The 7th PIOA exit exams were held in Honiara, Solomon Islands from 21-25 September 2026. The exams consist of 2 written papers (2 hours each), 2 computer exams on Operative surgery, 1 on Imaging and Investigation and 2 clinical vivas where trainees demonstrate clinical examaination and clinical reasoning and decision making. In total there were 4 candidates and 3 successful candidates.
We welcome our new fellows Dr Paul Lomavatu (Fiji), Dr Manoa Veleniyasana (Fiji) and Dr Robert Fa’ataga (Samoa).
From L Andreas Loefler (Examiner), Stephen Kodvaru (Examiner), Robert Fa’ataga (Samoa graduate), Paul Lomavatu (Fiji graduate) Richard Lander (Chief examiner), Shaun Mauiliu (Examiner)
held on 14–27 September 2026 at the National Referral Hospital, Honiara, Solomon Islands
The Pacific Islands Orthopaedic Association held its Introductory and Trauma modules at the National Referral Hospital in Honiara from 14 to 27 September 2026. The twoweek programme brought together regional and international faculty, trainees from across the Pacific, practical clinical teaching, faculty development, and the first orthopaedic exit examinations hosted in Solomon Islands.
Faculty: Dr Claude Martin, Wilson Li, and Vivek Trikha from AO Alliance; Professor Nik Friederich from Switzerland; Areta Samuelu and Shaun Mauiliu from Samoa; Thomas Kiel from Papua New Guinea; and Stephen Kodovaru, James Tewa’ani, and Clay Siosi from Solomon Islands.Trainees: Michael Leota and Ariel Loane from Samoa; Tomasi Tokalauvere, Mohammed Iqbal, and Jesse Vosawale from Fiji; Vanua Ilo from Vanuatu; Agnes Auto, Daniel Makiawa, Steven Kutukana, Willie Abuito, and Oralae Pitakia from Solomon Islands; Dickson Wak and Jacque Pahun from Papua New Guinea; Julio Martins and Jacinto Vaz from Timor-Leste; and Taukoriri Tibiriano from Kiribati.
The Introductory Module covered orthopaedic history-taking, examination of all musculoskeletal regions, and relevant special tests. The Trauma Module introduced injury patterns and fractures through a holistic approach to management, including Emergency Management of Severe Trauma (EMST) and operative care. Bone healing, principles of fracture fixation, and operative approaches were addressed in detail. Morning handovers, ward rounds and lectures were complemented by afternoon practical sessions involving physical examination and sawbone exercises. For the first time, trainees were also allocated topics to present, an initiative that was well received by both trainees and faculty.
AO Alliance, under the leadership of Dr Claude Martin, delivered a Faculty Education Training (FET) workshop. The programme began with four weeks of online preparation and culminated in an intensive one-day, in-person session. The workshop strengthened essential skills for planning and delivering eƯective training.
Honiara also hosted the orthopaedic exit examinations for the first time in Solomon Islands. The four candidates were Kevin Lapu from Papua New Guinea; Manoa Valeniyasana and Paul Lomavatu from Fiji; and Robert Fa’ataga from Samoa. Dr Richard Lander and Dr Andreas Loefler conducted the examinations, assisted by Dr Kodovaru and Dr Mauilu. Paul, Manoa, and Robert achieved successful outcomes. Kevin is encouraged to consider another attempt next year.
We sincerely thank the local orthopaedic team, led by Head of Department Dr Patrick Housia, for their warm welcome and support throughout the programme. Their assistance enabled faculty and trainees to participate in morning handovers and access patients in the wards and clinics.We thank the Solomon Islands Ministry of Health and medical services support through the Permanent Secretary Dr Gregory Jilini and the National Referral Hospital management for approving and hosting the modules. We also acknowledge the transport team and kitchen staƯ for providing timely transport and meals for trainees and faculty throughout the two weeks, as well as the Chinese Medical Center and the Radiology Department for making their facilities available for the programme.We thank the National University of Samoa for its overall support and guidance in the delivery of the curriculum, course content, and assessments.
Finally, we gratefully acknowledge the sponsors whose support enabled the modules to be held in Honiara: AO Alliance, South Pacific Projects, the Hans Joerg Wyss Foundation, the World Health Organization (WHO), the Pacific Community (SPC), DFAT, and the World Bank.
My experience of the Introductory and Trauma modules
From L to R Agnes Auto (Solomon Islands), Jesse Vosawale (Fiji), Jacky Pahun (PNG), and Vanua Ilo (Vanuatu)From L to R Ari Ioane (Samoa), Tomasi Tokalauvere (Fiji), Julio Martins (Timor Leste)From L to R Dickson Wak (PNG), Jacky Pahun (PNG)Rear: Oralae Pitaki and Agnes Auto (Solomon Islands) , Front: Ari Ioane (Samoa) and Jacky Pahun (PNG)
Jacky – the PIOA module this year 2026 in Honiara was a highly engaging and valuable learning experience. The teaching component adopted a student-centred approach, with students taking an active role in delivering lectures in accordance with the teaching principles demonstrated and taught to us by Claude from AO. This approach encouraged greater participation, improved understanding, and facilitated retention of the course content. The lectures were delivered according to schedule, and adequate time was allocated for practical sessions and examination practice. The programme was sufficiently well organised that, on several occasions, we were able to progress ahead of the scheduled lectures and practical sessions, allowing additional time for revision and consolidation of knowledge.
Oralae – what I enjoyed most about the Honiara module was learning from my other colleagues through their presentations and also getting to know how they handle cases in their countries with limited resources.
Agnes – since joining the PIOA training programme in 2022, I have gained not only knowledge and skills, but also mentors, colleagues, and lifelong connections across the Pacific and beyond. Through PIOA, I have also been inspired by other women in Orthopaedics and am proud to be part of a growing community of female trainees.
This recent module was one of the best learning experiences I have had. Thank you to PIOA, the facilitators, mentors, lecturers, and fellow trainees for making it so memorable, and for investing in our training and strengthening Orthopaedics across the Pacific.
Rear from left: Dr. Oralae Pitakia (Honiara, Solomon Islands) and Dr. Agnes Auto (Honiara, Solomon Islands) Front from Left: Dr Ari Ioane ( Apia, Samoa) and Dr Jacky Pahun (Lae, PNG)
Ari – I fell in love with orthopedics in my fifth year of medical school. I had completed a few clinical rotations and was still unsure which specialty to pursue when a junior orthopedic registrar took me under his wing. Orthopedics brought together everything I enjoyed: anatomy, physics, and time in theatre. Since then, I have been determined to be part of this speciality because it offers the opportunity to give patients their lives back. We help a 70-year-old grandmother walk again after a hip fracture. A child born with bilateral club feet can run at his school athletics tryouts. To be alive is to be in motion, and orthopaedics gives that to our patients. I am grateful to be part of the PIOA family, which is helping me achieve my dreams and bring motion to my patients.
Jacky – My decision to pursue orthopaedics is also strongly influenced by a personal experience from childhood. I sustained a fracture as a child which, in retrospect, I now understand to have been a supracondylar fracture of the humerus. Unfortunately, the injury was inadequately managed, resulting in a residual gunstock deformity. This experience has had a lasting influence on my commitment to orthopaedic surgery. It has particularly strengthened my desire to improve the management of paediatric fractures and to help ensure that children receive timely, appropriate treatment so that preventable deformities and lifelong functional consequences can be avoided.
Oralae – Firstly, I chose Orthopaedics because it gives me a lot of satisfaction when I see my patients regain function and maintain their quality of life. Secondly, because Orthopaedics in my country is male dominated and I hope to provide representation and inspire other females out there who would one day want to pursue Orthopaedics as their career.
Agnes – my passion for Orthopaedics developed during my 2019 internship at the National Referral Hospital in Honiara. I was inspired by the teamwork, dedication, and commitment to patient care, and seeing patients recover and regain function was priceless. I found myself spending every opportunity I had in Orthopaedics.
Here is a link to a recent journal article reviewing the work of PIOA in developing an orthopaedic service in the small Pacific Island countries.
Special thanks to Philip Lee, Sacha Rovinsky and David Rovinsky for preparing this and persevering with getting it published.
Lee PM, Rovinsky S, Caldwell MJA, Nguyen AT, Snyder EM, Soares D, Mauiliu TS, Samuelu A, Ezaki S, Withy K, Kamal R, Shapiro L, Gosselin RA, Rovinsky D. Expanding Orthopaedic Care Across the Pacific: A Global Health Model Translated Into the Pacific Islands Orthopaedic Association. J Am Acad Orthop Surg Glob Res Rev. 2026 Jul 31;10(8):e26.00088. doi: 10.5435/JAAOSGlobal-D-26-00088. PMID: 42562027; PMCID: PMC13395501.
Dr Hermann Oberli, shared more than three decades of experience building sustainable trauma and orthopaedic care in the Solomon Islands and across the Pacific.
The session brought together clinicians and trainees both in person and online from Australia, New Zealand and Europe. Dr Oberli’s presentation explored the realities of delivering trauma care in low‑resource, geographically dispersed environments, highlighting both the clinical challenges and the long‑term system solutions required for sustainable change.
Dr Oberli outlined the major barriers to trauma care in the Solomon Islands, including delayed patient presentation due to transport limitations, workforce shortages, limited infrastructure, infection risk in open fractures, and scarce diagnostic and surgical resources. Through powerful clinical case examples, he demonstrated how simple, context‑appropriate solutions—rather than high‑cost technology—can significantly improve patient outcomes.
A central theme of the presentation was sustainability. Dr Oberli emphasised that long‑term progress depends on three core pillars:
Infrastructure and appropriate equipment,
Local training and education, and
Data and digital systems to support continuous improvement.
He described the development of locally led orthopaedic training in the Solomon Islands, the establishment of the Pacific Islands Orthopaedic Association (PIOA), and the importance of visiting specialists acting as teachers and mentors rather than primary operators. Many Solomon Islands clinicians trained through these programmes are now consultants and educators, ensuring ongoing local capacity.
The presentation also addressed the role of telemedicine, innovation in low‑cost surgical techniques, and the challenges of data collection and follow‑up in remote settings. Dr Oberli spoke candidly about setbacks and failed projects, reinforcing the importance of adapting to local realities and maintaining long‑term partnerships.
This event offered a rare and compelling insight into global surgery, humanitarian medicine, and the leadership required to create lasting impact in resource‑limited environments.
Three PIOA graduates received their Master of Surgery (Orthopaedics) from the National University of Samoa in Apia on 1 April 2026. Dr Haynes Rasin, Dr Raymond Saulep attended the ceremony in person. Dr Thomas Kiele was uanable to attend but his degree was entrusted to Dr Saulep to hand over.
From L to R : Areta Samuelu (Director of Training PIOA),Raymond Saulep, Haynes Rasin, David Rovinsky (knee instructor from Hawaii)Richard Lander (Chief examiner), Thomas Kiele and Des Soares after exit exams held in Lautoka, Fiji in 2025Steven Kutukana, Areta Samuelu (Director of Training PIOA),Raymond Saulep, Haynes Rasin, David Rovinsky (knee instructor from Hawaii), Dickson Wak and Manoa Valeniyasana.
The Knee module was held from the 21st March to 2 April 2026 at the TTM Hospital in Apia, Samoa and was attended by nine (9) PIOA Trainees namely: Dickson Wak from Papua New Guinea, Steven Kutukana from Solomon Islands, Tzun Rafael from Palau, Vanua Ilo from Vanuatu, Taukoriri Tibriano from Kiribati , Manoa Valeniyasana and Paul Lomavatu from Fiji and Robert Fa’ataga and Michael Leota from Samoa.
This module was successfully facilitated with lectures, saw bone practicals and arthroscopy practical on Virtamed knee arthroscopy simulator by Dr. David Rovinsky from Hawaii, Dr Kaushik Hazratwala from Australia, Dr Desmond Soares from Australia and Dr Shaun Mauiliu and Areta Samuelu from Samoa.
Each morning would start off at 8:00 am with a ward round with a Trainee leading the case presentation. The Trainees present the relevant history and clinical examination findings as elicited with further discussions on the current investigations and management being done. Trainees are then asked to demonstrate how they would do clinical examinations to elicit certain signs and on the rationale for the patient management and treatment being done. Suggestions for further investigations and treatment improvement are then being put forward to the Trainees and the local team. This exercise is very helpful for Trainees in developing their clinical skills and to try and elucidate clinical reasoning which would be helpful in decision making.
Taukoriri Tibriano, Steven Kutukana and Paul Lomavatu practicing examination under the watchful eye of Kosh Hazratwala
At the Knee Module lectures Trainees were taught a systematic approach to history taking, clinical examination and investigation with a focus on common Knee orthopedic and trauma conditions. Most of the topics are also covered in the weekly zoom sessions prior to the modules, hence emphasis are put on the common and core pathologies.
Des Soares instructing Vanua Ilo and Robert Fa’ataga in the knee arthroscopy simulator
Practical sessions were done in the afternoons with Trainees in 3 rotations practicing clinical examinations with live patients with clinical signs, sawbones exercises which covered the common Knee Orthopaedic and trauma case management and an arthroscopy rotation using the Virtamed simulator. The sawbones rotations included: common fractures like patella fracture fixation with tension band wiring, tibial plateau fracture stabilization with spanning external fixation and definitive treatments, ACL and MCL, and LCL graft positioning using rope and screws and high tibial osteotomy, distal femur osteotomy. The arthroscopy station provided guided instruction in triangulation, diagnostic arthroscopy and then simulated arthroscopic knee conditions. The simulator provides a realistic opportunity to develop skills in arthroscopic techniques and triangulation before commencing clinical arthroscopy.
Tzun Rafael, Manoa Valeniyasana and Dickson Wak with the HTO and DFO models
The module was then concluded with a Knee Anatomy, Biomechanics and clinical scenario Quiz and practice Computer viva – 5 cases after which feedback was given to each Trainee.
During the module Dr. Kaushik Hazratwala was able to demonstrate for Dr Samuelu the technique for 1 patient with patella instability and 3 patients needing ACL reconstruction. This will assist the surgeons in Samoa to continue developing the skills to continue providing this this procedure in future.
Front: L to R: Dr Dickson Wak, Dr Hamish Leslie, Dr. Danielle Wadley, Dr Areta Samuelu , Dr Miles Callahan, Dr Steven Kutukana Rear L to R :, Taukoriri Tibriano, Robert Fa’ataga, Vanua Ilo, Manoa Valeniyasana, Tzun Rafael , Michael Leota and Paul Lomavatu .
The Foot and Ankle module was held from the 16th to 20th March 2026 at the TTM Hospital in Apia, Samoa and was attended by nine (9) PIOA Trainees namely: Dickson Wak from Papua New Guinea, Steven Kutukana from Solomon Islands, Tzun Rafael from Palau, Vanua Ilo from Vanuatu, Taukoriri Tibriano from Kiribati , Manoa Valeniyasana and Paul Lomavatu from Fiji and Robert Fa’ataga and Michael Leota from Samoa
This module was successfully facilitated with lectures and saw bone practicals by: Dr Hamish Leslie from New Zealand, Dr Miles Callahan and Dr. Danielle Wadley from Australia and Dr Areta Samuelu and Dr Shaun Mauiliu from Samoa.
Each morning would start off at 8:00 am with a ward round with a Trainee leading the case presentation. The Trainees present the relevant history and clinical examination findings as elicited with further discussions on the current investigations and management being done. Trainees are then asked to demonstrate how they would do clinical examinations to elicit certain signs and on the rationale for the patient management / treatment being done. Suggestions for further investigations and treatment improvement are then being put forward to the Trainees and the local team. This exercise is very helpful for Trainees in developing their clinical skills and to try and elucidate clinical reasoning which would be helpful in decision making.
Lectures at the Foot and Ankle Module were focused on systematic approach to history taking, clinical examination, investigation and management on common Foot and ankle orthopedic and trauma conditions. Some topics were covered in the weekly zoom sessions prior to the modules, however common important pathologies were revisited and emphasis reiterated.
Practical sessions were mostly done in the afternoons with Trainees in pairs which covering the common Foot and Ankle Orthopaedic and trauma case management including: ankle spanning external fixator application for distal tibia fracture, ankle fracture plate/screw fixation, ankle fracture Plaster of Paris application and tibial plafond plate/ screws fixation.
The module was then concluded with a Foot and Ankle Quiz after which feedback was given to each Trainee.
During the module Dr. Hamish Leslie was able to assist Dr Samuelu to perform complex surgery on two patients with residual club foot deformity. This will assist the surgeons in Samoa to continue providing this procedure in future.
