The Fellowship Directors Task Force is a forum where current fellowship directors meet to discuss concerns and share ideas on issues as diverse as funding, curriculum, certification and candidate matching.
The establishment of the Certificate of Added Qualifications in Hand Surgery in 1989 and the required completion of one year of specialized hand training led to a standardization and accreditation of Hand fellowships under the ACGME (Accreditation Council for Graduate Medical Education). Hand fellowships are now held to the same requirements as residency training programs.
Fellows are evaluated based on the six core competences: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice. The precise definitions of these can be found in the
ACGME 2012 Standards NEJM Report on the ACGME website. Other criteria include: fellow case logs, duty hours (duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities) and a comprehensive curricula with specified conferences.
There are currently 70 accredited fellowships with 130 positions. More than 90 percent (approximately 500) of graduating Orthopaedic residents now complete fellowship training in order to obtain the additional education and experience needed to become subspecialists. Eighteen percent of them applied to Hand in 2011. The percentage of Plastic and General residents who apply to Hand is not available, but Hand fellowship continues to attract significant numbers from both disciplines.
In the Hand candidate pool, we are now getting some of the best and brightest of the Orthopaedic and Plastic residents. This is due in part to the success of the Lending a Hand program and a conscious effort by many ASSH members to reach out to residents.
The Hand fellowship match under the National Residency Match Program continues to be strong and is seen as a poster child for the specialty match process. While the final numbers for 2012 are not in, it seems there were about 180 candidates for the 131 positions in 2013-14. There were a high number of unmatched candidates, many of whom were highly rated.
Hand fellowship funding continues to be handled locally by each program, but I believe it will become an issue in the future as educational funding dries up. Unlike the large Joint, Spine and Sports programs, Hand fellowships have never enjoyed wide industry support. Now that the majority of the educational grant money is doled out by the AOA grant program, Hand is still not an equal participant. Most fellowship directors feel their financial funding is stable for the next two years. It is after that period I would anticipate a cinch point.
Last year, the ASSH piloted a two-year Upper Extremity fellowship program to include a second integrated year of concentrated study in such areas as Shoulder/Elbow, Pediatric Upper Extremity, Research, Nerve Reconstruction and Microsurgery. Grants from the ASSH/AFSH partially funded the second year. The selected institutions were: Columbia University, Stanford University, The Philadelphia Hand Center and The Cleveland Clinic. The first recipients will begin their Hand fellowship in 2013. This exciting new educational pathway will hopefully lead to the development of talented experts who further the goals of Hand and Upper Extremity surgery. This program and efforts like the SHUEHORN curriculum emphasize just how critical and just how important the ASSH considers the role of Hand fellowship training.
Finally, the fellowship directors are participating in a task force headed by Charles Goldfarb, MD to determine why all fellowship-trained hand surgeons do not take the CAQ and then join the ASSH. We can report nearly 100% compliance by the fellowship directors in providing the names of their trainees.
Hand fellowship training is the bedrock of involvement and continuity in our specialty. As such, I hope each ASSH member will take the opportunity to teach. To quote G.K. Chesterson: "Education is simply the soul of a society as it passes from one generation to another."
A. Lee Osterman, MD
Chair, Fellowship Directors Task Force
LAST CHANCE! Today is Final Day to Register for Annual Meeting
In 2011, the ASSH introduced a free mobile app for the Annual Meeting, and over half the attendees used the app as their convenient Annual Meeting guide/planner.
Once again this year, the Hand Society is providing attendees with a
mobile app for the Annual Meeting. The app, which contains all the contents of the Annual Meeting Program, Abstract Book and handouts and does not require an Internet connection, is available on both the Apple (iPhone and iPad) and Android platforms.
For your convenience, the ASSH mobile-optimized the
Annual Meeting website this year. However, those who download the mobile app through the App Store (iOS devices) or Google Play (Android devices) will enjoy greater functionality than those who use the mobile website.
When you download the app to your device, you can:
- Browse a list of all sessions and speakers
- View the entire schedule of Annual Meeting activities
- Search for any piece of information regarding the Annual Meeting program, abstracts or exhibitors
- Create your own personal schedule inside the mobile app – and export it to your device calendar
- Take notes on any session in the app and email them to yourself
- Access handouts
- See all convention center maps
- Find speaker information
- And more
Download the app now. Updates will be forthcoming in Weekly Member Update and via email for those who are registered for the Annual Meeting.
| Never |
30% |
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49% |
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9% |
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11% |
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85% |
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15% |
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32% |
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34% |
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21% |
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13% |
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New Release: 'Tendon Transfer Surgery of the Upper Extremity: A Master Skills Publication'
The latest addition to the highly popular Master Skills series provides the surgeon with a solid foundation not only to identify patients who might benefit from tendon transfer, but also to tailor surgery to the specific needs of each patient.
Edited by Ann Van Heest, MD and Charles A. Goldfarb, MD, this textbook also provides key information for students, residents, and fellows first learning about tendon transfers, as well as experienced surgeons or therapists advancing their knowledge and surgical technique for tendon transfer surgery.