Curriculum and Clinical Experiences

As a fellow, you will initially see patients one on one with the attending physician. This serves as an opportunity to learn appropriate clinician-patient interaction skills and to become proficient in the diagnosis of upper extremity related disorders and trauma.

As the year progresses, you will begin to develop your own patient base. Although the attending will ultimately be responsible for these patients, as a fellow you will take primary responsibility for their care. You are expected to treat these patients as your own, be able to make the appropriate diagnosis, develop a comprehensive treatment program, schedule the necessary intervention, perform the surgery, follow the patient post-operatively, manage complications and ultimately see the patient through to recovery. You will also direct the patient’s physical and/or occupational hand therapy.

Duties in the operating room, such as the clinic, will increase as the year progresses. At first, you will assist the attending, learning by both observation and hands-on experience. As you become competent to perform a particular procedure, you will perform these surgeries on your own with the attending acting as the assistant. Finally, as your surgical skills and confidence improve, you will perform certain surgeries on your own, with the attending observing and intervening only when necessary.

This arrangement of gradually increasing responsibility is designed to transition the fellow from the level of a chief resident to the level of a highly competent hand and upper extremity surgeon. As a fellow, your level of autonomy will increase throughout the year, but you will never go unsupervised. The amount of direct attending intervention is according to the individual skill level of the fellow. An attending will always be immediately available in both the clinic and operating room setting for you. Also, all surgical cases will be discussed prior to surgery at the weekly “Indications Conference.”

Call Schedule

The work week includes two days of clinic, two days of surgery, and one educational day.  Call is one to two days a week and one to two weekends per month for upper extremity emergencies. Occasional additional general Orthopedic call may be arranged for additional income if desired.

Inpatient duties are limited to the appropriate post-operative care of your patients requiring in-patient surgery. These cases will be relatively uncommon, as most upper extremity patients at our institution are treated on an outpatient basis. However, as a fellow, you will have inpatient cases, such as hand infections and shoulder trauma, and will make inpatient rounds while on call.