Traveling Fellowship?

The ESCA (European Society for Surgery of the Knee, Shoulder, and Arthroscopy) and AOSSM (American Orthopaedic Society for Sports Medicine) run a competitive exchange fellowship every few years. A small group of American surgeons visits leading European orthopedic centers, attends the ESCA meeting, and builds lasting international connections. AOSSM runs parallel exchanges with APCAS (Asia) and SLARD (South America), and also hosts incoming groups from those regions in return. Applicants apply through AOSSM membership, and selection is competitive.

Drew's Itinerary: Amsterdam  Oslo  Brandenburg (outside Berlin)  Milan  Barcelona  Lyon  Prague (ESCA Meeting)"

"Key Takeaways from the Episode

More similar than different. The biggest surprise? How closely European sports medicine mirrors what's practiced in the US. Senior mentor Kurt Spindler — who did the same fellowship 30 years ago — noted that it felt very different back then. Today, both sides are drawing on the same evidence base and reaching similar clinical conclusions.

On stem cells and biologics. After our recent episode on stem cells, Drew asked the European surgeons directly. Their answer: largely the same as ours. Stem cell therapies are considered niche, evidence is lacking, and they're not part of mainstream practice there either. The grass is not greener.

OR efficiency that will make you jealous. The Amsterdam center had a five-minute room turnover. Not five minutes with a full crew frantically scrambling — just five minutes, because everyone knows their role and the workflow is seamless. They pre-stage the next case in an adjacent room. For context, we're happy with 20–30 minutes here.

Patients expect to stay overnight. In much of Europe, outpatient surgery as we know it doesn't fully exist for orthopedic procedures. ACL reconstruction patients commonly stay one or two nights. Surgeons privately agreed it probably isn't medically necessary — but patient expectation is baked in. Tell a patient they're going home the same day, and they feel like you don't care.

Training and mentorship. European medical education: 6 years of medical school straight from high school, followed by a 6-year orthopedic residency. Attendings at these centers often operate together more collaboratively, and junior surgeons remain in a mentorship-like structure for years after completing training — closer to a prolonged chief resident than independent practice.

Visiting residents. At several sites, residents from other countries (many from Italy) were spending months training abroad as part of their own program — a built-in international exchange at the trainee level.

The Barcelona schedule. OR block time starting at 3 PM, running until 10 PM. The surgeons saw patients or operated at another hospital in the morning, then transitioned to the evening shift. For the OR team, this was simply the norm. Unclear if anyone recommends this for the US."

"If Drew Could Practice Anywhere in Europe...Northern Italy. The food and culture of Milan/Lake Como make a compelling argument. (He was encouraged to pursue this fellowship by his very supportive wife Annalise, as evidenced by the Instagram photos from Lake Como that we're still not entirely sure were real.)"

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