Fellowship Information
Tufts Medical Center
New England Baptist Hospital
Newton Wellesley Hospital
Fellowship Information
If you have any questions regarding the Tufts Combined Hand Surgery Fellowship, please contact our Education Coordinator, Jane Dolph, at 617-636-5172 or jdolph@tufts-nemc.org.
Address all correspondence to:
Charles Cassidy, MD
Program Director, Tufts Hand Fellowship
Tufts Medical Center
800 Washington Street Box #26
Boston, MA 02111
Program Directors: Charles Cassidy, MD, and Andrew Terrono, MD
The Tufts Combined Hand Surgery Fellowship consists of six hand surgeons working at four hospitals. The hospitals include Tufts Medical Center, a tertiary care Tufts University School of Medicine hospital, two community hospitals (Newton Wellesley and St. Elizabeth's) and one orthopaedic hospital (New England Baptist). Dr. Chuck Cassidy and Dr. Joseph Izzi are in charge of education at the Tufts Medical Center. Dr. Paul Feldon is in charge of education at the Newton Wellesley Hospital and St. Elizabeth's Hospital. Dr. Edward Nalebuff, Dr. Andrew Terrono and Dr. Hervey Kimball are in charge of education at the New England Baptist Hospital.
There are two hand fellows in the program each year both starting Aug. 1 and completing their training July 31. Each fellow has the same rotation: six months at Tufts Medical Center with Drs. Cassidy and Ruby and then six months at Newton Wellesley Hospital, St. Elizabeth's Hospital and New England Baptist Hospital with Drs. Nalebuff, Terrono, Feldon and Kimball.
The formal education curriculum includes a weekly hand surgery conference at Tufts Medical Center. In addition, once a month we meet at one of the attending's homes to review interesting cases and to discuss journal articles. This conference is quite popular, and is frequently attended as well by former fellows and community hand surgeons. We also have a monthly conference to review less common hand topics such as tendon transfers, and brachial plexus injuries. This past year there were 470 surgical procedures performed by each hand fellow.
The hand fellow is paid at the rate of $59,900/year. We provide a one week course in microsurgery for each fellow.
Tufts Medical Center
Tufts Medical Center is the tertiary care facility for the Tufts University Affiliated Hospitals in the New England area. This is a 240-bed university hospital which includes 60 pediatric beds. A large variety of uncommon hand and upper extremity problems are treated by the staff and by the fellow. These include acute and chronic trauma cases, congenital anomalies, tumors, arthritis, arthroscopy, joint replacement and some micro-surgical cases. The fellow is expected to assume primary responsibility for the Hand Clinic patients at Tufts Medical Center. In addition, the fellow works closely with the senior staff at Tufts Medical Center assisting them both in the operating room and in the outpatient setting. There is a senior orthopaedic resident assigned to the hand service.
Senior staff perform more than 1,000 surgical procedures each year. There are 10,000 outpatient visits, including the 1,000 seen by the hand fellow.
In addition to the clinical experience, there are weekly hand surgical rounds. A gross anatomy lab, a pathology lab and a bioskills lab are available. An outstanding OT department is located on the clinic floor. Clinical and basic science research are strongly encouraged.
The Tufts Medical Center experience is designed to provide the fellow with a pre-practice opportunity to exercise judgment, as well as technical and teaching skills. Senior staff consultation is always readily available on site.
New England Baptist Hospital
The New England Baptist Hospital is a 100-bed referral hospital with a large emphasis on orthopaedic and reconstructive hand surgery. It is one of the Tufts affiliated orthopaedic teaching hospitals, educating nine orthopaedic residents and fellows in reconstructive total joint surgery, spine surgery, hand surgery and sports medicine.
The fellow will work with each of the attendings. During their rotation, the fellows will scrub on all cases and see patients in the office. The general approach is for the fellow to work-up new patients, formulate treatment programs and see the patient with the attending. A large volume of hand pathology comes through the office; approximately 50 new patients per week are seen. Rheumatoid and degenerative arthritis generally accounts for 20 percent of the surgical volume; nerve entrapments for another 15 percent; tendon repair and tenolysis for 15 percent; Dupuytren's for 15 percent; nonarthritic joint reconstruction for 15 percent; and tumors for 5 percent. Fractures, carpal tunnels, tendinitis, and ganglions account for the remaining 15 percent. The fellow will learn both the surgical and non-surgical management of degenerative arthritis, rheumatoid arthritis, common hand problems, entrapment neuropathies, and cumulative trauma. The preceptorship method of teaching is used frequently. Difficult and interesting cases are discussed either between patients or at the end of the day.
The fellow is also involved with the management of the post-operative patients. An experienced hand therapy department resides across the hall from the office.
The fellow will also gain experience in workman's compensation cases. Our responsibility in these cases is to advise on the need for further treatment and make recommendations regarding ability to return to work. Many times a final disability evaluation is rendered. The fellow is involved in these evaluations and will learn how to prepare medical/legal reports.
Because the practice is mainly elective, there is little night or weekend responsibility. This gives the fellow ample opportunity to study. Clinical research projects are in process at all times and the fellow is encouraged to become involved in these projects.
Newton Wellesley Hospital
The Newton Wellesley Hospital emergency room is busy, handling more than 33,000 visits annually. Hand injures present quite regularly, but mutilating hand trauma is seen only occasionally. The emergency room physicians, in general, are very competent and perform much of the primary care before referring patients to the office. Although the orthopaedic residents do not staff the emergency room, experience has shown that the hand fellow makes few trips to the emergency room for non-operative cases. One Tufts orthopaedic resident is assigned to the hand service at Newton Wellesley Hospital.
St. Elizabeth's Hospital
The St. Elizabeth's Hospital is a 350-bed community and Tufts affiliated teaching hospital located in the Brighton section of Boston, about halfway between Newton Wellesley Hospital and downtown Boston. Emergency Room coverage is provided by orthopaedic assistants who (physicians employed by St. Elizabeth's Hospital) who only call the hand fellow for cases that require admission or surgical attention. The time spent at St. Elizabeth's Hospital is about 25 percent of that spent at Newton Wellesley Hospital, but is generally perceived by the fellow as a pleasant change of scenery. St. Elizabeth's Hospital is the specialty referral center for all of the military services in New England. This provides a diverse base of acute and reconstructive hand problems. There is one staff doctor. The fellow accompanies him in the office and in the operating room, gaining experience both as a first assistant and as the primary surgeon.
This portion of the fellowship generates few nights or weekends in the hospital. Many fellows have also commented on the side benefit of the chance to learn about the business side of practice. Although the day-to-day clinical load is substantial, the fellow is given a half day off each week to allow time for study, hand dissections or personal business. Our goal for this portion of the fellowship is to give the fellow an intensive and broad exposure to hand surgery while allowing time for the digestion and integration of what is learned.
If you have any questions regarding the Tufts Combined Hand Surgery Fellowship, please do not hesitate to contact our Education Coordinator, Jane Dolph, at (617) 636-5172, or jdolph@tufts-nemc.org. Please address all correspondence to Charles Cassidy, M.D., Department of Orthopaedics, Tufts Medical Center, 800 Washington Street, Box 306, Boston MA 02111.