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 orthopedic 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 Orthopedic Hospital
New England Baptist Hospital (NEBH) is a 100-bed referral hospital with a large emphasis on orthopedic and reconstructive hand surgery. It is one of the Tufts-affiliated orthopedic teaching hospitals, training six orthopedic 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 are involved in these evaluations and learn how to prepare medical/legal reports.