Latest / AHF Podcast / Reflections & Insights: AHF 2025 Traveling Fellowship - Part I

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Reflections & Insights: AHF 2025 Traveling Fellowship - Part I · AHF Podcast

• 0:01
  Joseph M. Schwab: The end of the year is always a time for reflection.
• 0:04
  Joseph M. Schwab: And over the next few weeks, we wanted to take a moment to look back at what the AHF accomplished in 2025, and we're starting with something that captures the heart of this organization.
• 0:16
  Joseph M. Schwab: A two episode interview with our 2025 AHF traveling Fellows.
• 0:21
  Joseph M. Schwab: As we were putting this series together, it reminded me why the AHF feels different.
• 0:27
  Joseph M. Schwab: We often describe it as a family, and that's not just a phrase.
• 0:31
  Joseph M. Schwab: It's something you feel in the conversations and in the mentorship and in the shared curiosity and willingness to challenge ideas while still supporting one another.
• 0:44
  Joseph M. Schwab: If you're listening to this and thinking, I'd like to be a part of that.
• 0:48
  Joseph M. Schwab: There are a couple of easy ways to get involved.
• 0:51
  Joseph M. Schwab: First, join us at the AHF 2026 annual meeting June 5th and sixth in Nashville, Tennessee.
• 1:00
  Joseph M. Schwab: This year's theme is consensus and controversy and registration is already open.
• 1:07
  Joseph M. Schwab: You can find all the details@anteriorhipfoundation.com.
• 1:12
  Joseph M. Schwab: Look for the events.
• 1:14
  Joseph M. Schwab: Link in the menu above.
• 1:16
  Joseph M. Schwab: We'll also drop a direct link in the episode description second, and this one really helps.
• 1:24
  Joseph M. Schwab: Make sure you're subscribed to the podcast wherever you're listening or watching right now.
• 1:30
  Joseph M. Schwab: Hit subscribe, leave a rating, and if you're inclined, leave a comment.
• 1:35
  Joseph M. Schwab: We read every single one and they directly shape what we covered next.
• 1:41
  Joseph M. Schwab: So thank you for being a part of the AHF community.
• 1:46
  Joseph M. Schwab: Thank you for a great 2025 and here's to even more growth conversation and progress for both the AHF and for you in 2026.
• 1:58
  Joseph M. Schwab: Now let's start the episode.
• 2:22
  Joseph M. Schwab: Hello and welcome to the AHF podcast.
• 2:25
  Joseph M. Schwab: I'm your host, Joe Schwab.
• 2:27
  Joseph M. Schwab: For anyone considering the AHF Traveling Fellowship in 2026, today's conversation is essential listening.
• 2:35
  Joseph M. Schwab: The AHF Traveling Fellowship offers early career orthopedic surgeons, a rare opportunity to refine their anterior hip arthroplasty technique, expand their perspective, and build lifelong professional connections.
• 2:50
  Joseph M. Schwab: Over about two and a half weeks, leading up to the AHF 2026 annual meeting in Nashville, selected fellows travel across the US to observe advanced cases, exchange ideas with world-class mentors, experience diverse surgical settings firsthand.
• 3:08
  Joseph M. Schwab: Participate in the Premier Anterior Approach, hip replacement event of the year.
• 3:14
  Joseph M. Schwab: And before we get into it, information on the AHF Traveling Fellowship for 2026 can be found at anteriorhipfoundation.com/ahf-2026-traveling-fellowship.
• 3:30
  Joseph M. Schwab: I'll make sure to put a link in the show notes.
• 3:33
  Joseph M. Schwab: And that leads me to my guest.
• 3:35
  Joseph M. Schwab: Today I'm joined by three remarkable past traveling fellows, Jeremy Kubick, Qais Naziri, and Michael Field, along with Dr.
• 3:44
  Joseph M. Schwab: Alex Sah, one of the host surgeons that these fellows visited During their fellowship, we'll talk about the real experience on the ground, the insights they've gained and why this fellowship continues to be a transformative step for emerging leaders in anterior hip surgery.
• 4:05
  Joseph M. Schwab: Gentlemen, welcome to the AHF podcast.
• 4:09
  Joseph M. Schwab: I'd first like to have you go around and tell us a little bit about who you are, um, what's your current role or practice is, and what year you are in your, um, in your current practice.
• 4:20
  Joseph M. Schwab: And Michael, I'm gonna start with you.
• 4:24
  Michael Field: Hi everyone.
• 4:25
  Michael Field: My name is Michael Field.
• 4:27
  Michael Field: I'm based in the uk Uh, I work in the National Health Service with a practice between Ipswich and Suffolk and Colchester in Essex.
• 4:35
  Michael Field: I've been a consultant for 15 months with a focus on primary and revision hip arthroplasty.
• 4:43
  Michael Field: Um, my UK training was pure posterior hips, and this included a, a hip fellowship in the UK before heading to Ottawa and spending a year learning anterior hips there.
• 4:56
  Michael Field: Um, before starting my consultant post, uh, I'm currently purely posterior and working hard towards transitioning back to anterior hips with what looks like a start date of April of next year.
• 5:13
  Joseph M. Schwab: Qais, let's have you introduce yourself.
• 5:16
  Qais Naziri: As it going, my name is Qais Naziri.
• 5:18
  Qais Naziri: I am currently the Associate Program Director of the Orthopedic Residency at SUNY Downstate Medical Center in Brooklyn, New York.
• 5:29
  Qais Naziri: Uh, I'm entering into now my sixth year of practice.
• 5:32
  Qais Naziri: Um, I did an arthroplasty fellowship where we, we did a lot of anterior uh, uh, but um, when I came back to my home program, I was the only in the borough of Brooklyn that was doing the anterior approach.
• 5:50
  Qais Naziri: So how I started off was very careful because I knew that there wasn't anyone around me that could possibly help or, uh, you know, hold my hand throughout.
• 5:59
  Qais Naziri: This, uh, process of starting practice.
• 6:02
  Qais Naziri: So, um, as I, as I started, my practice grew.
• 6:07
  Qais Naziri: Um, I did anterior and all comers, uh, but it, what I lacked was the efficiency and the volume and my practice as academic in nature.
• 6:17
  Qais Naziri: So it, it doesn't really have a lot of room for that, but I did wanna see how the rest of the world operates and, um, I do feel that if you want to find knowledge, you have to seek that knowledge and you have to go and find it.
• 6:31
  Qais Naziri: Uh, and it was, it just seemed like the perfect time to go and, uh, have some weeks off and go and, and learn from those that do this and do it very well.
• 6:43
  Joseph M. Schwab: Jeremy, why don't you go ahead and introduce yourself.
• 6:46
  Jeremy Kubik: Good morning everyone.
• 6:47
  Jeremy Kubik: I'm Jeremy Kubik.
• 6:48
  Jeremy Kubik: Uh, I'm an academic surgeon based in, uh, Calgary, Alberta.
• 6:51
  Jeremy Kubik: I'm associated with the University of Calgary.
• 6:54
  Jeremy Kubik: Um, I'm in my fifth year practice, um, which is split between hip and knee arthroplasty and revision, um, as well as orthopedic trauma.
• 7:02
  Jeremy Kubik: I've fellowships in both.
• 7:04
  Jeremy Kubik: Um, also serve as the lead for, uh, our hip and knee arthroplasty division at the university.
• 7:10
  Jeremy Kubik: Um, and, uh, excited to be on the call this morning.
• 7:15
  Joseph M. Schwab: We're so lucky to have you guys here to share your experience.
• 7:19
  Joseph M. Schwab: We also have Dr.
• 7:20
  Joseph M. Schwab: Alex Sah, who was one of our, uh, host surgeons, uh, from California.
• 7:25
  Joseph M. Schwab: And Dr.
• 7:25
  Joseph M. Schwab: Sah, many people who have listened to the AHF podcast have heard him talk before.
• 7:31
  Joseph M. Schwab: Do you want to tell us a little bit about your practice and why you decided to be a host surgeon?
• 7:38
  Alexander Sah: Thank you Joe.
• 7:39
  Alexander Sah: My name's Alex Sah.
• 7:40
  Alexander Sah: I'm from Fremont, California and like Joe, I was a prior president of the Anterior Hip Foundation and I'm currently traveling fellowship director.
• 7:48
  Alexander Sah: This is really something that the AHF Board wanted to get started about two years ago.
• 7:53
  Alexander Sah: So we've had the pleasure and honor of hosting this fellowship for two years now, going on to our third year.
• 7:59
  Joseph M. Schwab: Gentlemen, if you could give us maybe in one or two sentences what the AHF Traveling Fellowship represents to you now that you've been through it.
• 8:09
  Joseph M. Schwab: Um, tell us a little bit about that.
• 8:11
  Joseph M. Schwab: And Jeremy, let's start with you.
• 8:14
  Jeremy Kubik: Sure.
• 8:14
  Jeremy Kubik: Um, so I.
• 8:16
  Jeremy Kubik: I've been an anterior hip surgeon since basically day one of practice without, um, having any formal training in it.
• 8:24
  Jeremy Kubik: And so I really looked at this fellowship as a finishing school, an ability to, or my desire to refine my technique, um, as well as refine my ability to teach as a, you know, I have residents and fellows joining me often.
• 8:42
  Jeremy Kubik: So, um, those are, that's kind of what I looked for in the fellowship.
• 8:45
  Jeremy Kubik: So, um, it was truly a finishing school for me, for anterior hips.
• 8:50
  Joseph M. Schwab: Michael, you're coming from the UK where obviously we, many of us know that anterior approach hip surgery is just not terribly common.
• 8:59
  Joseph M. Schwab: So what does the AHF traveling Fellowship represent to you now that you've been through it?
• 9:06
  Michael Field: I think two things.
• 9:07
  Michael Field: Firstly, similarly to Jeremy.
• 9:09
  Michael Field: I finished up my Canadian fellowship having trained with four fantastic bosses and seen.
• 9:16
  Michael Field: The use of, uh, a table on table, off table, um, capsule, preserving capsule excising.
• 9:22
  Michael Field: And I wasn't really clear in my mind as to which technique I wanted to take into my own practice back in the UK for when I started.
• 9:31
  Michael Field: So it was an opportunity to see a breadth of practice across the states and to cherry pick from that.
• 9:38
  Michael Field: And what I think is the best.
• 9:40
  Michael Field: And, and actually in all, in all fairness, the practice has been remarkably similar across the breadth of the states.
• 9:47
  Michael Field: Um, and secondly, I think it provides a real gravitas to, I've thus far taken the proposal to do anterior hips in my elective center through four committees.
• 10:00
  Michael Field: I have another two committees on Tuesday.
• 10:03
  Michael Field: And being able to say that last summer I had this real privilege of undertaking the, the traveling fellowship and seeing the greats of.
• 10:13
  Michael Field: North American hip surgery and learning from them I think gives real credibility to the, to introducing the practice in a safe and sensible fashion back in the uk.
• 10:25
  Joseph M. Schwab: And Qais, why don't you tell us your perspective?
• 10:30
  Qais Naziri: You know, think like what, uh, Jeremy said, like being in an academic practice, you have this obligation to kind of stay, uh, at the forefront of knowledge.
• 10:44
  Qais Naziri: And, you know, when I came back.
• 10:46
  Qais Naziri: join my practice.
• 10:48
  Qais Naziri: Um, I was the only one doing it an anterior, so anything that I did was new.
• 10:53
  Qais Naziri: So, uh, but after about four or five years, it starts to get a little dull in the sense that you don't know if how you are doing things is the best way.
• 11:08
  Qais Naziri: So, um, and I've been to a bunch of courses and even been involved in, uh, the faculty of some, but you don't get the same, uh, knowledge and the same depth of the experience when you're in a lab.
• 11:30
  Qais Naziri: So I just felt that, um, just being in the role that I am, I owed it to both my own self and everybody that, uh, I teach that I have to keep my.
• 11:44
  Qais Naziri: Skills fresh, and why not go and learn from the highest volume, most efficient and, uh, experienced surgeons.
• 11:55
  Qais Naziri: And the key to it is that everybody's anterior.
• 11:59
  Qais Naziri: And so if you're doing some other type of traveling fellowship, the experiences may not be what you want, but this is so, uh, honed in and so detailed just for the anterior hip.
• 12:14
  Qais Naziri: Um, it, it just felt like an opportunity that I didn't wanna miss.
• 12:23
  Joseph M. Schwab: Alex, I wanted to ask you, because you've been not only a host, but you were effectively one of the first traveling fellows with the Anterior hip foundation very early on before it was a formal thing.
• 12:37
  Joseph M. Schwab: What does the AHF Traveling Fellowship represent to you now that you've hosted it?
• 12:44
  Alexander Sah: That's a great question, Joe.
• 12:45
  Alexander Sah: It really is interesting to be on the other side of it because when I went through, as you said, visiting other faculty and uh, board members, it really changed my practice.
• 12:55
  Alexander Sah: It exposed me to something I otherwise would not have being in private practice and to have that support, uh, throughout the learning curve was really meaningful to me and it really didn't interrupt my practice.
• 13:07
  Alexander Sah: And so now as a host, our goal from all the faculty are to expose these fellows to as many advanced technologies and techniques in both primary and revision anterior hip replacement that we can among a diverse, uh, group of faculty and programs really across the country.
• 13:23
  Alexander Sah: So we're hoping these fellows will learn new skills and protocols that are meet.
• 13:27
  Alexander Sah: Meaningful to them and things that they could immediately implement in their practice as soon as that, as soon as they return home.
• 13:34
  Joseph M. Schwab: And gentlemen, I wanna kind of throw a couple of open questions to you and if, if, um, if it speaks to you, please, uh, feel free to answer.
• 13:42
  Joseph M. Schwab: But what originally motivated you to apply for this type of fellowship?
• 13:51
  Jeremy Kubik: I am happy to start.
• 13:52
  Jeremy Kubik: I, I think, uh, I echo what Qais had said in that once you're a few years into practice, you know, you, things potentially can become stagnant or at least, um, you understand what your own outcomes can be, but maybe the world around you is moved forward.
• 14:11
  Jeremy Kubik: And I think we owe it to our patients to keep up with the most advanced techniques.
• 14:17
  Jeremy Kubik: And so, um, that was kind of what motivated me.
• 14:22
  Jeremy Kubik: And then I, I think again, because I work in the Canadian system, uh, a public academic, um, system with, um, incredible inefficiencies, um.
• 14:35
  Jeremy Kubik: Uh, uh, another thing I wanted to learn on the fellowship was how efficient, um, the different surgeons could be, um, inside and outside the operating room.
• 14:45
  Jeremy Kubik: And, and we certainly saw that at, at every step of the way.
• 14:48
  Jeremy Kubik: Uh.
• 14:54
  Qais Naziri: Yeah, I think also the, um, being in an academic place, we don't always get the exposure to what's, uh, you know, the newest tech, the newest and, um, you know, you, you just always feel like you need to wait.
• 15:15
  Qais Naziri: A few more years until these things are already, uh, I guess been established.
• 15:22
  Qais Naziri: And, um, to go and see the, the leaders in the field in both efficiency, volume, and education.
• 15:33
  Qais Naziri: It just, it kind of boldens you to be able to go use it, you know?
• 15:40
  Qais Naziri: Uh, the funny thing is, is like, once I started to hear myself sounding like an old school surgeon, like, oh, I would never use that thing.
• 15:50
  Qais Naziri: I don't need that.
• 15:52
  Qais Naziri: And then they're like, well, now I sound like all the old heads.
• 15:55
  Qais Naziri: So at this point, I guess it's time to, to go back to school.
• 16:03
  Joseph M. Schwab: Michael, you had mentioned sort of the gravitas that came with being able to say you had done this fellowship.
• 16:08
  Joseph M. Schwab: Was that originally what you were thinking about or what motivated you to apply or was it something else?
• 16:14
  Joseph M. Schwab: Hmm.
• 16:16
  Michael Field: So I was very fortunate in that the year I spent in Canada, I, um, had a supported visit to the anterior hip foundation meeting in Nashville in 2024.
• 16:28
  Michael Field: And of course, remember meeting you there and it was actually that meeting that inspired me to then apply for the traveling fellowship, the, the prospect of spending time with.
• 16:39
  Michael Field: The various surgeons on the tracks.
• 16:41
  Michael Field: Um, but also the fellows presentations in from the first year at the meeting in 2024 were simply phenomenal.
• 16:49
  Michael Field: And I just sat there in the audience and thought I have to get myself in their shoes, if at all possible.
• 16:56
  Michael Field: So from that moment I was planning on applying.
• 17:00
  Joseph M. Schwab: So let's talk a little bit more about that.
• 17:02
  Joseph M. Schwab: So the fellows at the end of their traveling fellowship come to the, uh, it, it finishes at the annual meeting of the anterior hip Foundation, and there's some activities you get to present your, um, what your experience was like.
• 17:18
  Joseph M. Schwab: Um, and you get to, um, basically share with the rest of the AHF community, uh, what you learned and, and, uh, what you experienced.
• 17:28
  Joseph M. Schwab: What was that like?
• 17:29
  Michael Field: So I think, I think in terms of having been in the audience, it was seeing these, this extraordinary opportunity that, that the first year of fellows had had.
• 17:40
  Michael Field: Um, and in particular being struck by things like Charlie De Cook's, 12 by 12.
• 17:46
  Michael Field: Uh, and as coming, coming from a system where, um, our, our aim is to get four, four primary joints done in an all day list, the concept of 12 by 12 seems simply extraordinary and something you have to see to believe.
• 18:03
  Michael Field: And in fact, when we ultimately got to Charlie, we saw 16 by 11, uh, which was again, something you simply have to, um, see to believe.
• 18:12
  Michael Field: And then being, being on the other side of it, um, this summer was, was rather bizarre insofar as the, the two weeks of travel across the states, you, you are just discombobulated by everything you've seen in such, such a short space of time in the distance that you've traveled, and then all of a sudden you're up on stage in front of an enormous audience trying to distill it into.
• 18:38
  Michael Field: Something that you can communicate across.
• 18:40
  Michael Field: Um, and I'm still processing the, the two weeks, if I'm completely honest.
• 18:47
  Jeremy Kubik: I think the, the one thing that I would add is, um, we know other orthopedic organizations run traveling fellowships.
• 18:54
  Jeremy Kubik: Right.
• 18:54
  Jeremy Kubik: And, and I think, uh, with, without having done any of them, but knowing colleagues who have gone on different traveling fellowships, I think the one thing that the AHF Traveling Fellowship allows is a quick, heavy clinical.
• 19:09
  Jeremy Kubik: Experience.
• 19:11
  Jeremy Kubik: You know, after we reflected on that, I think we had probably seen more cases in the two weeks than, you know, other organizations would allow in their traveling fellowship.
• 19:21
  Jeremy Kubik: So I think it, um, you, you know, when we created the presentation at the end and reflected on it, you, you know, you really realize how much you see over that time.
• 19:32
  Jeremy Kubik: And, um, and, and I think that that stimulate a lot of chatter between, um, trainees like fellows who attended the conference and other surgeons asking about it.
• 19:42
  Jeremy Kubik: Because I think lots are familiar with, again, with traveling fellowships without their organizations.
• 19:47
  Jeremy Kubik: And this is, you know, certainly in its infancy.
• 19:50
  Jeremy Kubik: And, and I think it's exciting because it's in its infancy.
• 19:53
  Jeremy Kubik: It's, it's only gonna get.
• 19:55
  Jeremy Kubik: Better, you know?
• 19:56
  Jeremy Kubik: Um, so it, it was good to reflect on that.
• 19:59
  Jeremy Kubik: And I think the one thing from a technique standpoint,'cause you go through the two weeks and you kind of, the audience kind of wants you to give them a formula.
• 20:08
  Jeremy Kubik: Okay.
• 20:08
  Jeremy Kubik: How do you do an anterior hip now?
• 20:11
  Jeremy Kubik: Or how will you do it after working with all these high volume guys?
• 20:15
  Jeremy Kubik: Um, I still can't give that answer, but what I think we could say is there are many consistencies across the table between the surgeons that we, uh, that we worked with.
• 20:28
  Joseph M. Schwab: Your, your response kind of raises a question for me, Jeremy, and, and maybe, uh, some of you feel this way, maybe all of you feel this way, but was there something that you were expecting or was there a way that you thought a fellowship would go where your perception after it was done was different?
• 20:48
  Joseph M. Schwab: Meaning you sort of changed, uh, what you thought about the fellowship from before it started until after it was finished?
• 20:56
  Qais Naziri: I really didn't know what to expect.
• 20:59
  Qais Naziri: Um, I just thought that just exposure to these well-known names and uh, centers would be, uh, enough.
• 21:06
  Qais Naziri: I was actually, um, surprised on, uh, how hands-on it was, I do think it adds, uh, adds, you know, and a priceless amount of value in order to be scrubbed in, and really be a part of the surgeries.
• 21:21
  Qais Naziri: And, I mean, we've all been to courses and stuff and it's hard not to just, you're in there five minutes, you're watching another person do work on a, cadaver.
• 21:31
  Qais Naziri: It's not real.
• 21:32
  Qais Naziri: And you, you kind of zone out.
• 21:34
  Qais Naziri: You, you'll pick up little points here and there, and then you, and then you kind of just start looking around.
• 21:39
  Qais Naziri: 'cause just, you're not really scrubbed in.
• 21:41
  Qais Naziri: It's not a real patient.
• 21:43
  Qais Naziri: Uh, so, you know, it's, it's hard to maintain the amount of focus throughout.
• 21:51
  Qais Naziri: But these are real patients, these are real surgeries and you're, you're in there in real time.
• 21:56
  Qais Naziri: Uh, and, uh, to one point, uh.
• 22:00
  Qais Naziri: About the, uh, culmination of it.
• 22:03
  Qais Naziri: It was intriguing that at every spot we went to, everyone was asking how the other surgeon would do this or do that.
• 22:11
  Qais Naziri: And that is, is a highlight in that even those surgeons are, you're trying to keep honing in all of their skills.
• 22:23
  Qais Naziri: And if they're doing that, then like we are actually the, the bearers of knowledge throughout that process and we are helping their academic process keep going.
• 22:37
  Joseph M. Schwab: That, that's sort of fascinating.
• 22:39
  Joseph M. Schwab: Did I, Michael or Jeremy, did either of you have that sense that you were sort of conveyors of knowledge from one site to the next as well?
• 22:50
  Michael Field: Yeah, we def, we definitely talked about it over the course of the, um, the two weeks and, uh, we sort of, uh, almost wondered whether we had a, we had a duty of confidentiality between the, the various sites or whe whether it was okay to share.
• 23:04
  Joseph M. Schwab: I.
• 23:05
  Michael Field: Um, but I think on balance there is, there is a real, um.
• 23:09
  Michael Field: Kinship in the anterior hit foundation of sharing techniques and sharing expertise.
• 23:14
  Michael Field: So it was a bit of a privilege to be a conduit for that, if only to say, well, you guys are pretty similar,
• 23:20
  Joseph M. Schwab: So you didn't catch any flack for, uh, sharing, uh, sharing information between sites.
• 23:26
  Michael Field: not as far as I know, but seeing similar things was really great as well.
• 23:30
  Michael Field: I, I came into the traveling fellowship, convinced that off table, no fluoro, um, was, was the best way of doing an anterior hip.
• 23:41
  Michael Field: And seeing therefore starting off with, with Alex in, uh, Fremont and seeing use of the HANA table and seeing use of fluoro and ortho grid ai, uh, you know, I was, I was cynical to start with, and as we moved across the country and I saw it again and again and saw it in, used in subtly different ways, but still fundamentally the same.
• 24:03
  Michael Field: I was, was a complete convert.
• 24:07
  Michael Field: And I'm pleased to say that Mizuho and I have been chatting since, and it's looking like a HANA table's on its way to the UK for April, 2026.
• 24:16
  Joseph M. Schwab: Did that surprise you?
• 24:18
  Joseph M. Schwab: Did that, I mean, that, that's, that can be a, a, a major sort of strategic shift in how you approached, uh, doing anterior approach hip replacements.
• 24:28
  Joseph M. Schwab: Was that sort of insight or experience something that you expected or was that a surprise to you?
• 24:34
  Michael Field: It was a surprise.
• 24:35
  Michael Field: I'm fairly stubborn, I think, in, in, uh, in life.
• 24:38
  Michael Field: And, um, realizing, realizing that being open-minded and then being open to change was, was a really important part of the, the two weeks.
• 24:50
  Joseph M. Schwab: Yeah, Jeremy.
• 24:52
  Joseph M. Schwab: How did the, how did that affect you or how did your experience, if any, change the way that you were doing anterior approach?
• 25:01
  Jeremy Kubik: Well, it's interesting, um,'cause prior to the fellowship i, I have been using.
• 25:08
  Jeremy Kubik: The table.
• 25:09
  Jeremy Kubik: And I, I actually wanted to come into the fellowship to see off table.
• 25:13
  Jeremy Kubik: Um, and, and so I was hoping that we'd come across a surgeon who didn't use the table, but then after the end of the two weeks, I thought, no, table is absolutely the way to go.
• 25:28
  Jeremy Kubik: You know, and, and, and again, it's not to say that an anterior hip can't be done off table, but it just, it, it reinforced what I'd seen.
• 25:36
  Jeremy Kubik: And in learning from all the surgeons and, and seeing how they implement their, their technology, they're enabling tech with the table, for example, I think was really beneficial to just cement that, you know, what, um, the technique that I've been doing, I can just continue on that, refine it.
• 25:56
  Jeremy Kubik: I don't have to make a, make a huge switch, I think.
• 26:00
  Jeremy Kubik: Um, so that was certainly a, a valuable part of the fellowship.
• 26:04
  Joseph M. Schwab: Do you think if the AHF had offered both a table track and an off table track, you would've had the same type of experience or you would've chosen off table, or what would you, how would you have approached that?
• 26:18
  Jeremy Kubik: You know, in hindsight, I probably, um, I'm happy the way that it was set up because like I said, I can make small incremental change and it, it reinforced what I'd known.
• 26:31
  Jeremy Kubik: I if I, you know, I, I think if you had set that up and I hadn't have done the fellowship, I probably would've chased the off table, um, track, for example.
• 26:41
  Jeremy Kubik: But again, if you, you work with high, high volume surgeons, right?
• 26:46
  Jeremy Kubik: And so these are surgeons doing over a thousand hips a year, right?
• 26:51
  Jeremy Kubik: Which, you know, is probably the highest in the world.
• 26:54
  Jeremy Kubik: And, um, if they're doing it a certain way, there's a reason.
• 27:00
  Jeremy Kubik: And they, they, you know, they don't need to strong arm you to convince you that you just, you watch them work for a day or two and, you know, uh, you get it.
• 27:11
  Jeremy Kubik: It, it's pretty simple.
• 27:12
  Jeremy Kubik: I.
• 27:14
  Joseph M. Schwab: Was there anything that surprised you, uh, of something that you took away from the fellowship?
• 27:19
  Joseph M. Schwab: Something that you took away that you saw sort of systematically throughout the fellowship?
• 27:25
  Qais Naziri: Yeah.
• 27:26
  Qais Naziri: You know, um, in my practice there was, there wasn't a, a capsule that I didn't cut, and I cut it out and I kept picking more and more.
• 27:38
  Qais Naziri: And I felt that early on, you know, that, that, that it would've helped me to not have that as a barrier, uh, for exposure and stuff.
• 27:47
  Qais Naziri: And I, I, uh, thankfully haven't had a, had an instability problem almost ever.
• 27:52
  Qais Naziri: So, uh, it wasn't a, a reason, but then I saw everyone, basically, they kept the capsule or they tagged it, and there was an elegance to it that, that, um, I hadn't.
• 28:08
  Qais Naziri: Appreciated.
• 28:09
  Qais Naziri: So now I absolutely keep all the capsule, uh, and, uh, I just felt like I needed to add things to how I do things, and that was one of them.
• 28:23
  Qais Naziri: I love the hand table.
• 28:25
  Qais Naziri: That's what I was using anyway at most of the hospitals that I was working at.
• 28:30
  Qais Naziri: There's one hospital that we, we, we, we didn't have a hand at table and I had to, to, uh, like learn how to do it off table.
• 28:39
  Qais Naziri: But, um, the, and I could see both arguments, but most of the arguments that come with saying, oh, you don't need the table.
• 28:51
  Qais Naziri: You don't need fluoro.
• 28:52
  Qais Naziri: Well, we don't need iPhones and we don't need the internet.
• 28:57
  Qais Naziri: But if you're not using the most upped.
• 29:01
  Qais Naziri: To date and advanced, uh, the tools.
• 29:05
  Qais Naziri: Then I, I think that that says more about your needs of your ego than it does about the actual, uh, surgery and being able to see high volume surgeons use these things that maybe you think might slow you down.
• 29:22
  Qais Naziri: It, it adds to the process of it.
• 29:26
  Qais Naziri: So you can use the table and you can use floral and you can use Orthog grid and you can use all these, all these, uh, tools and it will, it could make you more efficient, make you more safe, not just slow you down or add cost.
• 29:44
  Joseph M. Schwab: um, any of you experience any, we'll, we'll say doubts as you were, um, entering into the fellowship or were there any concerns that you had with the schedule, or maybe more broadly, were there any sort of career or professional trade-offs that you had to make in order to, uh, pursue this fellowship?
• 30:05
  Jeremy Kubik: I mean, I think, um, certainly taking time off of, um, uh, busy practices, certainly.
• 30:12
  Jeremy Kubik: Um.
• 30:13
  Jeremy Kubik: Not an easy feat when you're on a call schedule and you have different obligations.
• 30:18
  Jeremy Kubik: And then not only that obligations at home, for example, I know we all have young kids now, so, um, that those aren't easy feats.
• 30:26
  Jeremy Kubik: But I think the one, um, forgiving thing about the traveling fellowship was that it was short and succinct.
• 30:33
  Jeremy Kubik: I think, um, you know, two and a half weeks was a perfect amount of time.
• 30:37
  Jeremy Kubik: I think if it would've been, you know, a month long, it would've been a l much harder pill to swallow, to apply and want to do it, I think so.
• 30:47
  Jeremy Kubik: Um, and, and again, it wasn't just one or two sites, right?
• 30:51
  Jeremy Kubik: Over the course of three days, I, I think it was a, a good amount of time to be able to do that.
• 30:56
  Jeremy Kubik: So I was certainly a bit anxious as I was leaving my practice for two and a half weeks saying, you know, um, you know, I hope this is worth it.
• 31:04
  Jeremy Kubik: And then, you know, within a few days, you know, you, you, you meet your co-fellows, you and you, you meet the, the surgeons who are.
• 31:13
  Jeremy Kubik: Truly there to, you know, um, they're, they're truly a humble group of surgeons.
• 31:19
  Jeremy Kubik: As much as they're big name surgeons, they're not there to try and make a name.
• 31:24
  Jeremy Kubik: They're, they're there to balance ideas off of.
• 31:27
  Jeremy Kubik: And so that kind of just reinforced, you know, it's a right decision and, uh, to take time away from practice, you know, and in, and now that we're six months outta the fellowship, I'm, I'm very glad that, you know, you took dedicated time off, um, to do that.
• 31:42
  Jeremy Kubik: And I think you need to take dedicated time off to do it.
• 31:45
  Jeremy Kubik: This is much different than just going to a weekend course to learn a technique.
• 31:53
  Jeremy Kubik: As said, the stakes aren't as high when you're, when you're working on a cadaver and you have eight conversations going around.
• 32:00
  Jeremy Kubik: Right.
• 32:01
  Jeremy Kubik: Um, so I think this is, um, a, a, a great experience for that reason.
• 32:07
  Jeremy Kubik: Um, and, and shed that apprehension that I had going for it.
• 32:11
  Joseph M. Schwab: from your perspective as a host, what do you hope fellows gain when they come to visit your practice?
• 32:19
  Alexander Sah: Hey Joe, as you can see from these fellows, they're all motivated.
• 32:22
  Alexander Sah: They're eager to learn.
• 32:23
  Alexander Sah: They're open-minded, so they really came to absorb as much as they could from the various sites.
• 32:28
  Alexander Sah: And what we really hope is we're not trying to convert them to do exactly the way we do things, but we're hoping that they will pick up a little bit at the per.
• 32:35
  Alexander Sah: Site a little more at the second site.
• 32:37
  Alexander Sah: Maybe things they like or don't like at the third site, but that way they can formulate a protocol and a plan specific for them what they like and bring it back to their practice that they can implement, you know, the following day or the following week when they return home.
• 32:50
  Alexander Sah: So our goal as hosts are really just to provide them as much exposure as possible, answer any questions they have, show them anything that they want to see so that we can really personalize their experience to them.
• 33:02
  Joseph M. Schwab: Michael, can you share a moment where you thought, this is exactly why I applied to this fellowship?
• 33:09
  Joseph M. Schwab: Did a moment like that occur to you?
• 33:13
  Michael Field: I.
• 33:14
  Michael Field: And I think it occurred again and again and again, and it was, I came into the fellowship thinking that I had to find out what was wrong with me as a surgeon to become more efficient.
• 33:26
  Michael Field: How, how do I get more cases done without compromising on quality?
• 33:32
  Michael Field: And I wanted to, to, to meet people like Alex and work out how I could be more like them in what I was doing.
• 33:40
  Michael Field: And there was a real moment where I realized I had it completely wrong.
• 33:44
  Michael Field: And actually what Alex and, and all of the other, um, surgeons across the track have done is they have built teams around them.
• 33:51
  Michael Field: People who can set a patient up properly, who can close a wound properly, who can do all of the other components that you need in the day to allow Alex to be the person who delivers 10 or 11 great joints because he's got that team around him.
• 34:08
  Michael Field: And that's really, that was a real moment of going, okay, I get it now.
• 34:12
  Michael Field: That's what I have to do.
• 34:13
  Joseph M. Schwab: Hmm, Qais.
• 34:15
  Joseph M. Schwab: Was there a moment?
• 34:17
  Joseph M. Schwab: Um, or was there something that surprised you the most once the fellowship actually started?
• 34:24
  Qais Naziri: I was, uh, I am fortunate that we, we got paired up with two excellent guys here and, uh, even.
• 34:36
  Qais Naziri: More fortunate that we were on, uh, track one or what I call varsity, uh, and that the, uh, experience from day one, um, you're on.
• 34:49
  Qais Naziri: And just to add a little bit to what, uh, Jeremy was saying, I can, like, it's been five or six months now and you can't really look back and say, how could this have been done any better?
• 35:04
  Qais Naziri: W or, uh, or, or there's no way it could have been shorter and it still, uh, uh, be as, um, as meaningful, you know, the, uh, when you think of fellowship for a whole year, half of that year, you're just, you're over it already.
• 35:24
  Qais Naziri: You just want to get out, out, out on your own and go and, and start practice.
• 35:30
  Qais Naziri: So if you, and we don't have that time.
• 35:34
  Qais Naziri: To go and do another year of fellowship.
• 35:36
  Qais Naziri: Well, and we probably don't need that, but in this, in the two and a half weeks, I thought it was a, it was a perfect amount of time.
• 35:48
  Qais Naziri: I'm not sure how it could have been done any better.
• 35:52
  Qais Naziri: Uh, it, it was just a digestible amount of knowledge because anything more would have been a burden probably on your home life or on your practice.
• 36:06
  Qais Naziri: But I think you guys hit that sweet spot with, uh, with how much, uh, experience and knowledge is, uh, is both useful, uh, and, uh, practical.
• 36:19
  Joseph M. Schwab: That's a good place to pause for today.
• 36:22
  Joseph M. Schwab: In this first part of the conversation, we've talked about where this fellowship begins, the expectations, the early impressions, and the moments that start to shape how you see hip surgery as well as the community around it.
• 36:35
  Joseph M. Schwab: But in part two, we go further.
• 36:38
  Joseph M. Schwab: We talk about what actually changes along the way, the cases that stick with you, the conversations that challenge your assumptions.
• 36:46
  Joseph M. Schwab: How the fellowship experience influences the way these surgeons think about their practice moving forward.
• 36:53
  Joseph M. Schwab: So make sure you're subscribed wherever you're listening because part two of this conversation drops next week.
• 37:01
  Joseph M. Schwab: Thank you for joining me for this episode of the AHF podcast.
• 37:06
  Joseph M. Schwab: You can find the AHF podcast on Apple Podcasts, Spotify, or in any of your favorite podcast apps.
• 37:14
  Joseph M. Schwab: As well as in video form on YouTube slash at Anterior Hip Foundation, all one word, episodes of the AHF podcast come out on Fridays.
• 37:26
  Joseph M. Schwab: I'm your host, Joe Schwab, asking you to keep those hips happy and healthy.