The University of Michigan Hand Fellowship includes two positions available to board-eligible plastic and orthopedic surgeons who wish additional training in the evaluation and management of upper extremity problems. Both positions are a one-year training program, running from August 1 through July 30 each year offering:
- A busy clinical practice, treating patients with a range of common and complex conditions, including traumatic injuries, arthritis, tendonitis, nerve compression, congenital conditions, vascular or circulation problems, and cancers of the hand. We also recently launched the first hand transplant program in the state of Michigan.
- A rotation schedule designed to immerse you in the full lifecycle of care, from the clinic to the OR to a patient’s postoperative rehabilitation.
- Opportunities to train in our microsurgery facilities and to learn from experts in peripheral nerve surgery, an area of strength for our section.
- Exposure to a range of clinical care settings, from adult and pediatric hospitals to outpatient clinics and ambulatory surgery centers, all part of Michigan Medicine, the high-volume academic medical center at the University of Michigan.
- Annual lectures from visiting experts as part of the Michigan Hand Surgery Visiting Professor program. Past visiting professors include Drs. Richard H. Gelberman, Allen T. Bishop, James P. Higgins, and James Chang.
- A truly combined program, with equal immersion in both plastic surgery-based and orthopaedic surgery-based Hand Services. Our fellows have found this to be a unique benefit to our program. This type of collaborative interaction is not found in many academic centers.
Although the faculty are evenly distributed between Orthopedic and Plastic Surgery, we think of ourselves first and foremost as Hand Surgeons, and we function as a unified group. The majority of training is carried out at the University of Michigan Medical Center, which includes the University Hospital and the adjacent C. S. Mott Children's Hospital. Outpatient clinics and ambulatory surgery centers are situated "off-campus", but these facilities are within 2-3 miles of the Medical Center.
The rotation schedule is set up in blocks to allow continuous immersion in the practice of these faculty members. The fellows accompany the faculty member to both the clinic and the operating room during these rotations, providing continuity of care between the initial evaluation, the operative management, and postoperative rehabilitation of each patient. The fellows are given incrementally increased responsibility throughout the year, as they move through the program.
Fellow 1 will have Plastic rotations August through September, Orthopedic rotations October through January, Plastic rotations February through May, and Orthopedic rotations June through July. Fellow 2 will have Orthopedic rotations August through September, Plastic rotations October through January, Orthopedic rotations February through May, and Plastic rotations June through July.
Our curriculum has been carefully designed to address the six core competencies set forth by ACGME:
- Medical knowledge
- Patient care
- Practice based learning and improvement
- Interpersonal and communication skills
- Systems based practice
Teaching curriculum covers the full spectrum of hand surgery in a series of weekly conferences held jointly with the Plastic Surgery and Orthopaedic Surgery hand teams. These conferences are the joint responsibility of the fellows, residents, PA, and faculty on the hand surgery service. The discussions are typically case-based, with occasional didactic lectures as well.
- Fingertip and nailbed injuries
- Soft tissue tumors
- Replantation and microsurgery
- Bone tumors
- Amputations and prosthetics
- Intrinsic hand flaps
- Compartment syndrome
- Regional and distant flaps
- Infections and bites
- Congenital hand conditions
- High-pressure injection injuries
- Thumb reconstruction
- Thermal injury (frostbite and burns)
- Brachial plexus palsy
- Dupuytren's disease
- Tetraplegia and cerebral palsy
- Phalangeal fractures (extra-articular)
- Basal joint arthritis/CMC arthroplasty
- Metacarpal fractures (extra-articular)
- Inflammatory arthritis
- Intra-articular hand fractures
- Arthroplasty and arthrodesis
- IP and MP dislocations
- Joint contractures
- Scaphoid fractures
- Swan-neck and boutonniere deformities
- Distal radius fractures
- Carpal instability
- Malunions of the hand and wrist
- DRUJ disorders
- Flexor tendon injuries
- Kienböck’s disease
- Extensor tendon injuries
- Forearm fractures
- Wrist arthroscopy
- Vascular disorders
- Hand therapy
- Nerve injuries
- Pain syndromes
- Compression neuropathies
- Stress and response to injury
- Tendon transfers
- Worker’s compensation/insurance
- Skin tumors
- Ethics, legal medicine and depositions
- CPT coding
Duty Hours & Call Schedule
At Michigan, the ACGME duty hour restrictions are strictly monitored and enforced for both residents and fellows. Hand surgery fellows at Michigan cover emergency hand call on average every third night. Junior residents provide "first call" coverage for floor calls and consults; the hand fellows are expected to supervise the residents when evaluating new emergency consults. When on call, the fellows are always backed up by attending surgeon.
Research & Academic Opportunities
We have a vibrant research element to the hand fellowship here at Michigan Medicine. Fellows can participate in M-CHOIR and M-OPEN research initiatives. M-CHOIR, or Michigan Center for Hand Outcome and Innovation Research, conducts hand centered research projects. M-OPEN, or Michigan Opioid Prescribing Engagement, focuses on new ways to manage pain and minimize opioid use for all surgical procedures in the state of Michigan. We also have a robust International Research Scholars program, bringing together bright minds from across the globe to collaborate at Michigan Medicine.
There are countless academic opportunities through the Hand Surgery Fellowship. We have a thriving production of publications, in addition to engaged faculty and staff who are at the top of their field. Our fellowship encourages learning from the global field of hand surgery. We provide research training for surgeons and physicians from around the world, and we offer two lectureships to hear from experts in the field of hand surgery.
Fellows will participate in a full 5-day Microsurgery Training Course early in their fellowship year. Led by Dr. Kagan Ozer, this course is conducted in live animal models with hands-on teaching provided by highly trained instructors in a state-of-the art training facility. In addition to the Basic course, more Advanced Microsurgery Training options are available in select cases.
Additional practice in microsurgical technique is possible at the University of Michigan Clinical Simulation Center (UMCSC). This Center is certified as a Level 1 Training Center by the American College of Surgeons. At this Center, a fully functioning operating microscope and a variety of realistic non-animal models are available for our trainees to practice their techniques with vessel anastomosis and nerve coaptation.
International Service Trips
Each of our fellows is given the opportunity to complete a service trip (usually about a week or so) to perform hand surgery in an underserved area of the world. This has proved to be an educational, eye-opening experience that our fellows have greatly appreciated. Recent destinations include Hue, Vietnam and Coimbatore, India.
The fellowships are shared between the Section of Plastic Surgery, within the Department of Surgery, and the Orthopedic Surgery Department. Our core hand surgery faculty consists of 7 surgeons:
- Kevin C. Chung, M.D., M.S.
- Steven C. Haase, M.D.
- Kagan Ozer, M.D.
- Jeffrey Lawton, M.D.
- John Lien, M.D.
- Erika D. Sears, M.D., M.S.
- Jennifer F. Waljee, M.D., M.P.H., M.S.
Graduates of the University of Michigan Hand Fellowship program have been universally successful at obtaining placement in their desired career path. Whether our graduates continue with a career in academia or pursue private practice, our goal is to prepare them to be excellent, responsible, ethical surgeons wherever they put down roots.
How to Apply
Hand surgery fellowship candidates must be board-eligible plastic or orthopaedic surgeons. Two fellows are accepted each year.
Beginning in 2017, the application process for hand fellowship has been standardized and centralized. Applications are now submitted online through the American Society for Surgery of the Hand (ASSH) website. Applicants will need to create an ASSH.org login to submit an application. The ASSH portal also provides methods for securely uploading your additional documents and letters of recommendation. (Mailed-in applications will no longer be accepted.)
The deadline for the Hand Surgery Fellowship application is December 15, 2018.
Please contact the Department of Surgery Education Office with any questions.