aaosnow.org August 2013 AAOS Now

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In the global orthopaedic com-munity, few organizations are better known or more highly

regarded than the AAOS. The Academy is viewed as a leader, particularly in its educational of-ferings—from periodicals such as the Journal of the AAOS to books such as Orthopaedic Basic Science, and from instructional courses to the Annual Meeting.

The Academy’s first comprehen-sive, multiyear international busi-ness plan was developed 20 years ago by the AAOS International Committee, then chaired by Theo-dore R. Waugh, MD. That original plan served as a springboard to enhance the Academy’s presence in the global community and as a blueprint for continued expansion.

But much has changed since the plan was last updated, and the AAOS is once again looking at international initiatives with a stra-tegic eye. At a board workshop in December 2012 and again during the June board meeting, discus-sions focused on how we could move to the next level and leverage our experience and expertise to benefit our patients and our mem-bers—both in the United States and abroad.

During those sessions, your board heard from other medical associations that have a significant international presence so that we could learn and benefit from their experiences. We also heard from Nikki Walker, global vice president, association management and con-sulting, MCI Group, who provided an excellent analysis of various international markets and strategies for capitalizing on them. In this col-umn, I would like to share some of those insights with you.

Growing for the futureAlthough nearly all board-certified orthopaedists in the United States are members of the AAOS, limits on graduate medical education, or-thopaedic residency programs, and orthopaedic fellowships mean that U.S. membership will grow slowly. Someday—perhaps sooner rather than later—U.S. membership alone may not be sufficient to support the Academy’s programs. A reason-able, well–thought-out strategy for international growth will likely be vital for the AAOS to maintain its leadership position.

Currently, international affiliate members account for approximate-ly 17 percent of AAOS member-ship; in other medical associations, international memberships account for 7 percent to nearly 40 percent of total membership. Nearly half of the Academy’s international mem-bers come from just 10 countries; Latin American countries—Brazil, Mexico, and Argentina—account for nearly a quarter of all interna-tional memberships.

One of every five international members who attend the AAOS Annual Meeting is from Latin America, which also accounts for nearly a third of all international revenues. Obviously, our neighbors in the Americas present a key op-portunity for future growth.

During the board workshop, we heard from the American College of Cardiology (ACC), which allows the establishment of international chapters in countries around the world. Currently, the ACC has 25 international chapters, which have triggered significant membership growth over the last 3 years.

Education as our missionInternational participation in the AAOS Annual Meeting is strong; about a third of all physician at-tendees at the AAOS Annual Meet-ing are from countries other than the United States.

For the 2013 Annual Meeting, the Central Program Committee received six applications for In-structional Course Lectures from international members—and all six were accepted. More than a third of the 1,300 abstracts accepted for scientific papers and/or posters had international coauthors.

We know that orthopaedic sur-geons in other countries are hungry for knowledge and skills (Fig. 1). These surgeons are looking for tangible products and skills that will make a difference in their daily professional lives and in the way they treat patients. And, just as in the United States, these surgeons have different learning preferences. In many areas of the world, face-to-face learning is preferred over online learning, although a com-bination of face-to-face and online learning is often acceptable.

For this reason, the AAOS cur-rently conducts approximately 15 international education programs each year and has established educational programming partner-ships with more than 35 different nations. These programs cost the Academy less than $100,000 a year to run; the bulk of the expenses, in-cluding faculty travel, housing, and program logistics, is covered by the host nation.

Attendees at these programs ea-gerly purchase any available AAOS educational materials; in the past 5 years alone, countries in which the AAOS has conducted educa-tional programs have generated almost $8 million in revenues to the Academy.

This year, the introduction of the “Best of the AAOS” brings key elements of the AAOS Annual Meeting to new audiences. This new product combines a patient safety–focused instructional course lecture, a symposium reviewing the best posters and papers of the meeting, and access to the iPosters. In the future, purchasers will be able to customize the product (within specific guidelines), bring-ing the best in orthopaedic educa-tion to surgeons around the world.

Innovative programs, such as our international scholarships and train-the-trainer multiyear pro-grams, have helped build alliances

around the world. In Vietnam, a multiyear surgical education pro-gram has focused on patient safety issues, resulting in greater attention to sterile techniques, adoption of the “sign-your-site” protocol, and reductions in infections.

But we’ve learned that we can—and must—do better in developing and building local partnerships and programs. In particular, with a revised strategic plan in place, the AAOS can help the global commu-nity of orthopaedic surgeons re-spond to the evolving needs of our profession. An integrated educa-tion strategy will benefit both U.S. and international members.

A humanitarian focusAll this can be accomplished with-out losing the humanitarian focus that engages your Academy and your colleagues on behalf of pa-tients in need. In fact, because “one size does not fit all,” the use of external, globally recognized rank-ings (such as the World Bank’s list of low-income countries) may help the AAOS establish education and pricing models suitable for various markets.

Naturally, in the event of a true disaster—such as the Haitian earthquake in 2010—the AAOS stands ready to provide support, both to our members who volun-teer for disaster relief and to the victims themselves.

Orthopaedic surgeons around the world share our own commit-ment to improve the musculoskel-etal health of patients and improve their lives. They want to acquire the surgical skills that will enable them to treat devastating injuries; they want to learn how to reduce surgical site infections and improve patient safety. As the AAOS devel-ops an international strategy, we will aim to help them meet those goals, without losing sight of the needs of our U.S. members.

Front and Center on the Global Stage● JoshuA J. JAcobs, MD

Across the president’s desk

Joshua J. Jacobs, MD

0% 20% 40% 60% 80% 100%

Reasons to Attend Annual Meeting

Learn new techniques/procedures

Access expanding orthopaedic research

Exposure to technical exhibits

93%

68%

60%

Fig. 1 International affiliate members rank learning new techniques/procedures and accessing expanding orthopaedic research as their primary reasons for attending the AAos Annual Meeting.

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