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Orthopaedics

Tufts Combined Hand Surgery Fellowship

Overview

The Tufts Combined Hand Surgery Fellowship at Tufts Medical Center (Tufts MC) accepts two fellows each year. The experience is designed to provide fellows with a pre-practice opportunity to exercise judgment and build superior technical and teaching skills.

Fellows matching into the program will begin the fellowship on August 1 and complete it the following July 31.

Train and Work with Leading Hand Specialists

Each fellow will complete the same three-month rotations comprised of six months at Tufts MC and six months divided among Newton-Wellesley Hospital, St. Elizabeth's Medical Center and New England Baptist Hospital. Clinical rotations offer a singular hands-on experience. You will develop exceptional surgical skills and nonsurgical treatment approaches, as well as superior diagnostic and decision-making abilities.

The formal curriculum includes a weekly hand surgery conference at Tufts MC, a monthly Hand Journal Club and a monthly conference dedicated to rare hand surgery topics. Additionally, fellows will attend  a week-long micro-surgery course and are provided with numerous opportunities to become involved in clinical and basic research.

Faculty

Charles Cassidy, MD
Jennifer Hoffman, MD

Clinical Opportunities

Fellows will spend six months at Tufts Medical Center, the tertiary care facility for the Tufts University-Affiliated Hospitals in New England.  This 415-bed university hospital also has 60 beds for pediatric cases.  The Hand Service performs an average of 815 surgical cases and sees approximately 6,800 patients each year for traumatic injuries and post-traumatic reconstruction of the elbow (arthroscopy and arthroplasty).  In addition, the hand service provides soft-tissue coverage for the orthopaedic service.

Diagnose and Treat Complex and Rare Hand Problems

While at Tufts MC, faculty and fellows  diagnose and treat a large variety of uncommon hand and upper extremity problems.  These include acute and chronic trauma cases, congenital anomalies, tumors, arthritis, arthroscopy, joint replacement and some micro-surgical cases.

Fellows also assume primary responsibility for the Hand Clinic patients and work closely with the senior staff at Tufts MC, assisting them in the operating room and in outpatient settings.  The team consists of two attending physicians, a fellow, a PGY-4 resident, PGY-2 resident, a physician assistant and two certified hand therapists.

In addition to the clinical experience, fellows participate in weekly hand surgical rounds.

Work with Specialists at a Nationally Renowned Orthopaedic Hospital

New England Baptist Hospital (NEBH) 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, training six orthopaedic residents and several fellows in reconstructive total joint surgery, spine surgery, hand surgery, foot and ankle surgery and sports medicine.

During this rotation, fellows work with the attending physicians, scrub in on all cases and see patients in the office.  Our approach is for fellows to work up new patients, formulate treatment programs and see the patient along with the attending.  A large volume of hand, wrist and elbow pathologies come through the office. About 50 new patients seek treatment each week.

The spectrum of surgical pathology includes elbow ligament, bone and tendon injuries, rheumatoid and degenerative arthritis of the elbow, wrist and hand, as well as nerve entrapments, fractures, Dupuytren's, tumors and other common hand problems.  Fellows will learn both surgical and nonsurgical management of degenerative arthritis, rheumatoid arthritis, common hand problems, entrapment neuropathies and cumulative trauma.

We often follow the preceptorship method of instruction.  Difficult and intriguing cases are discussed between patient meetings or at the end of the day.

Additionally, fellows will be involved with the management of the post-operative patients.  Our hand therapy department resides across the hall from the office.

Because the practice is mainly elective, there are not many night or weekend responsibilities, which provides ample time for study and research.  Clinical research opportunities are always available, and you are encouraged to participate in these projects.

Gain Experience in Workman’s Compensation Cases

Our responsibility in workman’s compensation cases is to recommend further treatment when necessary and evaluate the ability of patients to return to work.  Many times a final disability evaluation is rendered.  Fellows areinvolved in these evaluations and learn how to prepare medical/legal reports.

Manage Cases at a High-Volume Community Hospital

The Newton-Wellesley Hospital emergency room handles more than 33,000 visits annually.  Hand injures are treated regularly, but aside from the occasional brush chipper or snow blower, mutilating hand trauma is seen only from time to time.

The emergency room physicians manage much of the primary care before referring patients to the orthopaedic office.  Orthopaedic residents don’t staff the emergency room, but hand fellows will make occasional trips to the emergency room for non-operative cases.  One Tufts orthopaedic resident is assigned to the hand service at Newton-Wellesley Hospital.

Build Advanced Surgical Skills at a Busy Boston Hospital

St. Elizabeth's Medical Center 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 are employed by St. Elizabeth's Medical Center who only call the hand fellow for cases that require admission or surgical attention.

As a fellow, about 25 percent of your time is spent at St. Elizabeth's Medical Center while on the Newton-Wellesley Hospital rotation.  St. Elizabeth's Medical Center is the specialty referral center for all of the military services in New England.  It provides a diverse base of acute and reconstructive hand problems.  Fellows accompany the staff physician in his or her office and in the operating room, gaining experience both as first assistant and primary surgeon.      

This portion of the fellowship generates few nights or weekends in the hospital, freeing up time to read, spend time with family and enjoy the Boston area.  Many fellows have commented on the side benefit of learning about the business side of medical practice.

Although the day-to-day clinical load is substantial, fellows are given a half day off weekly for study time, hand dissections or personal business.  Our goal for this part of the fellowship is to provide an intensive and broad exposure to hand surgery while also allowing time to absorb and integrate what is learned.

Research Opportunities

Tufts MC houses a gross anatomy lab, a pathology lab and a bio-skills lab, as well as an outstanding OT department located on the clinic floor.  Fellows also are encouraged to contribute to the service’s clinical and basic science research activities.

How to Apply

Send the Universal Application, CV, personal statement, a passport-sized photo, a minimum of three letters of recommendation and no more than four letters of recommendation will be accepted, Medical School Dean’s Letter and Medical School Transcript, as well as USMLE Transcript with scores from Step 1, Step 2 and Step 3.  Please do not staple your documents or provided double-sided copies.   Please send all documents to: 

Attn:  Starla E. Pathk

Charles Cassidy, MDProgram Director, Tufts Hand Fellowship
Tufts Medical Center
800 Washington Street Box #306
Boston, MA 02111

Deadline is January 1.