About Our Upper Extremity Microsurgery Fellowship
The Hand and Microsurgery Fellowship at BIDMC is a one-year ACGME post-residency fellowship training program. The goal of the fellowship is to train fellows in the art and science of upper extremity pathology and surgery. It has been in existence since the early 1990’s. In the academic year 2020/2021, this fellowship will also formally merge with the Orthopedic Fellowship to become one BIDMC Combined Ortho-Plastic Surgery Hand Fellowship Program, with a full complement of 3 hand fellows. Currently, the two fellowships are already moving to a full integration, sharing the same faculty, didactics and rotations. As part of the fellowship experience, fellows have the opportunity to work with hand attending faculty from BIDMC, Atrius/New England Baptist Hospital, Boston Children's Hospital, and the Shriners Hospital for Children in Boston.
Fellows spend dedicated time on the hand plastic surgery service, as well as the orthopedic service. OR cases and clinic experience is available at the New England Baptist Hospital.
The program begins on July 1st and concludes on June 30 of the following year. With the formal merger in 2020-2021, the program will start on August 1 and end on July 31. The program participates in the National Residency Match Program, and it is highly competitive. Interested applications should submit their applications to the American Society for Surgery of the Hand (ASSH). Follow the instructions on their website.
Eligibility
Any resident who has completed a plastic, orthopedic, or general surgery residency program is eligible for the fellowship. The final applicant must be eligible to obtain a medical license in the Commonwealth of Massachusetts and meet all of the credentialing criteria of the BIDMC.
Program Goals
The goal of the Hand and Microsurgery Fellowship is to train fellows in the art and science of upper extremity pathology and surgery. The fellowship provides comprehensive training in the medical treatment of the upper extremity. It helps the trainee to refine his/her competence and to demonstrate proficiency in the preoperative, operative, and postoperative management of all types of hand surgery including innovative microsurgical approaches and techniques, wrist arthroscopies, wrist and hand arthroplasties, acute trauma, bony and soft tissue reconstruction procedures, and minimally invasive hand surgery.
Hand fellows are responsible for the care of patients with a wide range of degenerative, traumatic, idiopathic, and congenital and microvascular conditions of the upper extremity. Through close supervision and progressive responsibility, fellows are taught the necessary diagnostic, clinical judgment, and technical skills to carry out a complete range of medical and surgical treatment for the upper extremity. They are also taught to be compassionate and to effectively communicate with patients and their families, observing the highest level of ethics in all of their professional relations.
In this program, the fellows obtain extensive experience in the treatment of pediatric hand surgery, as well as congenital anomalies. Basic and fundamental surgical principles are emphasized as a way to address the most complex surgical problems. Throughout the year, there is an emphasis upon the importance of surgical planning and assessment. Complex cases are analyzed through multitude of approaches. Tri-dimensional and creative thinking, as well rigorous technical aspects of microsurgery are taught.
Clinical Rotations
BIDMC Hand Fellows rotate in a multitude of surgical and ambulatory settings, all of which expand the fellows experience in hand surgery. Throughout the year, the fellow rotates on the following services:
- Adult Hand Plastic Surgery, Beth Israel Deaconess Medical Center & Affiliates
- Adult Hand Orthopedic Surgery, Beth Israel Deaconess Medical Center
- Pediatric Surgery, Boston Children's Hospital
- Pediatric and Burn Surgery, Shriner's Burns Hospital
- Orthopedic Hand Elective Surgeries, New England Baptist Hospital
By spending dedicated time on both orthopedic and plastics surgery, working under the supervision of diverse faculty, as well rotating in a multitude of settings, fellows obtain exposure to a broad range of cases, from the most common to the most complex. Throughout the year, fellows learn diverse approaches in treating problems of the hand. This integrative approach results in better care of patients, better trained hand surgeons, and more innovative approaches in the medical treatment of the upper extremity.
Fellow Responsibilities
Fellows are responsible for covering cases in the ER, OR, as well as in private clinics and a weekly trauma clinic. In the trauma clinic, fellows treat patients referred from the ER. Depending upon the rotation, the fellow spends three to four days per week in the operating room. The fellows spend at least a day per week in the ambulatory setting, participating in clinics of the attending faculty, as well as a trauma clinic. They also participate with hand attending surgeons in hand call. Fellows consult and treat patients referred from the ER, plan and perform surgery and then follow-up with the patients throughout the year in the weekly clinic. Their weekly clinic experiences also allow for an in depth, year-long experience in the continuity of care for patients. They also see patients and also serve as teachers and mentors to residents and medical students.
Some of the cases seen in the trauma clinic, as well as from the cases of the attending surgeons, are re-evaluated during the Thursday Hand Surgical Indications Conference. At the conference, anatomy, diagnosis, operative planning and surgical techniques are emphasized. Rehabilitation and occupational therapy are also a priority. In this conference, fellows learn different perspectives and approaches to hand surgery.
Program Didactics and Research
The Hand/Microsurgery Fellowship offers a wealth of resources and learning opportunities. In addition to attending a weekly Hand Surgery Indications Conference, fellows also participate in a weekly Core Hand Curriculum, which also incorporates classic articles and current literature review. While on the Plastic Surgery Rotation, the fellow participates in the didactic meetings and M&M of the Division of Plastic Surgery. He can also attend the Vascular Anomalies Conference at Children's Hospital. When on the Orthopedic Service, fellows attend the Orthopedic Grand Rounds and M&M. Monthly, the fellow attends a city-wide Hand Journal Club attended by fellows and faculty from the BIDMC, Brigham and Women's Hospital, Children's Hospital and the Massachusetts General Hospital. Once or twice a year, a hand dissection/cadaver lab is also offered.
While on plastic surgery, fellows are required to give an hour long hand conference once a month. While on orthopedics, fellows are responsible for organizing a weekly Hand Surgical Indications Conference. The fellow is expected to be a mentor to junior residents and medical students. He/She will also be required to give a year-end presentation on the fellowship year.
Throughout the year, fellows are encouraged to develop research projects and to participate with faculty in their ongoing clinical research endeavors. Public presentations and the writing of abstracts, original articles, and books chapters are highly encouraged. All of the hand faculty are dedicated to clinical research and have ongoing projects in which the fellow can participate.
Faculty and Fellows
Program Director
Joseph Upton, MD (Plastic Surgery)
Other Faculty
Martin Dolan, MD (Orthopedic Surgery)
Arriyan S. Dowlatshahi, MD (Plastic Surgery)
Carl Harper, MD (Orthopedic Surgery)
Peter Kim, MD (Plastic Surgery)
Tamara Rozental, MD (Orthopedic Surgery)
Amir Taghinia, MD (Plastic Surgery)
Fellows
2018-2019: Elizabeth Baca, MD (Michigan State Plastic Surgery Residency Program)
2019-2020: David Colen, MD (University of Pennsylvania Plastic Surgery Residency Program)
