I am not at all surprised by what he perceived as a lack of interest on the part of the trainee in the front of the room for the part of orthopaedic surgery in which I am experienced. For a number of reasons, I do not come across this often in orthopaedics. The obvious ones are that the orthopaedist is constantly hands-on and dealing with patients, whereas in OM&S the oral surgeon has to be working on the patients, rarely dealing with them directly. (The attitude is understandable as OM&S is part of the foundation year. In orthopaedics, depending on the specialty you may have to bypass the foundation year.) Also, in orthopaedics, you train in adult medicine first where the path forward to a career is rather straightforward. In OM&S, children are admitted to hospital from day 1. That means, especially with particularly rare and often severe conditions, that the plan after the day 1 operation is to go back into the children's ward to make sure the patient gets a further operation -- it is a very different culture. And that can mean that the trainee may not see the patient again for a while.
In my initial observations of the oral surgery training programme and its approaches, I must admit I initially felt some degree of reticence with the use of simulation, models, surgical navigation and robotics. Wishing to retain the time a trainee would invest in the actual clinical experience as a foundation for later suturing and the like, I sought the opinions of some prominent people in the training programme. The majority agreed that these devices and approaches are important and should be used. To this end, I have chosen to remove the entire chapter on orthopaedics from the 2013 book, which contains much useful information for the trainee and covers many of the points that the Department of Anaesthetics wished to be covered. This makes room for more approaches to the maxilla and mandible using advanced technologies such as navigation, robots, and 3d printing. The 2016 edition will have this in the same chapter. d2c66b5586