ACPA Visiting Scholar Program: Report by Gayatri Moghe, Hyderabad, India

Alyssa KirkmanACPA News

A warm hello to all colleagues who have been so kind as to act as my hosts for the duration of the ACPA visiting scholar program. Instrumental in encouraging me to apply to the Visiting Scholar Program was Gunvor Semb, my sponsor, whom I truly look up to. As a result, I had the honor of becoming the twenty-first visiting scholar.

During the first half of my visit to centres in the United Kingdom, I had the opportunity to visit the Central Manchester University Hospital and the Birmingham Children’s’ Hospital. At these centres, I interacted with Jeanette Mooney, Haydn Bellardie, Victoria Clarke and Bruce Richard about various treatment options in ongoing orthodontic cases at our centre.

In the second half of my travel, I visited the Lancaster Cleft Palate Clinic, MD Anderson Cooper University, and the Children’s Hospital of Philadelphia. I could sit in and observe team meetings at these centres where interdisciplinary care was discussed for each patient. What impressed me was that every specialty received due importance and a holistic treatment approach was planned for each patient. One-on-one interactions with Drs. Ross Long and Hyun Duck Nang regarding phase 1 orthodontics will be very useful for most of our patients. It was an enlightening experience to learn about some low-cost innovative ideas to deliver care. I was able to see feeding issues addressed at birth of a child whilst observing at MD Anderson Cooper University, with Dr. Marilyn Cohen.

The second week was spent at Nationwide Children’s Hospital where I was mentored by Drs. Ana Mercado and Richard Kirschner. I had an opportunity to discuss early intervention speech with Dr. Adriane Baylis and also attended Genetics clinics with Dr. Gail Herman. Further on, Dr. Michelle Scott also discussed several ongoing cases in craniofacial orthodontics. The icing on the cake was a chance to observe the dental trauma day at the Pediatric Dental Department. Also, Dr. Rosie Mayro spared a lot of her time going through complex cases and discussing treatment possibilities with me. I was lucky to be invited for team day with Dr. Helen Sharp at Western Michigan University too.

At every centre, nurse practitioners explained how they work with children who have clefts, assisting new mothers with feeding advice. This would be the most important take-home message as most children who present to our centre are anaemic, malnourished and underweight. These discussions have armed me with new ways to help increase calorie intake before the child is scheduled for surgery. I had some informal interactions with Dr. John A. van Aalst and I was surprised by his deep understanding of the Indian cleft care scenario.

With particular emphasis on India, the desirable model to establish and follow proper and efficacious treatment protocols in cleft care may sometimes be difficult to follow. A bulk of the patient population has several unmet treatment needs, which need to be prioritized. Unfortunately, trained professionals are too few in number to deal with this problem of plenty.

With plans to start a “hub and spoke model of care”, our team was looking at training its key members so that they may help train other practitioners. I lack experience in several areas of team coordination and am currently “learning on the job.” I am a keen follower of the Eurocleft and Americleft projects for development of protocols for dental care in our scenario. It is indeed a privilege to watch various cleft teams at work and be able to learn and imbibe so much from all the members.

I hope to be able to work towards improvement of the cleft care spectrum in my home country and encourage others to follow suit.

My heartfelt thanks to all the centres for making me feel so welcome. Jeanette Mooney (UK), Dr. Ana Mercado, Dr. Ross Long, and Dr. Marilyn Cohen have ensured that I made the best use of this time. Wendy, Amatullah and Allison have been extremely supportive and I consider myself a proud member of the ACPA family. Had it not been for the support by Stryker, it would have been impossible to get such an opportunity. All in all, it was an excellent opportunity to learn, network, build contacts and to thank all those who continue to help us in our endeavours.