Harvard Hand/Upper Extremity Fellowship

The Harvard Hand/Upper Extremity Surgery Fellowship is under the supervision of Philip E. Blazar, MD and Donald S. Bae, MD, and includes several institutions and staff members. The majority of fellowship time is spent at Brigham and Women’s and Boston Children’s Hospital and their satellite locations including: Children's Hospital Waltham, BWH Foxborough and Brigham and Women's Faulkner Hospital. There is a two-month cross-rotation with the fellowship at Massachusetts General Hospital. Our Orthopaedics- and Plastics-trained fellow also rotates regularly at the VA Medical Center in Boston.

The fellowship period is twelve months commencing August 1. Four positions are offered in two tracks; three positions are for Orthopedically trained applicants and one for a Plastic Surgery trained applicant. The fellowship is oriented toward those wishing to make a significant commitment to treatment of problems of the hand and upper extremity.

We believe 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.

Fellowship Faculty

The attending staff is Philip Blazar, Brandon Earp, George Dyer, Dafang Zhang, Leah Demetri, Christian Sampson, Lydia Helliwell, Simon Talbot, and Matthew Carty at Brigham and Women’s Hospital; Donald Bae, Andrea Bauer, Carley Vuillermin, Amir Taghinia, Brian Labow, and Benjamin Gundlach at Boston Children’s Hospital; and Dr. Dina Galvin at VA Medical Center.

Hand Surgery Fellows’ Responsibilities

The Hand Surgery Fellow is, with the assistance of the residents and advanced practice clinicians, responsible for running their own service. They are 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 Boston Children’s Hospital simultaneously, alternating coverage between the Orthopaedic and Plastic Surgery staff. Both tracks cross rotate with the other service on a regular basis. While adult hand surgery constitutes the majority of the experience, about 20-30 percent of the fellowship experience is at Boston Children’s Hospital.

As for the operative responsibilities, besides their own patients, the fellows are responsible for assisting the faculty, along with residents and physician assistants assigned to the service.

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 a moderate amount of microsurgery. The service also sees a wide variety of “cold trauma” and post-traumatic reconstruction from many referral centers in the region. The attendings’ clinics and fellows’ offices are sources for elective cases and provide follow-up care. This is a significant source of exposure to hand and upper extremity pathology and an opportunity to manage the long term care and sequelae of these injuries and problems.

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 of the shoulder and elbow, nerve entrapments, post-traumatic reconstruction, wrist problems, Dupuytren’s disease, repetitive trauma syndromes, the injured worker, etc.

At Boston Children’s Hospital the fellows see the spectrum of disorders in the pediatric upper extremity. These include congenital differences, traumatic and post-traumatic problems, brachial plexus injuries, and other neuromuscular conditions, tumorous disorders, and sports-related conditions.

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.

At the VA the fellow sees a VA referral population from all over New England including a large variety of post-traumatic and arthritic conditions.

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

Conferences & Research

  1. Topics in Hand Surgery
    An informal weekly conference led by the Program Director discussing classic articles focusing on one topic while reviewing “state of the art” material, as well.
  2. Selected Readings in Pediatric Hand Surgery
    Biweekly conference includes readings from the "classic" literature and current textbooks.
  3. Residents Hand and Upper Extremity Conference
    Weekly conference on a preselected curriculum featuring case-based discussion.
  4. Anatomy
    Advanced hand and upper extremity anatomy is explored in detail in this session including dissection of fresh frozen cadavers with 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 their tenure the fellow will be expected to complete a research project and paper of their 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.

For more information about medical education at Brigham and Women's Hospital, please view our Graduate Medical Education at Brigham and Women’s Hospital video below.

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 the ASSH online application system.

Match date is annually in late spring and the rank order lists are due approximately three weeks earlier. Interviews are by invitation. Given the upper extremity focus of the fellowship, we only accept applications from residents trained in orthopaedic and plastic surgery disciplines.

Applicants are required to submit their applications via the ASSH portal by the November 15th deadline. Additionally, we require copies of applicant’s CV, and three letters of recommendation one of which should be from the applicant’s Department Chair, Program Director, or Chief of Hand Surgery. Formal interview days are then scheduled.

For additional information please see our FAQs page or contact:

Nancy Alessi
Project Coordinator
Brigham and Women's Hospital
Department of Orthopedics
75 Francis Street
Boston, MA 02115

Phone: 617-732-9551
email: nalessi@bwh.harvard.edu

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