Dr Ebere Osinachi Ugwu

My six-week fellowship in renowned hospitals in the United Kingdom (UK) was a memorable learning experience, made possible by the generous sponsorship of the British Foundation for International Reconstructive Surgery and Training (BFIRST). I applied for this fellowship driven by my commitment to providing high-quality, affordable reconstructive care to underserved Nigerian women, with the aim of restoring dignity, improving quality of life, and promoting early presentation of patients with breast cancer. The fellowship was an opportunity for exposure to high volume Oncoplastic and Reconstructive breast surgeries in order to achieve this goal. I also sought to improve my expertise in Cleft and Craniofacial Surgery, and to understudy NHS organisational models adaptable to Nigeria. I  am pleased to report that the fellowship exceeded all my goals and expectations.

My fellowship took place at the Royal Victoria Infirmary, Newcastle under Mr David Sainsbury, and at Wythenshawe Hospital, Manchester under Mr Benjamin Baker. Both centres provided rich clinical exposure aligned with my training needs.

Royal Victoria Infirmary (RVI), Newcastle

With the Cleft Team at the Royal Victoria Infirmary(RVI), Newcastle

Cleft and Craniofacial Surgery: I participated in a wide range of Cleft and Craniofacial procedures including cleft lip repair, cleft palate repair, ear reconstruction and rhinoplasty. I attended the comprehensive cleft clinic and multidisciplinary team (MDT) meeting, where I witnessed the effectiveness of the one-stop clinic model – a system where patients receive holistic care from all relevant specialists during a single visit. This model is ideal for replication in my institution to strengthen cleft care delivery. The professionalism and team work of the Cleft team was truly inspiring.

With the Sarcoma Team at the Royal Victoria Infirmary(RVI), Newcastle

Sarcoma Management: I had the privilege of joining Mr Maniram Ragbir and the Sarcoma Team. I observed the structure, communication flow, and coordinated decision making of an efficient sarcoma MDT. A particularly valuable experience was observing a free osteocutaneous fibula flap for forearm reconstruction after sarcoma excision, which showcased meticulous microsurgical planning and execution.

Dermatoscopy: Exposure to dermatoscopy in the General Plastic Surgery clinics reinforced its importance in early skin cancer detection, especially relevant for Nigeria, where patients with skin cancers often present late.

Laser Therapy: Time in the Laser Suite provided my first practical exposure to medical lasers used for hypertrophic scars, benign skin lesions, acne scars, vascular lesions and skin rejuvenation. This experience has equipped me with foundational knowledge essential for establishing a laser therapy service in my centre.

 

Wythenshawe Hospital, Manchester

With the Breast Surgery Team at Wythenshawe Hospital, Manchester

This rotation offered dedicated exposure to microsurgical breast reconstruction including twelve DIEP flaps, a DUG flap and a number of nipple reconstructions and symmetrisation procedures. Joint oncoplastic clinics enhanced my understanding of patient assessment and shared decision-making. This was my first opportunity to witness high-volume microvascular breast reconstruction, and it provided exactly the level of exposure and technical clarity I hoped for when applying for the fellowship. The wealth of experience, mentorship and teamwork of the entire breast surgery team made this rotation exceptionally impactful. I also observed a rare case of shoulder reconstruction following forequarter amputation for sarcoma resection using an elbow joint incorporated osteomyocutaneous free flap from the amputated limb.

 

CONFERENCES/MEETINGS ATTENDED

BFIRST supported my participation in three significant academic meetings/conferences:

 

At the Royal Society of Medicine’s Breast Reconstruction Meeting

1. Breast reconstruction: Global perspectives, past, present and future by the Royal Society of Medicine (Plastic Surgery Section) on 6^th September, 2025 in London. Sessions covered the full spectrum of autologous breast reconstruction and innovations such as robotics, 3D printing, and exoscopes. The lecture on improving post-mastectomy breast reconstruction uptake in LMICs, using lessons from India, was transformative. It highlighted community- centred awareness campaigns and early engagement by plastic surgeons – strategies directly applicable to Nigeria. Meeting Mr Brian Sommerlad, whose cleft palate repair technique we use in Nigeria, was a memorable highlight. I was also inspired by the legacy of Mr Venkat Ramakrishnan, in whose honour the meeting was held.

It was an honour to meet Mr Brian Sommerlad at RSM’s Breast Reconstruction Meeting

1. BAPRAS Celtic Meeting 2025, Dundee (11-12 September, 2025): Strengthened my insight into cleft care quality assurance and international collaboration, reinforcing the importance of structured cleft service delivery.

At the BAPRAS celtic meeting in Dundee

1. Royal College of Surgeons’ Women at the Cutting Edge, Birmingham (17 October, 2025): An empowering meeting with talks on resilience, innovations, work life balance and leveraging social media for awareness campaigns. Meeting Miss Georgette Oni, who has long been an inspiration to me, was an honour.

It was an honour to meet Miss Georgette Oni at the Royal College of Surgeons’ Women at the Cutting Edge in Birmingham

SIGHTSEEING AND SOCIAL EVENTS

 
At Blackpool tower

At Madame Tussauds’ Blackpool​​​​​​​

I enjoyed the cultural richness of the UK, visiting the V&A Dundee, Discovery Point, River Tay, Newcastle United Stadium, Blackpool Zoo, Tower and Madame Tussauds. I had privilege of attending the retirement dinner in honour of Mr Peter Hodgkinson, one of UK’s leading Cleft and Craniofacial Surgeon and dining with the BFIRST Co-ordinator, Miss Kate Radcliffe.

With Kate Radcliffe

IMPLEMENTATION OF MY FELLOWSHIP EXPERIENCE

I intend to leverage partnerships with BFIRST, my UK and Nigerian mentors, the management of my institution, NAPRAS, other stakeholders and policy makers to implement the following strategies in Nigeria:

• Increase community awareness of Oncoplastic and Reconstructive breast surgery throughoutreaches and social media campaigns
• Establishment of an Oncoplastic and Reconstructive breast surgery service/centre in myinstitution especially microsurgical breast reconstruction
• Constitution of a soft tissue tumour MDT in my institution
• Implementation of comprehensive cleft care one-stop clinic similar to the RVI model in my institution
• Organisationn of annual skin cancer screening programmes for high-risk individuals using clinical examinations supported by dermatoscopy
• Establishment of a laser suite for scar management and treatment of benigh skin conditions in my institution
• Advocacy for the integration of comprehensive longitudinal cleft care and
• Oncoplastic/Reconstructive breast surgery into Nigeria’s National Health Insurance Scheme.

CONCLUSION

I achieved all my fellowship objectives and gained far more in mentorship and professional growth. I express my profound gratitude to BFIRST, the BFIRST Co-ordinator, my supervising consultants, all other consultants, colleagues and team members who contributed to my training. I also appreciate my fellowship buddies, whose support made my stay enjoyable and productive. I am grateful to my trainers at the University College Hospital, Ibadan; my senior colleagues and hospital management at my institution; my family and friends for the support. Finally, I thank BFIRST for the surgical loupes, which are now a valuable part of my surgical armamentarium.

With profound gratitude,

Dr Ebere Osinachi Ugwu

Consultant Plastic Surgeon

National Orthopaedic Hospital, Enugu, Nigeria