Orthopaedic surgeon Dr Thomas Clifton, FRACS used the 2024 RACS Medtronic Younger Fellows Travel Grant to complete a six-month Fellowship at Wrightington Hospital in England. At this leading centre for upper limb surgery, he worked alongside Professor Adam Watts, a global leader in elbow surgery—gaining valuable experience in advanced limb procedures. 

“It was a real privilege,” Dr Clifton says. “He was pivotal in shaping my elbow practice and I have adopted his techniques for primary and revision elbow replacements, biceps repairs and elbow arthroscopy.”

High-volume training and exposure
Dr Clifton says the Fellowship exposed him to “some of the most complex elbow and shoulder cases in the world. We dealt with trauma and degenerative conditions—covering everything from the shoulder down to the hand.

“The Fellowship involved teaching juniors, being trained by world experts in cadaver labs, attending specialist meetings, and contributing to research shaping the future of upper limb surgery.”

Dr Clifton says a key difference in upper limb surgery between the UK and Australia is the former’s centralised service for complex cases. In the UK, patients are referred to centres of excellence that manage a high volume of these procedures. This model enables Fellows to observe and participate in a larger number of procedures. As a result, they receive higher-quality surgical training.

The Fellowship was entirely within the UK’s National Health Service, offering a high volume of cases. “I was operating every day, often as the primary surgeon, which accelerated my learning,” Dr Clifton says. 

A safe space for innovation
Wrightington Hospital’s onsite cadaver lab provided Dr Clifton with the opportunity to refine his surgical techniques before applying them clinically. “It’s safe, practical, and I highly recommend this approach.”  

Beyond clinical work, the Fellowship also gave him access to research opportunities and professional networks, broadening his perspective on global innovations in upper limb surgery. 
Bringing new techniques home

Dr Clifton completed the Fellowship early last year. Since returning to Perth, he has introduced several advanced procedures into his practice. These include custom shoulder replacements, base-of-thumb joint replacements, and elbow revision surgery. 

“I’m already putting much of it into practice. These are highly complex cases where standard procedures have failed elsewhere. The replacements are 3D-printed, top-of-the-line, and uniquely designed for each patient.”

Dr Clifton notes that while Australia is still developing in this area, there are significant opportunities to advance and build on emerging expertise. “We’re not as engaged in attending international meetings or keeping up with innovations in elbow and shoulder surgery. The Fellowship really expanded my horizon.”

He encourages other surgeons to apply for the RACS scholarships and grants. “I think many Trainees are unaware of the full range of opportunities RACS offers. These grants can really help you become the best surgeon you can be.”

A career shaped by early experience
Dr Clifton’s path to surgery began with personal experience. “I had a lot of sports injuries growing up and was always interested in how they were managed. Once I got into medicine, I realised quite quickly that surgery was for me. I loved the fast-paced environment and the opportunity to make real, meaningful change in people’s lives.”

Dr Clifton works across both public and private healthcare systems. He operates and teaches at Sir Charles Gairdner Hospital and performs private procedures at Hollywood Hospital. His focus remains on managing complex upper limb cases combining his clinical work with research and teaching.

Outside the hospital, life is just as busy. With three young children, he says, “It can be tricky to balance everything, but I have a very supportive wife. I also try to stay fit with swimming and running, though there’s not much time left after work and kids.”