The UF Hand Fellowship Program participates in the National Resident Matching Program (NRMP).
The Department of Orthopaedic Surgery and Sports Medicine at the University of Florida offers two fellowship positions in Hand & Upper Extremity surgery per year beginning every August 1st. There is a strong emphasis on all aspects of upper extremity surgery including the shoulder. These fellowship positions are best suited for applicants with a strong orthopaedic background. The fellows work in a collegial, multidisciplinary environment with wide exposure, supervised self-directed study, and excellent support from the attendings. There are two main venues where clinic and surgical care are carried out - the locations are within 10 mins driving distance of each other and are described below in greater detail.
The University of Florida Upper Extremity Fellowship Program
Program Overview
Overall, this fellowship is approximately 70% Hand, Wrist, and Microvascular surgery & 30% Shoulder + Elbow surgery. Those who train at this program come out fully capable of performing fingertip to shoulder surgery, including shoulder arthroscopy & arthroplasty in their current practices.
With regards to attendings, Dr. Chidgey, Dr. Dell, Dr. Kim and Dr. Matthias have varied practices, which include a wide array of adult and pediatric acquired and post-traumatic hand and upper extremity issues.
Drs. Dell and Matthias perform most of the elective microsurgical, tendon transfer, congenital and degenerative arthritis procedures. Dr. Matthias’ scope also includes nerve transfers and brachial plexus birth and traumatic injuries. Dr. Kim (new staff) is also building a similar practice but with a heavy focus and interest on microvascular surgery and soft tissue reconstruction. Dr. Chidgey performs bread and butter hand and upper extremity surgery, in addition to outpatient trauma and reconstructive cases.
Drs. T. Wright, J. Wright, and King have a predominantly shoulder practice with particular interest in complex shoulder and elbow conditions including primary and revision arthroplasty. They each address elbow trauma as well as elbow arthroplasty. Dr. Thomas Wright also performs a variety of hand surgery.
There is excellent exposure to principles of rheumatoid reconstruction, arthroscopy of wrist, elbow, and shoulder, and primary reconstruction procedures. There is also a large tertiary referral base, which leads to a significant introduction to complex cases of the upper extremity. The vast majority of surgical cases are performed at the Florida Surgical Center (ambulatory) where most attendings run 2 rooms supporting the fellow in gaining early independence balanced with close supervision. Next door is the Orthopaedic Surgery and Sports Medicine Institute where all clinics are held. Shoulder arthroplasty is currently performed primarily at the new South Tower of Shands Hospital. Most patients go home the same day.
In the future there will be an optional 6-week rotation with plastics hand to offer exposure to flaps and microvascular surgery.
Program Structure
The program consists of two 3-month alternating blocks in which fellows spend time with staff as follows, with example schedules:
Block 1
- Paul C. Dell (Senior Professor)
- Rob Matthias (Program Director)
- Jongmin Kim (Associate Professor) (new staff – currently integrating)
On this rotation you will have exposure to:
- Bread and butter hand and upper extremity surgery (including both open and endoscopic carpal tunnel)
- Elective hand, wrist, elbow reconstructive surgery (arthroplasty, arthrodesis)
- Wrist Instability
- Traumatic conditions in both adult and pediatric populations
- Athletic injuries
- Tertiary referrals from outside providers for second opinion, revisions, reconstructions, high complexity cases
- Rheumatologic reconstruction
- Tendon transfers for nerve injury, neurologic conditions, pediatric conditions
- Congenital hand surgery
- Microsurgery
Mondays:
8:30am - 11am
- Research.
- Anatomy lab every other week.
Tuesdays:
7am - 8am
- Fellow case presentations via PPT virtual format
- OR with Dr. Matthias - ambulatory surgical center
Wednesdays:
6:30am - 7:30am
- Shoulder Chapter/Article Review Fellows + Staff (2 OKU chapters, 2-3 Journal articles every other week)
- Dell Clinic // Matthias OR 1 day/mo at @ main campus
Thursdays:
- Drs. Matthias/Dell OR - ambulatory surgical center
Fridays:
- Matthias Clinic // Kim OR
Block 2
- Thomas Wright (Division Chief)
- Larry Chidgey (Associate Professor)
- Kim Jongmin (Assistant Professor) (new staff – currently integrating)
- Jay King (Associate Professor)
- Jonathan Wright (Assistant Professor)
On this rotation you will have exposure to:
- Shoulder Arthroplasty (routine utilization of intraoperative navigation technology)
- Shoulder Arthroscopy
- Bread and butter hand and upper extremity surgery (including both open and endoscopic carpal tunnel)
- Elective hand, wrist, elbow reconstructive surgery (arthroplasty, arthrodesis)
- Traumatic conditions of the hand, wrist, elbow and shoulder
- Tertiary referrals from outside providers for second opinion, revisions, reconstructions, high complexity shoulder cases
- Hand surgery as mentioned above with Dr. Kim
Mondays:
8:30am - 11am
- Research. Anatomy lab every other week.
Tuesdays:
7am - 8am
- Fellow case presentations (or journal club articles) via PPT virtual format
- OR with Dr. Wright - ambulatory surgical center (Elective hand surgery, shoulder arthroscopy)
Wednesdays:
6:30am - 7:30am
- Shoulder Chapter/Article Review Fellows + Staff (2 OKU chapters, 2-3 Journal articles every other week)
- OR with Dr. Wright - Main Campus OR
Thursdays:
- Dr. T.Wright - Clinic OSMI // Dr. Chidgey - OR ambulatory surgical center // Dr. Kim - OR ambulatory surgical center
Fridays:
- Dr. King - OR main campus // Dr. J.Wright - OR main campus // Dr. Kim OR main campus
Didactics
Every Tuesday (7am-8am) morning there is an hour of dedicated hand & upper extremity educational time. This is in the form of didactics, a journal club, or case conference depending on which Monday of the month it is.
There is also a schedule of topics covered regularly during the year on the 3rd Tuesday and a Friday on a monthly basis. One Friday a month the Division presents a topic to the entire Department. For each topic there are a few critical classic and current articles covered. Informal indications preop conference is run Monday afternoons and Thursday afternoons with the attendings specific to each rotation. Every other Wednesday morning from 630 to 730 there is a shoulder and elbow topic review using OKU shoulder and elbow as an outline.
An informal education session is held one evening a month. The faculty and fellows gather for drinks, appetizers, and dinner, then review topics in upper extremity as chosen by the fellows. This time allows for collegial discussion and case review covering a variety of topics.
There is an opportunity and requirement for a research project. The 1st Tuesday evening of every month Dr. Wright and the research coordinator meet with the fellows to help guide their year’s research project. Each fellow may start their own project or complete a prior year’s project.
There is funding available to support the biomechanics lab, cadaver study, and clinical studies with statistical support and a database of Dr. Wright’s shoulder patients with multicenter studies in progress.
Fellows may arrange sawbones labs and cadaver dissection labs in areas of their interest with the attendings’ support at the onsite anatomy lab. On Dr. Dell’s service there is a 30 minute weekly meeting with Dr. Dell, the fellow and the hand therapists to facilitate the fellow’s learning of postoperative rehabilitation and coordinate patient care for more complex problems such as tendon repairs, transfers, intrinsic tightness, and RA.
Hand Call
Hand call is split between Ortho/Plastics during weekdays (Ortho is Monday and Wednesday, Plastics Is Tuesday and Thursday). Weekends are alternated as are holidays.
Most problems are directly handled by the on-call Orthopaedic residents and on-call attending. A junior resident is always available for first call.
Fellows are called in only when complicated surgical cases are indicated by the staff/resident on call (eg. Revascularizations mangled upper extremities).
The Medical Center is a Level One Trauma Center but not a replant center so replants may be accepted on a case-by-case basis. There is a wide spectrum of fractures spanning the fingertips to the shoulder, though the majority are scheduled on an outpatient basis.
For the 2022-2023 fellows they have been called in for emergent cases as follows (6 months into fellowship):
- Fellow 1 – Revascularization x 3, Spaghetti wrist injury x 2, Mangled pediatric hand x 1
- Fellow 2 – Mangled hand x 2
Benefits
The annual salary is dependent upon post-graduate years. There is no moonlighting allowed since this is an accredited Hand Fellowship, though there is an after-hours Orthopaedic clinic available to work for extra remuneration if desired.
Each Fellow may attend two meetings: one, the annual American Society for Surgery of the Hand (ASSH) and second, the annual University of Florida Hand Fellow Alumni Meeting. Often there are multiple shoulder conferences that the fellow may attend as well.
There is a two-week vacation. There is an additional stipend to cover a pair of loupes for each fellow plus conference registration and travel. Health insurance is provided for each individual as well as their family.
Contact Beth Keene via e-mail or call 352-273-7374 for further information.
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