A day with Pascal Hagenah
Resident in shoulder, elbow, and
knee surgery and traumatology
The daily routine of a hospital physician is diverse. In our section “A Day With,” you can accompany resident Pascal Hagenah from his rounds to the operating room.
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Have you ever wondered what the daily routine of a resident physician in a specialist clinic looks like? What is the work of a young doctor like, who starts his rounds in the early hours of the morning, cares for patients throughout the day, assists in operations, and is committed to providing optimal care for his patients? In the section “A day with...,” we accompany assistant physician Pascal Hagenah through his varied and demanding working day at Sportklinik Hellersen.
7:20 a.m.:
The day begins for the assistant physician with the chief's rounds. Together with Dr. Markus Leyh, chief for shoulder, elbow, knee surgery, and traumatology, and the senior physicians in the department, he gets an overview of the recovery of patients who have recently undergone surgery. While Dr. Markus Leyh gives the assistant doctors important instructions, Pascal Hagenah expertly changes bandages, treats wounds, and speaks reassuringly to the patients. One patient with a severe comminuted fracture hopes to be discharged, but the Chief has to put her off: “We still need to observe her. The swelling has to go down before we can operate.” For another patient, however, there is good news this morning: “If everything looks good, you can go home today,” says Dr. Markus Leyh.
7.45 a.m.:
After rounds, the joint morning meeting of the endoprosthetics and shoulder, elbow, knee surgery, and traumatology departments begins. The assistant physicians, senior physicians, and chiefs of the departments review the X-ray images together. First, they focus on the postoperative X-ray images: How is the bone aligned after plating? Is the osteosynthesis material correctly positioned? One X-ray shows a particularly complex case: “If we perform such a procedure and you are interested in watching, you are welcome to come to the operating room,” encourages Chief Dr. Markus Leyh the assistant physicians.
Next, the X-rays from the previous day's emergency service are reviewed. This involves documenting which patients were admitted during the shift, how the fracture occurred, what measures were or will be taken, and how the current images should be assessed.
In the case of complex fractures, senior physicians or chief physicians may re-examine the images and call the patients in for a check-up to ensure a complete diagnosis.
Another important part of the meeting is the surgery schedule for the day. Surgeries are prioritized, rescheduled if necessary, or emergencies are integrated into the schedule. With five regular and two outpatient operating rooms at Sportklinik Hellersen, planning requires the utmost precision to ensure an efficient and structured daily routine.
8.10 a.m.:
Chief Dr. Markus Leyh regularly takes the time to discuss the patients' health status in detail with the assistant physician. Together, they review medication adjustments, the next steps, and the next stages of treatment. Dr. Markus Leyh ensures that all measures are precisely coordinated. Through this personal exchange, Pascal Hagenah not only learns how to tailor treatment more effectively, but also gains valuable insights that help him develop further.
8.30 a.m.:
In the doctor's office, Pascal Hagenah turns his attention to his next task: preparing the doctor's letter for the patient who is to be discharged today. He carefully summarizes all relevant medical information — from the diagnosis and treatments performed to the recommended follow-up measures. The doctor's letter serves as an important basis for further treatment and aftercare, both for the patient and for other treating physicians.
„I find it exciting to work in a specialized clinic where I can learn from experienced colleagues from various fields.“
Pascal Hagenah
Assistant physician for shoulder, elbow, and knee surgery and traumatology
8.45 a.m.:
The assistant doctor takes over the emergency room. On his way there, he takes a quick look into the treatment room to see if a patient has already arrived. Since no patient is waiting for him at this point, he continues on to the emergency room to care for a patient in the pre-admission area.
8.50 a.m.:
In the pre-admission area, he welcomes a mother with her 16-year-old son, who is scheduled to undergo surgery the next day for a cruciate ligament rupture. The examination begins with a thorough medical history, during which he asks the patient about his medical history and current symptoms. He is particularly interested in the answer to the question “Have you ever had surgery on your left knee?” in order to better assess any risks or complications. He also asks about medication, previous illnesses, allergies, and sporting activities. The 16-year-old plays soccer regularly. This is followed by an examination of the knee, during which Pascal Hagenah again checks how far the leg can be bent and stretched preoperatively, as this is crucial for the healing process.
After the examination, the assistant doctor explains the surgical procedure to the patient and his mother: “We will reconstruct the cruciate ligament using the body's own tissue so that you can be active again quickly.” This is followed by detailed information about the course of the operation and the associated risks. “There are possible risks such as infections or complications with the transplant, but these are rare,” he says, discussing the most important points with the patient.
9.30 a.m.:
The prepared doctor's letter is signed by Chief Dr. Leyh. Pascal Hagenah then takes over the patient's discharge.
9.50 a.m.:
Now it's time to prepare for the upcoming operation. Today, he is assisting with knee arthroscopy in the outpatient operating room. “If an operation is already scheduled the day before, I make sure to find out specific information about the procedure in advance so that I am optimally prepared.” Thorough planning is essential for him, especially when he is performing the operation himself — even though he can always count on the support of a senior physician.
10.15 a.m.:
The outpatient procedure begins: The surgical team is ready and the monitor shows the first images of the knee joint. A senior physician performs the arthroscopy while the assistant physician supports him, hands him instruments, and closely monitors the procedure. With precise movements, fine medical instruments are inserted through the small incisions in the skin to repair the medial meniscus and treat cartilage damage. Every detail is visible on the monitor, allowing the team to work with precision.
The six-year training program in orthopedics and trauma surgery is primarily practice-oriented: Resident physicians learn through surgical procedures and everyday clinical work.
11.20 a.m.:
Back in the emergency room, an emergency awaits him. It is a work-related accident: a patient slipped on his way to work and fell on his knee. The patient is now complaining of severe pain in his knee and tailbone. The resident takes on the case and requests an X-ray for a thorough examination to rule out possible injuries.
11.30 a.m.:
No sooner is he back in the doctor's office than the phone rings again. Another work-related accident. A woman fell yesterday and wants to have her pain checked out. Here, too, after a physical examination, the patient is referred to the X-ray department.
11.40 a.m.:
The first patient, who injured himself on his way to work, is back in the emergency room. After Pascal Hagenah examines the X-rays of the knee and coccyx and finds nothing unusual, he calls in the senior physician, Dr. Kerstin Hengstmann. She examines the patient again and looks at the images thoroughly. The senior physician also finds no injuries. Despite the unremarkable findings, it is decided that the patient should take it easy. He is therefore given a sick note for one week to relieve and rest the affected knee and coccyx area.
11.50 a.m.:
The patient is also back in the emergency room. After the senior physician has thoroughly reviewed her case, she gives the all-clear. The examinations and X-rays have shown no abnormalities and there are no signs of serious injuries.
12.10 p.m.:
Take a break! Take a deep breath and recharge your batteries before continuing with your work.
12.40 p.m.:
Time for the necessary ward work: The assistant physician documents treatment steps, writes doctor's letters, and checks or changes medication. If necessary, he or she adjusts the therapy or carries out further examinations, always in close consultation with the senior physicians or the chief to ensure that all measures correspond to the best possible patient care.
At the same time, after consulting with a senior physician, he or she processes requests for pension insurance applications, fills out forms, answers specific questions, and has the documents checked to ensure their accuracy.
3:15 p.m.:
Today, Pascal Hagenah is taking over the emergency service, which begins at 3:15 p.m. following the regular opening hours of the outpatient clinics.
In principle, an assistant physician must be fit for duty for this service — fitness for duty is assessed by the Chief. The physician on duty on site must be able to treat acute emergencies in-house together with the anesthesiologists.
In addition, expertise in radiation protection is required. Only then can the assistant physician independently order and evaluate X-rays. Obtaining an X-ray license requires at least one year of training, during which assistant physicians acquire the necessary expertise to indicate and interpret X-ray images.
To be fit for duty, the assistant physician must also have a sound knowledge of orthopedics and trauma surgery and be able to apply bandages and casts. In the emergency service, their tasks include providing initial care to patients, making diagnoses, and evaluating X-rays. A senior physician on call is available by telephone at all times.
The emergency service ends at 7:30 a.m. the following morning. As his last official act, the doctor on duty, Pascal Hagenah, presents all patients from the emergency service to the team. The X-rays are reviewed together during the morning meeting. He then takes off his doctor's coat – the emergency service is over, and there were no special incidents.
Step by step trowards specialist medical training
After successfully completing their medical studies, prospective doctors must decide on a specialty. In Germany, further training to become a specialist takes five to six years, depending on the field.
While searching for a suitable training position in the field of orthopedics and trauma surgery, Pascal Hagenah decided on the Sportklinik Hellersen. He learned about a vacancy through his father, Dr. Joachim Hagenah, who was working as a chief in endoprosthetics at the time. The prospect of working at a renowned clinic close to home while gaining valuable professional experience ultimately prompted him to apply. He was already familiar with the clinic from various internships and thus had the opportunity to work with his father — a wish he had long cherished.
At the Sportklinik Hellersen, Pascal Hagenah found the ideal conditions for his specialist training. The six-year training program in orthopedics and trauma surgery is primarily practice-oriented: assistant doctors learn through surgical procedures and everyday clinical work. “At the beginning, you hold the hooks, and later, with more experience, you are allowed to operate independently,” he explains. A particular highlight was his first endoprosthesis operation, which he was able to perform together with his father, Dr. Joachim Hagenah – an unforgettable experience.
"At the beginning, you hold the hooks, but later, with more experience, you can operate independently."
Pascal Hagenah
Assistant physician for shoulder, elbow, and knee surgery and traumatology
What Pascal Hagenah particularly appreciates about working at Sportklinik Hellersen is the high level of expertise. “I find it exciting to work in a specialized clinic where I can learn from experienced colleagues from various fields,” he says. Rotating through different surgical departments and conservative orthopedics has already given him a wide range of expertise.
Despite the positive experiences he is gaining at the Sportklinik Hellersen, he also has to work in other clinics in order to complete his specialist training. “It's part of the process to deepen and apply my knowledge of trauma surgery, intensive care, and emergency medicine in larger hospitals. But afterwards, I would like to return to the Sportklinik Hellersen,” explains Pascal Hagenah. On October 1, Pascal Hagenah transferred to another clinic to complete his specialist training.
