This fellowship is accredited by the ACGME as a post-graduate 12-month fellowship open to applicants who have completed their orthopedic or plastic surgery residency training. The fellowship begins August 1st to allow time to prepare for and complete the orthopedic board examination in July.

Through clinical and research excellence, our well-regarded training program has remained at the forefront of the subspecialty. We are interested in applicants from diverse backgrounds with unique experiences who display technical and intellectual talents. All applicants will be considered based on merit.

The Hand & Upper Extremity Surgery deals with all aspects of the upper extremity, including disorders of bones, joints, ligaments, tendons, nerves, vessels, skin, and soft tissue from the shoulder to the fingertips. Our educational program is designed to educate physicians in the art and science of hand and upper extremity surgery and to develop competent clinicians and surgeons in preparation for independent practice. The fellowship embraces total care of the hand and upper extremity.

The goal of our educational program is to foster a thoughtful approach to the diagnosis and treatment of hand and upper extremity disorders. The teaching staff provides instruction and supervision to the fellows in a variety of forums including the National Hand Specialists office, operating room, rehabilitation unit, conferences, journal club, anatomy lab, STAT Laboratory and Microsurgical Laboratory. Approximately 4,500 surgical procedures are performed annually, which provide the fellow an opportunity to participate in every aspect of hand and upper extremity reconstruction.

Responsibilities

The responsibilities of the fellows are broad. Each fellow will benefit from clinical rotations and time in the laboratories. Each fellow is expected to complete at least one research project with a faculty member as a sponsor/mentor that will be suitable for presentation and/or publication. Grant funding is available for these projects through the Hand Research Committee. We have an active teaching schedule with clinical, surgical, and laboratory teaching. Surgical procedures of the week are discussed at a weekly conference which includes case presentations. There is a monthly Congenital Clinic and Journal Club. Fellows will attend national and local courses on hand surgery. Fellows are actively involved with resident education. Clinical responsibilities include patient clinics (two days per week) and surgery (two or three days per week).

Clinical Rotations

The Hand Service is arranged into five teams and the fellows will spend two months on each team. The Fellow is assigned to a team with a resident and several attending physicians. Each fellow will also spend one month at the Children’s Hospital of Philadelphia (CHOP) to enhance the congenital experience.

Research

Ongoing clinical research takes place throughout the year.

Call

Each fellow takes call. The fellows take second call for the emergency room for hand and upper extremity trauma. The Hand Service has four Physician Assistants, three of which carry the first call pager Monday through Friday during the day and on Tuesday and Thursday until 8:30 pm. The first call pager is then passed to the resident on call for the day. Residents from Georgetown, Johns Hopkins, MedStar Union Memorial and residents on an elective rotation from various institutions take first call. Second call is taken by the fellow and third call is taken by the attending. For the first three months of the fellowship all surgical cases, including those that come in during a fellow’s on-call period, are staffed by one of the attending surgeons. An attending surgeon must be present for at least a portion of every surgery that the fellow performs. After the initial 3 months the hand center’s Clinical Competency Committee meets in late October to determine if the fellows have graduated to the point where they are prepared to have independent operating privileges, with the understanding that the attending staff is available for further advice and assistance as needed.

Vacation

Each fellow is allocated four weeks of vacation during their one-year training. Vacation may be taken in conjunction with, but not in addition to, specialty meetings and national hand surgery courses. Prior approval must be arranged with the Site Coordinator for GME to ensure adequate clinic, OR, and call coverage.

Performance feedback

Each fellow will spend two months on team. A written performance evaluation is completed for each team rotation by an assigned member of the faculty. Mid-term and year-end evaluations are completed by the Program Director. The fellow will complete a program evaluation and faculty evaluations mid-term and year-end. 360 degree behavioral and technical assessments are completed quarterly by nursing staff from the OR, floor and ED, physician assistants, therapists, clinic staff, and therapists. The mid-term meeting with the Program Director is to ensure that goals and expectations are being met and to provide performance feedback and guidance.