Utility Of Orthopedic Hand Surgery Fellowship Training For Plastic Surgery Residents
Jason Silvestre, MD1, Benjamin Chang, MD1, L Scott Levin, MD1, Robert H. Wilson, MD2.
1University of Pennsylvania, Philadelphia, PA, USA, 2Howard University Hospital, Washington, PA, USA.
PURPOSE: Multiple pathways exist for hand surgery training in the United States. Plastic surgery residents often select orthopedic hand surgery fellowships to complement their skills and bridge perceived deficiencies in bone and joint cases. This study aims to quantify the impact of this approach on operative hand experience.
METHODS: ACGME case logs were analyzed for independent plastic surgery residents and orthopedic hand surgery fellows (2017-2020). Reported operative volumes were abstracted for hand surgery case categories and compared between residency and fellowship. Temporal trends were described, intra-pathway variabilities calculated, and inter-pathway differences elucidated with Mann Whitney U tests.
RESULTS: 393 plastic surgery residents and 606 orthopedic hand surgery fellows were included. There was a constant volume of reported hand surgery cases in both specialties over the study period (p>0.05). More variability existed during orthopedic hand surgery fellowship training (p<0.05). One year of fellowship training afforded significantly more cases than three years of residency training (793 ± 228 vs 428 ± 146, p<0.001). Case categories with the highest positive fold difference encountered during orthopedic surgery hand fellowship (p<0.001) were fracture / dislocation (3.2), nerve decompression (3.1), tendon (2.9), and Dupuytren's contractures (2.7) (p<0.001).
CONCLUSION: Orthopedic hand surgery fellowships can double operative hand experience encountered during plastic surgery residency. Significant increases are especially encountered for select case categories. Prospective applicants can make informed decisions on the utility of this approach when pursuing fellowship training.
Back to 2022 Posters