Letter to the Editor


The International Centre for Orthopaedic Education


Sir,

Thank you very much for your letter of September 12 1995, regarding your sup- port for the International Centre for Orthopaedic Education (ICOE). As you know, the ICOE grew out of the International Symposium on Orthopaedic Educational Needs and Resources held in San Francisco in 1992. The concept was supported by 74 national orthopaedic societies and international societies rep resenting 44 countries.
Considerable funds were raised to develop the data base and in less than one year of operation we have had over 1500 educational, research, teaching, service, and other opportunities available worldwide. To date more than 700 physicians have enquired about possible educational experiences. We are extremely appreciative of the efforts of the various national societies worldwide who have publicised the development of the ICOE and con- tinue to promote its development.
I note from your article in the EFORT Bulletin that you are begining to estab- lish a parallel organisation through EFORT, which looks very similar in for- mat and content to the ICOE. The latter was organised by the American Ortho- paedic Association (AOA) through considerable fund-raising efforts. Although it is under the auspices of the American Orthopaedic Association, it is an inde- pendent office with an independent staff.
You should know that the development costs to date have been over $300 000 and we are in the process of trying to raise one to two million dollars to endow this Centre in perpetuity. We are providing this service absolutely free to indi- viduals worldwide and plan to continue to do so. We have various other long- range plans which will be solely dependent upon the acquisition of the endowment.
The main impetus for establishing the ICOE was until now the haphazard way by which such postresidency educational experiences were a§anged and the multi- plicity of methods which were used by individuals to organise such experiences. It was hoped that by having a single repository for this inforn ation worldwide that a centralised `command post' to facilitate postgraduate educational experiences between countries could be establ shed. I have great concem that the project which you are embarking upon will be a duplication of the ICOE.
As I mentioned above, it has required considerable resources to establish the data base and to continue to keep the service updated, to add new offerings on a daily basis, and to provide infor nation to interested individuals worldwide. I would hope that the Execu- tive Board of EFORT would not consider the establishment of a separate structure for arranging these Visiting Fellowships.
I would like to propose that EFORT considers obtaining this information and then contributing it to the ICOE so that interested European surgeons can then be directed to the Centre to arrange for their educational experience in Europe. The offerings can certainly be limited to orthopaedic surgeons in Europe by having that stated on the application forrn, i.e. this experience is only available to European orthopaedic surgeons. As is listed in your proposal and is the fundamental tenet of the ICOE, the host is responsible for selecting those individuals whom he or she wishes to accept, and should practice in Europe be a criterion, so be it. There are many offerings in the ICOE which make very specific restrictions on who may apply.
I do hope that you and the Executive Board of EFORT will consider supporting the ICOE and encourage the EFORT members to provide educational offerings to the ICOE, even although the offering hosts wish to accept only European ortho- paedic surgeons. Those wishing to extend the offering to orthopaedic surgeons worldwide could do so. Once again, I do thank you for your supportive letter.

Stuart L. Weinstein, MD
Chairman
Intemational Centre for Orthopaedic Education

Reply:
Sir,
Thank you very much for your letter of September 29 1995, to Professor Jacques Duparc. As the initiator of the EFORT Visiting Fellowship I am delighted to learn from your comments that you do not con- sider it as a competitor to the International Centre for Orthopaedic Education (ICOE), but rather as an additional way of enhancing international exchange of orthopaedic knowledge by helping young ortl opaedic surgeons to visit orthopaedic centres in other countries.
The European Visiting Fellowship is a parallel organisation, but its structure, aims and the potential participants will be different in many ways from those of the ICOE.
First, as a newly-established organisation - as a federation and not as an associa- tion with a well-organised and strictly centralised structure - EFORT has no mon- ey for setting up such a sophisticated organisation as the ICOE. To begin with there will not be a central institution responsible for the organisation of Visiting Fellow- ships. In Bulletin No 3 (May 1995) we merely request chairrnen of orthopaedic institutions throughout Europe to indicate whether or not they are willing to accept visitors. From all orthopaedic institutions willing to do so a list or book will be printed and distributed to the national associations. All contacts and all arrange ments for visits will be made directly in a completely personal atmosphere.
The main goal of EFORT is the harmonisation of orthopaedics and traumatol- ogy in Europe. This process cannot occur by exchanging science and practical know-how alone. The enhancement of personal contacts and the establishment of personal friendships are of utmost importance in achieving this goal and the language spoken by the individual surgeons also plays a decisive role. Although English has been decreed our official language, there are only two countries (United Kingdom and Ireland) which have English as their mother ton- gue! Furthermore, every medical system is becoming more and more influenced (and even managed) by political factors.
The various languages and the various political systems in Europe are problems which do not necessarily facil«tate the achievement of harmonisation. Visiting Fellowships are an excellent way of stimulating personal contacts and friendships. With this in mind you will note that the EFORT Visiting Fellowship is by no means in competition with ICOE. On the contrary, we fully support the ICOE. With the `personal touch' in mind, we are sure that many European orthopaedic institutions will be willing to offer a visiting post, which they would not dare to do so in the ICOE. On the other hand, we think that it would be inappropriate for orthopaedic institutions in your computer files to indicate that they are not interest- ed in accepting visitors from outside Europe.
Thank you once again for your very informative letter. We, the EFORT Executive Board, congratulate you for establishing a worldwide International Centre of Orthopaedic Education. As mentioned in Bulletin No 3 we fully support your intentions and stimulate chairmen of European orthopaedic institutions to join the ICOE.

Erwin W. Morscher
President of EFORT

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Created on 21-11-1996 at 19.00 by Nicola Vachaviolos