How A Traveling Fellowship Shapes Orthopaedic Leaders

Ready to Rethink How Orthopaedic Leaders are Made? We sit down with Rex C. Haydon, MD, PhD, FAOA, archaeologist turned musculoskeletal oncologist and Second President‑Elect of the American Orthopaedic Association—to trace the ABC Traveling Fellowship from its post‑war roots to its modern role as a launchpad for mid‑career transformation. Across five to six weeks and multiple continents, the fellowship pairs deep academic exchange with the kind of shared experience that forges lifelong mentors, collaborators, and friends. From resourceful solutions in international settings to the power of hosting fellows and paying forward the mentorship you received, this episode makes a compelling case for leaving your comfort zone to grow your career, your community, and your impact.

Transcript

SPEAKER_01 0:23

Welcome to the AOA Future in Orthopedic Surgery Podcast Series. This AOA podcast series will focus on the future in orthopedic surgery and the impact on leaders in our profession. These podcasts will focus on the vast spectrum of change that will occur as the future reveals itself. We will consider changes as they occur in the domains of culture, employment, technology, school book practice, compensation, and other areas. My name is Doug Blundy, host for this podcast series. Joining us today is Dr. Rex Hayden. Dr. Hayden is the Simon and Calt Families Professor of Orthopedic Surgery and Rehabilitation Medicine and Associate Director of the Molecular Oncology Laboratory at the University of Chicago. He's currently the second president-elect of the American Orthopedic Association. He specializes in the surgical care of bone and soft tissue tumors, including limb salvage and reconstructive surgery of the upper and lower extremities.

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Dr.

SPEAKER_01 1:27

Hayden finished medical school at the University of Chicago Pritzker School of Medicine, and then did his residency in orthopedic surgery and his fellowship in musculoskeletal oncology also at the University of Chicago. A skilled physician scientist, his research focuses on advancing the treatment of musculoskeletal tumors. He's accepted career development awards from both the Orthopedic Research and Education Foundation and the National Institutes of Health. Additionally, Dr. Hayden's research has been supported by the Musculoskeletal Tumor Foundation. Prior to entering medicine, Dr. Hayden was trained in archaeology and physical anthropology, culminating in a PhD in anthropology in 1993. And so today we'll discuss Dr. Hayden's leadership journey through his ABC Fellowship and how that impacts his leadership progression. So, Dr. Hayden, welcome to the podcast, sir. Thank you. Thank you. Really excited to be here. And it's an honor to talk to one of the members of the presidential line of the AOA. And uh, why don't you just give us a brief synopsis of your journey to what got you to where you are now?

SPEAKER_00 2:39

Well, I think uh as far as leadership in orthopedics, a lot of that is something that I learned through exposure to others. I was very fortunate to be at the University of Chicago, obviously, for most of my career. And I've had some, obviously, some amazing role models who really influenced me very heavily in that. I think the obligations of leadership, styles of leadership. And actually they were the ones that also introduced me to the ABC Fellowship, particularly Dr. Michael Simon. So I would say leadership is always a journey. I'm not there yet, but I've certainly learned a lot along the way. And the ABC Fellowship was one of the key points in my career that really helped.

SPEAKER_01 3:21

Let's talk about the ABC Fellowship for a minute. I mean, the those folks that are part of it are extremely loyal to it. It's a big deal, it's a big part of their career. But a lot of people who have never done it, it's kind of a little bit vague as to what it's all about. Can you tell us a little bit about the history of the fellowship and the evolution of it to where it is today?

SPEAKER_00 3:41

No, absolutely. So the fellowship was actually a product of the American Orthopedics Association. Dr. Harris, who I think at the time was in practice in Toronto but was the president of the AOA shortly after World War II, I think there was a perception that the sort of exchange of physicians across the Atlantic, which was part of routine training, actually, and I think innovation, education of leaders in the field, there was a real concern that in the aftermath of World War II, that many of the kind of upcoming leaders of the British orthopedic community would really have very limited ability to at least come to a Canada in the United States to continue that. And I think there was a, there's felt to be a need that, you know, we create an ongoing traveling fellowship that promoted that. So Dr. Harris was very pivotal in arranging for funding and organizing this. And it's now just celebrated its 75th year, I think, in 2023. And it's really stood the test of time as you know, it's not necessarily the same program that it was when it first started. And it's evolved with the times. And as technology and needs have changed in the field, it's sort of kept up with all that. The idea is every other year we entertain physicians from at that time it was mainly Britain, but it's now including Britain, South Africa, New Zealand, and Australia. They would come here in odd years, and members of the US and Canadian orthopedic communities travel to those countries on the even years. And so this is something that, you know, typically about five to six weeks. I think right now there's seven fellows that constitute each cohort. And it's, I said, it's changed in some respects, but I think that, you know, the spirit of interaction and camaraderie, because it's not, it is certainly an important academic and clinical tool to promote excellence, but it goes beyond that. These are relationships that you keep your entire life.

SPEAKER_01 5:49

I was always impressed with that, with the tremendous relational nature of this, as you can imagine, not just with the uh the places that you visit, but also the members of the class itself.

SPEAKER_00 6:00

No, absolutely. I think certainly the centers that you visit are going to be important and you remember them, but your fellow fellows, and the ABC is probably the most important one, the NATF and some of the other fellowships that are offered through the AOA and honestly through any organization. Many of the colleagues that you're spending five to six weeks, you these are lifelong friends in every respect.

SPEAKER_01 6:25

Yeah, I was gonna say, because I've had friends that did the JOA, the Japanese Orthopedic Association Fellowship, and then the use of the NITF, which is the North American Traveling Fellowship. And then I believe wasn't there also a Swiss-Austrian one or German or as well.

SPEAKER_00 6:41

Austrian-Swiss German, the ASG. Very good.

SPEAKER_01 6:45

And I guess the ABC was the granddaddy that spawned these other ones, right?

What The Fellowship Looks Like Today

SPEAKER_00 6:50

It it is. It started with that. And uh, you know, it's one of the few fellowships that, and I think the AOA, all of these are open to all subspecialties within orthopedics. That's sort of unique. I know some specialty societies have ones that are unique to them, but this is really representing the full spectrum of the orthopedic community. So it really is very special in that regard. It's probably one of the oldest and most prestigious. And quite apart from the impact it has on us, it helps to identify and support people that have interests in leadership going forward. So the impact it has on you goes it goes far beyond just the interactions during the time of the fellowship. It persists afterwards. You join a real community of remarkable people that is very special.

SPEAKER_01 7:35

So you said that Dr. Simon was in your department, of course, and was urging you along those way, those lines. That's of course a very, very strong influencer to help you progress along these lines. How did you first hear about? I'm sure did Dr. Simon talked to you about it. And how did you get interested in that and how did that progress?

SPEAKER_00 7:54

Yeah, I, you know, it was mainly Dr. Simon. I started by applying for the NATF and did that in 2005. Absolutely loved it. Again, very different kinds of experiences that you get out of that. Those are mainly U.S. and Canadian centers. Many of these are individuals that you're going to run into at your annual meeting on a regular basis. So I first learned about the AOA and the opportunities for traveling fellowships through him. I started with the NATF, again, really enjoyed it, and then applied, I think about four years later for the ABC and went on that. And they're very different, but they still share the same spirit of leadership through collaboration, leadership through, I would say, engaging with people outside of your institution. And as you can imagine, I spent most of my career at the University of Chicago. These kinds of experiences, for me in particular, were really, really eye-opening.

SPEAKER_01 8:49

I bet they were, yeah. Can you tell us a little bit about the application process? How was that?

SPEAKER_00 8:54

Yeah, the ABC is generally for individuals in their mid-career. I believe the requirement is actually that you be within 12 years from finishing your fellowship. It is a review process that is meant to identify leaders. And these can be leaders in clinical expertise, in education, in research, in service work. There's a whole variety of skills that go into this. So I'm not saying it would, it's trying to necessarily identify a specific category of leadership, but it's really a review process that selects five from the U.S. We are just coming towards the end of the cohort that will be selected for 2027. So applications are still being received. And I would encourage anybody that is sort of in that category. It really just requires a CV, some statements, two letters from AOA members, and that's pretty much it.

SPEAKER_01 9:54

That's a fairly significant demand, and there's a commitment that goes along with it. Can you tell us about how does that affect your practice and your family and everything else? How does that work? It's something you don't do casually. If you're going to do it, you need to commit to it.

SPEAKER_00 10:07

Yes. No, I my first I would recommend highly before you apply is talk to your family, talk to your colleagues, your partners. It's about five, sometimes even up to six weeks outs out of your practice, away from your family. I would absolutely recommend it highly, but only if you know your colleagues and your family are supportive of it. You certainly don't want to come back to issues that you couldn't have dealt with by at least talking to them in advance. So, yes, it's significant investment of time. Usually I think colleagues are willing to support you. I think institutions, you can imagine this day and age, it's a little harder for institutions to have their kind of star faculty away for a long period of time. And I think there's some effort to be sensitive to that and maybe even shorten at least the period of time over which you're in the traveling fellowship. It used to be, I think, up to eight weeks. So it's definitely gone down to accommodate that.

Applying And Who Should Apply

SPEAKER_01 11:10

So how does that work? So y'all fly out together and go to a certain spot, and then how long do you stay there before you move to another one? How many places do you go to?

SPEAKER_00 11:19

Yeah, that's another thing that's evolved over time. So we traditionally we start in Great Britain, usually at a designated site. We meet with members of the BOA that are responsible for organizing that part. In Great Britain, traditionally, there's anywhere between, I would say, seven to eight places that you visit, maybe over about three and a half weeks or so, four weeks. Ours actually included a trip to Ireland, which is not necessarily part of by Ireland, I mean Dublin, so the Republic of Ireland. So that was really special. It's outside the UK, but they obviously represent part of the UK community in some respects. And so that is carefully organized by the British Orthopedics Association. And there's an alternate. So once you leave Britain, you either go to South Africa, which is what we did. We went, we visited five centers over about maybe a two-week period, or you go to New Zealand and Australia. And those sort of alternate, at least when the US and Canadian fellows are visiting Britain and other members of the carousel. Wow. Yeah. And you said there were seven folks in your cohort, or there were seven in our cohorts. So two Canadians, Mark Glazebrook and Eric Boehm were some of the representatives from Canada. And then we had Kevin Bozick, Lisa, Lisa Gallich, we had Bill Mahalko and John Sperling and myself. So a little heavy on the orthoplasty, but I have to say it is a group that we really, I cannot tell you how meaningful it was. And when y'all get to a spot, you y'all do some presentations and you Yeah, there's each center is usually responsible for putting together some form of an academic program. So there is definitely presentations for each kind of requested to put together, you know, about four, I would say, academic presentations and one that's a non-orthopedic fun topic. And we leave it up to the centers to decide which ones they want to hear. And then we also hear, and oftentimes the individual centers will try to come up with presentations on their sides that complement or are similar or at least are counterpoints to what we're presenting on our end. So that's the academic program. There's usually a social aspect to it, which is always a lot of fun. I can go into details, but honestly, there are so many incredible experiences that we had that were purely social and memories of a lifetime, without a doubt. This was six weeks straight. It was about six weeks. It's traditionally for the ABC, it's usually in May. And what it oftentimes would, it would coincide with the AOA annual meeting, such that when you came back, they would give a little bit of time to reacquaint yourself with your family, um, take care of emergency stuff at work, and then you would basically go to the AOA annual meeting. And one of the best memories that I had was I think it coincided with one of the decade anniversaries of the ABC Fellowship, and they were having a special celebration, and you meet all the amazing people that preceded you in this. And it was just an incredible evening that I will always remember. Wow.

SPEAKER_01 14:41

That is spectacular. So how does the how has that fellowship subsequently impacted you in your journey going forward? And what key learnings maybe did you take away from it?

SPEAKER_00 14:53

Well, I, as I said, I've spent all of my career at the University of Chicago. So for me, it had a particularly important impact and being able to see, although I had amazing role models in my immediate neighborhood and probably felt that I really needed, did not need to really go outside. Leadership comes in a lot of different styles and varieties. And the only way to see that is to go and not just do it over Zoom, quite honestly, to meet people where they're at, see how their leadership, where it comes from, the traditions that have given rise to it, the personalities behind it, the interactions that, again, a Zoom meeting is not necessarily going to be able to capture that. So I really learned a tremendous amount, not just about different health systems and different academic perspectives, which come from the formal presentations, but you just you meet some incredible people that inspire you, that teach you a lot about their own personal experiences. So that's really what I took away from it.

SPEAKER_01 15:50

And how is it, how has that helped you forward with your leadership roles, both within the University of Chicago and then and outside organizations?

Time Away, Family, And Coverage

SPEAKER_00 15:58

Well, I think first and foremost, I mean, obviously, you get you sort of find your leadership style often by seeing others who have a similar style that you either want to emulate or that maybe have skills that mirror your own. So in the immediate sense, you gain mentors, you gain people that you can go to to bounce ideas off of. So there's a lot of practical, but probably the most, I would say, value to which the relationships that you build. But the most important far and away is learning about the different kind of successful styles that are out there when they seem to work, which one you think is going to be most appropriate to you? And I I took a lot of those lessons back and applied them when I came back.

SPEAKER_01 17:06

I've talked to some folks that have young families, both men and women, and they are a little reticent to be away from their children and their and then also their busy practices. Any words of advice or wisdom? I could think of some myself, but what any thoughts that you would have that you would tell folks like that that were hesitant because of such things?

SPEAKER_00 17:27

Well, I think this is all about being proactive and organizing. As I said, the first thing that you want to do is talk to them and make sure that they are supportive of it. There has been some attempt from the fellowship also to try to engineer in selected weekends where family can sometimes visit. That's always very helpful. But regardless of how you do this, it's still going to be some time away. So I think making sure that your practice is adequately covered is going to be important from the family standpoint. Sometimes having family members come and help, you'll know far in advance. So for many people, having parents or other family members that can come and just help if there's a lot of day-to-day logistical issues that come up that just helps to reduce some of the stress that it can cause. But honestly, the most important thing is to go to the members of your family, if your children are old enough, talk to them and just make sure that they're okay with it and staying in touch with them. There's always time to call and obviously connect. It's pretty easy in this day and age of technology. It's a little harder kind of in the past. But I would strongly recommend just broaching the subject early before you apply, make sure they're committed. And as you go forward, have a plan. Make sure that you've gotten family members or other people that can help support your family behind.

Travel Itinerary And Academic Program

SPEAKER_01 18:45

Now, one thing I was thinking about on this is that there's always another, like for instance, I do trauma. I don't think this is different from tumor because it's a pretty intense and important role that you play in that. But for my point, there's always another fracture that's there. And there's always another one that you could do. And when you get to our stage in our career and you look back, you're thinking, I don't think of the 75th acetagum or the 300th acetagulum or the 900th subtrochanteric fracture. It those things just kind of fade into the background. We do very, very important work on that. But more the things that really stand out are the tremendous experiences that we have doing things such as this, that our very specific role in our profession affords us that very few people in the world can ever have access to. And it seems to me that opportunities like this, a good selling point, or the good reason why people should consider it is there's always another. I'm not talking about the time from your family. Of course, that's priceless, but in terms of your practice, there's always more to do. And at some point, Time, it doesn't matter. And these other things do. As long as you're as clinically productive as you can be in your practice, it's okay and it's good. And these are the experiences that will mark your career and make permanent memories, even when all the other orthopedic surgery facts fade into the background. Your thoughts?

SPEAKER_00 20:19

So, yeah, I would echo what you say. I think first and foremost, doing lots and lots of surgery in your home institution, you gain a great deal of proficiency and efficiency in doing things the way you have always done them. I think the beauty of going to this kind of a traveling fellowship is you learn different ways of doing it. And I know you have been involved in working abroad. I learned so much. And I said the ABC Fellowship is probably one of the best examples of where you can learn some really new, I mean, just mind-blowing new perspectives on how we evaluate patients, how we treat them. So you have to sort of imagine that doing the same thing, no matter how often you do it, you can get faster at it, you can get better at it. But really, it's almost like those technological innovations that totally revolutionize things. That you're only going to find by going outside of your comfort zone and really learning from other people, in like on their terms, going to them. And I can't emphasize that enough. Now, you're right. That's from a clinical standpoint, there's enormous benefit to us from your family standpoint. That this is hard. But I would say that to the extent that your family wants to support your growth as a professional, as a surgeon, as a leader in the field, if you explain it to them, and again, you're careful and proactive in how you organize the support for your family when you're gone, I think they they want you to grow and they're going to be supportive of it. So I really would say that. So yes, fractures, tumors are similar. We can all get, I would say, even better using the same techniques that we've always used. But this is an opportunity to learn and go beyond that.

SPEAKER_01 22:13

Another point on this is that when I was getting my MBA, I was going to skip graduation. It's like I've been to a half graduation, so I don't need to do this. And my wife stopped me short and said, absolutely not, you will go. I'm like, come on, I don't need to do that. She goes, it's not for you. It's for you boys. Your children need to see their parents succeed. You need to serve as that role model. You're not walking the stage for you, you're walking it for them so that they can see that and emulate it. And I would imagine, in many ways, the ABC Fellowship is the same thing. When you explain to your children, this is a very important thing that mom or dad is getting to do. I don't, I hate the fact that I'm gonna be away from you, but in your life, you need to use this as an example. Your thoughts.

SPEAKER_00 23:03

Absolutely. I think if you don't do that, all they see is you spending time late at night doing coursework, and they don't see what it was all for. I have to say that they, when they see you on the stage and receiving this sort of an award, they take immense pride in it, I think. And instead of just seeing you working all the time, seeing what this has created, and you're right, inspiring them is ultimately it's I agree, walking across the stage and taking getting awards that is probably for me not very appealing. But for those who have supported you, not just your family, but sometimes your colleagues, they want to see that. They need that.

SPEAKER_01 23:45

And I imagine a few other folks at the University of Chicago have done this as well. I can think of a couple who in your department's also done these fellowships, maybe not ABC, but certain AOA fellowships.

Leadership Lessons And Lasting Community

SPEAKER_00 23:55

Yeah, we I was in 2009. I think Dr. Wolf was in 20, I think, 13. Sure. Dr. Liu, we have Dr. Lee. So we've had quite a, and this, those are the people after me. Obviously, Dr. Simon has been a person who really set this tradition, particularly at the University of Chicago. So we have a lot of people. And one of the, I have to say, as fun as it is to go to these centers as part of the tour, it is such a blast to actually host them. You get these different groups, and this is your opportunity to pay back. You've received a lot. You need to do the same that many people did for you. And I, it's fascinating because we there is, I think there was a larger meeting in Johannesburg, and they had fellows from all the different carousel organizations there that included fellows from many years that had been through Chicago, and they were having dinner and they texted me. And I have to say, it was just it brought back so many memories of the various kind of hosting events when they would return to see me. So it's a really special community, and it's one that's celebrated every year, either our crew going out to them or their crew coming to us.

SPEAKER_01 25:07

Now, I would be remiss, because a lot of folks may not be aware of this. You did not get into orthopedics through a conventional route. And when we had an 1887 Society meeting at the last AOA annual meeting, I got to learn that you had an entire career as an archaeologist and an anthropologist. Um just for the interest and the diversity on this podcast here. Tell us a little bit about what you did prior to entering into medicine. How has that influenced your thoughts on medicine? And you and I actually talked to us. I actually said to you, I said, wow, that must be very interesting looking at ancient bones with tumors. And you said, no, man, it's interesting seeing the trauma that happened to all these folks in the ancient times. Tell us about that.

SPEAKER_00 26:00

Yeah. So no interest in medicine or orthopedics when I went to college and ended up doing archaeology. My interest was purely archaeology and nothing more. I ended up specializing in an area of archaeology that excavates human remains. It's actually not possible in the U.S. anymore, but it still occurs in other countries in careful context. But you can imagine part of this is doing the excavation, but a lot of it's analyzing the human remains to see what did they die from? What conditions did they have? What does that say about the societies that they belong to? And so there's a very, very close relationship between that part of archaeology and anthropology and oftentimes forensics, including medical forensics. So that was my first encounter with physicians. I really had no, that was not on the radar screen, but ended up doing my kind of PhD research in a lab, met physicians because this was more forensic in its focus. And I met some people that were clinician scientists. And quite honestly, it just first of all, I saw much more direct relevance to the things I was doing, to kind of helping patients, which I did not see in anthropology as much as I loved it. And I saw this opportunity to flip between doing research on one side and then doing clinical care on the other, and using the two of them to inform each other. So I ended up applying for medicine at the end of my PhD. Orthopedics wasn't even immediately on my radar at that time either, but I ended up doing a rotation, worked with Dr. Peabody in the OR. And I think, as you can imagine, anybody that works with Dr. Peabody for any anything more than 30 seconds is going to love orthopedics. And so the die was cast at that point. And I'm really just incredibly fortunate. My wife still works in the field. I have the opportunity to go and still do this through her. So when they finish excavating and there are materials that have unusual fractures, and you would be infinitely better than I am at this because tumors are rarely seen in ancient contexts. But there's a lot that you can gather from what is this fracture? How would this fracture have happened? What does this say about this individual in this age? What activities were they doing? Is it warfare? Is this something else that we need to be alerted to? So there's a tremendous amount of overlap in the knowledge or just applying it differently. And the funny thing about this is I we just finished doing residency interviews. And one of the things that I have done is physical anthropologists are used to looking at bone fragments, right? We were trained in osteology. We have all the same basic knowledge of bones, but we're using it to side bones and do things. One of the things that I will do as a problem-solving exercise is I have our prospective medical students who are applying for residency here basically look at fragments and try to reapply the knowledge that they have of anatomy to side things based on a small fragment. And it's a great tool, same knowledge, and it's something that I've gotten very used to, where I can go into the field and take the knowledge that I've acquired for clinical care and try to use that same knowledge to address questions about culture or about history. And for me, it is, you know, when you get tired or maybe you get a little exhausted of with clinical care, you can do molecular biology research, you can do archaeology. And I think being able to pivot between these things, even though the knowledge that sits at the center of all those is pretty much the same. You're just applying it differently. I have to say I love, love that.

SPEAKER_01 29:51

And I believe that this is a family thing for y'all. Don't you and your wife, when you go out, sometimes you take your children with you?

Balancing Young Families And Growth

SPEAKER_00 29:57

Yep. Yep. It's a family thing. My daughter goes. So yeah, I have to say it's we all have different hobbies. And I know you've done work abroad. I've also spent time when I've been in Peru, which is where she does the majority of her work. I've worked with the local hospitals there. In fact, at some point when I retire, I will probably go down and teach and be involved there as well. And I think the kind of knowledge to be a lifelong learner, to constantly challenge yourself, the best thing is to go to settings that you're not comfortable with. And I have to say the surgeons that I've met are brilliant, absolutely brilliant, technical, technically speaking, how they kind of view problems, the kind of resourcefulness that they have. I have taken many of those techniques back and really I think everybody could benefit from these kinds of exchange programs, whether it is mission work abroad, fellowships that involve traveling, those are all, I think they they build on the same thing.

SPEAKER_01 30:54

So one last pitch for the ABC fellowship. So the application deadline has been extended a little bit. So if you had to give your elevator speech to somebody who is thinking about it, what would you say?

SPEAKER_00 31:08

I think it's a life-changing experience for many people. You're in the mid-part of your career and you're ripe for change and transformation. And this is probably one of the best ways to meet some of the people who are the transformers in our field and to learn from them. I think it is a unique experience that crosses all the different subspecialties. So as opposed to being confined just to yours, you're going to learn from the full spectrum across the orthopedic specialty and then learning about different approaches that come from working in different health systems, different health-related problems. And again, these may not be the ones that you're going to encounter at your own home institution, but you will learn lessons that will absolutely make you a different person. And joining this community is unlike any, I would say, organization or club that you will ever meet in any other respect. So I would really strongly encourage anybody. And then just go on the website and find the application there. There's a, yep. There's a just look at ABC AOA. It'll probably take you directly to the traveling fellowship site and click there and it will take you to the link.

SPEAKER_01 32:20

Wow, it has been an absolute joy and pleasure talking with archaeologist, musculoskeletal oncologist, and second president-elect of the American Orthopedic Association, Dr. Rex Hayden. Dr. Hayden, thank you so much for being on the podcast, sir.

SPEAKER_00 32:34

No, thank you so much. It's been a real privilege and honor.

SPEAKER_01 32:37

And y'all stay tuned for future series in this AOA podcast channel.