Participation in the 2025 KSES – ASES Exchange Travelling Fellowship Program

Only two days after returning from a month-long journey that felt neither short nor long, I find myself compelled to record my reflections. First of all, I wish to express my sincere gratitude to the President, officers, and members of the Korean Shoulder and Elbow Society (KSES) for selecting me as a traveling fellow. From September 16 to October 18, 2023, together with Dr. Yoon-Sang Jeon (Inha University Hospital), I had the privilege of visiting several distinguished institutions recommended by the American Shoulder and Elbow Society (ASES) and participating in a variety of educational programs.

1. Great Lakes Orthopaedic Center, Traverse City, Michigan
A mentor in a tranquil lakeside town
Our journey began in Traverse City, a peaceful lakeside town of about 20,000 residents, accessible via a connecting flight through Chicago. Dr. Christopher Chuinard, the director of the Great Lakes Orthopaedic Center, personally oversaw every part of our stay. His minimally invasive arthroplasty and remarkable surgical efficiency left a strong impression, as did the serenity of the town and the leisurely, contented lifestyle of its residents. Traverse City will remain in my memory as a pleasant gift amid a busy schedule. One of my personal bucket-list dreams has been to go halibut fishing in Alaska, and to my delight, I was able to savor halibut cuisine at dinner there.

2. Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
A bastion of orthopaedic tradition
In Philadelphia, a city of 1.6 million and the birthplace of American history, stands the Rothman Orthopaedic Institute, consistently ranked among the top five orthopaedic centers in the United States. With Dr. Charles Getz picking us up at the airport, we observed surgeries by Dr. Joseph Abboud and Dr. Surena Namdari at two hospital sites. We also had the opportunity to present and discuss our research during an academic meeting with all shoulder and elbow faculty members. Highlights included witnessing Dr. Abboud’s technique of inserting a subacromial spacer after rotator cuff repair, receiving a Philadelphia Phillies cap from Dr. Getz, and visiting the Rocky Balboa statue with local fellows - memories that remain vivid.

3. Cleveland Clinic, Cleveland, Ohio A model of integrated medical, educational, and research excellence

Located in Cleveland (population 360,000), the Cleveland Clinic - founded by former military physicians - is recognized alongside the Mayo Clinic as one of the world’s most advanced integrated hospital systems. Their thoughtful hospitality included sending a car to meet us at the airport. We joined academic meetings that included PhD faculty, participated in evening journal clubs where fellows presented SCI(E) papers, and observed surgeries by Drs. Jason Ho, Eric Ricchetti, and Charles Cogan. A particularly memorable technique involved detaching the lesser tuberosity using an osteotome during subscapularis release, followed by reattachment with bone sutures after implant insertion. The research lab equipped with micro-MRI and custom-built biomechanical testing machines also stood out. We shared this rotation with fellows from China (Drs Yi Lu and Zimin Wang) and Latin America (Drs Alessandro Niro Fulvi and Catalina Larrague), spending Sunday together touring downtown Cleveland - a meaningful exchange beyond the operating room. Lastly, I made unforgettable memories watching a Guardians game from the VIP seats at the Cleveland Clinic together with the staff.

 
4. Johns Hopkins Hospital & University of Maryland Hospital, Baltimore, Maryland
The essence of multidisciplinary excellence and regional care
In Baltimore (population 560,000), where we first rented a car, we visited Ellicott City’s Korean market to refresh ourselves with familiar flavors after weeks of rich food. At Johns Hopkins Hospital, we observed Dr. Edward McFarland’s textbook total shoulder arthroplasty, where he improved range of motion by resecting the anterior capsule—a technique that prompted questions about potential instability from sacrificing a static stabilizer. Dr. Uma Srikumaran impressed us with his quick, precise method of locating the proximal biceps with his index finger during minimally invasive tenodesis and his overall attentiveness to us. During one operation, a patient developed ventricular tachycardia followed by bradycardia, and within seconds, more than ten anesthesiology and code team members rushed in, swiftly stabilizing the patient-a powerful display of teamwork and system efficiency. At the University of Maryland Hospital, we observed surgeries by Drs. Syed Hasan and Mohit Gilotra at two ambulatory surgery centers dedicated to orthopaedics - an efficient and cost-effective model that could benefit Korea. Dr. Gilotra mainly performed arthroscopic procedures, including a lower trapezius tendon transfer, and was an excellent host. We also presented our research at an academic meeting jointly organized by Baltimore’s three university hospitals and joined a journal club with about fifty attendees engaged in lively discussion. Finally, Dr. Logan Kolakowski graciously took us to Washington, D.C., where, despite the government shutdown, we toured the Monument, the White House, and the Capitol, making for a memorable day.

5. Tampa General Hospital, Tampa, Florida
A warm southern city - one of the meccas of shoulder arthroplasty
In Tampa (population 410,000), the warm, slightly humid air created a vacation-like atmosphere. While dining at a Vietnamese restaurant shortly after arrival, a fellow Phillies fan noticed my cap (it was the week of the Dodgers-Phillies series) and greeted me with a cheerful smile. That evening, Dr. Mark Frankle invited us to his home, where we joined him, his wife, and three fellows on a boat cruise and dinner at a riverside restaurant. On the return trip, we sang together at a karaoke machine installed on the boat, a truly delightful experience. As a master of shoulder arthroplasty, Dr. Frankle’s practice focused almost entirely on primary and revision reverse total shoulder arthroplasty, with a high case volume offering a wide variety of complications to observe. His remark that “a great surgeon is one who manages complications well” was particularly memorable. We also toured FIVE Labs, an affiliated research center equipped with a full range of biomechanical testing systems, highlighting the depth of their research infrastructure.

6. Arthrex, Naples, Florida
The city of Arthrex
The resort town of Naples (population 20,000) is home to Arthrex Headquarters, where we attended the “Advanced Shoulder Arthroscopy: The Cowboy Way” program - a fascinating three-day course. We listened to lectures on advanced arthroscopic techniques and participated in cadaver workshops, performing surgical steps firsthand and exchanging insights with local surgeons.

7. University of California, San Francisco (UCSF), San Francisco, California
A leader in sports injury treatment and translational research
In San Francisco (population 800,000), after a five-hour flight delay from Miami, we arrived late Saturday night to the cool contrast of the West Coast climate. On Sunday, we hiked with Drs. Benjamin Ma and Sara Edwards at Lands End, followed by two days observing surgeries and visiting the MITO (Muscle Injury and Translational Research) Lab, which focuses on sports and regenerative medicine. We were later invited by Chinese fellows to their Airbnb, where “Chef Wang” served a superb home-cooked meal—a heartwarming moment of fellowship abroad.

8. ASES Annual Meeting, San Diego, California
The pinnacle gathering of shoulder and elbow surgery in the United States
Our final destination was San Diego (population 1.39 million), host of the ASES Annual Meeting. Following Dr. Yoon-Sang Jeon’s recommendation, we stayed at a hotel in North San Diego. During free hours, we met with Drs. Jung-Youn Kim, In Park, and Sung-Min Rhee (who received the Neer Award at this ASES meeting). The ASES meeting allowed us to reconnect with professors, fellows, and residents we had met throughout our journey, as well as colleagues from China and Latin America. On the opening day, I was invited to attend the Indian American Shoulder and Elbow Society Dinner Symposium, where I was surprised by the large number of Indian Americans holding key positions at top U.S. institutions. It was also deeply moving to see Dr. Joaquin Sanchez-Sotelo who I had met at Mayo Clinic during my 2016 postdoctoral fellowship, deliver the ASES Presidential Lecture, with the introductory remarks by my previous principal investigator, Dr. Shawn O’Driscoll - a truly full-circle moment.


 
Reflections
Throughout this month-long fellowship, I gained invaluable insights and experiences that will greatly enrich my future clinical and research endeavors. I extend my heartfelt appreciation to Drs. Jung-Han Kim and Sung-Il Wang for their invaluable advice and assistance during preparation, as well as to the ASES secretariat, all host institutions, and my steadfast travel companion Dr. Yoon-Sang Jeon, whose dedication and cooperation made this meaningful journey smooth and rewarding from start to finish.

Jung-Taek Hwang
Department of Orthopaedic Surgery
Chuncheon Sacred Heart Hospital,
Hallym University College of Medicine, Korea