Harvard Hand/Upper Extremity Fellowship

2018-19 Fellowship

The Harvard Hand/Upper Extremity Surgery Fellowship is under the supervision of Phillip E. Blazar, M.D., and includes several institutions and staff members. The major fellowship time is spent at Brigham and Women’s Hospital and Children’s Hospital. In addition, outpatient care and/or operative experience is provided at the Children's Hospital Waltham, BWH Foxborough and Brigham and Women's Faulkner Hospital, a community hospital nearby. There is a two-month cross-rotation with the fellowship at Massachusetts General Hospital.

The fellowship period is twelve months commencing August 1. Three positions are offered. The fellowship is oriented toward those wishing to make a significant commitment to treatment of problems of the hand and upper extremity.

The staff believes that a good fellowship experience requires both supervision and independence. Initially, the fellows are closely supervised, with faculty assistance in all operative situations. As the fellows’ experience and knowledge increases they are given greater independence, but with a faculty member available for consultation at all times. This approach has resulted in excellent patient care, an outstanding educational experience, and camaraderie among all members of the service.

Additional Information

Fellowship Faculty

The attending staff is Barry P. Simmons, Philip E. Blazar, Brandon E. Earp, George S. Dyer and Arnold Alqueza at Brigham and Women’s Hospital and Peter M. Waters, Donald S. Bae, Andrea Bauer and Carley Vuillermin at Children’s Hospital. At MGH fellows work with Jesse B. Jupiter, Sang-Gil Lee, Chaitanya Mudgal, Neal Chen and Kyle Eberlin.

Hand Surgery Fellows’ Responsibilities

The Hand Surgery Fellow is, with the assistance of the residents rotating on that service, responsible for running his/her own service. He/she is given junior staff privileges at Brigham and Women's Hospital and Brigham and Women's Faulkner Hospitals and can be given independent responsibility, with the advice of the faculty, depending on experience.

The Hand Surgery Service covers the emergency room at the Brigham and Women’s and Children’s Hospitals simultaneously, alternating on a weekly basis with the Plastic Surgery Service. One of three fellows is at Children's Hospital and two of the fellows are at the adult institutions during any given day.

As for the operative responsibilities, besides her/his own patients, the fellow and resident are responsible for assisting the faculty. Often more than one staff physician will need assistance, and the fellows and residents will arrange the coverage.

Our fellowship is ACGME accredited. The fellows are required to keep track of their clinical and operative cases in the ACGME database. Duty hours are also mandated to be recorded.

Patient Sources

As mentioned, the Hand Surgery Service is responsible for emergency room coverage and this is the source of most of the trauma and microsurgery. The clinics and fellow’s office are sources for elective referrals and follow-up care. This is a significant source of exposure to hand an upper extremity problems and an opportunity to manage the long term care and sequelae of these injuries and problems.

At Children’s Hospital the fellows see the spectrum of disorders in the pediatric upper extremity. These include trauma, post-traumatic reconstruction, arthritis, brachial plexus injuries, reconstruction, free tissue transfers and a wide-breadth of congenital deformities. Brigham & Women’s is a well-known arthritis hospital and generates a large amount of reconstructive surgery in the arthritic upper extremity. This includes not only the more common osteoarthritis but also rheumatoid arthritis, lupus, scleroderma, psoriatic arthritis, etc. This is the source for the multiple patients requiring total joints, including not only hand and wrist but also elbow and shoulder.

Besides these specialty areas the offices generate most of the routine problems of the hand and upper extremity seen in practice. These include common problems about the shoulder and elbow, nerve entrapments, post-traumatic reconstruction, wrist problems, Dupuytren’s disease, repetitive trauma syndromes, the injured worker, etc.

The outpatient experience is extensive including the clinic and private offices, both at the adult institutions and Children's Hospital.

A close liaison exists with the Plastic Surgery Service. Their staff is especially experienced in microsurgery, including free tissue transfers. As time and reponsibility allows, the Hand Surgery Fellows are encouraged to participate in those cases and patient care.

The Massachusetts General Hospital has the busiest emergency room in the state, and besides a broad spectrum of upper extremity cases, there is an emphasis on both acute trauma and post-traumatic reconstruction.

Besides these specialty areas the offices generate most of the routine problems of the hand and upper extremity seen in practice. These include common problems about the shoulder and elbow, nerve entrapments, post-traumatic reconstruction, wrist problems, Dupuytren’s disease, repetitive trauma syndromes, the injured worker, etc.

The outpatient experience is extensive including the clinic and private offices, both at the adult institutions and Children's Hospital.

Conferences & Research
  1. “Classics” Journal Club
    An informal conference led by the Program Director discussing 5-12 classic articles focusing on one topic per session on a 52-week schedule.

  2. Selected Readings in Pediatric Hand Surgery
    Biweekly conference includes readings from the "classic" literature and current textbooks.

  3. Adult Residents Hand and Upper Extremity Conference
    Weekly conference includes a preselected curriculum and case-based discussion given by the house staff on the service.

  4. Anatomy
    Advanced hand and upper extremity anatomy is explored in detail in this conference with dissection of fresh frozen cadavers and directed bibliography. Presentations and prosection are the responsibility of a resident/fellow team.

  5. Indications Conference
    This weekly conference explores one or two cases in detail. Cases are chosen from the fellow clinics and faculty practices.

  6. Journal Club
    Journal club occurs monthly and meets in conjunction with other Boston hand fellowship programs and faculty.

Other conferences that the fellow is encouraged to attend include Orthopedic Grand Rounds and the monthly department M&M conference.

Before the beginning of the academic year the fellows are required to complete a microsurgical course. There is a microsurgery laboratory available in the plastic surgery department. Laboratories are also available for research in biomechanics, cartilage repair and synovium metabolism if the fellows wish. Any other research project that the fellow would like to pursue would be encouraged. The facilities of Harvard Medical School are across the street.

During his/her tenure the fellow will be expected to complete a research project and paper of his/her choosing. This could be either in basic science or a clinical area. Time is left during the fellows rotations for these projects.

Each fellow is supported for two courses yearly, one locally and one nationally.

Salary and Benefits

The fellows are employed by the Brigham and Women’s Hospital. The salary is commensurate with the level of training, usually PGY 6. Benefits include malpractice insurance, health insurance, disability insurance, parking, computers, an office and administrative support. A business office is available to allow the fellows to become acquainted with the business aspects of medicine including CPT coding, running an office, dealing with insurance carriers and managed care.

The Selection Process

This fellowship participates in the “Combined Musculoskeletal Matching Program (CMSMP)” run by the National Resident Matching Program. Inquiries and registration should be directed to the National Resident Matching Program, 2121 K Street, N.W., Suite 1000, Washington, DC 20037-1141. Telephone: Local (202) 400-2233, Toll Free 866-653-NRMP (6767), support@nrmp.org.

Prospective applicants should apply via ASSH online application system.

The match date is May 23, 2018 and the rank order lists are due approximately three weeks earlier. Interviews are by invitation. Given the upper extremity focus of the fellowship, orthopaedic residency training is required. Applicants are required to submit their applications via the ASSH portal by the November 15th deadline. The Universal Hand Surgery Application form is preferred. Additionally, we require copies of applicant’s CV, medical school transcript, Dean’s letter and three letters of recommendation, including one from your Chairman. Formal interview days are then scheduled. An attempt will be made to coordinate interview days with other geographically local programs.

For additional information please see our FAQ page or contact:

Angela Singleton-Scott
Harvard Hand Fellowship Coordinator
Brigham and Women's Hospital
Department of Orthopedics
75 Francis Street
Boston, MA 02115
Phone: 617-732-5384
Fax: 617-730-2818
email: asingletonscott@partners.org

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