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Hand Surgery

At A Glance

Program Type: Military Medical Center

Location: Bethesda, MD

Accredited: Yes, Accreditation Council for Graduate Medical Education (ACGME)

Program Length: 1 year

Required Pre-Requisite Training: Orthopedic Residency Program PGY5 level with approval

Categorical Year in Specialty Required: No

Total Approved Complement: 2

Approved per Year (if applicable): N/A

Dedicated Research Year Offered: No

Medical Student Rotation Availability: No

Additional Degree Concurrent with Training (e.g. MPH): No

Program Description

The Walter Reed Hand Surgery Fellowship is one of only two orthopaedic fellowships in the U.S. military. This 12-month program trains two fellows per year, and is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME). Both fellowships begin on August 1 of the year of their academic hand surgery fellowship appointment.

Six months of training occurs at the Union Memorial Hospital Curtis National Hand Center in Baltimore, Maryland, under the direct supervision of over a dozen experienced hand surgeons with orthopaedic and plastic surgery backgrounds. During this portion of the year, the Walter Reed National Military Medical Center (WRNMMC) fellowship trains amongst the Union Memorial hand surgery fellows. The eclectic combination of surgeons, fellows, hand therapists, and patients makes the experience truly unique and broadens the fellow’s repertoire of surgical technique and philosophy.

The hand surgery fellow spends the next six months at the WRNMMC a worldwide tertiary referral center for conditions of the upper extremity. The hand surgery fellow participates in orthopaedic resident education through direct supervision of residents and by providing didactic lectures on care of the upper extremity. The WRNMMC fellow is the focal point in the planning and performing of all hand surgery activities at WRNMMC. The fellow also performs surgery with WRNMMC hand surgery faculty at two outpatient surgery facilities. During this six month rotation, one day a week is typically spent at Fairfax Hospital of Virginia and Childrens' National Medical Center in Washington, D.C. to broaden the fellow experience in treatment of pediatric and congenital differences of the upper extremity. This experience is under the direction of board certified hand surgeons with pediatric hand surgery training.

The WRNMMC hand surgery fellow is exposed to the full breadth of hand pathology, including complex war and industrial injuries, acute high- and low-energy trauma, post-traumatic conditions, congenital differences, disorders from repetitive motion and overuse, and arthritic deformities.

Mission, Vision and Aims

Mission

The mission of the NCC Fellowship is to train and provide the Army and Navy with world class Hand Surgeons who will become leaders in the sub-surgical specialty and have been trained in the necessary specific skills taken from the fields of Orthopaedic Surgery, Neurosurgery, Vascular Surgery and Plastic Surgery to identify, treat and restore patients who have medical and surgical conditions specific to the field of Hand Surgery.

Vision

The Department of Orthopaedics is dedicated to relieving pain, improving function, and restoring quality of life to the individuals who suffer from musculoskeletal injury or disease.

"Empowering the next generation of Hand surgeons, our Fellowship program envisions a future where excellence in patient care, groundbreaking research, and unparalleled training converge. We strive to be at the forefront of Hand education, fostering a collaborative and innovative environment that nurtures the development of compassionate, skilled professionals. With a commitment to advancing the boundaries of Hand knowledge and providing exceptional patient-centered care, our vision is to be recognized as a premier destination for aspiring hand surgeons educated to making a lasting impact on the field and the lives of those we serve."

Aims

Prepare physicians to independently practice.
Develop fellows graduates to successfully pass the the Hand certification training exam.
Develop military officers proficient in military health readiness.
Foster opportunities for residents to pursue their individual research interests during their training.
Demonstrate knowledge of established operative and non-operative care, and the application of this knowledge to patient care.

Curriculum and Schedules

An intricate didactic schedule while at Union Memorial is in place in which there is a formal didactic event on nearly every calendar day. While at WRNMMC, the didactics include:

An indication conference once weekly.
A journal club once weekly on a topic selected by the fellow based upon their interest
A hand surgery education conference once weekly.
These above weekly conferences are supplemented by anatomical dissections at least once monthly.

Fellows will complete the following rotations:

Six months WRNMMC: Hand Trauma, Microvascular Training, General Hand Practice, and Arthroscopy
Six months Union Memorial Hospital: Hand Trauma, Microvascular Training, General Hand Practice, Arthroscopy, and Replant Surgery

In our one year program, there are no elective rotations available.

Fellows take call while at WRNMMC one time per week.

There is a daily education conference at 6:30 a.m. in which all medically evacuated patients are presented and discussed. This conference serves as the main focus for military specific education as all levels of evacuation and the care at each level are discussed. Indications for advanced surgical procedures and at which level of care are all discussed at this conference.

The microsurgery course is an elective depending upon the fellow’s microsurgical experience and comfort level.

One time monthly a leadership journal club takes place.

Scholarly and Professional Development Opportunities

There is extensive ongoing research and each fellow engages in at least one project in which a presentation and eventual publication is expected.

One quality improvement project is always underway in the hand surgery department and the fellows are routinely involved in this effort.

Participating Sites

Walter Reed National Military Medical Center
Union Memorial Hospital
Children's National Hospital
Inova Fairfax Medical Campus

Applicant Information, Rotation and Interview Opportunities

As a fellowship, we do not offer rotation opportunities, however, applicants are welcome to contact us via email for more information about our program, dha.ncr.walter-reed-med-ctr.list.ncc-handsurg@health.mil.

Applicants are encouraged to contact our program via email for an interview, dha.ncr.walter-reed-med-ctr.list.ncc-handsurg@health.mil.

Program graduates take the Hand certificate of added qualification after completing their hand surgery fellowship. This exam is offered annually. Additional details include:

The Subspecialty Certificate in Orthopaedic Surgery of the Hand is for Board-Certified orthopaedic surgeons who have demonstrated qualifications in hand surgery beyond those expected of other orthopaedic surgeons by virtue of additional training and a practice characterized by volume and diversity of cases in hand surgery or have made significant contributions to this field.
The examination is developed and administered by the Joint Committee on Surgery of the Hand of the American Boards of Orthopaedic Surgery, Plastic Surgery, and Surgery.
Applicants must have completed a one year ACGME accredited fellowship in surgery of the hand to qualify. In addition, a one year case list must be submitted which meets the required number of cases in five of nine categories.
Applications are available online each September and the examination is given the following August by computer at Pearson Vue Test Centers nationwide. This is a four hour examination consisting of 175 multiple-choice questions designed to evaluate the candidate’s cognitive knowledge relevant to surgery of the hand.
Candidates who have met all the requirements and have passed the examination will receive a Subspecialty Certificate in Surgery of the Hand issued by the American Board of Orthopaedic Surgery. This Subspecialty Certificate will be valid through the expiration of the Diplomate’s General Certificate. After receiving the Subspecialty Certificate, it is highly recommended that Diplomates take a combined examination when the Certificates expire, so they will be recertifying both Certificates with one examination.

Teaching Opportunities

The fellows are very involved in the education of the residents and medical students both during didactics and during the operative procedures. This is both an expectation and a real reward for the engaged fellow.

Fellows are encouraged to attend departmental journal clubs, other educational opportunities and may help in the anatomy lab with the medical students.

Faculty

Orthopaedic surgery- hand surgery fellowship and advanced microsurgical training.
Plastic surgery- hand surgery fellowship and advanced microsurgical training.

Well-Being

The hand surgery fellowship at Walter Reed encourages fellows to spend time on their well-being. We have initiated a later start for practice on Thursday mornings so that fellows can rest/exercise before beginning the day. Additionally, we have an open door policy for all to ensure that we address any psychosocial well-being needs.