A passion for improving surgical standards

A common theme with world-leading consultants is a desire to pass on their skills and knowledge to drive education and improve standards as much as possible.

Mr Iain McFadyen is no exception. As Consultant Orthopaedic Trauma Surgeon at the University Hospitals of North Midlands, Stoke-on-Trent, with a special interest in limb reconstruction and bone infection he has a busy work schedule.

But he is also dedicated to improving standards in trauma care and has been Co-Chair of Fracture Guideline Development Groups at the National Institute for Health and Care Excellence and was also involved with the configuration of services and drafting standards for trauma care at the British Orthopaedic Association.

He explains: “As a surgeon, all you want to do is treat people and get on with surgery which is definitely the most rewarding part of the job. But because trauma is so overwhelming, even in smaller hospitals, you can't treat every injury yourself. You have to make sure that colleagues’ education and training is up to scratch.

“That is rewarding because getting standards established for other surgeons to follow has been very helpful to the profession but frustrating because the NHS is a megalith that changes extremely slowly.”

Significantly, Iain has just been appointed as the new Chairman for Trauma at global trauma and orthopaedic education and research organisation AO Trauma covering Europe and his native South Africa.

“AO is an international education foundation, the largest education and research foundation in orthopaedic trauma in the world and is all about advancing knowledge and education in orthopaedic trauma and musculoskeletal disorders It's in every country in the world with thousands of members and trains tens of thousands of surgeons every year,” he adds.

“The role involves overseeing the education and research committees for those regions, planning courses from instructing junior resident surgeon right through to master's level instructing surgeons who've been in practice for 15 years.”

Iain was previously Vice President of AO UK and Ireland which has supported his new appointment marking a major step up that he knows will be even more productive and rewarding.

Currently he is a member of an international editorial board re-writing Principles of Fracture Management, a key orthopaedic textbook produced by AO.

“The exciting thing about the revised edition is that it will be an online product with an artificial intelligence component. The whole textbook is being re-designed for the modern generation of doctors who no longer read large volumes from cover to cover but who know how to use AI to interact with on-line content.”

Additionally, he helped edit the BOA and British Association of Plastic Surgeons textbook, Standards for the Treatment of Open Fractures. 

“That was quite a political project as well as an academic project because getting orthopaedic surgeons and plastic surgeons together to agree on clinical guidelines and academic content and the content of a textbook required great diplomacy skills and negotiation,” he says.

Iain also has a medicolegal practice covering both clinical negligence and personal injury and, as a full member of TLA, receives full administrative support giving him freedom to balance the work producing up to 50 reports a year with his other commitments.

“I have worked as a full member with TLA since it started. The team is dedicated to matching the right expert with the right legal team and then ensuring the specialist can work with no distractions or administrative inconvenience.

“As an expert, TLA are fantastic because they give me the freedom to balance my medicolegal work with my other commitments. They understand that legal teams need good, organised, happy experts who are true leaders in their field.”

With his medicolegal work, Iain prefers focusing on clinical negligence. “I like being a neutral voice of reason in often highly emotive situations because a negligence claim usually comes about because the patient is facing a terrible outcome - it's a very emotional time for them,” he explains. 

“But you need to remember that medical errors can happen even with very good care. It's detective work wading through the details to see what has actually caused the bad outcome. Was it due to a breach in the standard of care, a complication that couldn't have been avoided or something that arisen out of a medical error that was not negligent?”

Iain has a special interest in the treatment of fracture-related infection, particularly in soft tissue involving flesh eating bugs.

“They're very difficult for patients but also for doctors because they are hard to recognise and treat. They often lead to horrible outcomes, unhappy patients and legal claims and it can be extremely complicated trying to filter through it all to decide if there has been a breach in the standard of care or not.

“Legal teams struggle to find appropriate experts, so I've been pleased to help because I have wide experience in those kinds of infections from my clinical practice that comes from having started my training in South Africa where such infections are more common. I've always had a bit of a head start over British counterparts and I've used and built on that both in trauma and infection ever since moving from South Africa.”

Outside of work, Iain also admits to being “a South African cliché” with interests including rugby and barbecues or “braai.”

“There isn't a Springboks match that I will miss. And there isn't an opportunity to have a barbecue that I will miss ever!” he laughs.

Please email Emily Fallick, Case Manager at TLA EmilyF@tla-medicolegal.com for Mr Iain McFadyen’s CV and further details.