What is the point of the American-British-Canadian (ABC) fellowship?

J Bone Joint Surg [Br] 2009;91-B:138-40. To be asked “Do you think that the ABC Fellowship has a future?” at the interview was something of a surprise. The initial response was “Well, I hope so, given that we are looking at giving it six weeks away from home.” You wouldn’t want to waste your effort on something that has had it’s time, now would you? There was, of course, serious intent in the question. Participation in the ABC is not something centred only in the present but is wrapped in the history of the fellowship and the experiences of those former fellows. The experience gained for the future and the responsibilities which fellows owe to the ABC are what it stands for. The first ABC Fellowship was the innovation of Professor R. I. Harris, Chief of Orthopaedics in Toronto and President of the American Orthopaedic Association in 1948. The Second World War had created great destruction, but it was a time of innovation in orthopaedics. There had been a great exchange of ideas between surgeons brought together to treat the casualties, but in the period of economic re-building and austerity that followed, that contact was lost. The stated aim of the fellowship was to give a group of promising young surgeons the opportunity to travel to North America and visit major orthopaedic centres, which the economics of the time would have rendered impossible without the significant financial support which Prof. Harris brought together. At this point it was not called the ABC, but it was clear to the initial group of fellows that they were involved in something important. When, in 1949, a group of North American surgeons made the reverse trip it was agreed by those involved that the ABC should be formed. No further exchange took place until after the 1952 Combined Meeting of the Orthopaedic Associations of the English-speaking World in London. At that meeting, members of the 1948 ABC group, led by Phillip Newman and Derrick Strange, successfully lobbied the British Orthopaedic Association (BOA) to establish the ABC in its current form; on even years a group of British and Commonwealth surgeons would visit North America, and on odd years a Canadian-American group would make the reverse trip. The exact structure of the groups has evolved over the intervening years. Their experiences and the history of the Fellowships are described eloquently in Derrick Strange’s book, available from the BOA.1 In 2008 the ABC Fellowship marked the 60th anniversary of the first trip. Looking back at the picture of the Fellows that sailed on the Queen Elizabeth in 1948, it is clear that the group comprised promising young surgeons, many of whom went on to make a significant mark on orthopaedics: Adams, Charnley, Durbin, Ellis, Fairbank, Langton, Newman, Patrick, Pearson, Smillie, Sommerville, Strange and Wishart. Members of this and subsequent groups have been very clear in recognising the boost given to their ideas, techniques and careers by the trip. For the 2008 group the BOA selected four fellows: Dominic Meek from Glasgow, Kevin Mulhall from Dublin, Rob Pollock from London and Alasdair Sutherland from Aberdeen. In addition, Richard Williams from Brisbane, Peter Poon from Auckland and Andrew Barrow from Johannesburg were all nominated by their respective National Associations. The special interests and practices of the fellows were diverse and varied, creating a group that was exceptionally well balanced, and suited to the variety of experiences on offer in the 13 North American cities visited. The full travel diary is available online at http://journals.jbjs.org.uk/education/TravellersIndex.dtl (date last accessed 23 September 2008).