Duration: 1 year August 1 - July 31
Number of Positions: 2
Fellowship Director's Message
I would like to welcome you to our Hand & Upper Extremity Fellowship website. We are both proud and honored to be working with fellows and residents in order to train the next generation of hand & upper extremity surgeons. With our high volume and diverse case load, I can assure you that our fellowship will be demanding, challenging, and most importantly, it will provide you with all of the necessary tools needed to develop into an exceptional upper extremity surgeon. I, and my colleagues, look forward to meeting and speaking with you about the possibility of working with you in the near future.
The Hand & Upper Extremity Fellowship program at the Orlando Health Jewett Orthopedic Institute has the primary aim of educating and training hand fellows with the goal of allowing them to develop and graduate as autonomous hand surgeons who can contribute positively to the community that they serve. This falls in line with the overall mission statement of Orlando Health which is to improve the health and quality of life of the individuals and communities that it serves in the Central Florida area. Our goal is that, with the commitment from our faculty, we will be able to assist in mentoring fellows with the intent of fostering all of the positive attributes that we believe a surgeon who enters into a hand & upper extremity fellowship will require in order to become a positive, contributing physician member of the community in which they serve. These attributes include: integrity, excellent surgical skill, leadership, a strong foundation and commitment to research, and relentless advocacy to all patient populations including the underserved.
Why Orlando Health?
At our institution, we pride ourselves in providing exceptional hand and upper extremity care at one of the busiest level one trauma centers (both adult and pediatric) in the state of Florida. The clinical volume that you will experience as a fellow is unparalleled in the region and will help develop and hone your skills in various areas of hand, upper extremity, and microvascular surgery. Orlando Health is the only hand and upper extremity fellowship program in the city of Orlando, and is one of only four hand and upper extremity fellowships in the state of Florida. As such, this allows our trainees to see a variety of complex pathologies from across the entire state. We also have a diverse group of faculty members who's expertise encompasses the entire spectrum of hand and upper extremity surgery to give you a very balanced clinical education. Some of these subspecialties are highlighted below.
Fellows receive a robust experience in the most innovative surgical techniques including endoscopy for peripheral nerve compression syndromes such as carpal and cubital tunnel syndromes, as well as arthroscopy for acute, chronic, traumatic, and sports related conditions of the hand, wrist, elbow, and shoulder.
Shoulder pathology ranges from elective sports related injuries such as rotator cuff and labral tears, chronic conditions such as rheumatoid and osteoarthritis, and traumatic injuries including fractures and penetrating trauma to the arm and shoulder. Our graduating fellows will be well versed in not only recognizing and diagnosing these ailments but will also be well-prepared to treat these conditions with the most up to date surgical techniques and implants. Surgical procedures learned will include open reduction internal fixation for fracture care as well as arthroscopy and arthroplasty for joint disease.
Fellows will be given funding to attend a microsurgical training course before the start of their fellowship where they will be given a strong foundation of microsurgical knowledge and training that they will continue to build on throughout their fellowship year. Core teaching faculty will also conduct one on one microsurgery training sessions bimonthly in our bioskills lab. In addition, all core hand faculty perform replantations, revascularizations, and both local and free flap reconstructions regularly throughout the entire year for longitudinal and graduated microvascular instruction.
We have a team of experienced, adroit surgeons that have been treating brachial plexus pathologies for over 30 years. The pediatric brachial plexus team is made up of Drs Desai, Birnbaum, and Jafrani, while Dr's Desai and Zumsteg lead the adult brachial plexus clinic. This excellent team of surgeons delivers cutting edge surgical techniques with regard to all aspects of brachial plexus care including nerve and tendon transfers, selective arthrodesis, and free functioning muscle transfers. This team also performs nerve transfers for targeted muscle reinnervation for upper extremity amputation pathology, as well spinal cord injuries.
No hand and upper extremity fellowship would be complete without exposure to pediatric hand surgery. Our fellowship is proud to offer a robust congenital hand experience working with core hand and pediatric orthopaedic faculty which will offer a wide variety of pediatric cases. This includes exposure to pediatric hand and upper extremity congenital deformities as well as traumatic pediatric hand injuries while taking call at Central Florida's only level one pediatric trauma center: the Arnold Palmer Hospital for Children.
Fellows take "second home call" with primary call coverage coming from either a resident or an advanced practice provider. Fellows will take an average of 7 days of call per month which includes one to two weekend(s) per month. Hand call is centralized with all surgical call cases being done on the main campus downtown. Fellows are assigned call with a core faculty attending. This allows for a team based, mentorship model approach, while also giving the fellows adequate autonomy.
Stipend & Conferences
Fellows will be given a $3000 stipend to spend on a pair of surgical loupes (if not already owned) and/or the annual ASSH meeting for which attendance is mandatory. In addition, any other approved conference for which the fellow has research accepted for presentation, will also be covered by the department in order for them to present their work.
Didactic instruction will be the cornerstone of the fellows education. Conferences will include, a weekly preop and postop conference & lecture series, bimonthly resident/fellow hand & upper extremity conferences, morbidity and mortality conferences, grand rounds with guest lecturers, monthly hand & UE journal clubs, review of Green's Operative Hand Surgery and classic Stern publications. We value our fellow's education above all else and therefore all didactic conferences will be "protected" time for the fellow.
Research is an integral part of fellow education. Prior to graduation, each fellow will complete a minimum of one research project worthy of acceptance to a peer reviewed journal such as the Journal of Hand Surgery. There will be several resources available in order to achieve this goal including a funded statistician, access to a university biomechanics lab, and a dedicated research division to assist with IRB and journal submission. In addition, there will be monthly research meetings staffed by core faculty in order to mentor the fellow along the research pathway.