My Journey from the U.S. Air Force to Texas Hip and Knee

Today’s blog will focus a bit more on my personal life and the route that I have taken in

medicine. The path of every surgeon’s career is unique and potentially filled with significant

changes along the way. In my case, the course to starting a fellowship year at Texas Hip and

Knee was largely influenced by my military career in the Air Force where each military

assignment gradually steered me toward joint replacement surgery. The main influences

guiding this path include my first military assignment, my deployment to Afghanistan, and the

recent COVID-19 pandemic, but my story really begins prior to attending medical school.

Medical Training

After finishing my undergraduate training in Biochemistry, I decided to pursue a career in

pharmaceutical research and development. I completed a Master’s program in Biotechnology

and then worked for Merck & Co., Inc., for a period of four years. While at Merck, I had an

amazing opportunity to mostly engage in vaccine development on a variety of projects. My

time at Merck was very rewarding and I was able to contribute to projects that ultimately have

helped many people, but I always felt that my work was too distant from the patient’s that I

was trying to help treat. As a result, I performed some volunteer work at a hospital in

Philadelphia, where I was able to assist with direct patient care and decide that medicine was

the career that was right for me.

As anyone who has had a friend or family member attend medical school knows, the path

getting into and completing medical school is a long one. I was raised in a military family and,

therefore, had an interest in potentially entering the military myself for my medical training.

Ultimately, I decided to begin my military career by attending the military’s medical school in

Bethesda, Maryland. As medical school came to a close, I learned that I had secured a

residency in Orthopedic Surgery in San Antonio, TX. My residency was also completed through

the military at Brooke Army Medical Center in a combined Army and Air Force residency

program.

Military Service as an Orthopedic Surgeon

After completion of medical school and residency, my first military assignment was in England.

The assignment was an amazing opportunity to hone my skills in a relatively small orthopedic

practice, which allowed me to grow as a surgeon, expand the scope of my practice, and learn

from experiences as I prepared for and completed board certification in Orthopedics. The

limitations of that practice, however, were significant. Due to resource limitations overseas, I

was not able to perform any joint replacements. While I obtained great experience in other

facets of orthopedics, I always felt that a significant component was missing.

Following three years in England, I moved to the United States Air Force Academy in Colorado.

I was stationed in Colorado Springs for four years, which allowed me to become one of the

primary surgeons in the military’s busiest joint replacement community while also serving as

the team physician for the USAFA Preparatory School. During that time, I was surrounded by

colleagues who provided tremendous mentorship as I refined my skills and started planning for

my time after the military. Developing my joint replacement practice was the primary driver

towards my ultimate decision to pursue a fellowship in joint replacement, but the decision

became even clearer to me during my military deployment to Afghanistan. While the

deployment provided a unique opportunity to care for American, foreign allies, and enemy

combatant patients, my surgical capabilities were again limited. I saw many patients whose

lives were devastated by large blast injuries, but the resources available were frequently

salvage procedures. Many patients could have benefited from joint replacements, but implants

and appropriate medical infrastructure were not available. While the deployment was a

remarkably fulfilling experience, I felt a void for patients needing further surgery that I could

only provide at home.

When I returned to Colorado, I returned to my military practice where joint replacement was

my primary focus. Unfortunately, that was also dramatically affected by unforeseen

circumstances, which in that case was the COVID-19 pandemic. My practice, as those of many

surgeons, required a transition in patient management and treatment algorithms for many

months. I struggled with having only non-operative options that are minimally effective for

patients as I waited for surgical capabilities to return. As elective procedures finally restarted, I

was reminded about how much I enjoy seeing joint replacement surgery change the lives of my

patients. I was convinced more than ever that joint replacement surgery is the facet of

orthopedics that I wanted to explore further as I transitioned away from the military.

Fellowship

As with all stages of my medical career so far, the path towards starting a fellowship year in

joint replacement was also lengthy, but ultimately brought me to Fort Worth, TX, and the Texas

Hip and Knee Center. I evaluated many options for my deep dive into joint replacement, but I

found the Texas Hip and Knee Center to have everything that I needed in a training program.

Now that I am almost five months into the year-long fellowship, I can attest to the fact that the

fellowship is living up to the promises made to me. I have had the opportunity to work with

eight amazing orthopedic surgeons whose focus is solely on knee and hip replacements. The

surgeons have a diverse background with respect to having completed their fellowships at

many of the top programs around the country. They are also at many different stages of their

careers, which has provided an opportunity to learn from surgeons that vary from having

several decades of experience to others who have completed their fellowship within the last

couple of years.

The breadth of the surgical experience for me has been tremendous as well. The surgeons have

worked for years to build their reputation in this area, which has resulted in the practice serving

as a large referral center for the Dallas-Fort Worth community. Everything from non-operative

arthritis management, primary joint replacement, complex revision procedures, infection cases,

and complex fractures around joint replacement implants are completed at Texas Hip and

Knee. Additionally, joint replacement implants from all of the major vendors in the United

States are utilized in surgeries, which has expanded my experience further. I have participated

in surgeries at a regional hospital, an orthopedic specialty hospital, and an ambulatory surgery

center. The techniques used by the surgeons have provided an incredibly diverse experience

for me as well. In hip replacement, for example, surgeons in the group utilize all of the surgical

approaches to the hip joint itself. In knee replacement, many different methods of

appropriately carrying out the surgery and balancing the implants are used. In addition, some

of the surgeons utilize the most recent technological advances in orthopedics, such as robotic

assisted surgery. Taken together, every aspect of joint replacement surgery is practiced within

this group and has provided an amazing learning environment for my fellowship.

Outside of the operating room, I have experienced other opportunities to grow as a surgeon

and learn more about joint replacement. Many of these opportunities have involved medical

students from a local medical school who are interested in potentially pursuing a career in

orthopedic surgery. These activities have included morning conferences to discuss different

aspects of joint replacement, journal club meetings where we have reviewed hot topics in joint

replacement being debated in our literature, and training labs where we have demonstrated

joint replacement surgery techniques. Additionally, my military background has provided

opportunities to discuss military medicine with students and provide some mentorship for

students who have decided on a military career similar to mine.

Next Steps

Although I am still in the first half of my fellowship at Texas Hip and Knee, the preparation for

my time after this year has already begun. During my time in Colorado Springs, my wife, two

kids, and I fell in love with the area and decided that we wanted to make Colorado our

permanent home. Therefore, I am planning a return to Colorado at the completion of my

fellowship, where I plan to build a joint replacement practice similar to that of Texas Hip and

Knee. I cannot think of a better orthopedic practice to model after and I know that my time in

Fort Worth will provide the thorough, complete, and multi-faceted experience that I need to

provide excellent care for my patients of the future.